Design And Implementation Of Shanxi Province Remote Medical Immediate Settlement System

With the development of social economy,the migrating population is increasing year by year,remote medical treatment is more and more popular.Being a localized management,our medical insurance policy causes some problems such as long period of reimbursement,high pressure with capital,and overhead in transportation of patients.Therefore,to promote nationwide network and a direct remote medical settlement of primary medical treatment,it is necessary for an adaption to the need of migration of the basic medical insurance and guarantee sustainability of system.Based on the actual needs of remote medical settlement business in shaanxi province,a real-time settlement system for remote medical treatment in shaanxi province is designed and implemented with a compliance to protocols of software engineering.Connected with the remote medical treatment system of the department of human resources and social security,the system solves the urgent problems associated with advanced payment of medical insurance enrollees of urban employees,fund settlement and data sharing among institutions.The real-time settlement system is mainly composed of five subsystems:Settlement Software of designated medical institutions,pre-settlement service of designated medical institutions,core management system of remote medical treatment,pre-settlement interface of insured places and pre-settlement interface of insured places.In the requirement analysis stage,it studies the key business processes,such as the unification of the three catalogues,the identification of the qualifications of medical personnel in different places,and the settlement of insurance personnel in different places.It aslo analyze the information flow between the management agencies and clarify the system requirements.In the system design stage,from different angles,it designed from network,database and relationship etc.In the technical modeling stage,we choose the B/S/S architecture model of J2EE platform,Oracle 10 database,Weblogic 11 middleware,Web Service and Tuxedo connection,in order to realize the data interaction between Shaanxi Provincial remote medical settlement system and ministerial remote medical settlement platform.To solve the inter provincial remote medical billing problems;In the detailed design stage,five important functions are selected,such as registration in different places,audit of hospitalization expenses in different places,daily reconciliation of hospitalization settlement data in different places,monthly settlement of medical institutions and notice of payment of expenses,It shows the concrete realization of functions.In the system testing phase,the function test and performance test of the core system of Shaanxi Province were carried out,and the test cases and test results were described in detail.Finally,the paper summarizes and prospects the remote settlement system in Shaanxi Province,and puts forward reasonable suggestions.