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    醫保智能審核系統功能模塊

    時間:2019-08-07 09:25:05  來源:  作者:
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    序號

    項目及技術要求

    1.

    醫保智能審核

    1.1

    醫保規則(系統內部分規則)

    1.1.1

    自入院開始只有檢查無治療連續天數

    1.1.2

    在院期間與其他住院記錄在院期間日期重疊

    1.1.3

    限兒童使用藥品

    1.1.4

    限性別使用藥品

    1.1.5

    藥品限制特性項目

    1.1.6

    藥品限病種使用

    1.1.7

    項目加收

    1.1.8

    診療時間不合理

    1.1.9

    臨床聯合用藥禁忌

    1.1.10

    藥品使用種類過多

    1.1.11

    診療使用超出病種范圍

    1.1.12

    統籌支持比例過高

    1.1.13

    病種限藥品使用(范圍指定)

    1.1.14

    藥品限新生兒支付管理

    1.1.15

    藥品限中醫醫師支付管理

    1.1.16

    藥品限醫院級別支付管理

    1.1.17

    住院物理治療項目療程限制

    1.1.18

    限兒童使用項目

    1.1.19

    限性別使用項目

    1.1.20

    臨床用藥兒童禁忌

    1.1.21

    同一人月結算次數

    1.1.22

    醫囑和費用明細數量不對照

    1.1.23

    限工傷

    1.1.24

    限生育

    1.1.25

    限急救藥品

    1.1.26

    限項目合理時間范圍

    1.1.27

    單病種費用超標

    1.1.28

    大額單病種費用超標

    1.1.29

    限離休

    1.1.30

    限住院

    1.1.31

    限制出院帶藥

    1.1.32

    ★審核庫規則大于等于120條以上,系統可以根據院方需求自定義添加,定制,匹配日照現有兩套運行系統并現場演示規則庫。

    1.2

    事前審核

    1.2.1

    事前審核監控系統的主要功能是在醫生通過HIS系統為患者開具處方或開立醫囑時,對處方(醫囑)中超臨床規則和超醫保規則的處方進行實時分析并給予警示,一旦出現超臨床規則、超醫保規則的藥品或項目異常,系統將實時發出警示,減少或避免處方中的不合理用藥行為、處方中的違規診療行為,這種通過實時提醒從源頭把關的形式也大大提高了醫院醫保部門對醫保處方的審核工作效率。

    1.3

    事中審核

    1.3.1

    醫院醫保科通過部署事中審核分析系統,可將醫院一段時間、某醫生、某科室或全院的處方(醫囑)數據進行智能審核分析,并通過分析結果,為醫院醫保科或醫院管理者提供綜合的多維度的醫保處方分析報告,從而更好的促進醫生對醫保藥品和收費項目的合理合規使用,使得醫院開具診療單和藥方單滿足合理、合法、合規,達到醫保中心對合理診療的監管要求。

    1.4

    事后追溯統計系統

    1.4.1

    根據事前,事中審核處理結果進行統計、查詢。全息多維度查詢信息。為醫院管理追責、主管部門決策提供有效數據支持。如:本月內一科限工傷用藥違規300例,限兒童用藥違規200例。

    本月內一科張醫生限兒童用藥違規3例。違規病人詳細信息,違規具體藥物,違規金額,與醫保科交流過程及處理結果等信息。

    1.5

    審核規則維護

    1.5.1

    用戶可對監控規則、監控規則集(封裝相同監控目的若干同類規則)進行增加、修改、刪除,可以定義或調整監控規則的規則類型、數據映射、算法、參數、啟動條件(執行時間)、重要程度、優先級、閾值等。

    1.5.2

    監控分析指標是指由用戶定義的,可輔助用戶進行醫療服務監控的一系列統計分析指標,一般情況下無法直接設定閾值進行違規判斷。例如:醫療服務機構次均普通門診費用、同比或環比增長率、同等級醫療服務機構中的排名等,系統無法依據統計指標判定醫療服務機構是否存在疑點,但是用戶有可能通過指標的異常變化分析出可能存在疑點的對象,因此系統提供監控分析指標作為監控規則的補充。

    1.5.3

    ★實現門診特病方案維護,對醫院日照醫保報銷中的所有特病適用的藥品和項目進行維護,在HIS中進行特病報銷審核時,提示醫生違規處方并現場演示。

    1.6

    規則引擎管理

    1.6.1

    醫療服務監控系統由具有規則引擎能力的執行環境負責執行已定制的醫療服務監控規則庫,規則引擎由系統后臺自動運行,基本不存在前臺頁面。規則引擎執行監控規則后,對所有違反監控規則(超過規則閾值)的對象及其醫療服務記錄生成監控疑點記錄。規則引擎執行監控分析規則時,只產生相應指標的統計數據,系統不進行閾值判斷,也不生成疑點記錄。規則引擎執行規則時,還會跟蹤執行過程,記錄執行順序、執行步驟、執行過程以及錯誤記錄等日志信息。規則跟蹤是規則引擎運行管理中唯一前臺可見的業務模塊,用于查看日志信息,可以發現規則執行中的錯誤并繼續執行該規則。

    2.

