摘要
目的:基本医疗保险城乡统筹和一体化管理进入了实质化执行阶段,分块管理的医保三险(城镇职工、城镇居民、新农合)正逐步改为统一的经办机构,这也是完善医保制度、体现社会公平、提高管理效率和保障绩效的客观要求,总结并讨论现行的医疗保险信息系统在多开发商、维护升级应用过程中难点及应用经验,提出数据交互与共享方面实施工作的技术难点和解决方法,希望能对未来医疗保险信息系统的整合工作有所帮助。方法通过对现状及问题的分析,举例说明包括数据项标准、数据格式、代码标准等数据接口标准建设方面应采取的措施,提出可行性规范的解决办法。结果结合当前形式和政策的要求,从科学性、系统性、可扩展性、兼容性和综合性方面对信息系统数据接口进行管理规范,确保了政策顺利实施。结论建立标准化的信息分类编码是打造具有可扩展性、实现方式灵活、能较快的适应调整政策和运行环境等改变成功系统的重中之重。
Objective Urban and rural basic medical insurance coordination and their integrative management have come into an essential implementation phrase,and the three kinds of medical insurances(urban workers,urban residents and the NCMS)under block management are gradual y replaced by a unified agency,which is also the objective requirement of medical insurance system maturity,social equity embodiment,management ef iciency improvement and performance guarantee.The dif iculty and experience of current medical insurance information system by multiple developers in the process of maintenance,upgrade and application are summarized and discussed,and the technical dif iculty and solution in data exchange and share are proposed,in the hope of helping the future integration of medical insurance information system.Methods Through the analysis of current situation and problems,measures to be taken in the construction of data interface standard,including data item criteria,data format,coding standard etc.are il ustrated,and feasible and standard solutions are proposed.Results According to the requirement of present situations and policies,information system data interface is managed and regulated from the aspects of science,scalability,compatibility and integration,making sure that policies are carried out smoothly.Conclusion To establish standardized information classification and coding is the top priority in the successful system that means creating scalable,flexible approach,adapting quickly to adjust policies and changes in the operating environment.
作者
李颖
肖启民
LI Ying;XIAO Qi-min(The People's Hospital of Liaocheng City,Liaocheng 252000,Shandong,China)
关键词
医保三险合一
信息系统整合
数据接口
Three-to-one medical insurance integration
Information system integration
Data interface
