Intelligent hemodialysis outpatient medical insurance fee control method and device and computer system

Abstract

The invention discloses an intelligent hemodialysis outpatient medical insurance fee control method and device and a computer system. The method comprises the following steps: acquiring cost data of a patient: acquiring hospitalization and outpatient dialysis cost generated by the patient from a hospital HIS (hospital information system), and acquiring the fee deduction condition of the patient in each treatment from a hemodialysis information management system; classifying the cost data according to charging item characteristics, and classifying the costs of hemodialysis, blood perfusion and hemodiafiltration respectively; classifying the classified cost to each patient according to the cost generation time, the name of the patient and the identity card number, and respectively counting the number of hemodialysis times, the number of blood perfusion times and the number of hemodialysis filtration times according to the number of the dialysis treatment cost of the patient; the current cost and times of hemodialysis, blood perfusion and hemodialysis filtration of the patient and the remaining times of the current month and / or the current year are transmitted to a cloud server; the patient and the medical staff obtain the number of dialysis times per month and each year of the patient and the cost of each dialysis from the server.

Description

Technical Field

[0001] The present invention relates to an intelligent medical insurance cost control method, device and computer system for hemodialysis outpatient patients applied in blood purification diagnosis and treatment. Background Art

[0002] The current method for outpatient hemodialysis patient expense management is (taking Wuhan as an example): patients go to the outpatient clinic to ask the attending doctor for a dialysis treatment order, which is issued once every half month, but the total number of times does not exceed 13 times / month. The head nurse writes a list of the paid fees and pastes it on the medical record, or enters it into the hemodialysis information management system, and deducts the fees according to the patient's actual treatment situation each time.

[0003] The current cost management methods for outpatient hemodialysis patients have the following shortcomings: it is impossible to accurately and intelligently count the number of dialysis sessions reimbursed by medical insurance for each patient each month and year, and there is a possibility of over-limit; when a patient's condition changes and he needs to be hospitalized, the number of dialysis sessions incurred during the hospitalization period should also be included in the total number of times for that month, but the existing cost management solutions cannot intelligently identify and count them; there is no intelligent reminder when the number of dialysis sessions exceeds the limit, resulting in a large number of over-limit total times at the end of the year; there is a lack of a communication platform between medical staff and patients, and it is currently impossible to achieve real-time communication and management of costs through an intelligent platform; traditional cost management methods may also result in incorrect deductions and omissions, and medical staff and patients may not be able to detect errors and correct them in time, resulting in unnecessary conflicts; the intelligent platform cannot be used to save medical time costs. Summary of the invention

[0004] The present invention proposes an intelligent medical insurance cost control method, device and computer system for outpatient hemodialysis patients, which can realize accurate and intelligent statistics of the number of dialysis reimbursement stipulated by medical insurance for each outpatient hemodialysis patient every month and every year, and avoid over-limit situations.

[0005] First, an intelligent medical insurance cost control method for outpatient hemodialysis patients is provided, comprising: obtaining two parts of patient cost data: obtaining the patient's hospitalization and outpatient dialysis costs from the hospital HIS system, and obtaining the deductions for each treatment of the patient from the hemodialysis information management system; classifying and arranging the cost data according to the characteristics of the charging items, and classifying the costs of hemodialysis, hemoperfusion and hemodiafiltration separately; attributing the classified costs to each patient according to the time when the costs were incurred, the patient's name and ID number, and counting the number of hemodialysis, hemoperfusion and hemodiafiltration according to the number of hemodialysis costs, the number of hemoperfusion costs and the number of hemodiafiltration costs of the patient, and transmitting the current costs and times of the patient's hemodialysis, hemoperfusion and hemodiafiltration and the remaining times for the month and / or the year to the cloud server.

[0006] In a second aspect, an intelligent medical insurance cost control device for outpatient hemodialysis patients is provided, comprising: a data acquisition module, which is configured to obtain two parts of cost data of the patient: obtaining the hospitalization and outpatient dialysis costs incurred by the patient from the hospital HIS system, and obtaining the deduction situation of each treatment of the patient from the hemodialysis information management system; a classification module, which is configured to classify and sort the cost data according to the characteristics of the charging items, and classify the costs of hemodialysis, hemoperfusion and hemodiafiltration into one category respectively; a statistical analysis module, which is configured to attribute the classified costs to each patient according to the time of cost generation, the patient's name and ID number, and count the number of hemodialysis, the number of hemoperfusion and the number of hemodiafiltration costs according to the number of hemodialysis costs, the number of hemoperfusion costs and the number of hemodiafiltration costs of the patient, and transmit the current costs and times of the patient's hemodialysis, hemoperfusion and hemodiafiltration and the remaining times of the month and / or the year to the cloud server.

