臺灣博碩士論文加值系統

電子健康紀錄(Electronic Health Records)在世界上各國的醫療改革中位居重要地位。時至今日電子健康紀錄的採用率未盡理想。其主要原因包含互操作性以及資訊安全的疑慮。政府透過一系列健康醫療的政策介入應能夠消弭這些障礙。本研究的目的為檢驗美國、中國與英國在電子健康紀錄政策方面的現況、傾向與偏好。本研究使用型樣匹配，並依Rothwell 與Zegveld所提出的創新政策架構執行比較政策分析。結果顯示，美國最為注重環境面政策中的”法律與規範”；中國和英國則最強調需求面政策中的”公共服務”。

Electronic Health Record plays a key role in health reform throughout the world. To date, its adoption rate is below satisfactory. The major reasons include interoperability and concerns on data security. Such barriers are expected to be mitigated by enacting a series of healthcare-relating policies by the governments. The purpose of this work is to examine the current state, tendencies, and preferences of EHR policies in the U.S., China, and the U.K. This work utilizes a pattern matching and conducts a comparative policy analysis using the innovation policy framework of Rothwell and Zegveld. Results show that the U.S. focuses on “Legal and Regulatory” of Environmental-side policy, while China and the U.K. concentrate on “Public Services” policy of the Demand side.

摘要 I
ABSTARCT II
誌謝 III
TABLE OF CONTENTS IV
LIST OF TABLES VI
LIST OF FIGURES VII
I. INTRODUCTION 1
II. LITERATURE REVIEW 2
2.1 ELECTRONIC HEALTH RECORDS AND ITS BARRIERS TO ADOPTION 2
2.2 INNOVATION POLICY 4
2.3 EHR IN THE UNITED STATES 7
2.4 EHR IN CHINA 9
2.5 EHR IN THE UNITED KINGDOM 10
III. METHODS AND DATA 11
IV. RESULTS 15
4.1 EHR INNOVATION POLICY IN THE UNITED STATES 15
4.2 EHR INNOVATION POLICY IN CHINA 17
4.3 EHR INNOVATION POLICY IN THE UNITED KINGDOM 19
4.4 COMPARISON OF EHR POLICIES AMONG THE U.S., CHINA AND THE U.K. 21
V. FINDINGS AND DISCUSSION 26
5.1 INSIGHTS DRAWN FROM EHR INNOVATION POLICY IN THE UNITED STATES 26
5.2 INSIGHTS DRAWN FROM EHR INNOVATION POLICY IN CHINA 28
5.3 INSIGHTS DRAWN FROM EHR INNOVATION POLICY IN THE UNITED KINGDOM 30
5.4 COMPARISON OF EHR INNOVATION POLICY TRENDS BETWEEN NATIONS 33
VI. CONCLUSION 35
REFERENCES 37

