Hospital medical insurance two—channel drug whole process management system and new exploration of efficiency improvement and safety supervision

ZHANG Caifeng; HAO Ruiping; DONG Min; LIU Huiying

Abstract：Objective:In view of the problems of single patient application channel,cumbersome reimbursement process,time—consuming prescription review,difficult medication supervision and other problems in the traditional'two—channel'drug hospital management mode of medical insurance,explore the construction of a two—channel drug whole—process management system in hospital medical insurance,aiming at optimizing the application efficiency and strengthening the whole—process supervision ability.Methods:Based on the policy requirements and the actual needs of the hospital,the hospital hospital information system(HIS)system was integrated by information technology,and the closed—loop management system of application,review,circulation,supervision and quality improvement was designed.Use blockchain technology to ensure data security,introduce intelligent audit rules,improve application efficiency,serv-ice quality,and standardize the rationality of drug use.Results:After the system was launched,the time from application to drug purchase was reduced to less than 30 minutes,the average prescription circulation time was less than 1 minute,and the qualified prescription accuracy was increased by more than 90％.Audit efficiency was improved to 99.4％,and patient satisfaction increased to 98％.Conclusion:The whole process management system of two—channel prescription circulation in hospital medical insurance significantly improves the efficiency of application,review and service efficien-cy.In the future,it is necessary to further strengthen cross—institutional data interoperability,improve the risk preven-tion and control mechanism,and promote the application of the 'dual channel' model in a wider range.