Medical Management Information System Feasibility Analysis Report
The system establishes a comprehensive management platform for spatial and attribute information of medical resources, which is conducive to the scientific decision-making on the layout and distribution of medical resources, and it adds useful contents for the social serviceization of health information, and it also lays down a good foundation for the comprehensive development of health e-government.
The system has the following characteristics:
Advanced: the system makes full use of all kinds of mature and advanced technologies and equipments both at home and abroad nowadays, so that the system stands at a higher starting point and has a longer lifespan. Practicality: the system has a good practicality is, indeed, for medical resource management to provide effective means to facilitate their daily work. Reliability: the reliability of the system is also the basis of the system's vitality, so sometimes prefer to give up some immature or impractical "advanced" technology, equipment, but also must ensure the stability and reliability of the system. Resources **** enjoyment: all the resources on the network, can be integrated management, can be composed of units **** enjoyment. Each medical institution information, user information, etc., regardless of whether it is in the health bureau LAN or the Internet, are unified. Ease of use: friendly human-computer interaction interface, input query and other operations intuitive and convenient, full support for mouse operation, minimize manual data entry; prompted by a simple and clear information to guide the user to complete the various functions of the system. File help function is complete, convenient for non-computer professionals to learn and use. Expandability: The system is based on a modular design, can be easily expanded, when the business needs new features, can be easily expanded to maintain the vitality of the system.Basic Medical Management Information System
In 1998, the State Council issued the "Decision on the Establishment of a Basic Medical Insurance System for Urban Workers" (Guo Fa [1998] No. 44), which requires that all employers in urban areas, including enterprises, organs, institutions, social organizations, private non-enterprise units and their employees to participate in basic medical insurance, and the implementation of territorial management; The cost of basic medical insurance is borne by both the employer and the employee***; the employer's contribution rate should be controlled at about 6% of the employee's gross salary, and the employee's contribution rate is generally 2% of his or her salary income.
The reform of the medical security system is an important part of the reform of China's social security system, the goal is to adapt to the establishment of a socialist market economic system and improve the health of workers, the establishment of a social health care reform system combining a social coordinated medical fund and individual medical accounts. The establishment of a new system of medical reform in line with China's national conditions, is an important element of the establishment of a multi-level social security system, is a major initiative to improve the social security system, is of great significance and far-reaching impact.
Basic medical insurance is an emerging type of social insurance. Basic medical insurance with its wide coverage, involving many people, complexity, and social contribution to the characteristics of the labor insurance occupies an important position; is the basic pension insurance after the basic social insurance insurance is another important basic social insurance insurance.
The business volume of the basic medical insurance is huge, and the required information is widely distributed geographically, so it can not solve the problem fundamentally only by increasing the number of business personnel, but applying the modern means, constructing a huge computer network, strengthening the scientific management, asking for the benefits from the modernization, asking for the manpower from automation, asking for the information from the network, and improving the business, office efficiency and quality is the fundamental way out.
Based on the specific needs analysis of the basic medical insurance software system, the system will be modified or redeveloped in the process of implementation, its main functional modules are as follows:
I. Basic medical insurance collection system
(A) unit management
1, unit profile
2, unit contribution history
3, unit Special Policy
4, Unit Base Approval
5, Reminder (Payment) Notice
6, Accounts Receivable Log
7, Unit Profile Log
(2) Individual Management
1, Employee Profile
2, Employee Contribution History
3, Employee Medical Individual Accounts
4. Employee Medical Individual Account Settlement
5. Employee Profile Log
6. Employee Transfer Log
2. Basic Medical Insurance Settlement System
1. Basic Information
2. Medical Benefits Audit
3. Basic Medical Co-ordinator Payment
4. Approval of Basic Medical Co-ordinator Payment
5, Payment Policies
6, Special Policies for Payment Units
7, Management of Sentinel Hospitals
8, Types of Hospital Institutions
9, Payment History
10, Management of Sentinel Pharmacies
11, Payment History
12, Summary of Hospitals Paying for the Basic Medical Coordination Fund
13, Bank Data Interface
14, Drug Catalog
15, Diagnostic and Treatment Fee Catalog
16, Service Facility Fee Catalog
17, Surgical Items Catalog
18, Drug Types
19, Drug Dosage Forms
20, Disease Type Management
21, Disease Type Coding
22, the relationship between the type of disease and medical fees
three, billing subsystem
1, collection documents
2, generate bank data
four, designated hospital management system
1, inpatient hospitalization registration
2, medical advice management
3, bed management
4, Deposit management
5, inpatient fee audit
6, inpatient fee settlement
7, registration management
8, outpatient fee audit
9, outpatient fee settlement
10, special disease co-ordination fund payment audit and settlement
11, pharmacy management
12, and hospital system Interface management
V. Management system of designated pharmacies
1. Sale of medicines within the scope of medical insurance
2. Sale of medicines outside the scope of medical insurance
3. Record of sale of medicines on the same day
4. Management of imported medicine
5.
8, drug ranking analysis
9, drug sales trend analysis
6, IC card management subsystem
1, key management
2, card production, card issuance management
3, loss, damage reissuance management
4, blacklist management
5, the unit's use of the card statistics
seven Statistical Reporting Subsystem
1, Business Processing of Specialized Administrators
2, Statistical Tables of Undelivered Services
3, Units' Outstanding Fees
4, Use of Co-ordinated Funds
5, Retirees' Medical Expenses
6, Retirees' Medical Expenses
7, Class IIB Medical Expenses
8, single-disease medical fee statistics
9, medical fee statistics of medical institutions with the same disease
10, medical fee statistics of insured units
11, medical fee statistics of major diseases
12, outpatient inpatient medical fee statistics
13, out-of-town medical fee statistics
14, cumulative segmented Statistics on Medical Expenses
15, Statistics on Medical Expenses of Medical Institutions
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VIII. Participation Management Subsystem
1. Social Environment Information
2. Medical Insurance Fund Charging Policies
3. Medical Insurance Coordination Payment Policies
IX. Public Service System
1. Query on Basic Medical Insurance Policies
2. Quiz on Basic Medical Insurance
3. Introduction of social insurance organizations
4. Reform and development of the city's basic medical insurance system
5. Query on unit contributions
6. Query on medical personal accounts
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X. System Maintenance Subsystem
1. User Management Table
2. Coding Library
3. System Module Management
4. Departmental Maintenance
5. Maintenance of Public **** Variables
6. Maintenance of Module Update
7. Current User Status
8. System Log Maintenance
9, backup data registration and audit
10, area code
11, user area cross-reference table
12, hospitals, pharmacies and user cross-reference table