System and method for implementing medical data exchange and medical claim settlement

Abstract

To provide a system and method for implementing medical data exchange and providing medical claim settlement service based on the Fast Healthcare Interoperability Resources (FHIR) standard.SOLUTION: A system 100 includes: a data exchange processing module, a blockchain database, a service server, and an authority management computation module. The system converts the format of received medical data, encrypts the data for transmission, and provides medical claim settlement service.SELECTED DRAWING: Figure 1

Description

[Technical field]

[0001] The present disclosure relates to a system and method for data exchange and commercial service provision. In particular, the present disclosure relates to a system and method for achieving medical data exchange and providing medical claims services based on the FHIR standard. [Background technology]

[0002] Fast Healthcare Interoperability Resources (FHIR) is a set of standards for patient data rights recently issued by the U.S. government, which requires that when medical institutions exchange medical data, the structures of related medical data such as medical institutions, medical records, admission / discharge records and medical round records must all conform to a unified standard, effectively improving the interoperability of medical information between institutions.

[0003] When insurance institutions review medical compensation claims, the field names, definitions, and corresponding value formats of the medical records of each medical facility are different, making it difficult to integrate the records. Therefore, in order to smoothly integrate the records into the system and perform subsequent compensation claims services, the formats must be deciphered and adjusted by the compensation claims adjusters one by one. This not only increases the burden on the compensation claims adjusters, but also lengthens the time of the assessment program, and users who apply for medical compensation claims services must wait several weeks or even months before receiving compensation. It also affects users' trust in the compensation institutions.

[0004] In addition, due to the special nature of medical materials, data integration becomes more difficult as format conversion cannot be performed using public applications or network tools to avoid leaking patients' personal information and medical-related messages.

[0005] In light of this, there is a need to provide a system for medical information exchange and medical compensation claims that improves the interoperability of data between insurance organizations and medical institutions by integrating medical information provided by each medical institution while maintaining the safety of medical data, thereby shortening the overall time required for compensation claims, and enabling users who apply for such compensation claims services to receive compensation in a short period of time. Summary of the Invention

[0006] This disclosure is intended to provide a simplified summary of the disclosure so that the reader can have a basic understanding of the content of the disclosure. It is not an exhaustive overview of the disclosure and is not intended to identify key / key elements of embodiments of the invention or to delineate the scope of the invention.

[0007] According to a first aspect of the present invention, there is provided a system for enabling medical data exchange and medical claims based on Fast Healthcare Interoperability Resources (FHIR) standard data. The system is a system for communicating with a server, and the server includes a plurality of original medical documents having a first format. The system includes a document exchange processing module, a blockchain database, a service server, and an authority management operation module. The document exchange processing module has a built-in format converter for receiving original medical documents from the server and converting the original medical documents into a plurality of FHIR-standard documents based on a mapping command. The blockchain database is communicatively connected to the document exchange processing module and stores the FHIR-standard documents. The service server is communicatively connected to the document exchange processing module and the blockchain database and provides a compensation claim service based on the FHIR-standard documents. The authority management operation module is communicatively connected to the document exchange processing module and the service server and performs authority management for each of the FHIR-standard documents. When the FHIR-standard documents are transmitted between the document exchange processing module, the blockchain database, and the service server, the authority management operation module performs authority management for the FHIR-standard documents by performing the following steps (a) to (f): (a) obtaining a first public key and a first private key from the server, and a second public key and a second private key from the service server, respectively; (b) generating a cryptographic key based on a combination of the first private key and the second public key from step (a); (c) encrypting the FHIR normative material with the encryption key of step (b) to generate encrypted FHIR normative material; (d) signing the encrypted FHIR canonical material of step (c) under the first private key to generate a signed FHIR canonical material; (e) verifying the signed FHIR reference material of step (d) based on the first public key to decrypt the signature and recover the encrypted FHIR reference material of step (c); (f) generating a cryptographic key in step (b) based on a combination of the second private key in step (a) and the first public key, and decrypting the encrypted FHIR reference material in step (e) to obtain the decrypted FHIR reference material.

[0008] According to some embodiments of the present disclosure, the system is customized based on the FHIR standard material having a second format to generate a mapping instruction.

