System, method and equipment for rapidly extracting data in medical insurance flying inspection, and medium

Abstract

The invention discloses a medical insurance flying inspection rapid data extraction system, method and device and a medium. By arranging the data extraction task management module, the system can record and manage a standard header field of each data extraction task, so that standardization and normalization of data extraction are ensured. No matter how the data source changes, the system can perform data processing according to the preset standard header field, so that the consistency and comparability of the data are improved. Because the system supports to store respective files to be extracted for different data extraction tasks, the system can cope with data files with different sources and different formats. The data extraction processing module obtains required information from the data extraction task management module and the data extraction file management module, wherein the required information comprises a standard header field and a file to be subjected to data extraction. Then, the mapping relation between the original header field and the standard header field can be automatically analyzed, and a data value is extracted according to the mapping relation. The process is highly automatic, manual intervention is greatly reduced, and the efficiency and the accuracy of medical insurance flying inspection counting work are improved.

Description

Technical Field

[0001] The present application relates to the field of deep learning technology and medical insurance surveillance, and in particular to a medical insurance surveillance rapid data collection system, method, device and medium. Background Art

[0002] Medical insurance spot checks are mainly aimed at checking the illegal and irregular use of medical insurance funds by designated medical institutions. The data of various charging items used by patients during their visits are important basic data for spot checks. In the current medical insurance spot check work environment, medical experts are faced with a series of complex and cumbersome data extraction and processing processes. The traditional spot check process mainly relies on various audit systems, which generate the final audit results or audit reports through a series of complex steps, including data extraction, data cleaning, data standardization, configuration of audit rules, system audit of medical records, manual verification of audit results, adjustment of rules, and re-audit.

[0003] However, this method has significant limitations and shortcomings. First, the entire process is very complicated and time-consuming, requiring a large amount of data to be extracted from the hospital system in advance and careful pre-processing. This method of extracting data in advance is not only inefficient, but may also lead to data timeliness issues, affecting the accuracy and timeliness of the inspection results.

[0004] Secondly, the data field formats provided by different hospitals often vary greatly. This inconsistency poses a great challenge to the standardized processing of data, and requires a lot of manpower and material resources to uniformly process these data. This not only increases the workload, but may also introduce additional errors and risks.

[0005] Therefore, there is an urgent need for a medical insurance inspection rapid data collection system that can meet the data field formats provided by different hospitals and improve the efficiency of inspections. Summary of the invention

[0006] The present application provides a system, method, device and medium for quickly obtaining data from medical insurance spot checks, which are used to solve the problem that the existing medical insurance spot check data obtaining work cannot meet the data field formats provided by different hospitals and requires a large amount of resources and time to obtain data.

[0007] In a first aspect, the present application provides a medical insurance flight inspection rapid data collection system, the system comprising:

[0008] A data-collection task management module, used to record at least one standard header field of a data-collection task;

[0009] A data collection file management module, used for storing the data collection files to be collected for different data collection tasks;

[0010] The data extraction result storage module is used to store the data extraction results;

[0011] A data extraction processing module is used to obtain, for different data extraction tasks, the standard header fields of the data extraction task from the data extraction task management module, and the data extraction file to be extracted of the data extraction task from the data extraction file management module; obtain the original header fields in the data extraction file to be extracted; determine the mapping relationship between the original header fields and the standard header fields; according to the mapping relationship, extract the data values ​​of the standard header fields from the data extraction file to be extracted and store the standard header fields and the data values ​​of the standard header fields correspondingly in the data extraction result storage module.

[0012] In a second aspect, the present application also provides a method for quickly obtaining medical insurance data based on the above-mentioned system, the method comprising:

[0013] For different data collection tasks, the data collection processing module of the medical insurance flight inspection rapid data collection system performs the following operations:

[0014] Obtaining the standard header field of the data-collecting task from the data-collecting task management module of the medical insurance fast data-collecting system, and obtaining the data-collecting file to be collected for the data-collecting task from the data-collecting file management module of the medical insurance fast data-collecting system;

[0015] Get the original header fields in the data file to be retrieved;

[0016] Determine a mapping relationship between the original header field and the standard header field;

[0017] According to the mapping relationship, extract the data value of the standard header field from the data file to be extracted; and

[0018] The standard header fields and the data values ​​of the standard header fields are correspondingly stored in the data collection result storage module of the medical insurance spot check rapid data collection system.

[0019] In a third aspect, the present application also provides a computer device, which includes a processor, and the processor is used to implement the steps of the medical insurance inspection and rapid data collection method as described above when executing a computer program stored in a memory.

[0020] In a fourth aspect, the present application also provides a computer-readable storage medium storing a computer program, which, when executed by a processor, implements the steps of the method for rapid data collection of medical insurance spot checks as described above.

[0021] The beneficial effects of this application are as follows:

[0022] 1. By setting up the data extraction task management module, the system can record and manage the standard header fields of each data extraction task, which ensures the standardization and normalization of data extraction. No matter how the data source changes, the system can process the data according to the preset standard header fields, improving the consistency and comparability of the data. At the same time, as business needs increase, the system can easily expand new data extraction tasks without making major adjustments to the overall architecture.

