健保署自2014年9月推出健康存摺，在2018年5月為增加使用者之便利性，新增手機APP快速認證之方式登入健康存摺。截至2018年9月止，共計有56萬多人下載登入，僅占全國人口數的3.6%。健康存摺建置至今共花費約3,000多萬元，甚至每年編列400萬到500萬不等的宣傳預算與舉辦競賽活動，使用人數卻無顯著成長。爰此，本研究冀望以科技準備接受模式為研究架構加上信任變數，探討使用者對健康存摺的使用意圖，建構出系統的使用者模型，提供未來作為有效推廣之參考與改進方向。
本研究採問卷調查法，調查期間自2018年12月1日開始至2019年4月30日止，以有實際操作健康存摺下載的使用者為研究樣本，總計發放761份問卷，回收662份；有效問卷數量為581份，有效問卷率為87.76%。
研究結果顯示：(一) 影響健康存摺使用意圖之重要因素有科技準備度、認知易用性、認知有用性、信任，其中以「信任」之解釋力40.4%最高；(二)認知易用性與認知有用性皆受科技準備度影響；(三)認知易用性與認知有用性皆受信任影響；(四)認知易用性對於認知有用性有正向影響力；(五)使用者之「認知易用性」與「認知有用性」分別在信任、科技準備度與使用意圖間存在部分中介關係；(六)依據科技準備度將健康存摺使用者分成探索者、先驅者、懷疑者、執著者、落後者。最後，根據不同的使用者類型研擬出不同的推廣策略。

Since the Ministry of Health and Welfare launched the “My Health Bank” service in September 2014, a mobile application was newly added in May 2018 to make login authentication onto the system faster and more convenient. However, as of the end of September 2018, only 560,000 users have downloaded the application and logged in, representing only 3.6% of the total population in Taiwan. Up until now, approximately NTD30 million has been spent to build the “My Health Bank” system, in addition to NTD4 to 5 million budgeted each year for promotional and competition events. Despite this, there still has been no significant increase in the number of users. For this reason, this study aims to apply the Technology Readiness and Acceptance Model as the research framework coupled with trust variables to investigate users’ intention to use the “My Health Bank” system. From this, we hope to establish a user model for the system to serve as future reference and guidance for its effective promotion and improvement.
The questionnaire method was adopted to carry out an investigation for the period from 1 December 2018 to 30 April 2019, with users who have downloaded and operated the “My Health Bank” application as research samples. A total of 761 questionnaire surveys were distributed, with 662 surveys recovered. The total number of effective surveys is 581 and the recovery rate is 87.76%.
The study showed that: First, the important factors affecting the intention of “My Health Bank” were “Technology Readiness”, “Perceived Ease of Use”, “Perceived Usefulness” and “Trust”, and among which the explanation of “trust” is 40.4%.Second, “perceived ease of use” and “perceived usefulness” were both affected by “technology readiness”. Third, “perceived ease of use” and “perceived usefulness” were both affected by “trust”.Fourth, “Perceived Ease of Use” was positively correlated to “Perceived Usefulness”. Fifth, “Perceived Ease of Use “and “Perceived Usefulness “ both have partial mediating effect on the relationship among “Trust”, “Technology readiness” and “Intention to Use”. Sixth, According to “Technology readiness”, we divided the users of “My Health Bank” into different types: explorers, pioneers, skeptics, paranoids, and laggards. Finally, we developed different promotion strategies according to different types of users research proposed.

論文審定書 ........................................................ i
誌謝 ............................................................. ii
摘要 ............................................................ iii
Abstract ......................................................... iv
第一章、緒論 ...................................................... 1
第一節 研究背景與動機 .................................................. 1
第二節 研究問題與目的 .................................................. 5
第二章、文獻探討................................................... 9
第一節 電子健康紀錄與健康存摺 .......................................... 9
第二節 科技準備接受模型 ............................................... 16
第三節 科技使用與信任 ................................................. 25