[0009] According to a particular embodiment of the present disclosure, the first format is an extensible markup language (XML) and the second format is a JSON language, such that in one particular embodiment of the present disclosure, the format converter is an XML to JSON language format converter.

[0010] According to one embodiment of the present disclosure, after forming the encrypted FHIR normative material in step (c) and / or after forming the signed FHIR normative material in step (d), the method further includes transmitting the encrypted FHIR normative material, the signed FHIR normative material, or a combination thereof, to the blockchain database.

[0011] According to another embodiment of the present disclosure, after step (c), the method further includes: computing the encrypted FHIR normative material to obtain a hash value and transmitting the hash value to the blockchain database. In any embodiment, the service server further includes a material verification unit communicatively connected to the blockchain database and configured to compute the encrypted FHIR normative material to obtain a verification hash value and verify the consistency between the verification hash value and the hash value.

[0012] According to a second aspect of the present disclosure, there is provided a method for realizing medical information exchange and medical compensation claims on a user side based on FHIR standard materials, comprising: providing a server containing original medical information on a user side, where the original medical information has a first format; and providing a information exchange platform including a information exchange processing module, a blockchain database, a service server, and an authority management operation module, which are communicatively connected to each other, and which is communicatively connected to the server. The information exchange processing module has a built-in format converter for receiving the original medical information from the server and converting the original medical information into FHIR standard materials based on a mapping command; the blockchain database stores the FHIR standard materials; the service server receives the FHIR standard materials and provides a compensation claim service to the user side based on the FHIR standard materials; and the authority management operation module performs the following steps (a) to (f): (a) obtaining a first public key and a first private key from the server, and a second public key and a second private key from the service server, respectively; (b) generating a cryptographic key based on a combination of the first private key and the second public key from step (a); (c) encrypting the FHIR normative material with the encryption key of step (b) to generate encrypted FHIR normative material; (d) signing the encrypted FHIR canonical material of step (c) under the first private key to generate a signed FHIR canonical material; (e) verifying the signed FHIR reference material of step (d) based on the first public key to decrypt the signature and recover the encrypted FHIR reference material of step (c); (f) generating a cryptographic key in step (b) based on a combination of the second private key of step (a) and the first public key, and decrypting the encrypted FHIR reference material in step (e) to obtain the decrypted FHIR reference material.

[0013] In an optional embodiment, the mapping directive is generated by customization based on the FHIR standard material.

[0014] In an optional embodiment, after forming the encrypted FHIR reference material in step (c) and / or after forming the signed FHIR reference material in step (d), the authority management computing module further performs the following step of transmitting the encrypted FHIR reference material, the signed FHIR reference material, or a combination thereof to the blockchain database.

[0015] According to another embodiment of the present disclosure, the authority management computing module comprises: After step (c), the method further comprises the steps of: calculating the encrypted FHIR reference material to obtain a hash value; and transmitting the hash value to the block chain database.

[0016] In a non-limiting embodiment, the service server further includes a material verification unit communicatively connected to the blockchain database, for calculating the encrypted FHIR normative material to obtain a verification hash value, and verifying the consistency between the verification hash value and the hash value.

[0017] By referring to the following embodiments, those having ordinary skill in the art to which the present invention pertains can easily understand the basic spirit and other objects of the present invention, as well as the technical means and embodiments adopted by the present invention. [Brief description of the drawings]

[0018] In order to make the above and other objects, features, advantages and embodiments of the present invention more clearly understandable, reference is now made to the accompanying drawings, in which:

[0019] [Figure 1] FIG. 1 is a schematic diagram of a system 100 according to one embodiment of the present disclosure. [Diagram 2]2 is a flowchart of authority management by the authority management computing module 140 of the system 100 of FIG. 1. [Diagram 3] FIG. 3 is a schematic diagram of a system 300 according to another embodiment of the present disclosure. [Figure 4] 4 is a flowchart of a method 400 according to one embodiment of the present disclosure.

[0020] In accordance with common practice, the various features and components in the figures are not drawn to scale, but rather in a manner designed to best illustrate the particular features and components relevant to the present invention. Furthermore, the same or similar reference numerals are used to refer to similar components in different drawings. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0021] In order to provide a more detailed and complete description of the present disclosure, the following description is provided with the embodiments and specific examples of the present invention, but this is not intended to be the only form of implementation or application of the specific examples of the present invention. The embodiments include features of multiple specific examples and method steps and sequences for constructing and operating the specific examples. However, the same or equivalent functions and sequences of steps may be achieved by other specific examples.