[0023] 2. Since the system supports saving different data extraction files for different data extraction tasks, it can handle data files from different sources and in different formats.

[0024] 3. The data collection processing module automatically obtains the required information from the data collection task management module and the data collection file management module, including the standard header fields and the data collection files to be collected. Subsequently, it automatically analyzes the mapping relationship between the original header fields and the standard header fields, and extracts the data values ​​accordingly. This process is highly automated, greatly reducing manual intervention and improving the efficiency and accuracy of medical insurance inspection data collection work.

[0025] 4. By determining the mapping relationship and accurately extracting data, the system can ensure that the extracted data strictly corresponds to the preset standard header fields, thereby effectively avoiding problems such as data errors and omissions, inconsistent formats, etc., and helping to improve the quality and efficiency of medical insurance spot checks. BRIEF DESCRIPTION OF THE DRAWINGS

[0026] In order to more clearly illustrate the technical solutions in the embodiments of the present application, the drawings required for use in the description of the embodiments will be briefly introduced below. Obviously, the drawings described below are only some embodiments of the present application. For ordinary technicians in this field, other drawings can be obtained based on these drawings without paying creative labor.

[0027] Figure 1 A schematic diagram of the structure of a medical insurance flight inspection and rapid data collection system provided in an embodiment of the present application;

[0028] Figure 2 A schematic diagram of a manually configured mapping relationship between original header fields and standard header fields provided in this application;

[0029] Figure 3 An interface diagram of a medical insurance flight inspection rapid data collection system provided for this application;

[0030] Figure 4 A schematic diagram of a process for rapid data collection of medical insurance inspection provided in an embodiment of the present application;

[0031] Figure 5 It is a structural schematic diagram of a computer device provided in an optional embodiment of the present application. DETAILED DESCRIPTION

[0032] In order to make the purpose, technical solutions and advantages of the present application clearer, the present application will be further described in detail below in conjunction with the accompanying drawings. Obviously, the described embodiments are only part of the embodiments of the present application, rather than all the embodiments. Based on the embodiments in the present application, all other embodiments obtained by ordinary technicians in this field without making creative work are within the scope of protection of the present application.

[0033] In order to adapt to the differences in data formats among different hospitals and thus quickly and accurately perform medical insurance spot checks and provide data, the present application provides a medical insurance spot check and rapid data provision system, method, device and medium.

[0034] Embodiment 1:

[0035] This application provides a medical insurance flight inspection rapid data collection system. Figure 1 A schematic diagram of a medical insurance flight inspection rapid data collection system provided in an embodiment of the present application, the system comprising:

[0036] A data-provisioning task management module 11, used to record at least one standard header field of a data-provisioning task;

[0037] The data-collection file management module 12 is used to save the data-collection files to be collected for different data-collection tasks;

[0038] The extraction result storage module 13 is used to store the extraction results;

[0039] The data extraction processing module 14 is used to obtain the standard header field of the data extraction task from the data extraction task management module 11 for different data extraction tasks, and to obtain the data extraction file to be extracted of the data extraction task from the data extraction file management module 12; obtain the original header field in the data extraction file to be extracted; determine the mapping relationship between the original header field and the standard header field; according to the mapping relationship, extract the data value of the standard header field from the data extraction file to be extracted and store the standard header field and the data value of the standard header field correspondingly in the data extraction result storage module 13.

[0040] In order to achieve rapid and accurate medical insurance inspection and data collection, a medical insurance inspection and rapid data collection system is provided in this application. The system integrates a data collection task management module 11, a data collection file management module 12, a data collection result storage module 13, and a data collection processing module 14. Through the cooperation between the various modules of the system, it is possible to quickly collect data from the data collection files in different data formats of different hospitals, thereby reducing the difficulty of medical insurance inspection. The following is an introduction to each module of the system:

[0041] A. Data submission task management module 11.

[0042] The data-collecting task management module 11 is used to record at least one data-collecting task and the standard header fields respectively included in the at least one data-collecting task.

[0043] The standard header fields of any data extraction task can be managed in the form of a database table. For example, the name of a data extraction task is extract_data_task, and the standard header fields of the data extraction task are represented by the following Table 1 or Table 2:

[0044] Field Name Field Type Notes id int Primary Key ID task_id varchar(32) Task ID task_name varchar(100) Task Name task_data_table varchar(32) Task Data Table create_time timestamp Creation time Update_time timestamp Update time

[0045] Table 1

[0046]

[0047]

[0048] Table 2

[0049] In a possible implementation, the data-provisioning task management module 11 is also used to provide a task configuration interface, which is used to receive configured data-provisioning task information, wherein the data-provisioning task information includes a data-provisioning task name and a standard header field corresponding to the data-provisioning task name.

[0050] In order to facilitate the management of the data-collecting tasks, in the present application, the data-collecting task management module 11 provides a task configuration interface to receive the configured data-collecting task information through the task configuration interface. Among them, the data-collecting task information includes the data-collecting task name and the standard header field corresponding to the data-collecting task name. For example, the user can operate the medical insurance fast data-collecting system, input "Monthly Summary of Drug Sales Data" as the data-collecting task name into the task configuration interface, and configure the standard header fields corresponding to the task as "Drug ID", "Drug Name", "Sales Date Range", "Total Sales", and "Average Unit Price". In this way, the system clearly knows what key information needs to be extracted when executing the data-collecting task of "Monthly Summary of Drug Sales Data" and in what format to organize these data.

