Transcript PPT presentation

Introduction
Sumex I+
Quality assurance and electronic transfer of
physician’s invoice
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Schedule
Beta-Release
 as soon as possible
Final-Release for all modules
 1.5.2000
Download & documentation area
 www.tarmed.net
 www.xmldata.ch (schema files)
Mailing list, Support & FAQ
 www.tarmed.net
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Goals of Sumex I+
Reduction of costs by
 improvement of quality
 automated data acquisition and control
 no media breaks
Realization by
 tariff and drug validation
 generation of standardized XML invoice
 integration of electronic invoice transfer
 integration of printing of standardized invoice form
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Boundary conditions for Sumex I+
Boundary conditions relevant for physicians
 No increased costs
 No increased time requirement
 Free choice of the clearing center
Boundary conditions relevant for software houses
 Publication and standardization of all interfaces
 Hiding of XML standard and OCR-Print layout
behind functional interfaces
 Automatic update of data and software
 Quality and continuity guaranty of project by the
healthcare insurance companies
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Sumex I+ implementation
Validator modules:
 Search & browsing of tariff database
 Validation of services against the tariff rules
(tarmedValidator, labValidator, etc.)
Invoice module:
 Generation and printing of standardized OCR invoice
 Generation and transfer of XML invoice to insurance
 Automatic usage of validator modules internally
netUpdate package:
 Keeping software modules and databases up-to-date
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Sumex I+ modules
Validators
 tarmedValidator
 labValidator
 migelValidator
 drugValidator
 physioValidator
Managers
 MDInvoiceManager
netUpdate Package
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Technical implementation
MDInvoiceManager and validation modules
 ATL-DLL modules written in C++
netUpdate package
 MFC-EXE modules written in C++
Database access
 OleDB access on local ready-only mdb-File
 All databases are password protected
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Interface definition - tarmedValidator
 TarmedValidator
handles connections to the Tarmed database
 Catalog
retrieval of catalog information from the Tarmed
database for populating lists or combo boxes
 Search
browsing of and retrieval of detailed information
from the Tarmed database
 Utility
automatically generates service records for a
given code
 Validate
checks whether supplied service data conform
to the Tarmed rules
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tarmedValidator browser & validate functionality
Initialize module
ITarmedValidator
SetLanguage
Initialize GUI
Quit?
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ICatalog
GetFirstUnit
Set input data
ITarmedInput
PutPatSex
Search data
ISearch & IUtility
Validate data
IValidate
SearchCode
AddService
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recordTarmedType: fields to store in physician software
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code
ref_code
quantity
date
number (session number)
ean_provider
ean_responsible
billing_role (both | mt | tt | none)
medical_role (self_employed | employee)
body_location (none | left | right)
external_factor.mt (default=1.0)
external_factor.tt (default=1.0)
validate
remark
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recordTarmedType: fields set by tarmedValidator
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record_id
unit.mt
unit_factor.mt
scale_factor.mt
amount.mt
unit.tt
unit_factor.tt
scale_factor.tt
amount.tt
amount
vat_rate
 anaesthesia (obsolete)
 medical_indicated (obsolete)
 ean_section (obsolete)
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Architectural blue print
Validators
Communication
Communication Factory
Invoice Manager
Manager Factory
Validator Factory
Physician software
Communication
Insurance software
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MDInvoiceManager overview
COM
Physician
software
Invoice Manager
Data Validation
COM
tarmed
Validator
XML Data Modeler
COM / XML
Printer
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OCR
print
Secure
Communication
(MediPort)
Server
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Interface definition - MDInvoiceManager
 IMDInvoiceRequestManager
management of the InvoiceRequests (creation
and further processing)
 IMDInvoiceRequest
setting the XMLContents (invoice standard)
 IMDInvoiceResult
providing the invoice results
 ITarmedInput
setting tarmed specific input data
 IAddress
setting address data
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MDInvoiceRequestManager
Physician software
MDInvoiceRequestManager
MDInvoice
Result
Get
Values
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Special
Data
TarMed
Input
Put
Values
MDInvoice
Request
Create
Store
Special
Data
Address
MDInvoice
Request
Manager
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MDInvoiceRequestManager methods
 CreateMDInvoiceRequest
 Print
 Store
 Send
 PrintAndStore
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MDInvoiceRequest methods
 Initialize
 CreateTarmedInput
 CreateAddress
 SetHeader, SetInvoice, SetESR,
SetBiller, SetProvider, SetInsurance,
SetPatient, SetGuarantor, SetReferrer,
SetEmployer, SetTreatment, SetKVG,
SetVVG, SetUVG, SetICG, SetMVG
 AddDiagnosis, AddSurgery,
AddTarmedService,
AddTarmedServiceEx,
AddCantonalService, AddLagService,
AddDrugService, AddMigelService,
AddPhysioService,
AddUnclassifiedService
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netUpdate package
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Hardware & Software requirements
Software
 Windows 98 or higher
 Windows 2000 or higher recommended
Note: Windows 95 is not supported by MSXML4
Hardware
 Pentium III 500 MHz
 250 MB free disk space
 128 MB RAM
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Summary: win-win situation for all
physician
 can produce a correct invoice according to the rules
 has a free choice of the intermediate or print locally
software house
 have to implement only one interface
 Hiding of standards behind functional interfaces
insurance
 receive high quality invoices
 automated data processing is possible (XML or OCR invoices)
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