Second Generation of Medical Information System for National Health Insurance Project (MED2)

The Bureau of National Health Insurance (BNHI) is a government-run insurance provider under the direct supervision of the Department of Health. In addition, the Bureau is also the only legitimate insurer to implement the National Health Insurance Program. Six branches spread across Taiwan to serve the general public, which provide over 120 billion US dollars to hospitals every year . MED2 uses the latest technologies and system structures combined with modular designs to increase the BHNI's adaptiveness, productivity as well as centralize management processes. On top of MED2 is a convenient website which provides communication between the BHNI and healthcare centers throughout Taiwan, and enables the BNHI to issue insurance and statistical information to hospitals as well as providing an insurance claims portal.

History
In 1995, the National Health Insurance program was launched, providing a universal healthcare solution to all Taiwanese citizens. However development of the first Medical Information System started in 1994 when the III was awarded the project from by the Department of Health, Executive Yuan. MED2 was in development for almost seven years (2001-2008) and integrates data from Department of Health to minimize the inconsistencies found in the previous version.

Challenges

• Working with dynamic payment regulations to adhere to new BNHI regulations
• Providing feasible means to manage an enormous amount of daily hospital claims data
• Processing data timely and correctly, as well as sharing and transmitting data among branches of BNHI throughout the country
• Conversion of the output from data processing immediately into proper syntax and format for users
• Kernel Integration with six other systems as well as the previous Medical Information System
• Building twenty-nine subsystems to manage over 20 thousand hospitals and clinics in Taiwan
• Ensuring data consistency and speed between the BNHI and its branches
• Providing over 28000 man hours of system training to over 6000 users

Benefits

• Modular Examination Mechanisms - Applies modular rule-based examination mechanisms to outpatient, inpatient, and pharmacy claims, which are easily configured by system administrators.
• Flexible Payment System - Budget configuration keeps the expenditure of national health insurance within a reasonable range. MED2 provides pay withholding and excess recovery mechanisms which allows the BNHI to pay hospital claims quickly and allows hospitals to return excess money easily.
• Fully Integrated Accounts - Hospital management, payment, and financial systems are fully integrated allowing users to control expenditures easily.
• Complete and Timely Data Exchange - Enables the BNHI to process business audits and hospital claims timely and effectively.
• Controllable Execution Environment - Central control increases data security and avoids errors caused by manual intervention.
• Embedded Auditing Procedure - Users receive warning messages immediately from every check point, and resolve any system abnormalities according to the audit log.

Customer Links

• Bureau of National Health Insurance

Contact Window
For any inquiries e-mail services@infoexplorer.com.tw