[0051] In a possible implementation, the task information corresponding to different task information may be stored in a dispersed manner to isolate data of different tasks, avoid data confusion, and improve task query efficiency.

[0052] In order to further enhance user experience and system flexibility, the task configuration interface can also support dynamic adjustment of standard header fields. That is, when users need to add, delete or modify the standard header fields of a certain data-collecting task, there is no need to rewrite the code or upgrade the system. It can be completed through a friendly interface.

[0053] In order to ensure the accuracy and security of data, the medical insurance inspection rapid system can also perform permission control on the task configuration interface. Only authorized users can access and modify the task information to prevent unauthorized access or data tampering. Permission control can be achieved through user role management, access control list (ACL), etc. to ensure that the system operates in accordance with the established security policy.

[0054] B. Data file management module 12.

[0055] The data collection file management module 12 is used to save the data collection files to be collected for different data collection tasks. These data collection files can be automatically obtained by the medical insurance fast data collection system from the docked data source, such as the hospital information system, medical insurance platform system, etc., or they can be data source files uploaded by users and not yet processed by the system, containing the original data that the medical insurance fast data collection system needs to extract and analyze.

[0056] In a possible implementation, the data-collecting file management module 12 is further used to provide a file configuration interface, and the file configuration interface is used to receive the data-collecting files to be collected uploaded for different data-collecting tasks.

[0057] In the present application, in addition to managing and saving the files to be submitted associated with different submission tasks, the submission file management module 12 also provides a file configuration interface. This interface is designed to provide users with a flexible and convenient way so that they can upload the corresponding files to be submitted for a specific submission task. Exemplarily, the user first logs in by entering the user name and password through the login interface of the medical insurance flight inspection rapid submission system. After logging in, select or create a specific submission task in the system interface. Through the link or button provided by the system, the user accesses the file configuration interface. In the file configuration interface, the user selects the file to be submitted to be uploaded and specifies which submission task it is associated with. Then, click the "Upload" button to send the file to the system. After the upload is completed, the medical insurance flight inspection rapid submission system will display the status information of the file upload, such as "upload successful" or "upload failure and reason". The user can judge whether it is necessary to re-upload or contact the system administrator based on this information.

[0058] C. Extraction result storage module 13.

[0059] The data collection result storage module 13 is used to store the data collection results of the data collection tasks generated by the medical insurance spot check rapid data collection system for different data collection tasks.

[0060] D. Data processing module 14.

[0061] The data processing module 14 is a key component in the medical insurance flight inspection rapid data collection system. It is responsible for processing specific data collection tasks, obtaining the standard header fields of the task from the data collection task management module 11, obtaining the corresponding data collection files to be collected from the data collection file management module 12, and performing a series of operations to extract and convert data, and finally saving the results to the data collection result storage module 13. Exemplarily, the data collection processing module 14 obtains the standard header fields of the current data collection task from the data collection task management module 11, which define the data structure that the system expects to extract from the data collection files to be collected. And obtain the data collection files to be collected for the specified data collection task from the data collection file management module 12, parse the data collection files to be collected, and identify and extract the original header fields in the files. For example, the original header fields in the file are identified and extracted by entity recognition technology. Then the original header fields are compared with the standard header fields to determine the mapping relationship between them. According to the determined field mapping relationship, the data values ​​of the corresponding fields are extracted from the data collection files to be collected. The extracted data values ​​are converted into a format that meets the requirements of the standard header fields (such as data type conversion, data cleaning, etc.). The converted standard header fields and their data values ​​are correspondingly saved in the data extraction result storage module 13 for subsequent medical insurance spot check processing.

[0062] For example, a user starts a data-collecting task through the interface of the medical insurance spot check rapid data-collecting system, and instructs the data-collecting processing module 14 to perform data-collecting processing. After receiving the instruction, the data-collecting processing module 14 can obtain the standard header field information of the data-collecting task from the data-collecting task management module 11, and obtain the data-collecting file to be collected from the data-collecting file management module 12. Then use an appropriate parser (such as a CSV parser, an Excel parser, etc.) to parse the file content and identify the original header fields in the data-collecting file to be collected. Obtain the mapping relationship between the original header fields and the standard header fields. Traverse the data rows in the data-collecting file to be collected, and extract the data values ​​of the standard header fields according to the mapping relationship between the original header fields and the standard header fields. Save the processed data (i.e., the standard header fields and their data values) to the data-collecting result storage module 13.

[0063] In one example, the data processing module 14 can notify the user that the data processing task has been completed, and may provide a link or download option for the processing result. For example, notification is made through the system interface, SMS, email, etc., and notification can also be made through voice broadcast. The specific notification method can be flexibly set according to actual needs and is not specifically limited here.

[0064] In a possible implementation, the mapping relationship between the original header field and the standard header field may be manually configured. Exemplarily, the system further includes: a display module;

[0065] The display module is used to display the interface;

[0066] The data processing module 14 is specifically used to display the standard header field and the original header field through the display module; and provide a relationship configuration interface, which is used to receive the configured mapping relationship between the original header field and the standard header field.