第三章、研究方法.................................................. 33
第一節 研究架構與假設 ................................................. 33
第二節 研究設計....................................................... 38
第三節 研究工具....................................................... 38
第四章、資料分析與探討 ............................................ 55
第一節 樣本基本資料敘述統計 ........................................... 55
第三節 使用者之背景屬性與各研究變項之分析 .............................. 63
第四節 科技準備接受模型研究假說實證分析 ................................ 81
第五節 使用者之科技準備度分類 ......................................... 95
第五章、結論與建議 ............................................... 105
第一節 結論 ......................................................... 105
第二節 建議 ......................................................... 111
第三節 研究限制與後續研究建議 ........................................ 116
參考文獻 ........................................................ 119
附錄一正式問卷 .................................................. 125

王雲東(2012)。社會研究方法：量化與質性取向及其應用(二版)。新北市：威士曼文化。
朱勗華(2016)。健康資訊雲端化與隱私權保障之研究。東吳大學法律專業碩士班碩士學位論文，台北市。
何冠霖(2017)。民眾下載健康存摺資料影響因素之實證研究。義守大學醫務管理學系碩士學位論文，高雄市。
江欣蒨(2017)。以科技持續模式探討個人電子健康紀錄之使用意願-以健康存摺為例。中山醫學大學醫學資訊學系碩士學位論文，台中市。
吳政澤(2010)。以雲端運算建構健康管理平台之研究。臺北醫學大學資訊研究所碩士學位論文，台北市。
吳明隆(2005)。SPSS統計應用學習實務─問卷分析與應用統計。台北市：知城數位科技。
吳明隆、張毓仁（2011）。SPSS（PASW）與統計應用分析I。臺北市。五南圖書出版股份有限公司。
吳明隆、涂金堂(2014)。SPSS與統計應用分析。臺北市。五南圖書出版股份有限公司。
李仲彬(2011)。「信任」在電子治理中所扮演的角色：以文獻檢閱為基礎的初探性分析。公共行政學報，39，105-147。
李宏仁、袁劍雲、江佳霖、林韋儒（2015）。消費者線上購物行為關鍵決定因素：一個整合性理論觀點。顧客滿意學刊，11(2)，271-303。
林音谷(2009)。自然人憑證推動與公民信任關係之研究－政策規劃者與執行者之觀點。臺灣大學政治學研究所學位論文，台北市。
林靖文(2011)。運用科技準備度與科技接受模型探討公共圖書館使用者使用數位服務科技之意願─以國立臺中圖書館為例。臺灣大學文學院圖書資訊學系碩士學位論文，台北市。
夏守智(2017)。電子化政府會否提升民眾對政府信任度?：基於中國之實證研究。中國行政評論，23(3)，99-117。
徐自瑄(2016)。運用科技準備接受模式探討網購農產品之研究。中興大學生物產業管理研究所碩士學位論文，臺中市。
張樹之、沈威政（2015）。探索社交網路服務採用者之重要信任因素：以Facebook為例。科技管理學刊，20(2)，71-98。
陳照森（2012）。社群網站信任與科技接受模式之實證研究。全球商業經營管理學報，(4)，53-66。
陳建文、駱達彪、蕭國鐘、潘有崴（2013）。影響顧客使用銀行虛擬通路意圖之研究。臺灣企業績效學刊，6(2)，213-231。
陳宜棻、蔡家文、謝昌隆、曾珮瑜（2015）。探討台灣高速鐵路網路訂票系統之顧客使用意願。績效與策略研究，12(1)，1-26。
陳宜檉、蕭雅文、林怡倩（2017）。旅遊社群網站網路口碑信任對旅遊商品購買意願影響之研究：延伸科技接受模式的理論觀點。觀光與休閒管理期刊，5(1)，28-41。
陳詩旻(2017)。從科技接受模式與科技準備度探討大學圖書館自助式服務科技使用情形與使用意願。淡江大學資訊與圖書館學系碩士論文，台北市。
彭思舟、許立群、黃永進（2012）。線上購物者購買行為之實證研究：科技接受模式之權變觀點。顧客滿意學刊，8(2)，183-210。
黃東益、李仲彬(2010)。電子治理與民眾對政府信任：台灣的個案分析。行政暨政策學報，51，77-124。
楊台寧、張書豪、蕭煥龍(2011)。影響納稅義務人網路報稅行為意圖之研究。顧客滿意學刊，7(2)，161-188。
楊燦銘(2016)。結合健康信念模型與計畫行為理論探討健康存摺之接受意圖，國立雲林科技大學資訊管理系碩士論文，雲林縣。
廖珮雯(2011)。影響醫院病患個人健康紀錄使用意願之因素，台北醫學大學醫務管理學研究所碩士論文，台北市。
鄭文愷(2017)。健康存摺易用性與有用性之初探─以民眾與醫師之觀點為例，世新大學行政管理學系碩士學位論文，台北市。
賴怡芳(2016)。影響民眾使用健康存摺系統意圖之因素研究，中正大學資訊管理系醫療資訊管理研究所碩士學位論文，嘉義縣。
蕭文龍(2009)。多變量分析最佳入門實用書─SPSS+LISERL(第二版)。台北市：碁峰資訊。
國家發展委員會(2018)。服務型智慧政府推動計畫–第五階段電子化政府計畫(核定版)。
Al-Sobhi, F., Weerakkody, V.,Kamal, M. M. (2010). An exploratory study on the role of intermediaries in delivering public services in Madinah City: Case of Saudi Arabia.Transforming Government. People, Process and Policy, 4(1), 14-36.
Baron, R. M. and Kenny, D. A., (1986).The Moderator-Mediator Variable Distinction in Social Psychological Research:Conceptual, Strategic, and Statistical Considerations, Journal of Personality and Social Psychology,51(6),1173-1182.
Carter,L.(2008).E-Government diffusion:A comparison of adoption constructs.Transforming Government:People,Process and Policy,2(3),147-161.
Chen,S.C.(2008).An Integrated Model of Technology Readiness and TAM with TPB in the Continued Intentions of Self-Service Technologies(Doctor's dissertation,Tatung University).Retrieved from http://ndltd.ncl.edu.tw/cgi-bin/gs32/gsweb.cgi/login?o=dwebmge
Chircu,A.M.,Davis, G. B.,and Kauffman,R.J.(2000).Trust ,Expertise and Ecommerce Intermediary Adoption, Proceedings of the Sixth Americas Conference on Information Systems,710-716,New York,NY.
