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研究生:蕭景元
論文名稱:電腦化醫令系統之人機互動改善
論文名稱(外文):Improvement of the Human-Computer Interaction of the Computerized Physician Order Entry Systems
指導教授:王明揚王明揚引用關係
口試委員:潘錫光黃雪玲黃育信
口試日期:2011-5-25
學位類別:碩士
校院名稱:國立清華大學
系所名稱:工業工程與工程管理學系
學門:工程學門
學類:工業工程學類
論文種類:學術論文
論文出版年:2011
畢業學年度:99
語文別:中文
論文頁數:152
中文關鍵詞:電腦化醫令系統人機互動使用性病人安全
相關次數:
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隨著臺灣的資訊科技進步及全民健保之需求,傳統利用口語或紙本傳達醫囑的看診方式,幾乎已被電腦化醫令系統取代。電腦化醫令系統的建立雖可提升醫療院所看診效率與服務品質,但系統在設計上若未考量介面使用性及人機互動,反而會致使諸多問題發生,這些問題包含使用者操作系統之低滿意度及低接受度,以及造成醫療疏失或用藥疏失,致使病患受傷或死亡等。
本研究之研究目的為透過人機互動觀點,評估電腦化醫令系統之人機互動及介面使用性,針對系統之介面設計問題提出改善方法,並發展一套未來設計、建立及改善電腦化醫令系統人機介面設計的參考依據,冀望能藉由改善電腦化醫令系統介面及人機互動,提升醫療服務品質及病人安全。
本研究邀請5位專家透過啟發式評估法及人機互動觀點,針對台灣某家醫學中心所採用的門診電腦化醫令系統(個案系統)進行介面使用性及人機互動之評估。5位專家共提出個案系統存在242項介面使用性及人機互動問題,本研究更進一步將問題分為「彈性及效率類問題」、「幫助及導引類問題」、「資訊不完整及訊息表達問題」、「一致性與標準化問題」、「操作狀態可視性及反應回饋問題」、「符合使用者預期及認知問題」、「不必要的資訊或功能問題」、「顯示元件設計不良問題」等8大類問題。接著,本研究根據系統問題提出共38項電腦化醫令系統介面設計之改善建議,以實作模擬系統的方式驗證系統改善之績效,結果發現依據改善建議建置而成之模擬系統於「效率」、「錯誤次數」、「滿意度」及「學習性」等衡量指標,皆明顯優於個案系統。
本研究提供一系列評估、改善乃至於驗證現有電腦化醫令系統之步驟,冀望國內各醫療院所的電腦化醫令系統人機互動可獲得改善,以發揮出其真正之成效,進一步提升整體醫療服務品質及病人安全,落實更理想的醫療環境。
摘要 i
Abstract ii
目錄 iv
圖目錄 vii
表目錄 x
第一章 緒論 1
1.1 研究背景與研究動機 1
1.2 研究目的 3
1.3 研究範圍及限制 4
1.4 論文架構 5
第二章 文獻探討 7
2.1 電腦化醫令系統 7
2.1.1 電腦化醫令系統之定義 7
2.1.2 電腦化醫令系統之優點 9
2.1.3 電腦化醫令系統之潛在問題 12
2.1.4 小結 14
2.2 人機互動 14
2.2.1 人機互動定義 14
2.2.2 人機互動組成元件 15
2.2.3 小結 17
2.3 使用性 17
2.3.1 使用性定義 17
2.3.2 使用性標準 18
2.3.3 使用性評估方法 20
2.3.4 使用性工程生命週期 26
2.3.5 小結 28
第三章 研究方法 29
3.1 研究流程 29
3.2 第一階段:系統定義 30
3.3 第二階段:系統評估 31
3.3.1 系統評估人員 31
3.3.2 系統評估流程 32
3.4 第三階段:系統改善 33
3.5 第四階段:系統實證 33
3.5.1 前測 34
3.5.2 正式實驗 37
第四章 研究結果與討論 38
4.1 第一階段系統定義結果與討論 38
4.1.1 情境(Situation) 38
4.1.2 使用者(Individual) 39
4.1.3 任務(Task) 40
4.1.4 衡量標準(Evaluation Aspect) 43
4.2 第二階段系統評估結果與討論 44
4.2.1 使用性問題彙總 45
4.2.2 以子系統分類個案系統之使用性問題 45
4.2.3 以設計準則分類個案系統之使用性問題 53
4.2.3.1 彈性及效率類問題 53
4.2.3.2 幫助及導引類問題 55
4.2.3.3 資訊不完整及訊息表達問題 57
4.2.3.4 一致性問題 60
4.2.3.5 操作狀態可視性及反應回饋問題 63
4.2.3.6 符合使用者預期及認知問題 65
4.2.3.7 不必要的資訊或功能問題 66
4.2.3.8 顯示元件設計不良問題 68
4.2.4 討論 72
4.3 第三階段系統改善結果與討論 75
4.3.1 彈性及效率類問題改善方案 75
4.3.2 幫助及導引類問題改善方案 82
4.3.3 資訊不完整及訊息表達問題改善方案 84
4.3.4 一致性與標準化問題改善方案 85
4.3.5 操作狀態可視性及反應回饋問題改善方案 87
4.3.6 符合使用者預期及認知問題改善方案 88
4.3.7 不必要的資訊或功能問題改善方案 92
4.3.8 顯示元件設計不良問題改善方案 93
4.3.9 討論 97
4.4 第四階段系統驗證結果與討論 98
4.4.1 前測結果 99
4.4.1.1 受試者資料及平均實驗時間 99
4.4.1.2 實驗問卷 99
4.4.1.3 模擬系統改善個案系統之績效 100
4.4.2 正式實驗結果 100
4.4.2.1 受試者資料及平均實驗時間 101
4.4.2.2 模擬系統改善個案系統之績效 101
4.4.2.3 受試者對模擬系統介面之設計意見 105
4.4.3 討論 108
第五章 結論與建議 109
5.1 結論 109
5.2 未來研究建議 110
參考文獻 112
附錄一 實驗問卷(系統介面設計滿意度評量表) 121
附錄二 個案系統作業任務 124
附錄三 模擬系統作業任務 125
附錄四 個案系統242項介面使用性及人機互動問題 126
附錄五 模擬電腦化醫令系統畫面說明 144


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