[0022] I. Definition Certain proper nouns used in the specification, examples and appended claims are collected here for convenience. Unless otherwise defined in the specification, the meanings of scientific and technical terms used herein are understood to be the same as those commonly used in the art to which the present invention pertains. In addition, unless conflicting with the context, singular nouns used herein cover the plural of the noun, and plural nouns used herein cover the singular of the noun. Specifically, in the specification and claims, the singular forms "a" and "an" include plural references, unless the context dictates otherwise. In addition, in the specification and claims, "at least one" is synonymous with the "one or more" expression, and both mean to include one, two, three or more.

[0023] The "server side" or "user side" includes any computing device capable of a communicative connection to at least one server. The communicative connection is not limited to a wired or wireless network connection. According to an embodiment of the present invention, the "server side" or "user side" includes at least one graphical display device and graphical user interfaces, whereby a user can view information and interact through application programs, tools, services or software of the graphical user interface. In the present disclosure, the server side user is preferably an insurance claims adjuster, and the user side user is a policyholder.

[0024] In this disclosure, the term "server" refers to at least one type of storage unit and communication unit. The storage unit includes electronically dependent, non-electronically dependent, removable and non-removable media, and any suitable method or technology can be applied to store desired information (e.g., computer-readable instructions, material structures, application program modules, and other materials) on the media. Storage media include, but are not limited to, random access memory (RAM), read only memory (ROM), electrically erasable programmable read-only memory (EEPROM), flash memory, or other memory technology, compact disc read memory (CD-ROM), digital versatile AV disc (DVD), or other optical memory, magnetic disk, magnetic tape, magnetic disk disk storage, and other magnetic storage devices, or any other medium that stores the required information and is accessible to a processor. In general, the communication unit can embodied computer-readable instructions, material, structures, application program modules, and other data in various data signals and transmitted over any communication medium. By way of example, and not limitation, communication media includes wired media (eg, a wired network or direct-wired connection) and wireless media (eg, acoustic, infrared, radio, microwave, diffusion techniques, and other wireless media technologies).

[0025] In this disclosure, the term "Fast Healthcare Interoperability Resources (FHIR)" refers to the electronic medical information exchange standard published by the International Health Information Exchange Layer 7 Protocol Consortium, which is used to improve data exchange and operability between different medical systems. Specifically, FHIR provides standardized definitions for structures including clinical and non-clinical data (e.g., electronic medical records, clinical notes, video materials, prescriptions, patient information) in medical processes, i.e., by defining fields, attributes, and relationships between data, each field has a specific data type and format, and medical information can be exchanged and shared according to a consistent structure and standard between different systems, facilitating data intercommunication between medical institutions or insurance organizations.

[0026] The term "rights management" as used herein refers to the organization and management of data, system or resource access programs, and aims to ensure that only authorized users or entities can access certain resources, functions or data. In general, "rights management" includes user identity identification and verification, delegation authority, authority review and monitoring, authority classification management, etc. In an exemplary embodiment of the present disclosure, the medical information exchange and compensation claim service system of the present invention performs acquisition rights management for medical information by establishing encrypted transmission and transmission verification.

[0027] A "hash" as used herein is a mathematical function for verifying data integrity, which converts input data into a series of fixed-length character strings (i.e., hash values). Generally, when the same hash is used, the same hash value can be generated only with the same content, so by comparing the content of two sets of hash values, the consistency of the material content can be confirmed.

[0028] II. Specific Embodiments Due to the non-uniformity of formats of various types of medical information, the systems of insurance organizations cannot automatically introduce them and need to allocate additional manpower to decipher the content and adjust the format defects. In order to alleviate this problem, the present disclosure provides a novel medical information exchange system that improves the interoperability of medical resources between different organizations based on the unified standard defined by FHIR, while maintaining the privacy of medical information.

