Digital Health Care in Taiwan 1st Edition by Po Chang Lee, Joyce Tsung Hsi Wang, Tzu Yu Chen, Chia hui Peng ISBN 3031051602 9783031051593

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ISBN 10: 3031051602
ISBN 13: 9783031051593
Author: Po Chang Lee, Joyce Tsung Hsi Wang, Tzu Yu Chen, Chia hui Peng

This open access book introduces the National Health Insurance (NHI) system of Taiwan with a particular emphasis on its application of digital technology to improve healthcare access and quality. The authors explicate how Taiwan integrates its strong Information and Communications Technology (ICT) industry with 5G to construct an information system that facilitates medical information exchange, collects data for planning and research, refines medical claims review procedures and even assists in fighting COVID-19.
Taiwan’s NHI, launched in 1995, is a single-payer system funded primarily through payroll-based premiums. It covers all citizens and foreign residents with the same comprehensive benefits without the long waiting times seen in other single-payer systems. Though premium rate adjustment and various reforms were carried out in 2010, the NHI finds itself at a crossroads over its financial stability. With the advancement of technologies and an aging population, it faces challenges of expanding coverage to newly developed treatments and diagnosis methods and applying the latest innovations to deliver telemedicine and more patient-centered services. The NHI, like the national health systems of other countries, also needs to address the privacy concerns of the personal health data it collects and the issues regarding opening this data for research or commercial use.
In this book, the 12 chapters cover the history, characteristics, current status, innovations and future reform plans of the NHI in the digital era. Topics explored include: Income Strategy Payment Structure Pursuing Health Equity Infrastructure of the Medical Information System Innovative Applications of the Medical Information Applications of Big Data and Artificial Intelligence Digital Health Care in Taiwan is essential reading for academic researchers and students in healthcare administration, health policy, health systems research, and health services delivery, as well as policymakers and public officials in relevant government departments. It also would appeal to academics, practitioners, and other professionals in public health, health sciences, social welfare, and health and biotechnology law

Digital Health Care in Taiwan 1st Edition Table of contents:

Chapter 1: Introduction to the National Health Insurance of Taiwan
The Core Concepts of Taiwan’s National Health Insurance
The Organisational Structure and History of the National Health Insurance Administration
Characteristics of Taiwan’s National Health Insurance
The Finance of the National Health Insurance in Taiwan
Medical Utilisation of the National Health Insurance
The Payment System of the National Health Insurance
The Healthcare Quality of the National Health Insurance
The Information System of the National Health Insurance
Achievement of the National Health Insurance
The Critical Blueprints of Taiwan’s National Health Insurance
Chapter 2: Income Strategy
Introduction
Sources of National Health Insurance Income
Premium Income
Proportions of Various Sources of Income
Enrolment Eligibility and Premium Calculations
Classification of the Insured
Calculation of Premiums
Calculation of the Premium Rate
The Annual Premium Rate Review Process
The Financial Structure of National Health Insurance
Establishment of an Actuarial Model to Calculate the Premium Rate
Co-payments Under the National Health Insurance Act and How They Are Charged
Co-payments for Outpatient Visits
Co-payments for Emergency Care
Co-payment Rates for Inpatient Care
Fair Burden─Change Unnecessary Health Care [1]The Value of National Health Insurance Manifests When Major Illnesses Occur
Provide the Best Drugs for Patients in Need
Avoid the Vicious Circle
Drug Co-payments May Increase Slightly
Conclusion
Reference
Chapter 3: Payment Structure
Introduction
Different Payment Methods in the National Health Insurance System
A Simple Explanation of the Global Budget Payment System
Introduction to Each Payment Method
Implementation of Pay-for-Performance and Bundled Payment in Recent Years
Global Budget Payment System
Planning the Annual Global Budget
Global Budget Distribution and Management
Reducing the Provision of Unnecessary and Excessive Medical Services to Increase the Value of the Relative Value Unit
Relative Value Units and Relative Value Unit Values are the Overall Causes and Outcomes of Each Other
Adjusting Relative Value Units to Promote Balanced Development of Medical Specialties
Guaranteeing the Relative Value Unit Value to Encourage Investment in the Healthcare Workforce
Establishment and Revision of Fee Schedule
Fee Schedule Revision Procedure
Health Technology Assessment
Items Not Been Covered by the NHI
Self-Management Plan Under the Global Budget Payment System and Corresponding Measures of Insufficient Budgeting
Self-Management Plan
Subtracting Relative Value Units Directly
Sharing the Relative Value Unit Gap
Analysis and Reflections
Chapter 4: Comprehensive Policies
Introduction
Implementation of the Separation of Medicine and Pharmacy from a National Health Insurance Perspective
The Meaning of Separating Medicine and Pharmacy
The Effectiveness of Separating Medicine and Pharmacy
Ownership of Dispensing Rights from a Legal Perspective
The Person in Charge of Medical Services in the National Health Insurance System
The Strategy to Promote Separation of Medicine and Pharmacy—Discussion and Conclusions
Patient-Centered Integrated Care Plans
National Health Insurance Big Data Reflect the Ageing Population
The Family Doctor Integrated Care Program
Providing a New Model of Integration and Interdisciplinary Services
Incorporating the Labor Power of Home Care into Integrated Care
Promoting the Vertical Integration of Hospitals and Clinics
Healthcare Digital Transformation Brings Win–Win–Win for Physicians, Patients, and National Health Insurance
Connection to Long-Term Care After Hospital Discharge
Covering the Discharge Planning and Follow-Up Management Fee Through National Health Insurance
Implementation of Long-Term Care 2.0
Connection Between National Health Insurance Discharge Planning and Long-Term Care 2.0
Tiered Medical Care System
Current Distribution of Hospital Levels
Encouraging Big Hospitals to Treat Acute, Severe, and Difficult Diseases
Small Hospitals Are the Leaders of Community Medical Care
Consolidate Small Hospitals in Remote Areas to Continuously Protect the Health of Residents
Co-Payment Adjustment
Current Situation Analysis
The Planning, Thinking, and Direction of Outpatient Co-Payments
Conclusion
References
Chapter 5: Pursuing Health Equity
Introduction
Removing Barriers to Health Care to Protect the Disadvantaged
Decoupling of the Payment of Premiums from the Right to Receive Medical Care
The National Health Insurance Premium Deferment Paying Measures of the COVID-19 Epidemic
Medical Services on Remote and Offshore Islands
The Integrated Delivery System
Improvement Plan for Medically Underserved Areas
Upgrading Medical Services in Underserved Areas
National Health Insurance Strives to Remove Barriers to Medical Treatment
Prospects
National Health Insurance Stands by Patients with Rare Diseases
Rare Diseases Are Categorized as Catastrophic Illnesses to Waive Patient Co-Payments
Strengthening Control Measures for Orphan Drugs
My Health Bank—Promoting Self-Health Management
My Health Bank Guards Our Health
Rapid Cell Phone-Based Certification Allows Users to Manage Their Medical Information Easily
Family Member Management Function Added to Safeguard Family Health
Software Development Kit Connects Health Services Better
Supporting Name-Based Mask Distribution System to Assist the Country in Epidemic Prevention
The Significance of Including National Health Insurance in Elementary School Teaching Materials
Chapter 6: Infrastructure of the Medical Information System
Introduction
Cornerstone of the National Health Insurance Database—Introduction to the NHI Medical Information System
Highly Automated Process of Medical Claims
Establishing National Health Insurance MediCloud System to Implement a Tiered Medical Care System
The National Health Insurance MediCloud System
Building Patient-Centered “NHI PharmaCloud System”
Upgrading of the “NHI MediCloud System”
Design of Active Reminders in the NHI MediCloud System
Personal Privacy Protection and Information Security Management
Cloud-Based Healthcare Technology Is a Future Trend
Continuously Upgrading the NHI MediCloud System
Applying the Technology to Provide Reminders Proactively
Image Upload, Retrieval, and Sharing
Importing ISO Certification to Protect Personal Information
Integrating Information Across Organizations to Safeguard the Health of All Residents
Continuous NHI MediCloud System Upgrade Enables Smart Medical Care
The National Health Insurance Information Security Management System and Data Protection Mechanism
Continuous Improvement of the Information Security Management Mechanism
