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Aiming to ensure patient safety in medical care, the National Health Insurance Administration (NHIA) continues to advance and enhance features of the NHI MediCloud System. Since 2018, its ongoing collaborative efforts with the Taichung Veterans General Hospital and the National Taiwan University Hospital have developed active medical reminder services for allergies and interactions with prescription drugs. The service recently passed final testing for its online launch. Effective immediately, 14 sets of life-threatening and absolutely contraindicated psychiatric drugs with drug-drug interactions will be available for reference by affiliated healthcare facilities. There is also a new feature that allows physicians to note the drugs to which patients are allergic. These two active reminder features will add more protections to the medication safety of patients.

    The NHIA said that starting in 2013, 12 major categories of medical data, including traditional Chinese medicine, Western medicine, laboratory test (examination) records and results available at patients’ healthcare facilities, will be archived and serve as reference for physicians when rendering a diagnosis, providing treatments, and prescribing drugs through the cloud-based medical information sharing platform. Starting in 2018, additional features have been successively added, including mechanisms for uploading medical images and inter-facility retrieval and sharing, active reminders sent to the physician when repeatedly prescribing a drug or performing laboratory testing (examination), and the reporting of non-comparable efficacy of drugs and quality of medical images. The system not only saves time and energy for the physician when browsing through massive amounts of data, but also effectively reminds the physician to avoid repeated prescriptions and laboratory tests (examinations) to further enhance the benefits of medical care and patient safety. It is estimated that this system has saved as much as NT$7.4 billion in NHI-covered drugs over the past six years and around NT$2.6 billion on laboratory testing (examinations) over the past year.

    The “NHI MediCloud System Benchmark Learning and Sharing Event” held today (6th) by the NHIA-invited 12 benchmark medical centers and regional hospitals to participate. The “application of cloud-based active medical care reminder mechanism in vertical integration of the team” was the theme of the event, where accomplishments in characteristic smart applications were also shared. In addition, the National Cheng Kung University Hospital and the Taiwan Association for Medical Informatics shared their plan of establishing a standard operating procedure for the cloud system to ensure security in information downloaded in separate batches; the National Taiwan University Hospital also introduced the active reminder mechanism for drug-drug interactions and drug allergies. Computers and posters throughout the venue in three major sharing zones facilitated demonstrations.

    During today's sharing event, many hospitals released their own value-added innovative services using the NHI MediCloud System. En Chu Kong Hospital and Hualien Armed Forces General Hospital, for example, have developed repeated medication reminders; Taipei Mackay Memorial Hospital and Chi Mei Medical Center provide integration of medication for the elderly; Taichung Veterans General Hospital has a checklist for the conversion and application of adverse drug reactions and drugs likely to give rise to postoperative bleeding; China Medical University Hospital aims to prevent acute kidney injury by monitoring nephrotoxic medications; E-Da Hospital and Landseed International Hospital provide reminders of drug-drug interactions; and Kaohsiung Medical University Chung-Ho Memorial Hospital compares laboratory values and provides reminders of medication safety while prescribing antihyperlipidemic and liver protective agents. Linkou Chang Gung Memorial Hospital and Changhua Christian Hospital, on the other hand, utilized the NHIA electronic referral platform to establish a complete two-way referral service. Text messages, emails, Line, apps, and the web are applied to facilitate communication and interaction with patients, who are thereby provided with integrated care. Preventive mechanisms such as medication safety have been developed by healthcare facilities, all in the interest of patients.

    Furthermore, it is worth mentioning that the NHIA also commissioned the National Cheng Kung University Hospital and the Taiwan Association for Medical Informatics in 2019 to include information security inspection items from the batch downloading process as part of ISO27001/CNS27001 certification for hospitals to effectively ensure the privacy of personal data and that the applicable requirements of the Cyber Security Management Act are followed. The standardized management procedure and simplified steps for batched download audits further ensure information security in the application of data through the cloud-based system. In addition, Taichung Veterans General Hospital indicates that it has been ISO27001 and CNS27001 certified, while St. Martin De Porres Hospital has established tracking records of the access control over IT staff and downloaded data to further enhance medication safety and personal data security of patients, which also possesses benchmark learning benefits.

    Today's sharing event saw a total participation of nearly 300 people, including  those from invited organizations such as the Taiwan Hospital Association, Taiwan Community Hospital Association, Taiwan Medical Association, Taiwan Dental Association, National Union of Chinese Medical Doctors’ Association, Taiwan Pharmacist Association, and 66 hospitals and primary care facilities.

    The NHIA said that the NHI is an asset shared among the people of Taiwan. In a ranking of 89 countries in the 2019 Health Care Index of CEOWORLD (a world-famous business magazine), five European countries, Australia, and four Asian countries were among the Top 10. Taiwan, in particular, came in first on the list, demonstrating Taiwan’s soft power in medical care and its fruitful results in national health and welfare. In addition, since the NHI MediCloud System has constantly been improved with innovative services, the NHIA has been honored with multiple awards, including the outstanding civil service contribution group award in 2018, the Digital Transformation Association's 2018 Digital Service Innovation Award for its outstanding open government project, the jury award in the 2019 Future Commerce Awards, Best Management Innovation- Golden Prize, and Best Management Innovation- Silver Prize. The cloud system was made known to the international society at the “APEC Conference on Medical Information Sharing for Enhancing Medical and Disease Management” held on August 8 and 9, 2019. Accomplishments were highly praised by the APEC economies and honored with the Silver Prize in the “digital transformation - public sector” group of the 2019 eAsia Awards.

    NHIA Director-General Po-Chang Lee expressed his appreciation for the support of all healthcare professionals and their recognition of the NHI MediCloud System, which provides increased integration of medical care for patients. It will be a powerful force in advancing the quality and safety of healthcare as it moves into the future. Upholding the core value of “Patient Safety and Information Security”, the NHIA strived to meet the needs of society while expanding and deepening applications of medical information and working towards the goal of building a smart and healthy Taiwan.

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