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    醫保控費監控知識庫

    時間:2019-08-18 09:28:26  來源:  作者:
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    “醫保監控知識庫”及智能審核平臺,是由醫保監控知識庫和基于監控規則的實時智能審核平臺組成,該知識庫包括藥品、收費項目、疾病診斷等結構化的醫學知識及相關聯的各種規則,能針對醫院常規診療項目所涉及的超說明書行為、超頻次診療、超醫保限制等用藥、治療過程,進行實時有效的監控,從而建立約束醫師不合規的醫療行為,能達到事中控費的效果,為構建三醫聯動智慧醫保的建立奠定基礎。


     

    技術規格和配置要求

    1、醫保監控知識庫管理平臺設計要求

    1)先進性

    采用先進的基于中間件的設計思想和開發方法,支持多節點互聯互通,支持大用戶量并發訪問,包括大并發下的緩存技術,頁面異步數據交換,支持Webservers,JSON等技術。

    2)安全性

    系統采用分級管理模式,對不同級別用戶的操作權限和數據訪問范圍有嚴格的限制,系統管理員可以根據情況靈活設置安全策略。系統級安全:定期備份、應急及恢復、災備解決方案。

    3)開發技術

    系統采用B/SC/SC/M/S架構,數據庫支持OracleSQL Server等大型數據庫,支持主流的應用服務器、集群及負載等。

    4)可擴展性

    采用模塊化的設計框架,模塊之間相對獨立又可相互關聯。在已有功能基礎上添加新模塊或新功能,都非常方便。而且系統采用對象化設計理念,程序接口和數據接口都要清晰,便于二次開發。

    5)易維護性

    采用代碼維護、公式調整、參數配置等手段,確保管理員可自維護系統基礎設置數據項。系統升級和日常維護只需要在服務器進行即可。提供應用系統相關技術文檔,開放數據庫權限,系統為管理員有系統設置和維護功能,包括用戶和權限設置、字段維護、代碼表維護、日志監控、數據批量處理、遠程備份、數據同步等等。

    2、醫保監控知識庫管理平臺性能要求

    1) 要求醫保監控知識庫管理平臺基于三層架構體系(用戶界面層-業務邏輯層-數據庫層)。服務器為windows2008以上版本的環境,客戶端為windows XP/win7/win8等環境,通信采用TCPHTTP/HTTPS 等協議。

    2) “醫保監控知識庫”要求以醫療衛生政策、臨床診療規范及指南、藥典、醫保政策及醫保目錄等為依據建立的醫保監控知識庫。支持事中、事后智能審核。

    3) 系統需要支持主流數據庫系統Microsoft SQL Server2005或以上版本、Oracle10g或以上版本;服務器操作系統支持Windows

    4) 醫保監控知識庫管理平臺必須擁有自然語言分析功能,平臺接收到醫院HIS上傳的內容后,能通過自然語言分析后,運用人工神經網絡等技術,與后臺的知識庫進行快速匹配并自動生成審核結果返回。

    5)系統要求與院方的HISLISPACS等系統無縫集成,并應提供標準的數據交換接口,支持被醫院其他信息系統的應用集成。

    3、醫保監控知識庫”醫保監控知識庫管理平臺功能模塊要求:

    主模塊

    子模塊

    功能說明

    備注

    中間件

    服務

    啟動、卸載中間件

     

    組網

    指定根節點、子節點的IP地址、命名及端口等。

     

    負載均衡

    啟動、關閉負載均衡功能

     

    WEB服務

    啟用、關閉HTTP/HTTPS服務,并設置相應的參數。

     

    用戶

    維護中間件的使用用戶及權限

     

    數據庫

    提供靈活的、多種主流數據庫的連接模式,測試通過后提供給插件、客戶端等調。

     

    智能審核引擎(插件)

    智能審核引擎以插件的形式安裝在服務器中間件,支持C/S三層插件、WEB預加載插件的注冊、修改、注銷功能。支持Webservers,JSONDLL等技術接入進行數據交換。

    智能審核引擎利用后用強大的醫保監控知識庫及智能算法,通過中間件接口接收到數據請求(包含患者基本信息、醫囑/處方信息等),經過計算后返回處理結果,接收方可根據處理結果對醫生行為進行管控。

     

    計劃任務

    注冊、修改、注銷各種定時任務。

     

    日志

    提供每日的中間件各種功能使用的日志

     

    醫保監控知識庫管理平臺

    登錄

    用戶登錄,自動識別用戶的性質及權限。

     

    系統管理

    員工管理、權限管理、密碼修改、版本管理、本地數據維護、退出系統等功能。

     

    知識庫

    藥品維護、診療項目、臨床診療指南、醫保規則、監控規則、自然語言分析等。提供新增、修改、刪除等維護功能。

     

    知識庫應用

    輔助診療(可選)

     

    智能審核

    監控平臺、預警審核。支持數據批量導入審核,可追蹤到具體哪個項目違規情況。

     

    統計報表

    提供按年、季度、月、自由錄入時間段等方式查詢所有預警項目及處理情況,自動生成各種圖表,支持導出數據及導出圖表等功能。

     

    常用工具

    提供計算器等功能

     

    幫助

    提供日志等功能

     

     


     

    醫保監控知識庫數據構成

     

    序號

    數據名稱

    分類

    數量(條)

    數量合計

    1

    商品庫
    (其中西藥、中成藥含本位碼、國藥準字、劑型、規格、包裝規格、廠家)

    西藥

    114234

    201164

    中成藥

    65344

    中藥飲片

    6187

    保健品

    15399

    2

    藥品說明書

    中成藥

    47271

    142839

    西藥

    73983

    中藥飲片

    6187

    保健品

    15398

    3

    共用字典

    疾病信息字典

    3282

    12699

    癥狀信息字典

    1750

    人群信息字典

    128

    肝腎功能信息字典

    54

    病史信息字典

    153

    藥物過敏信息字典

    958

    相互作用集信息字典

    1984

    特殊人員字典

    8

    頻次范圍字典

    86

    大類藥品字典

    449

    相互作用標準字典

    3847

    4

    西藥、中成藥適應癥

    疾病

    300821

    716531

    癥狀

    296484

    人群

    115285

    性別

    3941

    5

    西藥、中成藥禁忌癥

    肝腎功能

    60455

    1111136

    人群

    330681

    病史

    213454

    疾病

    296890

    癥狀

    79426

    藥物過敏

    63691

    其他

    62887

    性別

    3652

    6

    相互作用

    西藥之間

    335693

    384791

    中成藥與西藥之間

    20812

    中成藥之間

    1367

    說明書中的歸類藥品

    26919

    7

    藥品ATC分類

    西藥

    7268

    17218

    中成藥

    9950

    8

    用法用量

    疾病

    258

    7482

    癥狀

    19

    人群

    8

    用法

    32

    服法

    22

    頻次

    34

    年齡

    863

    體重

    295

    用量

    3640

    用量范圍

    1240

    肝腎功能

    169

    療程

    554

    療程范圍

    348

    9

    不良反應

    疾病

    445

    11732

    癥狀

    553

    人群

    8

    肝腎功能

    100

    常見度

    9210

    程度

    1416

    10

    配伍禁忌基礎數據

    總量

    16383

    16383

    11

    醫保限定支付數據

    1:性別;2:人群;3:醫院等級;4:住院或門診;5:保險類型;6:搶救;7:專科;8:嚴重情度;9:一線二線;10:疾病;11:癥狀;12醫技檢查

    68521

    68521

    12

    自然語言分析詞庫

    總量

    453710

    453710

     

    合計

     

     

    2690496


     

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