KR20170008444A - System for medical data collection and management, and method using the same - Google Patents
System for medical data collection and management, and method using the same Download PDFInfo
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- KR20170008444A KR20170008444A KR1020150099629A KR20150099629A KR20170008444A KR 20170008444 A KR20170008444 A KR 20170008444A KR 1020150099629 A KR1020150099629 A KR 1020150099629A KR 20150099629 A KR20150099629 A KR 20150099629A KR 20170008444 A KR20170008444 A KR 20170008444A
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Abstract
Description
More particularly, the present invention relates to a medical data collection management system, and more particularly, to a medical data collection management system that collects medical data of a medical termination process from a medical treatment start stage to an ending stage of a patient, The present invention relates to a medical care data collection management system that is constructed so that the billing institution can verify the billing data requested by the billing institution to the examination institution and use the same for medical treatment related business processing, and a method for managing the collection of medical care data using the same.
The health insurance system is intended to improve public health and promote social security by providing insurance benefits for prevention, diagnosis, treatment, rehabilitation, birth, death and health promotion of people's diseases and injuries. , A pharmacy, and a health checkup institution, the patient pays a certain amount of money to the claimant in accordance with the details set by the corporation after the patient's treatment.
The claimant who has treated the patient submits the data of the charge for the fee for medical treatment to the examination institution (for example, the health insurance assessment and assessment agency) in order to charge the hospital for the fee.
However, the medical care data for requesting medical treatment at the claimant may be prepared by using the point that the patient who is not a specialist does not know and the point which is requested after the medical care is finished. For example, the method of manipulation is a false claim, a false request (surgery, medical examination, examination), a false claim, a double bill for medical care, and the like. The patient may pay the manipulated fee at the point of care, or the manipulated fee billing data may be submitted to the reviewing institution without the patient knowing. Therefore, since the patient does not know the contents of the claim, the patient can pay the expenses that the patient may not pay, and the second problem is that when the claimant charges the examination fee to the examination institution, There is a problem in that the medical treatment expenses are unnecessarily spent in the industrial complex.
In particular, the core task of the review organization is the examination of the professional data such as the medical record, specifically the examination of the professional data to analyze the quality of the medical service such as the appropriate medical treatment, necessary excessive medical treatment, unnecessary excessive medical treatment, In addition, the general data related to the medical expenses should be verified with the examination. However, if the general data examination can not be properly conducted due to the examination that does not know the medical field, the professional data (treatment history, prescription history, etc.) And the manipulated professional data can pass the examination. Furthermore, since the professional data manipulated by the claimant is difficult to verify and the due date for the payment of the medical fee has been set, there is a problem that the examination is terminated without finding the manipulated data.
Also, there is a problem that it is impossible to examine an enormous amount of bills in detail on a daily basis.
As the principle is that the corporation pays the payment within the payment period, it is inevitable for the examination institution to pay the bill to the billing institution according to the result of the examination after the examination has been completed, and the unfairly expended medical expenses can not be reissued and re- There is a problem that can not be recovered except for costs.
The present invention, which has been devised in view of the above-described circumstances, is a system for collecting billing data for medical expenses after a patient's medical treatment has been completed in a billing institution in the past, for example, in outpatient treatment, during admission, during discharge, In the process of submitting to the reviewing organization, problems such as the alteration and manipulation of the data may occur in this process, problems such as neglect of examination by the reviewing organization, problems that the claims can not be examined accurately on a case-by-case basis, In order to solve the problem that is not solved, it is necessary to omit or simplify the examination of the micro-medical expenses by the report of the patient, to reduce the examination work volume of the examination body, to concentrate on the examination data of the medical examination data, We set up an industrial complex server in the complex, The collected medical data is compared with the medical data of the billing fee of the billing institution, and the medical data collection management system can be used for the medical bill examination processing related business and the medical data collection management method using the same And the like.
Another object of the present invention is to provide a health care data collection management system that enables healthcare servers and patient data to be exchanged with healthcare servers so that important infectious disease patients can be managed and tracked as healthcare data is continuously collected by satinservers, And a method for managing and collecting medical data using the same.
The technical objects of the present invention are not limited to the technical matters mentioned above, and other technical subjects not mentioned can be clearly understood by those skilled in the art from the following description.
