Yunnan Province, The Remote Settlement Of The Basic Medical Insurance Information Systems Research And Development

Site-off health insurance has been one of the most important issues for both the medical insurance institutions and insured persons. To address this concern, the use of information technology plays the key role in establishing provincial nonlocal medical service platform, in solving the inter-regional access to health insurance for the insured, and in reducing the burden of loaning. This is important for improving the social security, and it has become an urgent need for livelihood.As the objective of building nonlocal medical insurance billing system, in this article, we analyse the existing two-and three-level models of health insurance IC card system in the province scope. We also discuss some branches of the remote medical insurance billing system, such as the basic information management, management of the insured indivadule, expense manage, fund settlement and other business requirements. According to the present stage and the need for site-off medical insurance, we conducted overall architecture design under the premise of less impact on the transformation of the existing healthcare information system. From system architecture and application of the system design point of view, it is designed that the system includes trading and management platforms. In the designing phase, we discuss in detail the system's main business processes and main functions, data architecture, database design, system hardware and software, key technical strategies. Through this trading platform, it meet the requirement of remote real-time insurance card for medical treatment. What is more, the trading platform answered the site-off transaction request and function calling of 17 provincial health insurance system. By the management platform designing, it is implemented to central supervision of health insurance on the off-site medical personnel and medical data. On the other hand, on the business adminstration level, we design the management models for province-level settlement accounts center and for advanced loaning and funding to solve the issue of remote fund allocation.The system designing is based on the Tuxedo and J2EE technology and the B/S/S mode. In all, this selected technical modes has been-proven to be mature and stable. Nowadays, the system has been mapped out and deployed at the provincial level and Qujing, Nujiang and Pu'er. It has been realized in these places to achieve the billing of insured off-site medical card insurance, greatly reducing the burden of medical expenses. The results are so far so good.