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What we do

Infrastructure Management

Korea Pharmaceutical Information Service (KPIS)

Korea Pharmaceutical Information Service procedure

    1. Drug Informatization Management (Standardization of drug codes)

  • Drug manufacturers and importers apply for standardized code of KPIS after obtaining MFDS approval. KPIS notifies the applicant the code within 30 days of receiving application (Standardization , full declaration, and ATC code linkage of all drugs distributed in Korea)
  • 2. Manage and disclose information on drug production, import, supply, and consumption

  • Collects and manages distribution information of drug suppliers. Information about unsafe drugs which are suspended from sales by KFDA are sent to KPIS real-time. Then the information is provided to drug suppliers (manufacturer, importer, and wholesaler)
  • Produce national statistics of drug distribution information for the government, public, and institutions using DW of collected information through portal system
Operational Performance
  • Ensure transparency of drug distribution by managing national standardized drug code
  • Foster healthy development of drug industry by providing drug distribution information
  • Save health insurance expenditure by analyzing drug distribution and usage information (2013 : 22.8 billion KRW)
  • Protect public health by managing pharmaceutical distribution information real-time. Using the state of the art ICT technologies such as Internet of Things (loT)

    Harmful drug use will be prevented by linking the information to RFID Tag.

  • Generate national statistics based on drug distribution information (production, profit, and etc)

Healthcare Information Analysis procedure

Healthcare information analysis system is linked to related systems which collects necessary data in order to generate national healthcare statistics and indicators of medical claim review and assessment The system also analyzes series of data

ETL (Extraction, Transformation, Load): Completed claims review data is auto-matically sent to DW system. The data is then converted and cleansed and managed as EDW(Enterprise Data Warehouse), Data Mart, and Summary Tables

Inspection error in data: Loaded data in DW system secures accuracy and relia-bility by inspecting errors

End-users analysis: A large amount of reports of various topics are directly produced and utilized by using OLAP(On-Line Analytical Processing) tool

Every user can utilize necessary information such as records of medical claim, a trend of drug uses, pharmacy’s overlapped prescription

Operational Performance
  • Produce and provide international healthcare statistics (WHO, OECD)

    Support policy-making through swift/accurate production of national statistics

  • Reduce workforce for review and assessment standard and indicator development by using automation and science
  • Support healthcare research in related organizations and the academia
  • R&D support of medical & pharmaceutical industries
  • Various data analysis by analyzing medical records of all citizens
  • Continuous monitoring of changes in medical spending for efficient management of medical resources
  • Operate disease prevention program based on accumulated data on provided services

Healthcare resources management procedure

  • Providers report their status such as establishment, closure, temporary closure, changes in equipment and/or facility. HIRA gives provider code (eight digits) to providers which is used for claims process
  • Medical resources information that is managed by HIRA has been utilized for various purposes such as review and assessment If claims are made without reporting accurate information on resources, reimbursement may be adjusted automatically during claims review process. In addition, collected data is used for assessment process
  • Reported medical resources information is reviewed by various method and pro-vided to policy-makers as support materials
Operational Performance
  • Rational allocation and utilization of limited healthcare resources through integrated management of medical resources nationwide

    Medical resources information of HIRA is utilized for the national health statistics of government and international organizations (OECD, etc.)

  • Tracking distribution records of major medical equipments prevents false or recurring report - Barcode system (old equipment management)
  • Reduce medical spending by linking medical resources information with review and assessment data

Types of patient classification system

The types of patient classification system includes inpatient (KDRG), outpatient (KOPG), and Korean traditional medicine outpatient (KOPG-KM)

  • Patient classification system (Patient Classification System, PCS) classifies groups of out-patients or inpatients by clinical and resource con-sumption (eg: DRG).
  • When comparing levels of medical fee and quality among providers, the composition of patients must be at the same level. Patient classification system is a tool to adjust the differences among providers
Operational Performance
  • Contribute to create efficient and advanced medical claims review and quality assessment
    • Relative value given to a healthcare provider based on the average (eg. Cl)
  • Define appropriate payment unit of medical payment system (DRG)
  • Possess Korea’s only patient classification system and electronic classification program (Grouper)
  • Efficient management by using automated electronic classification program