Defense-in-Depth Mechanism Implementation and Internal and External Network Isolation Policies
Regular Information Security Testing and Drills to Reduce the Potential Risks of Information Security
Implement Database ID Entity Encryption Mechanism
Conclusion
Chapter 7: Innovative Applications of the Medical Information
Introduction
The Important Milestone: “2021—First Year of Telemedicine Being Covered”
The COVID-19 Pandemic Accelerates the Inclusion of Telemedicine into the Benefits Package of the National Health Insurance
Inclusion of Telemedicine in the Fee Schedule in 2021
Digital Technology Extends Medical Care
The Major Stride of Health Insurance Information Network and Far-Reaching Medical Services Made Possible by 5G
Brief Talk About the Health Insurance Information Network
Enter the 5G Era
Future Direction
Virtual NHI Card Users in the 5G Era
Planning for a New Generation NHI Card
The Virtual NHI Card Pilot Program
Continuous Function Progresses
Using the National Health Insurance Information System for COVID-19 Prevention
The Cross-Departmental Cooperation of the National Health Insurance Cloud System to Add a TOCC Reminder
Establish a Control System for Masks and Distribute Protective Materials Fairly
Enhance NHI Express APP and My Health Bank Functions for COVID-19 Prevention [1]The Name-Based Medical Mask Distribution System Is a Successful Model Established by Government and Private Sector Partnerships to Fight the COVID-19 Pandemic [2]Medical Masks Become Popular Anti-epidemic Materials
Government and Private Sectors Cooperate to Create the Mask Map
The Coverage Rate of Name-Based Medical Mask Distribution System Is Improving Continuously
The Resilience of the NHIA Organization Is a Blessing For All
References
Chapter 8: Drug and Medical Device Reimbursement
Introduction
How Are Drug Prices Determined?
Classification and Pricing of the Drugs Under the National Health Insurance
Adjustment of Drug Price
How to Classify Medical Devices and Determine the Price?
Medical Devices and Special Material Classifications and Price Determinations
Medical Devices and Special Materials Not Listed Independently or Not Covered
Amendment of Medical Devices and Special Materials and Adjustments to Reimbursement Payments
Perspective Control of Drug Costs Using the Drug Expenditure Target
Implementation of Overall Control of National Health Insurance Drug Prices
Drug Expense Savings by the Joint Efforts of the Medical Profession, Pharmaceutical Profession, and the Public
Drug Price Adjustments That Are More Transparent and Predictable
What Is the Managed Entry Agreement?
Drug Expenditures Grow Annually
Formulating Multiple Risk-Sharing Mechanisms
Using Health Technology Reassessment to Improve the Benefits of Drug and Medical Device Payments
Using Real-World Data to Evaluate the Payment Effects of Drugs and Medical Devices in Taiwan
Monitoring Efficacy of Hemophilia Treatment
Evaluation of Medication Use for Rare Diseases
Rolling Evaluation of Cancer Immunotherapy
Evaluation of New Oral Drugs for Hepatitis C
Evaluation of Long-Term Ventricular Assist System
Evaluation of Transcatheter Aortic Valve Implantation
Horizon Scanning for Budgeting New Drugs
Conclusion
Chapter 9: Coverage of Advanced Treatments and Medical Devices
Introduction
Including Immuno-oncology Therapy in National Health Insurance Benefits
Inclusion of Next-Generation Sequencing in National Health Insurance Benefits
Individual Genetic Testing
Future Direction: Next-Generation Sequencing
Expansion of the Coverage of Medications to Eradicate Hepatitis B and C
Why Is the Treatment of Viral Hepatitis So Important?
Treatment of Hepatitis B Medication Under National Health Insurance
Treatment of Hepatitis C Under the National Health Insurance
Medical Device Reform Under National Health Insurance
Adding New Functional Categories of Medical Devices Based on Clinical Needs
Claims for Self-Paid Medical Devices Are Increasing
Management of Balance-Billing of Medical Devices/Materials
Information Transparency Enhances Shared Decision-Making Between Physicians and Patients
Conclusion
Chapter 10: High-Value Medical Information and Quality Claims Review
Introduction
Review Process of Medical Expense Claims
The Review Process
Relevant Regulations and References for the Review System
Administrative Remedy Mechanism for Contracted Medical Institutions
Strengthening Front-End Claims Management
Progress the Review Operation to Avoid Deprivatizing Disputes
Pre-Inspection of Medical Expense Claims
Implementation of Institutional Self-Management
Integrating Examination and Test Results and Medical Claims Uploaded by Contracted Institutions
Strengthening the Network Infrastructure and Coverage Rate
Improving the Integrity of Real-Time Uploaded Data
Medical Information Is Fully Uploaded in Real Time
Strengthening the Uploading of Medical Information and the Integration of Claims for Reimbursement
Strengthening the Connection Between the Contracted Institution Hospital Information System and the National Health Insurance Information System—Usage of the Medical Visit Identifier and Timely Upload Improves Data Accuracy
Conclusion
Chapter 11: Applications of Big Data and Artificial Intelligence
Introduction
Application of Big Data
Big Data Analysis as the Most Useful Tool
Reduce Duplicated Medications
Avoid Unnecessary Medical Examinations and Tests
Digitalization of Review Tools
Making Good Use of Technology to Simplify the Process
Engage Medical Communities in a Collaborative Environment by Precise Management and Message Feedback
Application of Artificial Intelligence Facilitates Enhanced Review Efficiency
Automatic Intelligent Review System Prompts in the Professional Review System
Artificial Intelligence-Assisted Precision Review
Applying Artificial Intelligence Technology to Epidemic Prevention
Future Perspectives
Chapter 12: Digital Transformation of Big Data
Introduction
Issues: People’s Consent to Data Authorization Collection [1]National Health Insurance Open Data and Personal Data Protection—Challenges and Prospects of the Secondary Use of Health Data [2]Prospects of the Use of NHI Data
Academic Applications of the National Health Insurance Database
Development and Planning of Decision Aid Tools
Developing Virtual NHI Cards to Meet the Needs of Atypical Medical Fields
Artificial Intelligence Application Pilot Project of National Health Insurance Data
Conclusion
References
Appendix: National Health Insurance Act

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Tags: Po Chang Lee, Joyce Tsung Hsi Wang, Tzu Yu Chen, Chia hui Peng, Digital Health Care, Taiwan