Drug unified coding rule management method and code identifier taking medical insurance payment as core

Abstract

The invention relates to a drug unified coding rule management method and a code identifier taking medical insurance payment as a core. Medical insurance payment service attribute information is comprised; the problem that one code is multipurpose is solved; on one hand, medical insurance codes are put forward, and medical insurance coding and approving requirements can be met in a code generationprocess; and on the other hand, a mode of performing pushing by a system and automatically adjusting code information is adopted, data expression standards are unified, a standard dosage form codingsystem, a specification expression model which can be refined and split, four-layer pharmacological classification refined layer by layer according to pharmacological effects, and market access information associated all the time crate a basic condition for drug grouping and price comparison, and a current medical insurance settlement service is satisfied. The invention provides the handheld wireless code identifier. A drugstore and a consumer can use the identifier to scan a drug barcode on a drug package, so that basic information of a drug can be viewed through a display screen embedded ina handle, and whether the drug is applicable or not can be judged conveniently.

Description

technical field [0001] The invention belongs to the technical field of information processing, and in particular relates to a drug uniform coding rule, a management method and a code recognizer with medical insurance payment as the core. Background technique [0002] With the advancement of the national medical insurance reform, the joint procurement of drugs, drug transactions, and medical insurance payment are becoming more and more closely related, and data exchanges between different systems are frequent. A general-purpose system that can meet the entire process of drug circulation and meet the needs of various departments of medical insurance Coding method for managing requirements. However, the drug standard code issued by the State Food and Drug Administration in 2009 mainly meets the needs of drug production management and circulation, and lacks an effective coding system to support the organization of effective drug management by provincial medical insurance departm...

AI Technical Summary

Problems solved by technology

The existing drug codes cannot achieve timely and effective traceability of all links in the whole process, and cannot meet the needs of comprehensive supervision of business data in all systems (circulation supervision, use supervision, medical insurance reimbursement supervision, etc.), and the content of information adjustments cannot be updated and released in a timely manner. The implementation progress of the area cannot be unified, causing the following problems to exist for a long time:

[0003] 1. The current coding system does not judge the uniqueness of enterprises / products: in the existing codes, there are multiple codes for one factory, multiple codes for one drug, and multiple uses for one code position

[0004] 2. The coding of each business department and system is not unified: At present, the coding of each system is not unified, and it is impossible to achieve timely and effective traceability of all links in the whole process, and timely update and release of content that needs to be adjusted

[0005] 3. The current drug coding cannot support the principle of four universals and three categories: four universals (requiring independent coding of generic name, generic dosage form, generic specifications, and generic packaging and supporting policy rules), and three categories (treatment, nutrition, auxiliary) are not applied Drug selection and pricing decisions

[0006] 4. The current business process cannot take into account the needs of various departments: medicinal collection and medical institution transactions expect the adjustment information to be updated from time to time; the settlement terminal of the medical insurance center involves multi-system data interaction, and it is expected to regularly specify a certain time for multi-system maintenance before execution

The current business process spans many departments for a long time, and further timeliness specification requirements have not been formed in the process of exploration and coordination

[0007] 5. Multi-department letter communication is required, and the medical insurance code is manually maintained: According to the existing coding business process, each change of the drug medical insurance code is issued through the province, and manual maintenance is performed twice in various places. Each update costs the province and the land A lot of energy from relevant people in the city

[0008] The source of the above-mentioned problems can be traced back to the inconsistency in the naming of various drugs in different management or query systems about pharmaceutical products, and the inability to communicate directly between various systems, which brings great pressure to the management and query of the entire pharmaceutical industry. There are great limitations, resulting in the lack of unified coding rules for drug procurement informatization centered on medical insurance payment and settlement, and the inability to realize whole-process supervision

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