[0029] 1. Medical data exchange and medical compensation claim system 1 is a schematic diagram of a system 100 according to an embodiment of the present disclosure. As shown in FIG. 1, the system 100 of the present disclosure is communicatively connected to a server M, and structurally includes a document exchange processing module 110, a block chain database 120, a service server 130, and an authority management computing module 140. The server M is communicatively connected to the document exchange processing module 110, and in the system 100, the document exchange processing module 110, the block chain database 120, and the service server 130 are communicatively connected to each other, and the document exchange processing module 110 and the block chain database 120 are communicatively connected to the authority management computing module 140 respectively. Thus, the original medical documents having a first format in the server M can be transmitted to the system, converted into standard documents that meet FHIR, and provided to the service server 130 (i.e., insurance institution) to provide medical billing services to the user side.

[0030] Specifically, according to some embodiments of the present disclosure, the server M stores a plurality of original medical materials, which refer to electronic medical records developed by each institution or department to record contents (not limited to) such as the patient's personal information (such as name, sex, age, marital status, type, ethnicity, occupation, place of origin, current address, place of employment, phone number, etc.), past medical history, family history, current medical history (such as current symptoms, pain, discomfort, etc.), physical examination items, laboratory examination items, diagnosis results, treatment plan, medical history (such as medical examination date, start time of treatment, doctor's name, medical treatment process description, test order, prescription, etc.), medical comments, tracking records, hospitalization records (if any), etc. Different medical institutions and / or hospitals can adjust the arrangement of medical record items according to their needs.

[0031] In addition, the original medical materials can be presented as text information, image information, audio data or video recording information according to different diagnosis contents and formats, and stored in the server M of the medical institution and / or hospital in a first format that allows information to be shared among different applications, so that doctors can circulate and add to medical records. In an optional embodiment of the present disclosure, when the original medical materials are text information, the first format can be XML, JavaScript Object Notation (JSON), YAML (YAML Ain't Markup Language), Resource Description Framework (RDF), Terse RDF Triple Language (Turtle), Comma-Separated Values ​​(CSV), Hyper Text Markup Language (HTML), Rich Text Format (RTF; or multi-character format), etc. If the original medical material is image information, the first format may be Joint Photographic Experts Group (JPEG), Portable Network Graphics (PNG), Graphics Interchange Format (GIF), Bitmap (BMP), Scalable Vector Graphics (SVG), Tagged Image File Format (TIFF), or the like.If the original medical material is audio data, the first format may be Moving Picture Experts Group Audio Layer III (MP3), Waveform Audio File Format (WAV), Free Lossless Audio Codec (FLAC), Advanced Audio Coding, ACC, QuickTime Movie (AIFF), Windows Media Video (WMV), Flash Video (FLV), Moving Picture Experts Group (MPEG), Video Object (VOB), etc. In one embodiment of the present disclosure, the original medical material is text information, and the first format may be selected from the group consisting of XML, JSON, RDF, and Turtle language. According to a specific embodiment of the present disclosure, the XML language is used as the first format to record the structure and contents of the original medical material.

[0032] The data exchange processing module 110 is communicatively connected to the server M, and is configured to receive original medical data from the server M, and convert these original medical data having a first format into FHIR standard data respectively according to a mapping command. A format converter 112 is embedded in the data exchange processing module 110 to execute a conversion program.

[0033] The format converter 112 is a tool or program for converting one data format to another, but is not limited to converting data storage formats, and may convert specific items in the original medical material to corresponding fields defined in the FHIR standard material based on the mapping instructions, with or without changing the storage format. In a specific embodiment, the format converter 112 is a format converter from XML to JSON language.

[0034] According to one exemplary embodiment of the present disclosure, when the format converter 112 receives the original medical materials, it first reads the contents of the materials, parses the XML format into an internal representation format, and maps each element or item of the original medical materials to a corresponding field of the FHIR standard according to a pre-defined mapping rule, and then performs format conversion (including steps such as data sorting, conversion, tag renaming, etc.) to generate FHIR-standardized materials that conform to the target format, and contain the contents converted from the original medical materials. The converted data is stored in a database or any designated storage unit, and / or directly output to other systems or applications of medical and insurance institutions for use. According to an optional embodiment of the present disclosure, these FHIR-standardized materials can be directly output to the service server 130 for use, and can also be transmitted to and stored in the blockchain database 120.

[0035] The mapping instruction is an instruction or a model for determining the correspondence between two different data sets to realize data transformation, integration or matching. In the present disclosure, the mapping instruction is generated by customizing based on the FHIR standard material having a second format.

