基于互联网+社保药品电子监管平台

Social Security Drug Electronic Supervision Platform Based on Internet Plus

随着医药分离步伐的加快,药品监管对医保基金安全的影响越来越大,药品追溯体系对于药品管理显得尤为重要。提出的基于互联网+社保药品电子监管平台(以下简称药品电子监管平台),是基于"医保用药行为"、在顺应医药行业政策发展趋势的基础上,以"一药一码"为切入点,通过收集药品生产、流通和消费数据,利用信息技术主动、快速发现药品消费环节上存在的"一药多卖"和虚假购药行为,在药品交易过程中实现对"挂床就医"、"串药换药"、"刷卡套现"等骗保行为的实时监控和事前拦截,切断药品交易领域黑色利益链,减少基金流失,保证基金运行安全。

With the acceleration of the pace of medical separation,the influence of drug supervision on the safety of medical insurance funds is increasing. The drug traceability system is particularly important for drug management. The Internet-based social security drug e-regulatory platform （hereinafter referred to as drug electronic supervision platform） proposed in this paper is based on the “Medicare drug behavior” and on the basis of the development trend of the pharmaceutical industry policy,taking “one medicine and one code” as the entry point. Through the collection of pharmaceutical production, circulation, and consumption data, the use of information technology to actively and quickly discover the existence of “one-drug and multiple-selling” and illicit drug purchase behaviors in the drug consumption segment, and realize “Deception during hospitalization”、“ Deception in prescriptions” and “swiping card holders＇main arbitrage” during the drug trading process. The real-time monitoring and prior interception of fraudulent protection activities, cut off the black interest chain in the drug trading field,reduced the loss of funds,and ensured the safe operation of funds.