[0067] In the present application, the medical insurance flight inspection rapid system also includes a display module. The display module is responsible for presenting the user interface, so that the user can intuitively view the system status, operation results and make necessary configurations. At the same time, the data processing module 14 interacts with the user through the display module, especially in the field mapping relationship configuration, which provides great convenience. Before preparing for field mapping, the data processing module 14 will display the standard header fields obtained from the data task management module 11 and the original header fields parsed from the data file management module 12 through the display module. Among them, these fields can be displayed on the interface in the form of a list or table, which is convenient for users to view and compare. The data processing module 14 provides a relationship configuration interface, which is presented to the user through the display module. The user can select or enter the mapping relationship between the original header field and the standard header field on the interface through the relationship configuration interface. The relationship configuration interface may include drag and drop matching, drop-down menu selection, manual input and other methods to meet the needs and habits of different users. Once the user completes the configuration of the field mapping relationship through the relationship configuration interface, the data extraction processing module 14 can store it in the system and use these mapping relationships to convert data in subsequent data extraction processes. Figure 2 A schematic diagram of a manually configured mapping relationship between original header fields and standard header fields provided in this application.

[0068] In another possible implementation, the mapping relationship between the original header field and the standard header field can also be automatically generated by the system. Exemplarily, the data-collecting task management module 11 is also used to record, for different data-collecting tasks, the approximate header fields corresponding to the standard header fields of the data-collecting task;

[0069] The data processing module 14 is specifically used to obtain, for different data extraction tasks, the approximate header fields corresponding to the standard header fields of the data extraction task from the data extraction task management module 11; based on the approximate header fields corresponding to the standard header fields, determine the mapping relationship between the original header field and the standard header field.

[0070] In the present application, the number-picking task management module 11 can also record the approximate header fields corresponding to the standard header fields of each number-picking task. This function effectively solves the situation where the header field naming in different data sources may be different, but essentially represents the same data information when processing files from different data sources or formats. For each number-picking task, the number-picking task management module 11 records not only the standard header fields, but also the approximate header fields that may exist for these standard fields. These approximate header fields can be manually configured or derived based on historical data, user feedback or system analysis, and are used to improve the accuracy and flexibility of field mapping.

[0071] Before starting field mapping, the data processing module 14 will obtain the standard header fields of the current data extraction task and their corresponding approximate header fields from the data extraction task management module 11. Based on the obtained standard header fields and approximate header fields, the data processing module 14 determines the mapping relationship between the original header fields and the standard header fields. During the field mapping process, the data processing module 14 will automatically compare the original header fields with the standard header fields and their approximate header fields, and try to find the best matching result.

[0072] Among them, in order to improve the accuracy of the mapping relationship between the automatically determined original header field and the standard header field, in the present application, after the data extraction processing module 14 automatically determines the mapping relationship between the original header field and the standard header field, the mapping relationship can be displayed through the display module of the system, so that the user can timely understand the mapping relationship between the original header field and the standard header field and make corrections. If the user finds that there are errors or places that need to be adjusted in the mapping relationship, they can make manual corrections through the interface provided by the display module. The user can choose to modify the mapping relationship between the original header field and a specific standard header field, or add a new mapping relationship to cover the results of the automatic mapping. After completing the manual correction, the user needs to confirm whether the modified mapping relationship is correct. Once confirmed to be correct, the system will save the modified mapping relationship and use these corrected mapping relationships in subsequent data extraction processes.

[0073] The beneficial effects of this application are as follows:

[0074] 1. By setting up the data extraction task management module 11, the system can record and manage the standard header fields of each data extraction task, which ensures the standardization and normalization of data extraction. No matter how the data source changes, the system can process the data according to the preset standard header fields, improving the consistency and comparability of the data. At the same time, as business needs increase, the system can easily expand new data extraction tasks without making major adjustments to the overall architecture.

[0075] 2. Since the system supports saving different data extraction files for different data extraction tasks, it can handle data files from different sources and in different formats.

[0076] 3. The data collection processing module 14 automatically obtains the required information from the data collection task management module 11 and the data collection file management module 12, including the standard header fields and the data collection files to be collected. Subsequently, it automatically analyzes the mapping relationship between the original header fields and the standard header fields, and extracts the data values ​​accordingly. This process is highly automated, greatly reducing manual intervention and improving the efficiency and accuracy of medical insurance inspection data collection work.

[0077] 4. By determining the mapping relationship and accurately extracting data, the system can ensure that the extracted data strictly corresponds to the preset standard header fields, thereby effectively avoiding problems such as data errors and omissions, inconsistent formats, etc., and helping to improve the quality and efficiency of medical insurance spot checks.

[0078] Embodiment 2:

[0079] In order to improve the efficiency and accuracy of medical insurance flight inspection, based on the above embodiments, in this application, the system further includes: a query module and a display module;

[0080] The display module is used to display the interface;

[0081] The query module is also used to provide a general query configuration interface, which is used to query information; wherein the query information includes one or more of the following: query method, target data extraction task of the query, specific standard header field of the query, and target data value of the query; and, when the query information is received through the general query configuration interface, according to the query information, the data that meets the query information is queried from the data extraction result storage module 13, and the display module displays the query results.