[0036] Specifically, the document structure (e.g., JSON) defined in the FHIR standard document is analyzed, decomposed into resources and elements, the element configuration in each resource is managed, the field attributes and corresponding values ​​are defined, the correspondence between each item in the original medical document and the fields in the FHIR standard is determined, and the mapping command is generated. Here, the resource is the basic unit of medical document and includes medical information such as patient information, medical events, and medical observations, and the element is related information under the resource hierarchy. For example, the resource hierarchy of patient information includes elements such as name, gender, age, occupation, and place of origin.

[0037] According to some embodiments of the present disclosure, the second format is similar to the first format, and both select a suitable format for exchanging information between different applications or systems based on the profile type. Taking character information as an example, the second format may be selected from XML, JSON, RDF, and Turtle languages. In a non-limiting embodiment, the first format and the second format may be selected from XML, JSON, RDF, and Turtle languages, respectively, that is, the first format and the second format may be the same or different formats. According to a specific embodiment of the present disclosure, the first format is XML, and the second format is JSON.

[0038] The present disclosure is based on blockchain technology, which has advantages such as data security, transparency, decentralization, and tamper-proofing, and establishes a blockchain database 120 to store FHIR normative materials. As shown in FIG. 1, the blockchain database 120 is communicatively connected to the material exchange processing module 110 to receive and store these FHIR normative materials in the second format for subsequent query and operation.

[0039] The FHIR standard documents can be transmitted and stored in the blockchain database 120, or can be directly transmitted to the service server 130 that is communicatively connected to the document exchange processing module 110, so that a server-side system (i.e., the insurance institution's claims service system) or personnel (e.g., insurance claims adjusters) can generate and provide claims services based on these FHIR standard documents. Since the system of the present disclosure is for transmitting medical documents, the above claims services refer to claims for medical care, hospitalization, surgery, medication, outpatient care, rehabilitation, disabilities, and / or serious illnesses.

[0040] In addition, as shown in FIG. 1, the service server 130 is also communicatively connected to the blockchain database 120, so that the compensation claim service can be provided by accessing the FHIR standard materials in the blockchain database 120.

[0041] Medical materials contain a lot of personal information and sensitive health messages, and if they are intercepted during the exchange process, personal privacy may be exposed and identities may be falsely claimed, or medical records may be forged to commit medical fraud, etc. Therefore, in the present disclosure, an authority management calculation module 140 that is communicatively connected to the material exchange processing module 110 and the service server 130 is provided to manage the access authority of FHIR standard materials and ensure the safety and accuracy of medical materials.

[0042] 1 and 2 to better understand the operation of the authority management computing module 140. As shown in Fig. 2, the authority management computing module 140 is configured to perform the following steps:

[0043] S210: The first public key and the first private key are obtained from the server M, and the second public key and the second private key are obtained from the service server 130, respectively. S220: Generate an encryption key based on the combination of the first private key and the second public key of step S210. S230: Encrypt the FHIR reference material with the encryption key of step S220 to generate encrypted FHIR reference material. S240: Sign the encrypted FHIR reference material in step S230 based on the first private key to generate a signed FHIR reference material. S250: Perform signature verification on the signed FHIR reference material of step S240 based on the first public key to decrypt the signature, and recover the encrypted FHIR reference material of step S230. S260: Generate the encryption key of step S220 by combining the second private key and the first public key, decrypt the encrypted FHIR reference material of step S250, and obtain the decrypted FHIR reference material.

[0044] This allows for authority management of FHIR standard materials transmitted between the material exchange processing module 110, the blockchain database 120, and the service server 130.

[0045] Specifically, each medical institution or insurance institution has a pair of public keys and a pair of private keys to encrypt the profiles to be exchanged. Here, the public keys are published and circulated on the data exchange platform or system, and the private keys are stored by each institution. The authority management computing module combines the public keys and / or private keys of the sender and receiver to perform encryption / decryption and signature / signature verification, thereby verifying the accuracy of the data source and managing the access rights of FHIR standard data.

[0046] In step S210, first, a first public key and a first private key representing a server M (e.g., a hospital) and a second public key and a second private key of a service server 130 (e.g., an insurance company) are obtained, respectively, to perform the subsequent encryption steps.