Hereinafter, specific means for achieving the object of the present invention will be described.
According to another aspect of the present invention, there is provided a medical data collection and management system comprising: a satin card for storing patient information for confirming and updating medical data of a claimant including a clinic and a pharmacy; A satin terminal installed in the claimant to generate and inquire medical data of the patient using the patient information of the satin card and transmit the medical data to the satin server when requested by external input; A satin server for receiving and storing the consultation data from the satin terminal; .
A satin card reader installed in the billing institution and receiving the patient information by communication with the satin card and providing the same to the satin terminal; Further comprising a verification server for receiving the medical care data from the complex server for comparison verification of the medical care data, wherein the medical care data includes a request for updating of the medical care data from the visit of the claimant to the end of medical care, The updated clinical data is automatically and periodically transmitted to at least one of the satin server, the verification server, and the examination institution server.
In the above, the medical care data includes a billing institution designation number, a health insurance member number, a medical care course designated by the corporation, a designation number corresponding to a medical care course, a use time by a designated number of a medical care center, a use date, .
According to another aspect of the present invention, there is provided a medical data collection management system comprising: a terminal for transmitting medical treatment data of a patient having a serious epidemic disease to a health authority server; A health authority server for receiving medical treatment data corresponding to the critical infectious disease patient from the complex server and requesting the complex server to track the patient's behavior based on the medical care data; And a satellites server for checking the patient information corresponding to the medical care data transmitted from the health authority server from the DB server and searching the medical care data of the patient contactors including the patient guardian.
In the above, it is preferable that the information processing apparatus further comprises: an information processing unit that receives the patient information and the treatment data from the satin server and requests tracking of the patient's action, and transmits a tracking result of the patient based on the patient information and the treatment data, And a server.
According to another aspect of the present invention, there is provided a method for collecting medical data, the medical data collecting system including a satin server for receiving medical data from an ATM terminal installed in a billing institution including a clinic and a pharmacy, A method for collecting and managing medical data using a medical card, the method comprising the steps of: connecting to a satin card reader installed in the claiming institution with a card owned by the patient; Checking and generating the patient's medical care data through the public terminal connected to the industrial card reader with the industrial card owned by the patient and transmitting the data to the industrial server; Transmitting the medical care data to the satin server through an Internet network; The satin server receiving the medical care data and transmitting the medical care data to the validation server and requesting the verification; And verifying whether or not the operation data is manipulated by comparing the operation data received from the terminal with the verification data transmitted from the examination authority server installed in the examination institution.
In the above, the medical care data includes a billing institution designation number, a health insurance member number, a medical care course designated by the corporation, a designation number corresponding to a medical care course, a use time by a designated number of a medical care center, a use date, Wherein the medical data collection management method comprises the steps of:
According to another aspect of the present invention, there is provided a method for collecting and managing medical data, the method comprising the steps of: receiving medical data from a medical terminal, A method of collecting and managing medical care data using a system, the method comprising: storing medical treatment data including medical treatment details of a patient having major epidemics in the terminal, and transmitting the medical treatment data to a healthcare authority server through an Internet network; The health authority server confirms the patient information using the transmitted diagnosis data, and transmits the confirmed diagnosis data and the patient information to the complex server; Checking the patient's medical care data stored in the DB server using the medical care data and the patient information transmitted from the satin server; And the satin server includes a step of searching for a line item of the infectious disease patient and the patient contact person in association with the search server.
As described above, according to the present invention, since preliminary verification of the general medical care data and the medical care professional data is performed by using the medical care data collection management system separately constructed in the industrial complex, And it is effective to prevent the misjudgment that may occur due to the inability to accurately verify the contents.
As another effect, it is possible to compare the medical data charged to the examination institution by using the general data of the patient continuously collected in the medical treatment process of the patient, and to provide the examination data to the examination institution, In addition to providing the accurate patient care process and contents for the examination of the medical expenses, the Korean government can increase the reliability of the medical expenses expenditure and facilitate the management after the expenditure.
Another effect is that if the medical fee data reported by the patient and the medical fee data claimed by the claimant are identical among the general data set by the corporation and the medical expenses are small, the examination fee will be omitted, There is a shrinking effect.
