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
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