[0007] In the first aspect and / or the second aspect above, the current cost and number of hemodialysis, hemoperfusion and hemodiafiltration of the patient and the remaining number of times in the month and / or the year are sent to the patient's mobile phone in the form of text messages.

[0008] In the above-mentioned first aspect and / or second aspect, it is characterized in that when the number of hemodialysis, hemoperfusion or hemodiafiltration times of the patient's hospitalization and outpatient care in the same month exceeds the limit, the patient and medical staff are notified by text message.

[0009] In the above-mentioned first aspect and / or second aspect, the server shares the patient's monthly and annual dialysis times and the cost of each dialysis to the medical work platform deployed on the medical staff's electronic device and the patient's real-time query platform deployed on the patient's electronic device.

[0010] In a third aspect, a computer system is proposed, comprising: a processor; a memory, comprising one or more computer program modules; wherein the one or more computer program modules are stored in the memory and configured to be executed by the processor, and the one or more computer program modules include instructions for implementing the intelligent hemodialysis outpatient patient medical insurance cost control method.

[0011] A fourth aspect: A computer-readable storage medium is provided for storing non-transitory computer-readable instructions, which, when executed by a computer, can implement the intelligent medical insurance cost control method for outpatient hemodialysis patients.

[0012] The present invention realizes accurate and intelligent statistics of the number of dialysis reimbursement stipulated by medical insurance for each outpatient hemodialysis patient every month and every year, so as to avoid over-limit situations; in the event of over-limit of dialysis times, intelligent reminders can be given to avoid a large number of over-limit of total times at the end of the year; through real-time reminders when deducting fees, possible wrong deductions, missed deductions, etc. can be corrected in time, and corrections can be made in time to avoid contradictions; the use of an intelligent platform can save medical time costs; medical staff and patients can understand the cost situation in time through the terminal, and real-time communication and management of costs can be achieved; in the case of arrears (especially arrears of hemoperfusion and hemodiafiltration), medical staff can adjust the shift schedule and the patient's dialysis method in time to avoid excessive arrears and over-limit situations. BRIEF DESCRIPTION OF THE DRAWINGS

[0013] Figure 1 It is a flow chart of an intelligent medical insurance cost control method for hemodialysis outpatient patients provided by one embodiment of the present invention.

[0014] Figure 2 It is a logic block diagram of an intelligent medical insurance cost control device for outpatient hemodialysis patients provided by an embodiment of the present invention. DETAILED DESCRIPTION

[0015] Figure 1 The figure shows a flow chart of an intelligent hemodialysis outpatient medical insurance cost control method. Step 1: accurately identify the patient by name and ID number, and obtain two parts of the patient's cost data: obtain the patient's hospitalization and outpatient dialysis costs from the hospital HIS system, and obtain the patient's deductions for each treatment from the hemodialysis information management system.

[0016] Step 2: store the acquired cost data.

[0017] Step 3, classify and sort the stored cost data. Specifically, classify and sort the costs according to the characteristics of the charging items, which are divided into hemodialysis, hemoperfusion and hemodiafiltration. That is, the costs of hemodialysis, hemoperfusion and hemodiafiltration are classified separately.

[0018] Step 4, intelligently and accurately attribute the classified expenses to each patient according to the time when the expenses were incurred, the patient's name and ID number. According to the number of hemodialysis expenses, the number of hemoperfusion expenses and the number of hemodiafiltration expenses of the patient, the number of hemodialysis, the number of hemoperfusion and the number of hemodiafiltration expenses are counted respectively. One hemodialysis expense represents one hemodialysis, one hemoperfusion expense represents one hemoperfusion, and one hemodiafiltration expense represents one hemodiafiltration. The current cost and number of hemodialysis, hemoperfusion and hemodiafiltration of the patient, as well as the remaining number of times for the month and the year are sent to the patient's mobile phone via SMS and transmitted to the cloud server through the firewall. This step can intelligently count the number of dialysis expenses for each outpatient dialysis patient per month and throughout the year.

[0019] The firewall organically combines various software and hardware devices for security management and screening to help the system implementing the method build a relatively isolated protection barrier between its internal and external networks to protect user data and information security.

[0020] Medical staff and patients access the server through dotted devices (such as smartphones, tablets, and computers) to obtain the patient's monthly and annual dialysis frequency.

[0021] Patients will be reminded of some special situations: 1. The deductions for the patient's dialysis treatment on that day (including the remaining fees paid by the patient so far) will be sent to the patient's mobile phone in real time via text message, so that the patient can check the fees in real time and avoid mistakes in fees; 2. If the number of dialysis fees and single item number (such as hemodiafiltration not exceeding 3 times per month) incurred by the patient in the month exceeds the limit, the patient, the attending physician and the responsible nurse will be notified via text message to ensure that the patient's monthly dialysis fees are kept within the medical insurance limit as much as possible.