Davis, F. D. (1989). Perceived usefulness, perceived ease of use, and user acceptance of information technology. MIS quarterly, 13, 319-340.
DeLone, W. H., & E. R. McLean (2003). The DeLone and McLean model of information system success: A ten-year update. Journal of Management InformationSystems, 19(4), 9-30.
Erdogmus & Esen(2011).An investigation of the effects of technology rediness on technology acceptance in e-HRM.Procedia Social and Behavioral Sciences,24,487-495.
Godoe, P.and Johansen., T.S. (2012). Understanding adoption of new technologies: Technology readiness and technology acceptance as an integrated concept. Journal of European Psychology Students, 3(1), 38-52.
Grimsley, M., & A. Meehan (2008). Attaining social value from electronic government. Electronic Journal of e-Government, 6(1), 31-42.
Grimsley, M., & A. Meehan (2007). E-Government information systems: Evaluation-leddesign for public value and client trust. European Journal of Information Systems, 16, 134-148.
Hung, S.-Y., C.-M. Chang, & T.-J. Yua (2006). Determinants of user acceptance of the egovernment services: The case of online tax filing and payment system. Government Information Quarterly, 23(1), 97-122.
Jiun-Sheng, C. L. & Hsing-Chi, C. (2011). The role of technology readiness in self-service technology acceptance. Managing Service Quality, 21(4), 424-444.
Klopping,I.M.& McKinney,E.(2004).Extending the technology acceptance model and the task-technology fit model to consumer e-commerce. Information Technology,Learning, and Performance Journal,22(1),35-48.
Lankton,NK.& McKnight,DH.(2011).What does it mean to trust Facebook?: examining technology and interpersonal trust beliefs.ACM SIGMIS Database: The DATABASE for Advances in Information Systems,42(2),32-54.Legris, P.,Ingham, J.,Collerette, P.(2003).Why Do People Use Information Technology? A Critical Review of the Technology Acceptance Model.Information & Management,40(3),191-204.
Lin,C.H.,Shih,H.Y.&Sher,P.J.(2007).Integratingtechnology readiness into technology acceptance :The TRAM model. Psychology &Marketing, 24(7),641.
Lin,J.S.C.,& Chang,H.C.(2011).The role of technology readiness in self-service technology acceptance.Managing Service Quality,21(4),424-444.
Lopez-Nicolas, C., Molina-Castillo, F. J. & Bouwman, H. (2008). An assessment of advanced mobile services acceptance: Contributions from TAM and diffusion theory models. Information & Management, 45(6), 359-364.
McKnight,D.and Chervany,L.N.(2001-2002).What Trust Means in E-commerce Customer Relationships An Interdisciplinary Conceptual Typology,International Journal of Electronic Commerce,6(2), 35-59.
Parasuraman, A.(2000). Technology Readiness Index (TRI) a multiple-item scale to measure readiness to embrace new technologies. Journal of service research,2(4),307-320.
Parasuraman, A. & Colby,C.L.(2001).Techno-ready marketing: How and why your customers adopt technology. New York : The Free Press.
Parasuraman, A., & Colby, C. L. (2015). An updated and streamlined technology readiness index: TRI 2.0. Journal of Service Research, 18(1), 59-74.
Patwardhan, A., Pandey, N. & Dhume, S. M. (2015). Understanding physicians internet adoption pattern: A hybrid approach for pharmaceutical marketing. International Journal of Marketing & Business Communication, 4(2), n/a.
Papadopoulou, P., M. Nikolaidou, & D. Martakos (2010, January). What is trust in egovernment? A proposed typology. The 43th Hawaii International Conference on System Sciences, Koloa, Kauai, HI, USA.
Pavlou,P.A.(2003).Consumer acceptance of electornic commerce:Integrating trust and risk with the technology acceptance model,International Journal of Elcetronic Commerce,7(3),101-133.
Sang, S., J.-D. Lee, & J. Lee (2009). E-government adoption in ASEAN: The case of Cambodia. Internet Research, 19(5), 517-534.
Shankland, S. (2008). Google Health beta test begins. Retrieved from https://www.cnet.com/news/google-health-beta-test-begins/
Tsikriktsis,Nikos.(2004).A technology readiness-based taxonomy of customers: A replication and extension. Journal of Service Research, 7,42-52.
Walczuch,Lemmink&Streukens,S.(2007).The effect of service employees’technology acceptance. Journal Information and Management,44(2),206-215.
Warkentin,M.,Gefen,D.,Pavlou,P.A.,and Rose G.M.,(2002).Encouraging Citizen Adoption of E-government by Building Trust,Electronic Markets,12(3),157-162.
Zolin, R.Hinds, P.J.,Fruchter, R.,Levitt,R.E.(2004).Interpersonal trust in cross-functional, geographically distributed work: A longitudinal study. Information and organization,14(1),1-26.