[0047] In step S220, the first private key of the hospital and the second public key of the insurance company are combined to generate an encryption key through calculation. In a non-limiting embodiment, the encryption key may be a matrix, a string, or other form of data, and the specific format and type depend on the encryption algorithm and application scenario used.

[0048] In step S230, the FHIR reference material to be transmitted is encrypted with the encryption key generated in step S220. The encryption process uses a specific algorithm and encryption key to process the material and generate encrypted FHIR reference material, making it difficult for unauthorized parties to decrypt the content of the data. Only the party holding the corresponding private key (i.e., the insurance institution holding the second private key) can decrypt and restore the original readable content.

[0049] In order to ensure that the data originates from a specific hospital, in step S240, the hospital further signs the encrypted FHIR standard data with a first private key before transmitting the data. Since the first private key is not distributed on a public platform, the insurance institution can verify whether the data received includes a signature generated by the first private key to confirm whether the data originates from the hospital.

[0050] In step S250, the insurance institution uses the first public key to verify the signature, cancel the signature, and obtain the encrypted FHIR reference material. If the received material is not from the first server, the first public key cannot cancel the signature, and the encrypted FHIR reference material cannot be obtained.

[0051] Finally, in step S260, after obtaining the encrypted FHIR reference material, the insurance institution further uses its second private key in combination with the hospital's first public key to generate an encryption key identical to the encryption key generated in step S220 to decrypt the encrypted FHIR reference material, thereby restoring the encrypted content to a human-readable format and obtaining the FHIR reference material.

[0052] Preferably, the system further includes, after forming the encrypted FHIR reference material in step S230 and / or after forming the signed FHIR reference material in step S240, transmitting the encrypted FHIR reference material, the signed FHIR reference material, or a combination thereof to the blockchain database 120.

[0053] According to a particular embodiment, after step S230, the method further includes calculating the encrypted FHIR reference material to obtain a hash value corresponding to the encrypted FHIR reference material, and transmitting the hash value to the blockchain database 120.

[0054] Thus, as shown in FIG. 3, in another embodiment of the present disclosure, the system 300 has a structure substantially similar to that of the system 100, and includes a data exchange processing module 310, a block chain database 320, and a service server 330, which are communicatively connected to each other. The service server side 330 (i.e., insurance organization) of the system 300 further includes a data verification unit 332, which is communicatively connected to the block chain database 320, for calculating the received encrypted FHIR reference data to obtain a verification hash value, and comparing the verification hash value with the hash value to verify the consistency between the two. If the verification hash value matches the hash value, it indicates that the received encrypted FHIR reference data is the same as the encrypted FHIR reference data formed in step S230, or conversely, it indicates that the received encrypted FHIR reference data has been tampered with during the exchange process, losing its authenticity and cannot be used as a basis for providing a compensation claim service.

[0055] 2. How to exchange medical information and file medical compensation claims

[0056] 4 is a flowchart of a method 400 according to an embodiment of the present disclosure. As shown in FIG. 4, the method 400 of the present disclosure includes the following steps:

[0057] S410: A server is provided for storing original medical materials on the user side. S420: Receive original medical information from the server, convert the original medical information into FHIR standard information according to a mapping command, and provide a information exchange platform for providing a compensation claim service to the user side based on the FHIR standard information.

[0058] The disclosure provides a method 400 for providing a medical claim service to a user side by exchanging medical information between a medical institution and an insurance institution. Specifically, in step S410, first, the original medical documents of the user side of the compensation claim service are stored in a server of the medical institution, and the structure and content of the original medical documents are recorded as a first format (e.g., XML, JSON, RDF, Turtle language, etc.).

[0059] Next, in step S420, the original medical information stored in the server is transmitted to a information exchange platform, which is communicatively connected to the server and includes a information exchange processing module, a block chain database, a service server and an authority management computing module, which are communicatively connected to each other, to achieve the purpose of providing medical information exchange and user-side medical compensation claim services.

[0060] Specifically, the data exchange platform receives original medical data from the server through the data exchange processing module, and uses the built-in format converter to convert the original medical data into FHIR standard data based on the mapping command.