[0022] Figure 2 The logical block diagram of an intelligent medical insurance cost control device for outpatient hemodialysis patients is shown. The device includes a data acquisition module, a data storage module, a classification module, a statistical analysis module, a reminder module, a medical work platform, a patient real-time query platform and a medical-patient communication platform.

[0023] The data acquisition module is configured to accurately identify the patient by name and ID number, and to obtain two parts of the patient's expense data: obtaining the patient's inpatient and outpatient dialysis expenses from the hospital HIS system, and obtaining the patient's deductions for each treatment from the hemodialysis information management system.

[0024] The data storage module stores the acquired expense data.

[0025] The classification module classifies and organizes the stored expense data. Specifically, the expenses are classified and organized according to the characteristics of the charging items, and the charging item characteristics are divided into hemodialysis, hemoperfusion and hemodiafiltration. That is, the expenses of hemodialysis, hemoperfusion and hemodiafiltration are classified separately.

[0026] The statistical analysis module intelligently and accurately attributes the classified expenses to each patient according to the time of expense generation, patient name and ID number, and counts the number of hemodialysis, hemoperfusion and hemodiafiltration expenses according to the number of hemodialysis expenses, hemoperfusion expenses and hemodiafiltration expenses of the patient, and transmits the current expenses, number of hemodialysis, hemoperfusion and hemodiafiltration of the patient, as well as the remaining number of the month and the year to the cloud server through the firewall. This module can intelligently count the number of dialysis expenses for each outpatient dialysis patient per month and throughout the year.

[0027] The reminder module will send the patient's current cost and number of hemodialysis, hemoperfusion and hemodiafiltration as well as the remaining number of times for the month and the year to the patient's mobile phone via SMS.

[0028] The reminder module also reminds patients of some special situations: 1. The deductions for the patient's dialysis treatment on that day (including the remaining fees paid by the patient so far) are sent to the patient's mobile phone in real time via text messages, allowing the patient to check the fees in real time and avoid cost errors; 2. If the number of dialysis expenses incurred by the patient in the month and the number of single items (such as hemodiafiltration not exceeding 3 times per month) exceed the limit, the patient, the attending physician and the responsible nurse will be notified via text messages to ensure that the patient's monthly dialysis expenses are kept as much as possible within the medical insurance upper limit.

[0029] The medical work platform is a system for medical staff, which is deployed on electronic devices such as smartphones, tablets, and computers and can interact with cloud servers. Medical staff can query the number of dialysis sessions per month and per year for each outpatient patient from the cloud server in real time through the medical work platform. The medical work platform enables medical staff to keep abreast of the number of dialysis sessions for patients, provide cost and health education for patients who exceed the limit, and remind them to pay attention to salt and water control and try not to exceed the upper limit stipulated by medical insurance.

[0030] The patient real-time query platform is a patient-oriented system that is deployed on electronic devices such as smartphones, tablets, and computers and can interact with cloud servers. Patients can query their monthly and annual dialysis frequency and cost from the server through the patient real-time query platform cloud.

[0031] The patient real-time query platform and the medical work platform interact through the cloud server. That is, patients and medical staff can communicate online to avoid conflicts due to poor communication. For example, patients ask medical staff about the cost on the patient real-time query platform, and the medical staff will answer through the medical work platform.

[0032] The present invention also provides an embodiment of a computer. The computer includes a processor and a memory. The memory is used to store non-temporary computer-readable instructions (e.g., one or more computer program modules). The processor is used to run the non-temporary computer-readable instructions, and when the non-temporary computer-readable instructions are run by the processor, one or more steps in the intelligent hemodialysis outpatient medical insurance cost control method described above can be executed. The memory and the processor can be interconnected through a bus system and / or other forms of connection mechanisms.

[0033] For example, the processor may be a central processing unit (CPU), a graphics processing unit (GPU), or other forms of processing units with data processing capabilities and / or program execution capabilities. For example, the central processing unit (CPU) may be an X86 or ARM architecture, etc. The processor may be a general-purpose processor or a special-purpose processor, and may control other components in the computer to perform desired functions.

[0034] For example, the memory may include any combination of one or more computer program products, and the computer program product may include various forms of computer-readable storage media, such as volatile memory and / or non-volatile memory. Volatile memory may include, for example, random access memory (RAM) and / or cache memory (cache), etc. Non-volatile memory may include, for example, read-only memory (ROM), hard disk, erasable programmable read-only memory (EPROM), compact disc read-only memory (CD-ROM), USB memory, flash memory, etc. One or more computer program modules may be stored on the computer-readable storage medium, and the processor may run one or more computer program modules to implement various functions of the computer.

