CN116798581A - System of DRG/DIP grouping method for inpatients based on clinical decision support - Google Patents
System of DRG/DIP grouping method for inpatients based on clinical decision support Download PDFInfo
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- CN116798581A CN116798581A CN202310694801.1A CN202310694801A CN116798581A CN 116798581 A CN116798581 A CN 116798581A CN 202310694801 A CN202310694801 A CN 202310694801A CN 116798581 A CN116798581 A CN 116798581A
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- 238000000034 method Methods 0.000 title claims abstract description 18
- 238000003745 diagnosis Methods 0.000 claims abstract description 43
- 238000011282 treatment Methods 0.000 claims abstract description 18
- 229940079593 drug Drugs 0.000 claims abstract description 7
- 239000003814 drug Substances 0.000 claims abstract description 7
- 201000010099 disease Diseases 0.000 claims description 14
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 claims description 14
- 208000024891 symptom Diseases 0.000 claims description 7
- 238000006243 chemical reaction Methods 0.000 abstract description 2
- 238000010586 diagram Methods 0.000 description 4
- 239000002699 waste material Substances 0.000 description 4
- 230000007547 defect Effects 0.000 description 2
- 230000009286 beneficial effect Effects 0.000 description 1
- 238000003748 differential diagnosis Methods 0.000 description 1
- 230000003993 interaction Effects 0.000 description 1
- 238000004806 packaging method and process Methods 0.000 description 1
- 238000004088 simulation Methods 0.000 description 1
- 238000011269 treatment regimen Methods 0.000 description 1
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- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H40/00—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices
- G16H40/20—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms
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- G—PHYSICS
- G06—COMPUTING; CALCULATING OR COUNTING
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- G—PHYSICS
- G06—COMPUTING; CALCULATING OR COUNTING
- G06Q—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
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Abstract
The invention discloses a system of a DRG/DIP group-entering method of inpatients based on clinical decision support, which relates to the technical field of information and comprises the following steps of automatically acquiring main diagnosis of the patients in the stage of the patients just admitted, and actively popping up a mode pop-up prompt box; the system is embedded into a doctor workstation, seamlessly interacts with the workstation and reminds in real time; based on clinical decision capability, the current patient prime diagnosis examination, medication, treatment, complications and complications options are promoted, and the patients can be put into a group after the examination; the main diagnosis automatically acquired by the system can be modified, so that incorrect group entering of the diagnosis is avoided; the background automatically carries out ICD code conversion of medical insurance version when the current HIS diagnosis is put into a group, and carries out CHS-DRG grouping prompt; the system adopting the DRG/DIP group-entering method of the inpatients based on clinical decision support is tightly integrated with the clinical decision support through the bottom knowledge base and the medical map support, so that a more reasonable treatment scheme is provided for doctors, and the clinical medical quality is improved.
Description
Technical Field
The invention relates to the technical field of information, in particular to a system of a DRG/DIP group entering method of inpatients based on clinical decision support.
Background
After adopting the DRG/DIP payment mode, hospitals face the risk of policy hyperbranched of packaging payment of the DRG/DIP disease group of medical insurance patients. Therefore, a general hospital needs to perform simulation pre-grouping analysis on medical insurance patient data before uploading the medical insurance bureau so as to know the medical record grouping situation, analyze the difference between the hospitalization cost of the patient and the DRG/DIP group payment standard, and judge the hyperbranched balance situation of the medical record. If the patient is in high-rate or low-rate cases, patient hospitalization data are analyzed to find the reasons of the differences.
In general, when the DRG/DIP analog group entering of the medical records is carried out, the pre-grouping analysis is carried out based on the first page of the medical records of the patient discharged from the hospital or based on the first page of the medical records at the doctor end, the patient is subjected to hospitalization, the actual cost condition of the patient is determined, the pre-grouping analysis is carried out, if the medical records are defect medical records, the actual cost of the patient can not be controlled, and the defect is irrecoverable; and moreover, the clinical in-process management and control of the DRG/DIP group entering is performed based on patient admission, so that the political hyperbranched is avoided, the clinical medical quality is improved, and the medical resource waste is avoided.