[0082] In the present application, the medical insurance flight inspection rapid system also includes a query module, which can work in collaboration with the display module, allowing the user to conduct in-depth query and analysis of the data extraction results as needed. Among them, the query module is responsible for processing the user's query request and returning the corresponding results. Specifically, the query module provides a conventional query configuration interface, which allows the user to retrieve the data in the data extraction result storage module 13 according to specific query information. Among them, the conventional query configuration interface is a bridge for the user to interact with the query module. The user can enter query information through this interface, including but not limited to query methods (such as precise query, fuzzy query, range query, etc.), the target data extraction task of the query (that is, the result of which data extraction task the user wants to query), the specific standard header field of the query (that is, which field the user wants to query), and the target data value of the query (that is, the specific data value the user wants to find). After receiving the query information submitted by the user through the conventional query configuration interface, the query module will parse this information and generate corresponding query statements. Then, it will interact with the data extraction result storage module 13 to retrieve data records that meet the query conditions from the stored data. The queried data results will be passed to the display module by the query module for display.

[0083] In a possible implementation, the query results obtained by the query module support exporting in a certain format.

[0084] For example, an example of a general query is:

[0085] Standard header fields Supported query methods Patient Number Equivalence query, supports one or more values Name Fuzzy query, supports one or more values gender Equivalence query, supports one or more values ID number Fuzzy query, supports one or more values Date of Birth Date range query Medical category Equivalence query, supports one or more values Admission time Date range query Discharge time Date range query Admission diagnosis Fuzzy query, supports one or more values Discharge diagnosis Fuzzy query, supports one or more values Charge item code Fuzzy query, supports one or more values Charge item name Fuzzy query, supports one or more values Fee Item Category Equivalence query, supports one or more values Cost incurred time Date range query Fee Level Equivalence query, supports one or more values unit price Numeric range query quantity Numeric range query Amount Numeric range query

[0086] In a possible implementation, the query module is also used to provide a TopN query interface for charging items, and the TopN query interface for charging items is used to indicate obtaining the sum of data values ​​of different charging items in the target data extraction task in specific standard header fields, and outputting information of the top N charging items with the highest total data values; wherein N is a positive integer greater than 1, and the specific standard header field includes any one of the following: amount and quantity, and the information of the N charging items includes the name of the charging items; and the information of the N charging items is displayed through the display module.

[0087] An important inspection of medical insurance fly-in inspection is the various charging items and the verification of purchase, sales and inventory. Before the inspection, medical experts need to obtain the top N charging items with the highest sales quantity or cumulative sales amount in the current hospital. Therefore, in this application, the query module also provides a charging item TopN query interface, which provides users with the ability to deeply analyze and gain insight into the distribution of charging items in the withdrawal results, so as to facilitate medical experts to withdraw numbers quickly, thereby quickly identifying high-consumption items, monitoring abnormal expenses and other situations. The charging item TopN query interface can receive the charging item query information entered by the user, specifically for the query needs of the charging items, allowing the user to quickly obtain the information of the top N charging items sorted by amount or quantity in a specific withdrawal task. Among them, N is a positive integer greater than 1. The value of N can be system default or user-defined.

[0088] Among them, the specific standard header fields are limited to "amount" and "quantity". By querying the total amount, users can quickly identify which fee items account for the largest medical insurance expenditure; and by querying the total quantity, they can understand which items are used most frequently.

[0089] Exemplarily, the user needs to input the charging item query information through the charging item TopN query interface, and the charging item query information includes the target number-raising task and the specific standard header field (amount or quantity). When the query module receives the charging item query information, it obtains the number-raising result of the target number-raising task from the number-raising result storage module 13. The number-raising result is traversed, and for each charging item in the number-raising result, the sum of its data values ​​on the specified standard header field (amount or quantity) is calculated. Then, according to the size of the sum of the data values, each charging item is sorted to determine the top N charging items with the highest sum of data values. After sorting, the query module will extract the information of the top N charging items with the highest sum of data values, which usually includes the name of the charging item and the corresponding sum of data values ​​(or only includes the name of the charging item, depending on the user's needs). Finally, the information of these TopN charging items will be displayed to the user in an easy-to-understand format (such as a list, table or graphic) through the display module.

[0090] For example, if the specific standard header field is quantity, the SQL template of the query module is as follows:

[0091]

[0092]

[0093] For example, if the specific standard header field is amount, the SQL template of the query module is as follows:

[0094]

[0095] In a possible implementation, the system further includes: a flight inspection rule configuration module;

[0096] The flight inspection rule configuration module is used to store flight inspection rule information corresponding to at least one flight inspection type; wherein the at least one flight inspection type includes but is not limited to one or more of the following: repeated charges, over-standard charges, decomposed charges, and excessive inspections;

[0097] The query module is also used to provide a flight inspection query interface, and the flight inspection query interface is used to receive flight inspection result query information; wherein the flight inspection result query information includes the target flight inspection type and the target counting task; and, when the flight inspection result query information is received through the flight inspection query interface, the counting result of the target counting task is obtained from the counting result storage module 13, and the flight inspection rule information corresponding to the target flight inspection type is obtained from the flight inspection rule configuration module; and, according to the flight inspection rule information, the counting result is inspected to obtain the flight inspection result; and the flight inspection result is displayed through the display module.