Another effect is that the general health care data from the major epidemic patients continues to be collected from the health authorities 'servers and satellites' servers, so that important infectious disease patients can be managed and tracked so that the spread of important epidemics can be prevented, There is an effect that it can be facilitated.
BRIEF DESCRIPTION OF THE DRAWINGS The accompanying drawings, which are included to provide a further understanding of the invention and are incorporated in and constitute a part of this application, illustrate preferred embodiments of the invention and, together with the description, And shall not be interpreted.
1 is a block diagram showing a configuration of a medical care data collection management system according to a first embodiment of the present invention.
2 is a block diagram showing a configuration of a medical care data collection management system according to a second embodiment of the present invention.
FIG. 3 is a flowchart illustrating a process of a method for collecting and managing medical data according to a first embodiment of the present invention.
FIG. 4 is a flowchart illustrating a process of a method for collecting and managing medical data according to a second embodiment of the present invention.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Hereinafter, embodiments of the present invention will be described in detail with reference to the accompanying drawings. In the following detailed description of the operation principle of the preferred embodiment of the present invention, a detailed description of known functions and configurations incorporated herein will be omitted when it may unnecessarily obscure the subject matter of the present invention.
The same reference numerals are used for portions having similar functions and functions throughout the drawings. Throughout the specification, when a part is connected to another part, it includes not only a case where it is directly connected but also a case where the other part is indirectly connected with another part in between. In addition, the inclusion of an element does not exclude other elements, but may include other elements, unless specifically stated otherwise.
1 is a block diagram showing a configuration of a medical care data collection management system according to a first embodiment of the present invention.
1, the medical care data collection management system according to the first embodiment of the present invention includes a
The
Specifically, the functions of the
The
In addition, the
Here, the patient information may include, for example, a health insurance subscriber number, a patient personal information, and the like.
The
The
Here, the medical care data can be classified into general medical care data and specialized medical data. In the general medical care data, for example, in case of a hospital, a billing institution designation number, a health insurance member number, a medical care subject designated by the corporation, The use time, the use date, the period of use, and the total amount of the medical expenses. Even in the case of pharmacies and health check-ups, the general data of care may include information such as general data of care for a medical institution, and may include pharmaceutical preparations and prescriptions. Professional data is specialized data that requires medical knowledge such as medical records. In the present invention, the medical care data transmitted to the satin server can be transmitted to the
Furthermore, in consideration of convenience of the
The
The
The
The
FIG. 2 is a block diagram showing a configuration of a medical data collection and management system of a major infectious disease patient according to a second embodiment of the present invention.
The medical care data collection system according to the second embodiment of the present invention may include a
The
In order to manage the epidemic disease, the medical care data of the contact person corresponding to the patient, the protector who has contacted the patient, the patient who was in the same place at the time of the patient's treatment or the patient's caregiver is collected and stored by the
The
Further, the
In addition, the
The
FIG. 3 is a flowchart illustrating a process of a method for collecting and managing medical data according to a first embodiment of the present invention.
First, the
The
The
In addition, the
The general medical care data updated via the
The
Furthermore, in the
If the comparison and verification are performed in step S110, the determination result may be transmitted to the
4 is a flowchart illustrating a method of collecting medical data according to a second embodiment of the present invention.
First, the
The
The
Also, the
As described above, those skilled in the art will appreciate that the present invention may be embodied in other specific forms without departing from the spirit or essential characteristics thereof. It is therefore to be understood that the above-described embodiments are to be considered in all respects only as illustrative and not restrictive. The scope of the present invention is defined by the appended claims rather than the detailed description, and all changes or modifications derived from the meaning and scope of the claims and their equivalents should be construed as being included in the scope of the present invention.
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Claims (10)
A satin terminal installed in the claimant to generate and inquire medical data of the patient using the patient information of the satin card and transmit the medical data to the satin server when requested by external input; And
And a satin server for receiving and storing the medical care data from the medical terminal.
A satin card reader installed in the billing institution and receiving the patient information by communication with the satin card and providing the same to the satin terminal; And
And a verification server for receiving the consultation data from the complex server for comparison verification of the consultation data,
Wherein the medical care data is periodically updated and stored in the medical terminal when the medical care data is requested to be updated by use of the medical card from the visit of the claimant to the end of the medical treatment, And the updated medical care data is periodically transmitted to at least one of the medical care data collection management system and the medical care data collection management system.