Accordingly, there is a need to provide a system for a DRG/DIP approach to hospitalization patients based on clinical decision support that addresses the above-described issues.
Disclosure of Invention
The invention aims to provide a system of a DRG/DIP group-entering method of inpatients based on clinical decision support, which is tightly fused with the clinical decision support through a bottom knowledge base and a medical map support, provides a more reasonable treatment scheme for doctors and improves the clinical medical quality.
To achieve the above object, the present invention provides a system for a DRG/DIP group-entering method for inpatients based on clinical decision support, comprising the steps of:
s1: the doctor workstation automatically starts the DRG/DIP group-entering management plug-in container through the interface, switches the patient to enter the doctor's advice-making interface, and automatically triggers the group-entering management plug-in system;
s2: the system automatically acquires the admission diagnosis of the patient who is just admitted, automatically pops up a prompt box at the lower right corner of a doctor workstation page, displays main diagnosis information of the current patient, comprises HIS version ICD codes, and displays a clinical path instruction of the current main diagnosis;
s3: the system acquires symptom information of the first stage of patient admission, prompts a doctor to give a relevant possibility sequence according to the probability of symptoms and diagnosis to the current patient;
s4: entering a scheme group entering interface according to the determined main diagnosis, wherein the scheme group entering interface comprises clinical path buttons corresponding to the past hospitalization information, the active diagnosis of the hospitalization of the patient and the main diagnosis;
s5: the patient active diagnostic interface includes an examination protocol, a test protocol, a medication protocol, a treatment protocol, complications and complications options;
s6: according to the examination, medication, treatment, complications and complications options selected by the doctor, clicking a grouping button, displaying the diagnosis and treatment scheme of the current patient based on the main diagnosis, entering the DRG/DIP disease group, and displaying the name, weight and payment standard of the disease group entering the disease group currently.
Preferably, the system embeds a clinical knowledge base and builds a medical knowledge graph based on the medical knowledge base.
Preferably, the medical terms supported by clinical decision are translated into standard clinical ICD codes for underlying control, and are again converted into medical ICD codes for analog grouping.
Preferably, the bottom layer is provided with a DRG/DIP grouping subsystem, and the DRG/DIP grouping subsystem comprises a DRG grouping device and a DIP grouping directory which are automatically matched with a local municipal medical insurance grouping scheme.
Therefore, the system adopting the DRG/DIP group entering method for inpatients based on clinical decision support has the following beneficial effects:
(1) According to the invention, doctors do not need to pay attention to DRG/DIP grouping logic, main diagnosis of the patient is automatically acquired in the stage of the patient's admission, the prompt box is popped up in an active pop-up mode, the system is embedded into a doctor workstation, the system is in seamless interaction with the workstation, real-time reminding is carried out, and the doctor can put more energy into treatment for the patient.
(2) The invention is tightly fused with clinical decision support through the bottom knowledge base and the medical map support, provides a more reasonable treatment scheme for doctors, and improves the clinical medical quality.
(3) The invention carries out group administration by the diagnosis of the patient just admitted, so that doctors reasonably control the budget of the sick group according to the payment standard, the economic loss caused by the sick group hyperbranched to hospitals is avoided, the medical resource waste is avoided, the medical burden of common people is reduced, the use efficiency of the medical insurance foundation is improved, and the satisfaction degree of the doctor and the patient is improved.
(4) The invention automatically carries out ICD code conversion of medical insurance version and CHS-DRG grouping prompt in the background when the HIS diagnosis is put into the group.
The technical scheme of the invention is further described in detail through the drawings and the embodiments.