[0035] The present invention also provides an embodiment of a computer-readable storage medium, which is used to store non-transitory computer-readable instructions. When the non-transitory computer-readable instructions are executed by a computer, one or more steps in the above-mentioned cruise ship space overall layout design method can be implemented. When the intelligent hemodialysis outpatient medical insurance cost control device and method provided in the embodiment of the present application is implemented in the form of software and sold or used as an independent product, it can be stored in a computer-readable storage medium. For relevant instructions on the storage medium, please refer to the corresponding description of the memory in the computer above, which will not be repeated here.

Claims

1. An intelligent method for controlling medical insurance costs for outpatient hemodialysis patients, characterized in that: include: Obtain two parts of patient expense data: obtain the patient's inpatient and outpatient dialysis expenses from the hospital HIS system, and obtain the patient's deductions for each treatment from the hemodialysis information management system; The cost data were sorted and organized according to the characteristics of the charging items, and the costs of hemodialysis, hemoperfusion, and hemodiafiltration were classified separately; The classified expenses are attributed to each patient according to the time when the expenses were incurred, the patient's name and ID number. The number of hemodialysis, the number of hemoperfusion expenses and the number of hemodiafiltration expenses of the patient are counted respectively. The current expenses and number of hemodialysis, hemoperfusion and hemodiafiltration of the patient and the remaining number of times for the month and / or the year are transmitted to the cloud server.

2. The intelligent medical insurance cost control method for hemodialysis outpatients according to claim 1 is characterized in that: The current cost and number of hemodialysis, hemoperfusion and hemodiafiltration sessions as well as the remaining number of sessions in the current month and / or year are sent to the patient's mobile phone via SMS.

3. The intelligent medical insurance cost control method for hemodialysis outpatients according to claim 1 is characterized in that: When the number of hemodialysis, hemoperfusion or hemodiafiltration sessions during hospitalization and outpatient care exceeds the limit in the month, the patient and medical staff will be notified via text message.

4. The intelligent hemodialysis outpatient medical insurance cost control method according to claim 1, characterized in that: The number of dialysis sessions per month and per year and the cost of each dialysis session are obtained from the server.

5. An intelligent medical insurance cost control device for hemodialysis outpatients, characterized in that: include: The data acquisition module is configured to obtain two parts of patient expense data: obtaining the inpatient and outpatient dialysis expenses incurred by the patient from the hospital HIS system, and obtaining the deduction information of each treatment of the patient from the hemodialysis information management system; A classification module is configured to classify and sort the cost data according to the characteristics of the charging items, and classify the costs of hemodialysis, hemoperfusion and hemodiafiltration into one category respectively; The statistical analysis module is configured to attribute the classified expenses to each patient according to the time when the expenses were incurred, the patient's name and ID number, and to count the number of hemodialysis, the number of hemoperfusion and the number of hemodiafiltration expenses of the patient according to the number of hemodialysis expenses, the number of hemoperfusion expenses and the number of hemodiafiltration expenses, and transmit the current expenses and number of hemodialysis, hemoperfusion and hemodiafiltration of the patient and the remaining number of times for the month and / or the year to the cloud server.

6. The intelligent medical insurance cost control device for hemodialysis outpatients according to claim 5 is characterized in that: The system also includes a reminder module, which is configured to send the current cost and number of hemodialysis, hemoperfusion and hemodiafiltration of the patient and the remaining number of times in the current month and / or the current year to the patient's mobile phone in the form of text messages.

7. The intelligent medical insurance cost control device for hemodialysis outpatients according to claim 5 is characterized in that: The reminder module is also configured to notify the patient and medical staff via text message when the number of hemodialysis, hemoperfusion or hemodiafiltration sessions of the patient in hospital and outpatient clinics in the month exceeds the limit.

8. The intelligent medical insurance cost control device for outpatient hemodialysis patients according to claim 5 is characterized in that: The server shares the patient's monthly and annual dialysis times and the cost of each dialysis to the medical work platform deployed on the medical staff's electronic device and the patient's real-time query platform deployed on the patient's electronic device.

9. A computer system, characterized in that: include: processor; a memory including one or more computer program modules; Wherein, the one or more computer program modules are stored in the memory and configured to be executed by the processor, and the one or more computer program modules include instructions for implementing the intelligent hemodialysis outpatient patient medical insurance cost control method as described in any one of claims 1-4.

10. A computer-readable storage medium for storing non-transitory computer-readable instructions, characterized in that: When the non-temporary computer-readable instructions are executed by a computer, the intelligent medical insurance cost control method for outpatient hemodialysis patients described in any one of claims 1 to 4 can be implemented.

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