网络环境下医院医疗保险工作流程优化与重建

Business Process Reengineering of Medical Insurance in Web-based Environment

随之现代网络技术的应用与普及,计算机技术、网络技术、数据库技术等先进管理手段和方法正逐步走进医院管理者的日常工作中,同时,由于医保政策的调整及医保网络工作环境的逐步形成,一些旧的工作模式、工作方法已不能适应新的形势。我们利用业务流程优化与重建(Business Process Reengineering,BPR)理论,以服务病人为中心,树立人文关怀理念,结合医院实际,对原有医保工作流程进行了优化,着重对计算机网络环境下的医保病人就诊、住院、费用结算、信息审核等工作进行了优化和部分重组,在优化医院医保工作流程方面做了一些探索和工作。事实证明,优化后的工作流程,信息传递更为顺畅,提高了工作效率,加强了全过程的质量管理,取得了较好的应用效果。

As the widespread application of modem cyber technique, hospital administrators are gradually familiar with advanced management technologies, such as computer, Interact and database. Owning to the adjustment of medical insurance policy and the establishment of web- based rmedical insurance system, some traditional working styles and methods are not fit with new situation. Our practice was based on the theory of Business Process Reengineering （BPR）, the patient -oriented service as well as the ideology of respecting and caring the individuals. In the course of BPR, we focus on optimizing and partially reengineering the web - based procedures of fee paying on admission, registration, and hospitalization. The optimized process has improved the information transmission, increased working efficiency and enhanced the quality.