“互联网+”与大数据在医疗保险领域中的创新应用

The Innovative Application of “Internet+” and Big Data in the Field of Medical Insurance

多年以来,社保业务系统形成了多险合一系统为主的建设格局,并于近年开始向省级集中部署迈进。截至2017年底,从医疗保险角度看,全国共有支持城镇职工医保(含整合建设的城乡居民医保)业务经办管理的地市级以上社保系统334个,其中多险合一系统占85%;从地市角度看,94%的地市的城镇职工医保业务采用多险合一系统。18个省份已全面完成城乡居民医保系统整合建设,7个省份的部分地市完成系统整合建设。随着全民医保时代的到来,各类云计算、互联网、大数据新技术在医疗保险业务领域中的应用,将进一步促进医疗保险精准服务、精确管理和科学决策。但在新技术运用中需要特别重视数据安全,牢记个人隐私保护和信息安全的底线。

Over the years, the social insurance business system has formed a integrated insurances system, and has begun to move towards the provincial-level construction in recent years.By the end of 2017, from the perspective of medical insurance, there were 334 social security systems above the city level supported the medical insurance of urban workers（including medical insurance for urban and rural residents with integrated construction）, of which 85% adopted integrated insurances system.From the point of view of the cities, the medical insurance business of urban workers in 94% cities adopts a integrated insurances system. The 18 provinces have completed the integration of urban and rural residents＇ medical insurance system, and some of the 7 provinces have completed the system integration.With the advent of the national medical insurance era, the application of all kinds of cloud computing, internet and big data technology in the medical insurance field will further promote the precise service, accurate management and scientific decision-making of medical insurance. But in the application of new technology, we need to pay special attention to data security, and keep in mind the bottom line of personal privacy protection and information security.