[0098] In order to quickly conduct medical insurance inspections, in this application, the medical insurance inspection rapid data collection system also includes an inspection rule configuration module, which is responsible for saving and managing the inspection rule information corresponding to different inspection types. These inspection rules are the basis for the system to perform inspection operations, ensuring the accuracy and reliability of the inspection results. Among them, the inspection rule configuration module allows users to define, modify and save inspection rule information for multiple inspection types (such as repeated charges, over-standard charges, decomposed charges, excessive inspections, etc.). For example, for repeated charges, the inspection rule information for repeated charges can be to check whether there are multiple billings of the same or similar items in the same time period. If so, the repeated charges are charged repeatedly, otherwise, the charges are not repeated; for over-standard charges, whether the current actual charges exceed the standard price limit, if so, the over-standard charges are charged, if not, the over-standard charges are not charged; for decomposed charges, whether the current charging items belong to a pre-configured overall item, if so, the decomposed charges, if not, the charges are not decomposed; for excessive inspections, according to whether the actual inspection items of the current patient belong to the pre-configured reasonable inspection item set corresponding to the patient's symptoms, if so, the reasonable inspection, if not, the over-inspection inspection. During the specific implementation process, the flight inspection rule information can be flexibly set according to the actual flight inspection rule requirements, and no specific limitation is made here.

[0099] In order to facilitate users to conduct flight inspection queries, in this application, the query module adds a flight inspection query interface on the basis of the original function, so as to receive the flight inspection result query information input by the user through the flight inspection query interface, thereby realizing the query of the flight inspection result. Among them, the flight inspection result query information includes the target flight inspection type and the target number-raising task. After receiving the flight inspection result query information, the query module will obtain the number-raising result of the target number-raising task from the number-raising result storage module 13, and obtain the flight inspection rule information corresponding to the target flight inspection type from the flight inspection rule configuration module. Then, it performs flight inspection processing on the number-raising result according to these rule information. Among them, the flight inspection process involves checking the data in the number-raising result item by item, comparing the conditions in the flight inspection rule, and identifying possible violations. After the flight inspection is completed, the query module will pass the flight inspection result to the display module for display. Among them, the flight inspection result can include detailed information of the violation record, violation type, violation amount, etc., so that the user can conduct further analysis and processing.

[0100] Taking the example of repeated charges for unplanned checkups, according to medical common sense, when performing an anesthetic operation, if general anesthesia is charged, basic anesthesia should not be charged again. If a patient's medical expense record shows that both "general anesthesia" and "basic anesthesia" are charged at the same time during a visit, it is considered an illegal charge.

[0101] Based on this, the SQL template for designing the inspection rule information for repeated charges can be expressed as follows:

[0102]

[0103] Among them: ${item1} and ${item2} are dynamic parameters.

[0104] Figure 3 This is an interface diagram of a medical insurance inspection rapid data collection system provided by this application. Figure 3 As shown, when the user operates the medical insurance flight inspection and rapid data collection system, he can select the "Fly Inspection Specific Rule Query" button, then fill in the target data collection task in the jump interface, select the "duplicate charge" flight inspection type, and fill in the duplicate charge flight inspection rule information, such as filling in the same or similar project names, such as "general anesthesia" and "basic anesthesia", which corresponds to ${item1} and ${item2} in the sql template. Then click the query in the interface to call the flight inspection query interface. After the query module receives the flight inspection result query information through the flight inspection query interface, the query module will obtain the target data collection task from the data collection result storage module 13, and obtain the duplicate charge flight inspection rule information entered by the user from the flight inspection rule configuration module. Then, based on the flight inspection rule information, the data collection result is inspected to generate the flight inspection result.

[0105] Embodiment 3:

[0106] The present application provides a medical insurance inspection rapid data collection method based on any of the systems described in the above embodiments 1-2. Figure 4 A schematic diagram of a process for rapid data collection of medical insurance inspection provided in an embodiment of the present application, the process includes:

[0107] S301: For different data collection tasks, the data collection processing module of the medical insurance spot check rapid data collection system performs the following operations.

[0108] S302: Obtain the standard header field of the data-collecting task from the data-collecting task management module of the medical insurance spot check rapid data-collecting system, and obtain the data-collecting file to be collected for the data-collecting task from the data-collecting file management module of the medical insurance spot check rapid data-collecting system.

[0109] S303: Obtain the original header field in the data file to be retrieved.

[0110] S304: Determine a mapping relationship between the original header field and the standard header field.

[0111] S305: According to the mapping relationship, extract the data value of the standard header field from the file to be retrieved; and store the standard header field and the data value of the standard header field in a corresponding manner in the data retrieval result storage module of the medical insurance spot check rapid data retrieval system.

[0112] The medical insurance inspection and rapid data retrieval method provided in this application is applied to a computer device, which can be a smart device or a server.

[0113] It should be noted that the principle of solving the technical problem of the method for rapid data collection by spot medical inspection is similar to the principle of the system for rapid data collection by spot medical inspection in the above-mentioned embodiment. Please refer to the above-mentioned embodiment for details and no detailed description will be given here.

