INFORMATION SYSTEM FOR THE ACCOUNTING OF CENTRALLY PROCURED MEDICINES AND MEDICAL AIDS AND MANAGEMENT OF COMPENSATION WAITING QUEUES OF THE NHIFClient:
NATIONAL HELATH INSURANCE FUND UNDER THE MINISTRY OF HEALTHPeriod:
2014/11 – 2015/10Solutions:
The developed queue management system EVIS automates and combines processes involving the NHIF, health care institutions and patients, ensuring transparent and accurate decisions made on distribution of medical aids, medicines and compensations.
EVIS is an electronic service system enabling the provision of the relevant information electronically in real time to each party involved in the process and providing a quick, simple and reliable official means of communication between the NHIF, patients (regardless of the patient’s place of residence) and associated medical institutions.
EVIS has installed automated procedures, which exchange information with other NHIF systems (Document Management, the Register of the Insured by Compulsory Health Insurance, Financial Management and Accounting, etc.) without human intervention at the set intervals of time or upon the concurrence of certain conditions, and complete tasks, thus ensuring prompt and transparent queuing and compensation allocation activities.
EVIS helps to ensure the compliance of the processes with requirements of rules and laws, because the implemented solutions check whether, say, a physician, prescribing a procedure, surgery or allocating compensation holds an appropriate license, whether a medical institution has not exceeded its limits, etc.
Patients can always monitor their queue status and time online, receive reminders and promptly exchange information with medical institutions and the NHIF.
Joint activity partners implemented the queue management solution, which consists of the following:
- Accounting of expenses from the budget of the Compulsory Health Insurance Fund (CHIF) for centrally procured joint prostheses and their accessories, and the management of queues waiting for compensations allocated for patients having purchased the prostheses at their own expense, also including the inventory management functionality;
- Accounting and management of CHIF budget expenses for centrally procured medicines and medical aids, including the inventory management functionality;
- Accounting of CHIF budget expenses for orthopedic technical measures and the management of queues waiting for compensations allocated for patients having purchased the measures at their own expense;
- Accounting and management of CHIF budget expenses for outpatient oxygen treatment;
- Accounting of dental prosthesis expenses covered from the CHIF budget, also, accounting and management of compensations allocated for covering the expenses of prostheses purchased by patients at their own expense;
- Accounting and management of CHIF budget expenses for hearing aids and cochlear implants, BAHA bone-anchored hearing devices, middle air implants and spare cochlear implant processors.
The EVIS contains 4 components: warehouse management and calculation module, internal portal, external portal and public portal,
EVIS is used by all medical institutions (both public and private owned) that have agreements regarding compensations with NHIF.
EVIS is used by 50 internal users, 200 external users, public portal is designed to serve up to 1,5 million patients to monitor their queues status in real time regime.
SAP ERP Central Component (ECC), SAP NetWeaver Composition Environment (CE), SAP NetWeaver Process Integration (PI), JAVA, Oracle DBMS.