Sunday, 5 January 2014

Suzhou hospitals get real time online data monitoring for insurance and medication claims

The Suzhou social insurance fund has implemented an online real time data handling system for 43 hospitals that allows medical insurance claims and medication dispensing to be verified to enhance quality assurance and prevent fraud. The new system replaced the old manual input of claims data last year, and allows the health fund to collate medical insurance claims data alongside medication use and patient and hospital details. The system allows the social insurance centre managers to identify abnormal prescribing patterns and to give feedback directly to the hospital and the clinicians. For instance, in the first three months of operation data analysis has revealed that some male patients have been given medications for female medical problems and others have been given drugs for a different indication to the one for which they were being treated. The new system marks such anomalies with a red flag and gives feedback to the prescriber and to the hospital.
Source: Suzhou Daily

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