MEDFORM / Digitalization of processes for health insurance institutions
The standard daily pattern of medical practitioners includes a substantial administrative workload related primarily to health insurance institutions. In particular, treatment of serious conditions is often subject to a pre-approval of the medical examination board of insurance companies. Based on a request that the medical practitioner needs to fill out manually, depriving the medical practitioner of the most valuable – time dedicated to patients.
In Altamira, we have therefore developed the system MEDFORM which digitalizes all forms of all health insurance institutions and allows paper processes to be managed digitally.
WITH THE SUPPORT OF
Association of Innovative Pharmaceutical Industry
1. STARTING POINT
MEDFORM (https://medform.sk) is a project with the aim to digitalize such parts of medical bureaucracy that were sidelined so far. We think that a medical practitioner shall cure and not cope with the administrative burden.
Despite large investments into the digitalization of healthcare, there is still a large number of processes in place that are not digital and medical practitioners still work with a large amount of paper, applications, and protocols which they are forced to send insurance institutions by mail.
Usually, it is for example a case of treatment initiation and supervision protocol (with various oncological conditions), application of pre-approval for treatment which is exceptionally difficult financially, or any other applications or requests required by health insurance institutions and revised by medical examination boards. Templates of these forms are usually available on websites of health insurance institutions in various formats – RTF, PDF, or DOCX.
Forms are often rather complicated, include a large number of details which have to be slowly filled out by the hand of medical staff. Forms are physically delivered to insurance institutions by mail – except for the insurance institution Dôvera, which allows for digital delivery using their digital system.
An honest manual digitalization. There is a great number of forms and each includes a large number of details. Therefore, we have developed a system that facilitates to the fullest extent possible digitalization of such forms and “turns them” from their scattered “paper” format into structured forms which are part of web solution www.medform.sk. And then we started to digitalize them. For a system user – medical practitioner – the solution is straightforward and easy. Using the website’s simple interface, the medical practitioner chooses the insurance institution in which the patient is insured and a form that should be filled out.
Digitalization is an error-prone process. It is a manual, routine work with a result that needs to be thoroughly validated to be sure about the quality of outputs. And we have done that. All published, digitalized forms have passed internal QA check and thorough testing by an external tester, we can therefore safely assume that digitalized outputs are as expected by the user – medical practitioner.
MEDFORM.sk is a system that is based on absolute simplicity, user thus reaches digitalized forms within two or three clicks. Registration is an advantage, but not a condition of use. Without logging in the physician uses a single-purpose generation of applications that is downloadable in DOC/DOCX or PDF form. Once registered the medical practitioner has other features available in the system:
- management of patient database
- management of application and protocol database
- repeated (repetitive) creation of application and protocols from templates
- repeated (repetitive) creation of applications and protocols from previous forms
- monitoring and management of application expiration and notification to alert the medical practitioner and patient to create a new application
- statistical indicators
- communication module for SMS communication with a patient
- and many more.
3. LEGAL PERSPECTIVE
We also take into consideration the legal perspective of handling patients’ data, therefore in the solution of Medform.sk we cooperate with a renowned law firm Dagital Legal which is oriented primarily on issues related to personal data protection and GDPR. Our solution is fully in line with GDPR; besides it is operated in full compliance with standards ISO 9001 – quality management system and ISO 27001 – physical and data security.
The legal analysis which preceded the development of our solution is a guarantee of legal security of stored data, the abovementioned technical standards are on the other hand a guarantee of data and physical security.
The result is a unique information system on the web platform, which digitalizes all forms of all health insurance institutions and thus digitalizes the part of healthcare bureaucracy that has been neglected so far. We think that the next logical step is to interconnect the system Medform with systems of health insurance institutions, particularly with Všeobecná zdravotná poisťovňa, which as a health Insurance institution with the largest market share represents the most important piece of the whole process.
Electronic data interchange using designated interfaces between us as a software provider and insurance institutions is technically very easy, but far less complicated politically. We believe that MEDFORM can demonstrate that digitalization is possible, is not as difficult, and can lead to enormous time saving and, in the end, save money as well. Together with system users – medical practitioners – we can put pressure on insurance institutions that would sooner or later have to open their information systems and through API interfaces enable communication and transfer of such structured data from external sources.