Since the National Health Insurance (NHI) program launched on March 1, 1995, it has been devoted to providing insured with medical services. By gradually turning the declaration of medical care electronic and with the introduction of the IC card as well as the real-time upload feature, up to 21 years of data declared for the National Health Insurance has been accumulated; it can be said to be the largest personal database throughout the nation. For the past few years, the National Health Insurance Administration (NHIA) has taken a step further to apply the concept of big data. Thanks to cloud technology, the patient-centered NHI PharmaCloud System was created in July 2013 to enable physicians and pharmacists to search for a checklist of all the medications that the specific patient has used for the past three months in real time; it helps physicians determine the patient's condition and avoid repeated prescriptions and repeated medications for the patient and both physicians and pharmacists can safeguard medication safety for the general public.
Between July 1, 2013 and December 31, 2015, a total of 18,853 healthcare facilities searched and used the NHI PharmaCloud System, including 100% of hospitals (503), 67% of clinics (13,568, including 87% of Western medicine grassroots clinics [8,923], 20% of Traditional Chinese medicine clinics [699], and 60% dental clinics [3,946]), 82% of pharmacies (4,766), and 3% of nursing home (16). There were 53,905 healthcare professionals using the system to look for related information, with a total of 185,112,410 uses.
The NHI PharmaCloud System adds up all medications used across all healthcare facilities to render the repetition rate. The repeated medication rate of each of the six major outpatient drugs (hypotensive, hypolipidemic, hypoglycemic, schizophrenia, antidepressant, and sedative hypnotic drugs) showed a year-on-year drop by 30% to 50% in the third quarter of 2015 as compared to the third quarter of 2014. It is inferred that medicinal expenditures, totaling around NTD 10.4 billion, can be reduced as a result of the synergistic effect of outpatient physicians using the NHI PharmaCloud System, routine review and promotion of integrated outpatient care throughout 2015.
To coincide with the e-government policy and to take advantage of the constantly improving cloud computing technology that helps with administrative innovation, the NHIA constantly advances and expands the scope of medical information available for inquiries and system functions. The NHI PharmaCloud System plans to further expand to become the Health Insurance Medical Information Cloud Inquiry System starting in 2016. In addition to existing patient medication records, it is expected that nine major items will be added and made available for inquiries on a yearly basis. These nine major items include tests and exams, surgery details, coagulation factor medication records, medication records of regulatory drugs, allergic medication records, notes on drugs for which caution is recommended when used in patients aged 65 and older, dental dispositions and surgical items, rehabilitative medicine, and Traditional Chinese medicine dosing records. Meanwhile, efforts will be made to strengthen and promote utilization by more affiliated healthcare facilities to accordingly enhance the protection over medical safety of patients.
In light of the ageing population and the increasing number of patients with chronic diseases, the demand for medical care will surge in the future as well as the related medical expenditures. Healthy ageing and medical safety-related issues are gaining prominence. The NHI PharmaCloud System is a beginning and also an important cornerstone for medication safety. The NHIA continues to apply the network technology to further expand it to be the Health Insurance Medical Information Cloud Inquiry System. Besides medication safety, the scope of service is further extended to cover tests and exams, surgery, regulatory drugs, notes on drugs to be used in senior patients, and rehabilitation, realizing omnipresent protection of medical safety of our people.