Drawings
FIG. 1 is a schematic workflow diagram of a system of a DRG/DIP group entry method for hospitalized patients based on clinical decision support of the present invention;
FIG. 2 is a schematic diagram of the clinical decision support capability of a system of the DRG/DIP group approach of inpatients based on clinical decision support of the present invention;
FIG. 3 is a schematic diagram of a prompt box pop-up of an embodiment of a system for a DRG/DIP group approach for hospitalized patients based on clinical decision support in accordance with the present invention;
FIG. 4 is a diagram of the acquisition of patient admission symptom information for an embodiment of a system for a DRG/DIP group entry method for hospitalized patients based on clinical decision support in accordance with the present invention;
FIG. 5 is a flowchart of the test item operation of a system embodiment of a hospital stay DRG/DIP group approach based on clinical decision support of the present invention;
FIG. 6 is a diagnostically presented plan view of a system embodiment of a hospitalized patient DRG/DIP grouping method based on clinical decision support in accordance with the present invention;
fig. 7 is an active diagnostic interface of a system embodiment of a hospitalized patient DRG/DIP approach based on clinical decision support of the present invention.
Detailed Description
The technical scheme of the invention is further described below through the attached drawings and the embodiments.
Unless defined otherwise, technical or scientific terms used herein should be given the ordinary meaning as understood by one of ordinary skill in the art to which this invention belongs. The terms "first," "second," and the like, as used herein, do not denote any order, quantity, or importance, but rather are used to distinguish one element from another. The word "comprising" or "comprises", and the like, means that elements or items preceding the word are included in the element or item listed after the word and equivalents thereof, but does not exclude other elements or items. The terms "connected" or "connected," and the like, are not limited to physical or mechanical connections, but may include electrical connections, whether direct or indirect. "upper", "lower", "left", "right", etc. are used merely to indicate relative positional relationships, which may also be changed when the absolute position of the object to be described is changed.
Examples
As shown in fig. 1-2, the present invention provides a system for a DRG/DIP group approach for inpatients based on clinical decision support, comprising the steps of:
s1: the doctor workstation automatically starts the DRG/DIP group-entering management plug-in container through the interface, switches the patient to enter the doctor's advice-making interface, and automatically triggers the group-entering management plug-in system;
s2: the system automatically acquires the admission diagnosis of the patient who is just admitted, and automatically pops up a prompt box at the lower right corner of a doctor workstation page, as shown in fig. 3, displays main diagnosis information of the current patient, including HIS version ICD codes, and displays a clinical path specification of the current main diagnosis; the function is based on the medical knowledge base built in the program bottom layer, and comprises clinical path specification information. The instruction book is structured, and the content of the display response can be automatically switched according to the navigation bar. Through the bottom knowledge base and the medical map support, the medical treatment support is tightly fused with the clinical decision support, so that a more reasonable treatment scheme is provided for doctors, and the clinical medical quality is improved.
S3: as shown in fig. 4-7, the system acquires symptom information of the first stage of patient admission, prompts the doctor that the current patient gives a ranking of relevant possibilities according to the probability of symptoms and diagnosis; the doctor can also judge whether to modify the main diagnosis according to the differential diagnosis knowledge prompted by the system. If a possible diagnosis of the prompt is "selected", the main diagnosis of the page becomes the diagnosis of "selected", and the corresponding clinical path changes accordingly.
S4: entering a scheme group entering interface according to the determined main diagnosis, wherein the scheme group entering interface comprises clinical path buttons corresponding to the past hospitalization information, the active diagnosis of the hospitalization of the patient and the main diagnosis; the active diagnostic interface information may be modified and clicking on the clinical path may access the details page.
S5: the patient active diagnostic interface includes an examination protocol, a test protocol, a medication protocol, a treatment protocol, complications and complications options; the treatment regimen includes a surgical name and an operational name.
S6: according to the examination, medication, treatment, complications and complications options selected by the doctor, clicking a grouping button, displaying the diagnosis and treatment scheme of the current patient based on the main diagnosis, entering the DRG/DIP disease group, and displaying the name, weight and payment standard of the disease group entering the disease group currently. Group administration of admitted patients based on prime diagnosis and clinical decision support is completed. The complications and complications of the system prompt have the reminding of the disease severity, and for the complications or complications of different star grades, the complications and complications influence the entering of the disease group into the DRGs fine group and the auxiliary directory of the DIP.
