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论道医保新赛道,“数据要素×医疗保障”决赛在珠海举行
2 1 Shi Ji Jing Ji Bao Dao· 2025-09-13 11:49
Core Viewpoint - The "Data Element × Medical Security" competition held in Zhuhai focuses on enhancing the management level of medical data and improving the convenience of medical insurance services through data empowerment in the healthcare sector [1][2]. Group 1: Event Overview - The Guangdong division of the "Data Element ×" competition featured a "Medical Security" track, guided by the Guangdong Provincial Government and various local authorities, with a focus on driving data empowerment across multiple industries [1]. - The competition included 10 teams that presented projects aimed at improving medical data management and enhancing medical insurance services [1]. Group 2: Project Highlights - The project by Guoxin Health Insurance Service Co., Ltd. introduced a "data-driven, technology-enabled" model for intelligent supervision of medical insurance funds, achieving a 70% accuracy rate in identifying high-risk operations [2]. - The "Cloud Medical Insurance Prescription Data Element Empowerment Supervision Platform" by Qiyi Tianxia Big Data Technology aims to break down data barriers in healthcare, covering 17 medical institutions and 258 pharmacies in Zhuhai, with a prescription turnover exceeding 500 million yuan over five years [2]. Group 3: Expert Insights - Zhang Lei, a judge from Sun Yat-sen University, emphasized the importance of separating medical and insurance aspects in the competition, highlighting the use of AI and big data for effective management of medical insurance funds [2]. - Zhang also noted that digital tools for medical insurance should be continuously improved to balance the workload of doctors and policy feedback, promoting sustainable development for hospitals and rational use of insurance funds [2].