Strictly control the cost of medicine and make new moves! Doctor's prescription will be supervised in real time

Source: Fujian daily, November 18, 2016, "the difficulty of medical reform lies in the control of doctors' prescriptions." This is the consensus of the industry on the difficulty of medical behavior supervision In our province, the problem has been solved Recently, Fujian Medical Insurance Office issued the notice on doing a good job in the code management of medical insurance doctors in the province, which requires the medical insurance agencies in cities and districts within the province to complete the code collection, summary and audit of medical insurance doctors in the region around December 31 The approved codes shall be input into the provincial code base of medical insurance doctors, and the unified management of the whole province shall be implemented The provincial unified management doctor code is the first one in China The information included in the code of medical insurance doctor includes the basic personal information of the doctor, the information related to the qualification certificate of the doctor, the information related to the registration certificate of the practicing doctor, the medical institution, Department, position, title, etc Among these information, the most important is the doctor's identity card information and the doctor's qualification card related information After all codes are put into storage, the code of the medical insurance doctor will be "bound" with each medical insurance expense If the doctor prescribes the medicine unreasonably, the expense will be traced to an individual From cost tracking to individual, it is to manage the whole process of doctor's medical behavior "in advance, in the process and after the event", and realize accurate supervision and control of cost Fujian Province has been exploring the code management of medical insurance doctors, the head of the Fund Office of provincial medical insurance office told reporters In order to supervise doctors' medical behaviors, Fujian Province uses database and information system to check whether the prescription is reasonable and whether there is cheating of medical insurance funds However, this kind of supervision can only be traced back to the hospital, telling the hospital how much unreasonable expenses have been incurred internally, and at best only urging the hospital to strengthen supervision At the same time, due to the decentralized management of coding in different regions, the management promotion between regions and hospitals is different "After the provincial unified management, the designated medical institutions shall upload the code information of medical insurance doctors together with the medical expenses to the medical insurance agencies The medical insurance fund will not pay for the expenses incurred by doctors who are not included in the unified code management in providing medical services to the insured " The person in charge said, "these expenses include not only the doctor's diagnosis and treatment fee, but also the patient's medicine, inspection and other expenses The consequences of not paying are mainly borne by designated medical institutions." He further explained that "in advance" is "in advance reminder", which means that before doctors prescribe a prescription, they can know what violations they have through the system, so that they can correct themselves; "in the process" is "in the process control", which means that when they prescribe a prescription, the system can intercept their violations; afterwards, they review and trace their violations The other function of unified management of doctor code is to make doctors' identity clear, self-discipline and standardized management in multi-point practice, which will provide a strong management support for unlocking doctors' practice restrictions and promoting multi-point practice in our province The head of provincial medical insurance office said that in addition to the subordinate relationship between doctors and public hospitals, the management difficulty was also one of the reasons for the "cold" of multi-point practice policy After the unified management of codes, the second and third medical institutions where doctors practice multi-point should report the code information of multi-point doctors in the institutions, just like the hospitals where doctors currently belong, and the problem of who manages the behaviors of doctors after multi-point practice will be solved.