[0061] According to an embodiment of the present disclosure, the mapping command is an instruction or specification for a user to define and generate a correspondence relationship between each item in the original data and the fields of the FHIR standard document based on the structure (i.e., the hierarchical relationship between resources and elements in the FHIR standard document) and fields in the FHIR standard document. Therefore, after analyzing the structure of the original medical document, the format converter performs steps such as field rearrangement, conversion, and renaming based on the correspondence relationship defined in the mapping command, and generates medical documents that comply with the FHIR standard.

[0062] After the FHIR standard documents are generated, they are respectively transmitted to and stored in the blockchain database, and then transmitted to the server for use by the insurance institution's system or personnel, so as to provide the corresponding claims services to the user side.

[0063] In order to improve security and privacy when medical information is exchanged on the information exchange platform, the authority management computing module performs authority management for access to the medical information when the medical information is transmitted between the information exchange processing module, the blockchain database, and the service server. Specifically, the authority management computing module is for performing the steps of: (a) respectively obtaining a first public key and a first private key from the server, and a second public key and a second private key from the service server; (b) generating an encryption key based on the combination of the first private key and the second public key of step (a); (c) encrypting the FHIR reference material with the encryption key of step (b) to generate encrypted FHIR reference material; (d) signing the encrypted FHIR reference material of step (c) based on the first private key to generate signed FHIR reference material; (e) performing signature verification on the signed FHIR reference material of step (d) based on the first public key to release the signature, and recovering the encrypted FHIR reference material of step (c); and (f) generating the encryption key of step (b) based on the combination of the second private key and the first public key of step (a), and decrypting the encrypted FHIR reference material of step (e) to obtain the decrypted FHIR reference material.

[0064] Thanks to the authority management program that performs the encryption / decryption and signing / signature verification, even if a third party intercepts the medical data during transmission, the contents of the original medical data cannot be read, and it is possible to confirm that the medical data received is from the designated medical institution.

[0065] According to some preferred embodiments of the present disclosure, the authority management calculation module further performs the step of, after step (c), calculating a specific mathematical function and the encrypted FHIR reference material to obtain a hash value of a specific length of characters, and transmitting the hash value to the block chain database. In a preferred embodiment, the service server is further configured with a material verification unit. The material verification unit is communicatively connected to the block chain database, and calculates the encrypted FHIR reference material from the material exchange processing module or the block chain database to obtain a verification hash value, and compares the verification hash value with the hash value in the block chain database. If the comparison result is consistent, it indicates that the received encrypted FHIR reference material and the encrypted FHIR reference material formed in step (c) are the same; if the comparison result is not consistent, it indicates that the received encrypted FHIR reference material and the initial encrypted FHIR reference material formed in step (c) are different, and the content may have been tampered with during the exchange process.

[0066] As described above, the present disclosure provides a system and method for exchanging medical information and handling medical compensation claims, which converts medical information into information that meets the FHIR standard, thereby improving the interoperability of information between medical institutions and insurance organizations, effectively shortening the time required for compensation claim assessment, and automatically integrating medical information into the insurance organization's system, and providing medical compensation claim services to users.

[0067] It should be understood that the above description of the embodiments is merely an example, and various modifications may be made by those skilled in the art. The above specification, examples, and experimental results provide a complete description of the structure and use of the exemplary embodiments of the present invention. Although various specific embodiments of the present invention are disclosed in the above embodiments, they are not intended to limit the present invention. Those skilled in the art to which the present invention pertains may make various changes and modifications without departing from the principle and spirit of the present invention. Therefore, the protection scope of the present invention shall be subject to the scope of the attached patent application.

[0068] Explanation of symbols 100, 300 systems 110, 310 Material exchange processing module 112 Format conversion section 120, 320 Blockchain Database 130, 330 Service Server 332 Document Verification Unit 140, 340 Authority Management Calculation Module S210-S260, S410-S420 Step 400 ways M Server

