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The aim of this study is to establish a decision system to assist liver cancer patients to choose treatments, and explore whether patients' treatment preferences were concordant with their physicians' recommendations. We analyzed the patients' considerations involved in the evaluation of treatment and combined these considerations with Barcelona Clinic Liver Cancer (BCLC) clinical guidelines to design the surveys and adopted Multi-Attribute Utility Theory (MAUT) to establish a decision model for treatment selections. Without intervening the clinical processes, we interviewed 53 liver cancer patients(and their families) using this decision system to choose preferred treatments. The results showed: (1) There was a difference between liver cancer patients' treatment preferences and their physicians' recommendations;(2) Liver cancer patients with advanced stage, still prefer active treatment; (3) The most concerns on treatments were cure rate, survival rate and self-care ability. Instead of only following physicians' recommendations, this system assist liver cancer patients to evaluate treatment using various factors(considerations) including physiological, psychological and social support. For oncologists, we suggest the psychological processes of patients are taken into consideration, and this study provide an example of framework on cancer care interventions and expect to improve the care of liver cancer population in the future.

This article provides empirical data and findings in-regards to Taiwan's overall hospital EMRs and its EMR systems. In doing so, it aims to document information about the current status of the EMRs systems which have already been implemented and are currently in use in Taiwan. Objectively, this study contains breakthrough information for the international biomedical informatics community because it has been authorized to use the unpublished data and findings from one survey conducted during a major national Taiwanese project conducted by the National Taiwan Department of Health Committee. The title of this project is, "An evaluation on expediting the processing of Taiwan's heath care plans; which ultimately produced a final report indexed as RDEC-MIS-100-010". The methodology of this paper and study uses several statistical methods to precisely deduce knowledge about the overall user satisfaction of the hospital participants whom were polled during the above mentioned project.Furthermore, the research and raw data of this paper was then sought to further elaborate on the issue of Taiwan's EMRs systems by developing this paper. Specifically, this paperhas revealed several insightful findings and statistical results based on analytical scientific methodology performed by using a 21 question hospital satisfaction survey which polled 137 public and private hospitals in Taiwan. Through this collaboration, a total of 782 completed surveys were tallied and provided us an ample amount of data to produce several statistical figures and models to support or coinciding discussion and result portion of this paper. In addition to statistical results about Taiwan's overall hospital EMRs and EMR systems based on the resulting data, all coming from a 21 question satisfaction survey, this paper also consists of a comparative analysis between both public Taiwanese hospitals vs. private Taiwanese hospitals. Finally, based on the data analysis of this paper, we provide some the possible implications for some of the high and low variance trends observed after processing this information. 

With the development and implementation of Electronic Medical Records (EMRs) in various countries, the evaluation systems of the EMRs are also expanding gradually. We systematically reviewed qualitative studies exploring EMRs evaluation systems which include the American Health Information and Management Systems Society (RIMSS) EMR Adoption Model (EMRAM), Meaningful Use of EMRs, The People's Republic of China, PRC's ERR evaluation standard, Taiwan EMRs audit program, and then we study the plausibility and feasibility of adopting EMRs as a novel evaluation model. The result shows that the RIMSS EMRAM's main objective is to evaluate an EMRs application level and then to produce a function able market analysis report; meaningful use of EMRs is based on clinical workflow tasks; PRC's EHR evaluation standard specializes on the computerized medical records systems in hospitals; Taiwan EMRs audit program focuses on information security and interoperability. The main differences among these evaluation systems reveal that the infrastructure of information system and developmental goals. Our findings support the necessity of setting up a full time organization to continue the promotion of EMRs evaluation process such as RIMSS EMRAM. Furthermore, the government in each region should subsidies those hospitals higher than level/stage 6 in PRC's ERR evaluation standard or RIMSS EMRAM, and that all medical institutions should prepare for being evaluated by suitable evaluation system.

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