区块链赋能医疗收费电子票据管理的理论逻辑与实践经验

Theoretical Logic and Practical Experience of Blockchain Empowering Medical Electronic Bill Management

在健全多层次医疗保障体系的目标下,实行医疗收费电子票据改革愈发重要。然而,医疗收费电子票据在应用过程中存在的骗保风险高、流转链条脱节、监管追责繁难等现实困境制约了其规模化推广。基于数字技术赋能理论,厘清了区块链赋能医疗收费电子票据管理的理论逻辑,构建了区块链医疗收费电子票据平台;通过对平台在实践中形成的“链盖章”模式进行系统的案例分析探究了应用区块链开展医疗收费电子票据管理的实践经验。研究发现区块链技术能够通过塑造票据流通生态链、构建可信业务网络、更新监管治理模式3个维度革新医疗收费电子票据管理。在实践中,应用区块链技术开展医疗收费电子票据管理时,应打造“政府部门主导、技术提供方支持、多主体参与”的联合型区块链平台建设模式,搭建合作水平高效、技术应用能力和接受能力良好的高质量平台应用生态,同时,建立多层次多维度的平台评价体系,以便对平台进行有针对性改进。基于研究结论,从技术、标准、监管3个角度提出建议,助力区块链医疗收费电子票据平台的落地,加速医疗收费电子票据的发展。

With the goal of improving the multi-level medical security system,it is increasingly important to implement the reform of medical electronic bills.However,the high risk of fraudulent insurance,disconnected circulation chain,and difficult regulatory accountability in the application process of medical electronic bills have hindered their large-scale promotion.Based on the theory of digital technology empowerment,the theoretical logic of blockchain empowering medical electronic bill management has been clarified,and a blockchain medical electronic bill platform has been constructed.Through a systematic case analysis of the"chain seal"model formed by the platform in practice,the practical approach of blockchain empowering medical electronic bill management was explored.Research has found that blockchain technology can innovate medical electronic bill management through three dimensions:shaping the bill circulation ecosystem,building a trusted business network,and updating regulatory governance models.In practice,when applying blockchain technology to manage medical electronic bills,a joint blockchain platform construction model of"government department led,technology provider supported,and multi subject participation"should be created to build a high-quality platform application ecosystem with efficient cooperation,good technology application ability,and acceptance ability.At the same time,a multi-level and multi-dimensional platform evaluation system should be established to make targeted improvements to the platform.Based on research findings,suggestions are proposed from the perspectives of technology,standards,and regulation,to assist in the implementation of blockchain medical electronic bill platforms and accelerate the development of medical electronic bills.