Claims

1. A system for realizing medical data exchange and medical claims based on Fast Healthcare Interoperability Resources (FHIR) standard data, comprising: The system is for communicatively connecting to a server, the server including a plurality of original medical documents having a first format; The system includes a material exchange processing module, a block chain database, a service server, and an authority management computing module; The document exchange processing module includes a format converter for receiving original medical documents from the server and converting the original medical documents into a plurality of FHIR-standard documents according to a mapping command; The blockchain database is communicatively connected to the document exchange processing module and stores the FHIR normative documents; The service server is communicatively connected to the data exchange processing module and the block chain database, and provides a compensation claim service based on the FHIR standard data; The authority management calculation module is communicatively connected to the document exchange processing module and the service server, and performs authority management for each of the FHIR normative documents; When the FHIR reference material is transmitted between the material exchange processing module, the block chain database, and the service server, the authority management computing module performs authority management on the FHIR reference material by performing the following steps (a) to (f): (a) obtaining a first public key and a first private key from the server, and a second public key and a second private key from the service server, respectively; (b) generating a cryptographic key based on a combination of the first private key and the second public key of step (a); (c) encrypting the FHIR reference material with the encryption key of step (b) to generate encrypted FHIR reference material; (d) signing the encrypted FHIR reference material of step (c) under the first private key to generate signed FHIR reference material; (e) performing a signature verification on the signed FHIR reference material of step (d) based on the first public key to decrypt the signature and recover the encrypted FHIR reference material of step (c); (f) generating an encryption key in step (b) based on a combination of the second private key in step (a) and the first public key, and decrypting the encrypted FHIR normative material in step (e) to obtain the decrypted FHIR normative material.

2. 2. The system of claim 1, wherein the mapping instructions are generated by customizing based on a FHIR standard document having a second format.

3. 3. The system of claim 2, wherein the first format is an extensible markup language (XML) and the second format is a JSON language.

4. The system of claim 3 , wherein the format converter is an XML to JSON language format converter.

5. 2. The system of claim 1, further comprising, after forming the encrypted FHIR normative material in step (c) and / or after forming the signed FHIR normative material in step (d), transmitting the encrypted FHIR normative material, the signed FHIR normative material, or a combination thereof to the block chain database.

6. 6. The system of claim 5, further comprising, after step (c), computing the encrypted FHIR normative material to obtain a hash value and transmitting the hash value to the blockchain database.

7. 7. The system of claim 6, wherein the service server further comprises a material verification unit communicatively connected to the block chain database and configured to calculate the encrypted FHIR normative material to obtain a verification hash value and verify a match between the verification hash value and the hash value.

8. A method for enabling a user to exchange medical information and claim medical compensation based on FHIR standard information, providing a server containing original medical material at a user site, said original medical material having a first format; Providing a material exchange platform including a material exchange processing module, a block chain database, a service server, and an authority management computing module, which are communicatively connected to each other, and which is communicatively connected to the server; Including, The document exchange processing module includes a format converter for receiving the original medical documents from the server and converting the original medical documents into FHIR standard documents according to a mapping command; The blockchain database stores the FHIR normative material; The service server receives the FHIR standard data, and provides the user with a compensation claim service based on the FHIR standard data; The authority management computing module executes the following steps (a) to (f): (a) obtaining a first public key and a first private key from the server, and a second public key and a second private key from the service server, respectively; (b) generating a cryptographic key based on a combination of the first private key and the second public key of step (a); (c) encrypting the FHIR reference material with the encryption key of step (b) to generate encrypted FHIR reference material; (d) signing the encrypted FHIR reference material of step (c) under the first private key to generate signed FHIR reference material; (e) performing a signature verification on the signed FHIR reference material of step (d) based on the first public key to decrypt the signature and recover the encrypted FHIR reference material of step (c); (f) generating an encryption key in step (b) based on a combination of the second private key in step (a) and the first public key, and decrypting the encrypted FHIR reference material in step (e) to obtain the decrypted FHIR reference material.

9. The method of claim 8 , wherein the mapping instructions are generated by customization based on the FHIR standard material.

10. The authority management computing module includes:

10. The method of claim 8, further comprising, after forming the encrypted FHIR normative material in step (c) and / or after forming the signed FHIR normative material in step (d), performing the following step of transmitting the encrypted FHIR normative material, the signed FHIR normative material, or a combination thereof, to the block chain database.

11. The authority management computing module includes: after step (c), computing the encrypted FHIR reference material to obtain a hash value; and transmitting the hash value to the block chain database; The method of claim 10 further comprising:

12. The method of claim 11 , wherein the service server further comprises a material verification unit, communicatively connected to the block chain database, for calculating the encrypted FHIR normative material to obtain a verification hash value, and verifying the consistency between the verification hash value and the hash value.

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