The system embeds a clinical medical knowledge base and builds a medical knowledge graph based on the medical knowledge base.
The medical terms of clinical decision support are translated into standard clinical ICD codes for bottom comparison, and are again converted into medical insurance ICD codes for analog grouping. The patient is just admitted to the hospital and diagnosed and is managed into groups, so that doctors reasonably control the budget of the groups according to the payment standard, economic losses caused by hyperbranched of the groups to hospitals are avoided, medical resource waste is avoided, the medical burden of common people is reduced, the use efficiency of medical insurance funds is improved, and the satisfaction degree of three parties of medical insurance is improved.
The bottom layer is provided with a DRG/DIP grouping subsystem, and the DRG/DIP grouping subsystem comprises a DRG grouping device and a DIP grouping directory which are automatically matched with a local municipal medical insurance grouping scheme. After the patient is put into the group, the system can manually adjust the group and automatically remind the patient group to be switched according to the diagnosis and operation information modified by the doctor.
Therefore, the system adopting the DRG/DIP group-entering method for inpatients based on clinical decision support does not need doctors to pay attention to DRG/DIP grouping logic, main diagnosis of the patients is automatically acquired in the stage of the patients just admitted, and the system is embedded into a doctor workstation, seamlessly interacts with the workstation, reminds in real time, and enables the doctor to put more energy into treatment for the patients. Through the support of the bottom knowledge base and the medical atlas, the medical atlas is tightly fused with clinical decision support, a more reasonable treatment scheme is provided for doctors, the clinical medical quality is improved, the patient is just admitted to the hospital for diagnosis to carry out group administration, the doctors reasonably control the disease group budget according to the payment standard, the economic loss caused by the disease group hyperbranched to hospitals is avoided, the medical resource waste is avoided, the medical burden of common people is reduced, the use efficiency of medical insurance funds is improved, and the satisfaction degree of three doctor-insurance parties is improved.
Finally, it should be noted that: the above embodiments are only for illustrating the technical solution of the present invention and not for limiting it, and although the present invention has been described in detail with reference to the preferred embodiments, it will be understood by those skilled in the art that: the technical scheme of the invention can be modified or replaced by the same, and the modified technical scheme cannot deviate from the spirit and scope of the technical scheme of the invention.
Claims (4)
1. A system of hospitalized patient DRG/DIP group entry method based on clinical decision support, characterized in that: the method comprises the following steps:
s1: the doctor workstation automatically starts the DRG/DIP group-entering management plug-in container through the interface, switches the patient to enter the doctor's advice-making interface, and automatically triggers the group-entering management plug-in system;
s2: the system automatically acquires the admission diagnosis of the patient who is just admitted, automatically pops up a prompt box at the lower right corner of a doctor workstation page, displays main diagnosis information of the current patient, comprises HIS version ICD codes, and displays a clinical path instruction of the current main diagnosis;
s3: the system acquires symptom information of the first stage of patient admission, prompts a doctor to give a relevant possibility sequence according to the probability of symptoms and diagnosis to the current patient;
s4: entering a scheme group entering interface according to the determined main diagnosis, wherein the scheme group entering interface comprises clinical path buttons corresponding to the past hospitalization information, the active diagnosis of the hospitalization of the patient and the main diagnosis;
s5: the patient active diagnostic interface includes an examination protocol, a test protocol, a medication protocol, a treatment protocol, complications and complications options;
s6: according to the examination, medication, treatment, complications and complications options selected by the doctor, clicking a grouping button, displaying the diagnosis and treatment scheme of the current patient based on the main diagnosis, entering the DRG/DIP disease group, and displaying the name, weight and payment standard of the disease group entering the disease group currently.