Abramson, E. L., Barrón, Y., Quaresimo, J., & Kaushal, R. (2011). Electronic prescribing within an electronic health record reduces ambulatory prescribing errors. Joint Commission Journal on Quality and Patient Safety, 37(10), 470-478.
Amatayakul, M. (2007). Electronic health records: A practical guide for professionals and organizations: Amer Health Information Management.
Arun, V., & Susan, D. S. (2007). Barriers to the adoption of electronic health records: using concept mapping to develop a comprehensive empirical model. Health Informatics Journal, 13(2), 119-134. doi:10.1177/1460458207076468
Braun, E. (1980). Government policies for the stimulation of technological innovation.
Castillo, V. H., Martínez-García, A. I., & Pulido, J. R. G. (2010). A knowledge-based taxonomy of critical factors for adopting electronic health record systems by physicians: a systematic literature review. BMC Medical Informatics and Decision Making, 10, 60-60. doi:10.1186/1472-6947-10-60
Crosson, J. C., Ohman-Strickland, P. A., Hahn, K. A., DiCicco-Bloom, B., Shaw, E., Orzano, A. J., & Crabtree, B. F. (2007). Electronic Medical Records and Diabetes Quality of Care: Results From a Sample of Family Medicine Practices. The Annals of Family Medicine, 5(3), 209-215.
Dorr, D., Bonner, L. M., Cohen, A. N., Shoai, R. S., Perrin, R., Chaney, E., & Young, A. S. (2007). Informatics Systems to Promote Improved Care for Chronic Illness: A Literature Review. Journal of the American Medical Informatics Association, 14(2), 156-163. doi:10.1197/jamia.M2255
Edquist, C., & Hommen, L. (1999). Systems of innovation: theory and policy for the demand side1This article is based on work from the project “Innovation Systems and European Integration (ISE)”, funded by Targeted Socio-Economic Research, DG XII, European Commission, Contract No. SOE1-CT95-1004 (DG 12-SOLS). In particular, the article draws upon work originally produced as part of ISE subproject 3.2.2, “Public Technology Procurement as an Innovation Policy Instrument”.1. Technology in Society, 21(1), 63-79. doi:https://doi.org/10.1016/S0160-791X(98)00037-2
Furukawa, M. F., King, J., Patel, V., Hsiao, C.-J., Adler-Milstein, J., & Jha, A. K. (2014). Despite Substantial Progress In EHR Adoption, Health Information Exchange And Patient Engagement Remain Low In Office Settings. Health Affairs, 33(9), 1672-1679. doi:10.1377/hlthaff.2014.0445
GAO, R.-x., CHE, C.-l., & WU, X.-j. (2009). Research on the Innovative Cluster of Service Industry——A Case Study of Shanghai Healthcare Industry [J]. R&D Management, 6, 012.
Jamoom, E. W., Patel, V., Furukawa, M. F., & King, J. (2014). EHR adopters vs. non-adopters: Impacts of, barriers to, and federal initiatives for EHR adoption. Healthcare (Amsterdam, Netherlands), 2(1), 33-39. doi:10.1016/j.hjdsi.2013.12.004
Kemper, A. R., Uren, R. L., & Clark, S. J. (2006). Adoption of Electronic Health Records in Primary Care Pediatric Practices. Pediatrics, 118(1), e20.
Li, P., Xie, C., Pollard, T., Johnson, A. E. W., Cao, D., Kang, H., . . . Zhang, Z. (2017). Promoting Secondary Analysis of Electronic Medical Records in China: Summary of the PLAGH-MIT Critical Data Conference and Health Datathon. JMIR Medical Informatics, 5(4), e43. doi:10.2196/medinform.7380
Lin, C. K., Shyu, Z. J., & Ding, K. (2017). A Cross-Strait Comparison of Innovation Policy under Industry 4.0 and Sustainability Development Transition. Sustainability, 9(5). doi:10.3390/su9050786
Maroto, A., Gallego, J., & Rubalcaba, L. (2016). Publicly funded R&D for public sector performance and efficiency: evidence from Europe. R&D Management, 46(S2), 564-578. doi:10.1111/radm.12215
Martínez-Costa, C., Menárguez-Tortosa, M., & Fernández-Breis, J. T. (2010). An approach for the semantic interoperability of ISO EN 13606 and OpenEHR archetypes. Journal of Biomedical Informatics, 43(5), 736-746. doi:https://doi.org/10.1016/j.jbi.2010.05.013
Matthews, E. B. (2017). Integrating the Electronic Health Record into Behavioral Health Encounters: Strategies, Barriers, and Implications for Practice. Administration and Policy in Mental Health and Mental Health Services Research, 44(4), 512-523. doi:10.1007/s10488-015-0676-3
Middleton, B., Hammond, W. E., Brennan, P. F., & Cooper, G. F. (2005). Accelerating U.S. EHR Adoption: How to Get There From Here. Recommendations Based on the 2004 ACMI Retreat. Journal of the American Medical Informatics Association, 12(1), 13-19. doi:10.1197/jamia.M1669
Poissant, L., Pereira, J., Tamblyn, R., & Kawasumi, Y. (2005). The Impact of Electronic Health Records on Time Efficiency of Physicians and Nurses: A Systematic Review. Journal of the American Medical Informatics Association : JAMIA, 12(5), 505-516. doi:10.1197/jamia.M1700
Rogers, D. (2004). The evolution of a local R&D strategy: the experience of a service in the UK National Health Service (NHS). R&D Management, 34(1), 57-63. doi:10.1111/j.1467-9310.2004.00322.x
Rollman, B. L., Hanusa, B. H., Lowe, H. J., Gilbert, T., Kapoor, W. N., & Schulberg, H. C. (2002). A Randomized Trial Using Computerized Decision Support to Improve Treatment of Major Depression in Primary Care. Journal of General Internal Medicine, 17(7), 493-503. doi:10.1046/j.1525-1497.2002.10421.x
Rothwell, R., & Zegveld, W. (1981). Industrial Innovation and Public Policy: Preparing for the 1980s and the 1990s: Greenwood Pub Group.
Seebode, D., Jeanrenaud, S., & Bessant, J. (2012). Managing innovation for sustainability. R&D Management, 42(3), 195-206. doi:10.1111/j.1467-9310.2012.00678.x
Shyu, J. Z., & Chiu, Y. C. (2002). Innovation policy for developing Taiwan’s competitive advantages. R&D Management, 32(4), 369-374. doi:10.1111/1467-9310.00267
Singh, H., Naik, A. D., Rao, R., & Petersen, L. A. (2008). Reducing Diagnostic Errors through Effective Communication: Harnessing the Power of Information Technology. Journal of General Internal Medicine, 23(4), 489-494. doi:10.1007/s11606-007-0393-z
WHO. (2006). Electronic health records: manual for developing countries. (9290612177). Manila: WHO Regional Office for the Western Pacific.
Yadav, P., Steinbach, M., Kumar, V., & Simon, G. (2018). Mining Electronic Health Records (EHRs): A Survey. ACM Comput. Surv., 50(6), 1-40. doi:10.1145/3127881
Yin, R. (2003). K.(2003). Case study research: Design and methods. Sage Publications, Inc, 5, 11.
ZHAO, H.-l., & FENG, J. (2004). Implement the Strategy of Resources Integration to Raise the Comprehensive Competence of Chinese Medicine Industry [J]. R&D Management, 6.