Introduction to and Application Analysis of Taiwan’s NHI-MediCloud System

Abstract

Between 2013 and 2016, Taiwan’s National Health Insurance (NHI) expenditure increased by 4.22%. The main expenses driving this growth were examination and test fees as well as medication costs, which accounted for 73% of all NHI expenses. In addition, patients repeating the same examinations or being prescribed the same medication at different hospitals caused a serious waste of resources. To inhibit the growth of NHI expenditure and improve medical safety, the NHI Administration established the NHI-MediCloud System. This health information exchange system assists doctors in consulting patients’ medical information, such as medication records from anywhere in the country, examination and test results, and image data. This study determined the current implementation status and difficulties of health information exchange systems and the development of medical cloud information systems. Furthermore, it introduced in detail the categories in and contents of the NHI-MediCloud System. In addition, this study presented hospitals’ application experiences and proposed suggestions for future applications. The results revealed that from 2014 to 2017, reducing the days of repeat medication saved approximately US$ 9.63 million in expenditure for the six main categories of medication. Among the 20 most common examinations and tests, cloud sharing saved approximately US$ 38.5 million. Integrating cloud data with hospital information systems and establishing a comparison and notification function in the medical cloud system remarkably increased doctors’ willingness to use the systems. Moreover, this function helped to reduce medical procedures such as prescribing medication, performing examinations and tests, conducting surgeries, and providing rehabilitation, as well as mitigated medication interactions and drug allergies. Thus, medical safety for patients was improved and the growth of NHI expenditure was effectively inhibited.