    智能控費

    2.1

    五部委頒布《控費意見》21條量化指標統計

    2.1.1

    根據費用控制目標閾值統計醫療費用增長同比環比指標,

    2.1.2

    門診病人次均醫藥費用,監測比較

    2.1.3

    住院病人人均醫藥費用,監測比較

    2.1.4

    門診病人次均醫藥費用增幅,分析是否逐步降低

    2.1.5

    住院病人人均醫藥費用增幅,分析是否逐步降低

    2.1.6

    參保患者個人支出比例,分析是否逐步降低

    2.1.7

    醫保目錄外費用比例,監測比較

    2.1.8

    城市三級醫院普通門診就診人次占比

    2.1.9

    住院的人次人頭比

    2.1.10

    手術類型構成比

    2.1.11

    門診收入占醫療收入的比重

    2.1.12

    住院收入占醫療收入的比重

    2.1.13

    10種典型單病種例均費用

    2.1.14

    藥占比(不含中藥飲片)

    2.1.15

    檢查和化驗收入占醫療收入比重

    2.1.16

    衛生材料收入占醫療收入比重

    2.1.17

    掛號、診察、床位、治療、手術和護理收入總和占醫療收入比重

    2.1.18

    百元醫療收入消耗的衛生材料費用

    2.1.19

    平均住院日

    2.1.20

    管理費用率

    2.1.21

    資產負債率

    2.2

    醫保定額統計分析

     2.2.1

    主要對已出院醫保病人從基本信息、醫保結算信息及醫保管理信息三大方面統計分析,分析出醫保病人月度、季度、半年、年度費用情況,采用分科管理方法,分析醫保定額、制定科室定額,讓醫院管理人員及時掌握醫院、科室、醫生、病人的費用情況及醫保金額超標情況,為醫院管理者提供一個良好的分析平臺。

    2.2.2

    門診醫保根據不同的醫保人員類別及待遇類型進行分析,監控到科室、醫生及病人的醫生的醫保人數、醫保人次、參保人發生的總費用、參保人自費費用、乙類個人先自付費用、參保人起付標準費用+共付段(個人支付+統籌記賬金額)費用,人均定額費用及醫保超定額比例等。合理掌握科室、醫生下醫保病人的情況。

    1) 普通門診病人分析

    2) 門診慢性病分析

    3)門診特定項目分析 

    2.2.3

    醫院根據每個科室歷年來發生的費用制定每個科室的定額,根據科室、醫生來分析出每個月、季度、年的醫保費用、平均定額數、超定額比例、住院天數等。對超定額科室、醫生進行監控,詳細分析超標人均費用占比大的費別情況。協助醫院管理者調整醫保政策。

    1)普通住院醫保分析

    2)單病種醫保分析

    2.2.4

    根據職工生育保險醫療服務定額結算標準來對醫院生育保險人員進行分析。

    1) 門診生育保險分析

    2)住院生育保險分析

    2.2.5

    公費醫療改革實施后,相關人員也將納入到社保卡發放范疇,和基本醫保參保人員一樣持卡就醫、實時結算。對公費醫療病人從病人類型、科室、年齡、時間、費別等不同的角度進行多維分析。

    1) 門診公費醫療分析

    2) 住院公費醫療分析

    3)公費醫療材料占比分析

    4)公費醫療費別分析

    3.

    系統技術參數

    3.1

    數據技術要求

    3.1.1

    數據升級:供應商應提供定期的規則庫升級,系統更新服務。

    3.2

    軟件技術的要求

    3.2.1

    ★系統模塊化設計,客戶可以根據自身需求自定義功能模塊,采用B/S系統架構并現場演示。

    3.2.2

    ★統計分析報表需采用EChartsWeb前端流行圖表展示技術進行展示并現場演示

    3.2.1

    界面設計簡單直觀,可使醫院關于醫保的管理,決策數據來源一目了然。數據模塊根據醫院實際情況個性化定制。讓真個人機交互界面主次分明。系統針對醫院大數據分類分批進行違規審核,緊貼最新醫保審查規則,立足細節讓違規現象無處遁形。

    3.2.2

    與醫院其它系統的集成:“系統”應提供可集成到醫院其它系統的標準接口,能在Win 2000 / Win XP / Win 7 / Win 8中文操作系統平臺上運行。接口應成熟、穩定,集成方便。

    3.2.3

    系統可以配置相關的參數,達到可以針對某一類問題或某一個問題在不同科室、不同級別、甚至個別醫生給予警示。

    3.2.4

    醫保智能審核控費系統應滿足與醫院HIS系統用藥相關信息進行實時對接,接口應滿足對事前干預數據、事后分析統計數據的獲取,實現事前事中和事后的全過程管理。

     

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