[0114] The beneficial effects of this application are as follows:

[0115] 1. By setting up the data extraction task management module, the system can record and manage the standard header fields of each data extraction task, which ensures the standardization and normalization of data extraction. No matter how the data source changes, the system can process the data according to the preset standard header fields, improving the consistency and comparability of the data. At the same time, as business needs increase, the system can easily expand new data extraction tasks without making major adjustments to the overall architecture.

[0116] 2. Since the system supports saving different data extraction files for different data extraction tasks, it can handle data files from different sources and in different formats.

[0117] 3. The data collection processing module automatically obtains the required information from the data collection task management module and the data collection file management module, including the standard header fields and the data collection files to be collected. Subsequently, it automatically analyzes the mapping relationship between the original header fields and the standard header fields, and extracts the data values ​​accordingly. This process is highly automated, greatly reducing manual intervention and improving the efficiency and accuracy of medical insurance inspection data collection work.

[0118] 4. By determining the mapping relationship and accurately extracting data, the system can ensure that the extracted data strictly corresponds to the preset standard header fields, thereby effectively avoiding problems such as data errors and omissions, inconsistent formats, etc., and helping to improve the quality and efficiency of medical insurance spot checks.

[0119] Embodiment 4:

[0120] See also Figure 5 , Figure 5 is a schematic diagram of the structure of a computer device provided by an optional embodiment of the present application, such as Figure 5 As shown, the computer device includes: one or more processors 10, a memory 20, and interfaces for connecting various components, including high-speed interfaces and low-speed interfaces. Various components are connected to each other using different buses for communication, and can be installed on a common mainboard or installed in other ways as needed. The processor can process the instructions executed in the computer device, including instructions stored in or on the memory to display the graphical information of the GUI on an external input / output device (such as, a display device coupled to the interface). In some optional embodiments, if necessary, multiple processors and / or multiple buses can be used together with multiple memories and multiple memories. Similarly, multiple computer devices can be connected, and each device provides some necessary operations (for example, as a server array, a group of blade servers, or a multi-processor system). Figure 5 A processor 10 is taken as an example.

[0121] The processor 10 may be a central processing unit, a network processor or a combination thereof. The processor 10 may further include a hardware chip. The hardware chip may be a dedicated integrated circuit, a programmable logic device or a combination thereof. The programmable logic device may be a complex programmable logic device, a field programmable gate array, a general purpose array logic or any combination thereof.

[0122] The memory 20 stores instructions executable by at least one processor 10, so that at least one processor 10 executes the method shown in the above embodiment.

[0123] The memory 20 may include a program storage area and a data storage area, wherein the program storage area may store an operating system, an application required for at least one function; the data storage area may store data created by the use of a computer device based on the presentation of a small program landing page, etc. In addition, the memory 20 may include a high-speed random access memory, and may also include a non-transient memory, such as at least one disk storage device, a flash memory device, or other non-transient solid-state storage device. In some optional embodiments, the memory 20 may optionally include a memory remotely arranged relative to the processor 10, and these remote memories may be connected to the computer device via a network. Examples of the above-mentioned network include, but are not limited to, the Internet, an intranet, a local area network, a mobile communication network, and combinations thereof.

[0124] The memory 20 may include a volatile memory, such as a random access memory; the memory may also include a non-volatile memory, such as a flash memory, a hard disk or a solid state drive; the memory 20 may also include a combination of the above types of memory.

[0125] The computer device also includes an input device 30 and an output device 40. The processor 10, the memory 20, the input device 30 and the output device 40 may be connected via a bus or other means. Figure 5 The example of connecting through bus is taken in the following.

[0126] The input device 30 can receive input digital or character information, and generate key signal input related to the user settings and function control of the computer device, such as a touch screen, a keypad, a mouse, a track pad, a touch pad, an indicator bar, one or more mouse buttons, a trackball, a joystick, etc. The output device 40 may include a display device, an auxiliary lighting device (e.g., an LED) and a tactile feedback device (e.g., a vibration motor), etc. The above-mentioned display device includes but is not limited to a liquid crystal display, a light emitting diode, a display and a plasma display. In some optional embodiments, the display device can be a touch screen.

[0127] Embodiment 5:

[0128] On the basis of the above embodiments, an embodiment of the present application further provides a computer-readable storage medium, in which a computer program executable by a processor is stored. When the program runs on the processor, the processor implements the following steps when executing:

[0129] For different data collection tasks, the data collection processing module of the medical insurance flight inspection rapid data collection system performs the following operations:

[0130] Obtaining the standard header field of the data-collecting task from the data-collecting task management module of the medical insurance fast data-collecting system, and obtaining the data-collecting file to be collected for the data-collecting task from the data-collecting file management module of the medical insurance fast data-collecting system;

[0131] Get the original header fields in the data file to be retrieved;

[0132] Determine a mapping relationship between the original header field and the standard header field;

[0133] According to the mapping relationship, extract the data value of the standard header field from the data file to be extracted; and

[0134] The standard header fields and the data values ​​of the standard header fields are correspondingly stored in the data collection result storage module of the medical insurance spot check rapid data collection system.

[0135] Since the principle of solving the problem by the above-mentioned computer-readable storage medium is similar to the method for rapid data extraction of medical insurance spot checks, the implementation of the above-mentioned computer-readable storage medium can refer to Example 3 of the method, and the repeated parts will not be repeated.