2. A system for clinical decision support based hospitalization DRG/DIP method as claimed in claim 1, wherein: the system embeds a clinical medical knowledge base and builds a medical knowledge graph based on the medical knowledge base.
3. A system for clinical decision support based hospitalization DRG/DIP method as claimed in claim 1, wherein: the medical terms of clinical decision support are translated into standard clinical ICD codes for bottom comparison, and are again converted into medical insurance ICD codes for analog grouping.
4. A system for clinical decision support based hospitalized patient DRG/DIP method as claimed in claim 3, wherein: the bottom layer is provided with a DRG/DIP grouping subsystem, and the DRG/DIP grouping subsystem comprises a DRG grouping device and a DIP grouping directory which are automatically matched with a local municipal medical insurance grouping scheme.
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202310694801.1A CN116798581A (en) | 2023-06-13 | 2023-06-13 | System of DRG/DIP grouping method for inpatients based on clinical decision support |
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| Application Number | Priority Date | Filing Date | Title |
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| CN202310694801.1A CN116798581A (en) | 2023-06-13 | 2023-06-13 | System of DRG/DIP grouping method for inpatients based on clinical decision support |
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Citations (8)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US4667292A (en) * | 1984-02-16 | 1987-05-19 | Iameter Incorporated | Medical reimbursement computer system |
| CN112686684A (en) * | 2020-12-08 | 2021-04-20 | 望海康信(北京)科技股份公司 | Medical expense management system and corresponding equipment and storage medium |
| CN113921124A (en) * | 2021-10-12 | 2022-01-11 | 曹庆恒 | Medical expense management method and system |
| CN115099847A (en) * | 2022-06-17 | 2022-09-23 | 云知声智能科技股份有限公司 | Hospital cost control method and device, electronic equipment and storage medium |
| CN115346647A (en) * | 2022-07-26 | 2022-11-15 | 杭州吉音医疗科技有限公司 | Intelligent DIP clinical path planning management information method and system |
| CN115458138A (en) * | 2022-09-06 | 2022-12-09 | 云知声智能科技股份有限公司 | DIP pre-grouping recommendation method, device, equipment and storage medium |
| CN115482921A (en) * | 2022-08-01 | 2022-12-16 | 杭州吉音医疗科技有限公司 | Modeled DRGs clinical path planning management information system and method |
| CN115512829A (en) * | 2022-09-21 | 2022-12-23 | 华中科技大学同济医学院附属同济医院 | Method, device and medium for acquiring disease diagnosis related group |
-
2023
- 2023-06-13 CN CN202310694801.1A patent/CN116798581A/en active Pending
Patent Citations (8)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US4667292A (en) * | 1984-02-16 | 1987-05-19 | Iameter Incorporated | Medical reimbursement computer system |
| CN112686684A (en) * | 2020-12-08 | 2021-04-20 | 望海康信(北京)科技股份公司 | Medical expense management system and corresponding equipment and storage medium |
| CN113921124A (en) * | 2021-10-12 | 2022-01-11 | 曹庆恒 | Medical expense management method and system |
| CN115099847A (en) * | 2022-06-17 | 2022-09-23 | 云知声智能科技股份有限公司 | Hospital cost control method and device, electronic equipment and storage medium |
| CN115346647A (en) * | 2022-07-26 | 2022-11-15 | 杭州吉音医疗科技有限公司 | Intelligent DIP clinical path planning management information method and system |
| CN115482921A (en) * | 2022-08-01 | 2022-12-16 | 杭州吉音医疗科技有限公司 | Modeled DRGs clinical path planning management information system and method |
| CN115458138A (en) * | 2022-09-06 | 2022-12-09 | 云知声智能科技股份有限公司 | DIP pre-grouping recommendation method, device, equipment and storage medium |
| CN115512829A (en) * | 2022-09-21 | 2022-12-23 | 华中科技大学同济医学院附属同济医院 | Method, device and medium for acquiring disease diagnosis related group |
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