In addition to the medical codes for medical care actions that are taken, essential information that a clinical accounting system requires for making clinical accounting computations includes patient information, health insurance information, and diagnostic information. There are various conceivable operating forms for such information interchange. Although CLAIM does not specify an operating form, a conceivable operating form is presented hereinafter as an example of data interchange between an electronic medical chart system and clinical accounting system. The aim is to provide a better understanding for implementation system development. (See Table, "Example of operating form.")
Patient information and health insurance information are controlled by means of the clinical accounting system. Data input, too, is performed from the clinical accounting system side. On the other hand, the contents of medical care actions for medical requests and diagnosis information for medical care actions are input from the electronic medical chart system side. An electronic medical chart system in a case such as this includes a function for inputting medical care actions, but does not have a clinical accounting computation function. During outpatient appointment or during the input of hospitalization medical care action information (order), an MML patient information module and MML health insurance information module are sent from the clinical accounting system to the electronic medical chart system as an MML instance. When the medical care action information (order) is being input into the electronic medical chart system, the document ID that corresponds to the MML health insurance information module is input into the appointment request module so that the medical care action and utilized health insurance match. After the medical care action is input into the appointment request module, the MML instance that includes the appointment request module is transferred from the electronic medical chart system to the clinical accounting system. If necessary, diagnosis information is transferred from the electronic medical chart system to the clinical accounting system as an MML diagnosis information module and as an MML instance that is identical to or separate from the appointment request module. Based on the appointment request module that is transferred to the clinical accounting system, over-the-counter accounting or medical insurance invoice creation is performed with the clinical accounting system.
With the appointment request module, it is possible to record the status of three items: appointment, registration, and performance. When future follow-up consultation appointments and test appointments are sent to the clinical accounting system with an electronic medical chart system, the status is "appointment." During outpatient registration, the appointment information is sent from the clinical accounting system to the electronic medical chart system in "registration" status. And when the appointment information is implemented, medical care action information is sent from the electronic medical chart system to the clinical accounting system in "performance" status.
A point/monetary amount module has been prepared for viewing, from the electronic medical chart system, request points and requested monetary amounts that are computed by the clinical accounting system.
With the aforementioned operating form, patient information and health insurance information is assumed to be controlled not by the clinical accounting system but by a patient information control system that integrates the electronic medical chart system and clinical accounting system. Through the application of the aforementioned operating form with this form, too, it is thought that the module interchange system can be understood.
To link the clinical accounting and electronic medical chart systems, those who implement the CLAIM specifications should, at a minimum, implement not only appointment request modules and point/monetary amount modules but also MML patient information modules, MML health insurance information modules, and MML diagnosis information modules.
Table. Example of operating form
Medical Care Period
Utilized Module
Electronic Med. Chart System
Clinical Acct. System
[Initial Consultation]
Initial Registration
Patient information module
Chart
Clinical
Health insurance information module
Chart
Clinical
Appointment request module
Chart
Clinical
Initial consultation registration notice
Status = Registration
Order date/time (omitted)
Expected perf. date/time (omit)
Registration date/time
Performance date/time (omit)
Care Completion
Diagnosis information module
Chart
Ailment at initial consultation
Appointment request module
Chart
Clinical
Type of medical care action performed
Status = Performance
Order date/time (omitted)
Expected perf. date/timeiomitj
Registration date/time (omit)
Performance date/time
Appointment request module
Chart
Clinical
Future appointment
Status = Appointment
Order date/time
Expected performance date/time
Registration date/time (omitted)
Performance date/time (omit)
After clinical computation
Point/monetary amount module
Chart
Given day's acct. information
Status = Accounting complete
Order date/time (omitted)
Expected perf. date/time (omit)
Registration date/time (omit)
Performance date/time
Accounting compl. date/time
[Follow-up]
Registration
Patient information module
Chart
Clinical
Health insurance information module
Chart
Clinical
Appointment request module
Chart
Clinical
Follow-up consultation registration notice
Status = Registration
Appointed medical care action
Order date/time
Expected perf. date/time
Registration date/time
Performance date/time (omitted)
Care Completion
Diagnosis information module
Chart
Clinical
Additional ailment
Appointment request module
Chart
Clinical
Medical care action performed
Status = Performance
Order date/time (omitted)
Expected perf. date/time (omit)
Registration date/time (omit)
Performance date/time
Appointment request module
Chart
Clinical
Future appointment
Status = Appointment
Order date/time
Expected perf. date/time
Registration date/time (omitted)
Performance date/time (omit)