Claims

1. A medical insurance inspection rapid data collection system, characterized in that: The system comprises: A data-collection task management module, used to record at least one standard header field of a data-collection task; A data collection file management module, used for storing the data collection files to be collected for different data collection tasks; The data extraction result storage module is used to store the data extraction results; A data extraction processing module is used to obtain, for different data extraction tasks, the standard header fields of the data extraction task from the data extraction task management module, and the data extraction file to be extracted of the data extraction task from the data extraction file management module; obtain the original header fields in the data extraction file to be extracted; determine the mapping relationship between the original header fields and the standard header fields; according to the mapping relationship, extract the data values ​​of the standard header fields from the data extraction file to be extracted and store the standard header fields and the data values ​​of the standard header fields correspondingly in the data extraction result storage module.

2. The system according to claim 1, characterized in that The data-provisioning task management module is also used to provide a task configuration interface, which is used to receive configured data-provisioning task information, and the data-provisioning task information includes a data-provisioning task name and a standard header field corresponding to the data-provisioning task name.

3. The system according to claim 1, characterized in that The data extraction file management module is also used to provide a file configuration interface, and the file configuration interface is used to receive the data extraction files to be uploaded for different data extraction tasks.

4. The system according to claim 1, characterized in that The system further comprises: a display module; The display module is used to display the interface; The data processing module is specifically used to display the standard header field and the original header field through the display module; and provide a relationship configuration interface, which is used to receive the configured mapping relationship between the original header field and the standard header field.

5. The system according to claim 1, wherein: The data extraction task management module is further used to record, for different data extraction tasks, the approximate header fields corresponding to the standard header fields of the data extraction tasks; The data processing module is specifically used to obtain, for different data extraction tasks, the approximate header fields corresponding to the standard header fields of the data extraction task from the data extraction task management module; based on the approximate header fields corresponding to the standard header fields, determine the mapping relationship between the original header field and the standard header field.

6. The system according to claim 1, characterized in that The system also includes: a query module and a display module; The display module is used to display the interface; The query module is also used to provide a general query configuration interface, which is used to query information; wherein the query information includes one or more of the following: query method, target data extraction task of the query, specific standard header field of the query, and target data value of the query; and, when the query information is received through the general query configuration interface, according to the query information, the data that meets the query information is queried from the data extraction result storage module, and the display module displays the query results.

7. The system according to claim 6, characterized in that The query module is also used to provide a charging item TopN query interface, and the charging item TopN query interface is used to receive charging item query information; wherein, the charging item query information includes a target withdrawal task and a characteristic standard header field, wherein N is a positive integer greater than 1, and the specific standard header field includes any one of the following: amount and quantity; and, when the charging item query information is received through the charging item TopN query interface, obtaining the withdrawal result of the target withdrawal task from the withdrawal result storage module; for different charging items, determining the sum of the data values ​​of the charging item in the specific standard header field from the withdrawal result; and determining the information of the top N charging items with the highest total data value; wherein the information of the N charging items includes the name of the charging item; and displaying the information of the N charging items through the display module.

8. The system according to claim 6, characterized in that The system also includes: a flight inspection rule configuration module; The flight inspection rule configuration module is used to store flight inspection rule information corresponding to at least one flight inspection type; wherein the at least one flight inspection type includes but is not limited to one or more of the following: repeated charges, over-standard charges, decomposed charges, and excessive inspections; The query module is also used to provide a flight inspection query interface, and the flight inspection query interface is used to receive flight inspection result query information; wherein the flight inspection result query information includes a target flight inspection type and a target counting task; and, when the flight inspection result query information is received through the flight inspection query interface, the counting result of the target counting task is obtained from the counting result storage module, and the flight inspection rule information corresponding to the target flight inspection type is obtained from the flight inspection rule configuration module; and, according to the flight inspection rule information, the counting result is inspected to obtain the flight inspection result; and the flight inspection result is displayed through the display module.

9. A method for quickly obtaining medical insurance data based on the system of any one of claims 1 to 8, characterized in that: The method comprises: For different data collection tasks, the data collection processing module of the medical insurance flight inspection rapid data collection system performs the following operations: Obtaining the standard header field of the data-collecting task from the data-collecting task management module of the medical insurance fast data-collecting system, and obtaining the data-collecting file to be collected for the data-collecting task from the data-collecting file management module of the medical insurance fast data-collecting system; Get the original header fields in the data file to be retrieved; Determine a mapping relationship between the original header field and the standard header field; According to the mapping relationship, extract the data value of the standard header field from the data file to be extracted; and The standard header fields and the data values ​​of the standard header fields are correspondingly stored in the data collection result storage module of the medical insurance spot check rapid data collection system.

10. A computer device, characterized in that: The computer device includes a processor, and the processor is used to implement the steps of the medical insurance inspection and rapid data collection method as described in claim 9 above when executing the computer program stored in the memory.

11. A computer-readable storage medium, characterized in that: It stores a computer program that can be executed by a computer device. When the program is run on the computer device, the computer device executes the steps of the medical insurance inspection and rapid data collection method as described in claim 9 above.

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