And the total amount of the medical expenses. The medical treatment data includes a billing institution designation number, a health insurance member number, a medical care course designated by the corporation, a medical care section designation number corresponding to a medical care course, Collection management system.
A health authority server for receiving medical treatment data corresponding to the critical infectious disease patient from the complex server and requesting the complex server to track the patient's behavior based on the medical care data; And
And a satin server that confirms the patient information corresponding to the medical care data transmitted from the health authority server from the DB server and retrieves the medical care data of the patient contactors including the patient's caregiver.
And the total amount of the medical expenses. The medical treatment data includes a billing institution designation number, a health insurance member number, a medical care course designated by the corporation, a medical care section designation number corresponding to a medical care course, Collection management system.
And an inquiry institution server which receives the patient information and the treatment data from the satin server and receives a request for tracking the patient's behavior and transmits a result of tracking the patient based on the patient information and the treatment data to the complex server And a medical data collection management system.
Connecting to a satin card reader installed in the claiming institution with a satin card owned by the patient;
Checking and generating the patient's medical care data through the public terminal connected to the industrial card reader with the industrial card owned by the patient and transmitting the data to the industrial server;
Transmitting the medical care data to the satin server through an Internet network;
The satin server receiving the medical care data and transmitting the medical care data to the validation server and requesting the verification; And
And verifying whether or not the operation data is manipulated by comparing the operation data received from the public terminal with the operation data transmitted from the examination agency server installed in the examination institution.
And the total amount of the medical expenses. The medical treatment data includes a billing institution designation number, a health insurance member number, a medical care course designated by the corporation, a medical care section designation number corresponding to a medical care course, Collection management method.
Storing the medical care data including the general medical care details of the important epidemic patients in the terminal, and transmitting the medical care data to the health authority server through the Internet network;
The health authority server confirms the patient information using the transmitted diagnosis data, and transmits the confirmed diagnosis data and the patient information to the complex server;
Checking the patient's medical care data stored in the DB server using the medical care data and the patient information transmitted from the satin server; And
And the satin server retrieves the epidemic disease patient and the contact of the patient contact in association with the search server.
And the total amount of the medical expenses. The medical treatment data includes a billing institution designation number, a health insurance member number, a medical care course designated by the corporation, a medical care section designation number corresponding to a medical care course, Collection management method.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| KR1020150099629A KR20170008444A (en) | 2015-07-14 | 2015-07-14 | System for medical data collection and management, and method using the same |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| KR1020150099629A KR20170008444A (en) | 2015-07-14 | 2015-07-14 | System for medical data collection and management, and method using the same |
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| Publication Number | Publication Date |
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| KR20170008444A true KR20170008444A (en) | 2017-01-24 |
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| Application Number | Title | Priority Date | Filing Date |
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| KR1020150099629A KR20170008444A (en) | 2015-07-14 | 2015-07-14 | System for medical data collection and management, and method using the same |
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| KR (1) | KR20170008444A (en) |
Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2019164284A1 (en) * | 2018-02-23 | 2019-08-29 | 주식회사 라인웍스 | Method for learning and device for reviewing insurance review claim statement on basis of deep neural network |
| KR20230021232A (en) * | 2021-08-05 | 2023-02-14 | 주식회사 에이치엠씨네트웍스 | Apparatus and method for processing a paymnet |
-
2015
- 2015-07-14 KR KR1020150099629A patent/KR20170008444A/en not_active Application Discontinuation
Cited By (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2019164284A1 (en) * | 2018-02-23 | 2019-08-29 | 주식회사 라인웍스 | Method for learning and device for reviewing insurance review claim statement on basis of deep neural network |
| US11501381B2 (en) | 2018-02-23 | 2022-11-15 | Linewalks Inc. | Method for learning and device for reviewing insurance review claim statement on basis of deep neural network |
| KR20230021232A (en) * | 2021-08-05 | 2023-02-14 | 주식회사 에이치엠씨네트웍스 | Apparatus and method for processing a paymnet |
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