UBND TiNH BINH DINH So Y TE

S6: /SYT-NVY V/v Crng citing CNTT trong quail 1/

KCB va thanh toan BHYT

LONG HOA XA- HO' CHU NGHIA VIET NAM Doc 1ap - Tkr do - Hph phtic

Binh Dinh, ngayi 0 thong 3 nom 2018

Kinh grid: Cac con s15y kham chtta Nnh

Vim qua, BO Y t6 d'a ban hanh mot so van ban:

- COng van so 102/CNTT-YTDTI ngay 12/3/2018 ve vi"c tang cuon2, irng dung CNTT tai co so. kharn Wh, china Nnh.

- Cong van so 138/CNTT-TTUD ngay 27/3/2018 ve vi"e'c giai thie;u phAn mem tra cfru danh muc besnh theo ICD10.

- Con* van so 1677/BYT-BH ngay 28/3/2018 v6s vi& hung don giai quy& mot so van de 1,4 img dung CNTT trong quan ly KCB va thanh town BHYT.

(co ccic van ban kern theo).

So Y to thong boo 4:16n cac don vi bi6t de nghien ciru, trier khai thgc

No'i - Nhtr teen; - LAnh dao Sa; - Ltru: VT, NVY.

BQYTE CVC CONG NGHE THONG TIN

S6: 102/CNTT - YTDTI

V/v tang etrarng irng dung CNTT tai co so kham benh, than Nnh

CQNG Hem x'A HQI CH-6 NGHIA VIET NAM DOc 14p — Tir do — Hanh phtic

Ha 10i, ngay 12 thcing 3 nom 2018

Kinh girl:

- Giam d6c cac ca kham, chi-fa benh trirc thuOc BO Y te;

- Giam dOc Sa Y to va Thu truong Y to nganh.

Thuc hien Nghi quyet s6 36a/NQ-CP ngay 14/10/2015 dm Chinh phfi ve

Chinh phu dien V). va Quyet dinh se 1819/QD-TTg ngay 26/10/2015 dm Thil

Wang Chinh phu phe duyet chuang trinh qu6c gia ve irng dung cong nghe thong

tin trong hoot dOng cua ca quan nha nu& giai doan 2016 — 2020, Cue Cong

nghe thong tin (CNTT) de nghi Thu trt.remg cac ca kham benh, chaa benh

truc thuOc BO Y te, Giam d6c Sa Y to va ThU twang y to nganh (sau day ggi tat

la ThU truong don vi) day manh viec img dung CNTT tai dan vi, cu the nhu sau:

1. Chu dOng trien khai thuc hien ThOng tu s6 49/2017/TT-BYT ngay

28/12/2017 dm Bq Y to quy dinh ve hoot dOng y to tir xa va Thong tu so

54/2017/TT-BYT ngay 29/12/2017 dm Bo Y to Ban hanh bO tieu chi ang dung

cong nghe thong tin tai cac ca kham benh, chaa benh.

2. Xay dung, nang cap ha tang ky, thuat boo dam host dOng có hieu qua

dm he th6ng CNTT tai don vi.

3. Khan truong xay dung, b6 sung hoac nang cap cac phan mem phyc vu

guar' 15, benh vien va trien khai benh an dien tir

a) Phan mem quan 15, thong tin benh vien (HIS) phai chudn hoa toan b() danh Inge dang chung hien dang sir dung trong phAn mem theo danh muc dUng chung do BO Y to va ca quan có tham quyen ban hanh; hoan thien phan mem HIS có day du cac chirc nang dap irng yeti cau quan 1j, benh vien;

b) Phan mem quan 1j, thong tin xet nghiem (LIS) phai ap dung tieu chudn trong nu& va quoc to nham darn boo ket not lien thong, trao dOi de lieu giita

LIS voi phan mem HIS va cac trang thiet bi, may xet ngh*n;

c) Phdn mem quan IY, hru tat va truyen tai hinh anh (RIS/PACS) phai dp dung tieu chuan HL7 Ira DICOM nharn dam boo kha nang ket n6i lien thong,

1

Noi nh(tn: - Mu tren; - BO tremg (de b/c); - Cac Thir trueng (de b/c); - Cac Cvc: KCB, YDCT; - Cac Vv: BHYT, KHTC, BMTE; - Lau: VT, YTDT 1.

TRUbNG 6

CONS .ivtogG \‘,

-.c‘: •

TrAn Quy Ttreeng

trao dOi din lieu chAn doan hinh anh gift RIS/PACS vai phan mem HIS va vai cac thiet bi sinh anh;

d) Phan mem benh an dien tin (EMR) khi trien khai dam bao viec ket chia se din lieu day du tir phan mem HIS, LIS, RIS/PACS. PhAn mem EMR phai ap dung tieu chuan HL7 ban tin, kien truc tai, lieu lam sang (HL7 CDA) nhAm dam bao kha nang ket noi lien thOng, trao doi du lieu lam sang vai cac phan

X , mem y to khac.

d) Dam bao ket nOi lien thOng vai Ceng giam dinh kham chila benh bao hiem y to cua Bao hiem xa 118i Viet Nam,

e) Dam bac) to chirc, nhan luc CNTT, trien khai 'Ling dung CNTT y te; bo tri nhan luc CNTT thirc hien viec chuyen du lieu dien tin kham, china benh bao hiem y t6 (BHYT) vai co quan bao hiem xa hOi de phuc vu giam dinh thanh, quyet toan BHYT. Trong tru6ng hop don vi kh8ng c6 138 phan CNTT thi hop clang vai to chirc, ca nhan chuyen nganh CNTT de Van hanh he thOng CNTT.

4. Trion khai cac bien phap bao dam an toan, an ninh cho cac he thong

thong tin, ca sa din lieu tuan thu cac quy dinh tai LuSt An toan thong tin mang so

86/2015/QH13 ngay 19/11/2015 va cac van ban huang dan thi hanh Lust.

Tren day la nhang n8i dung v'e tang cueing irng dung CNTT tai cac ca ser

kham benh, china benh, de nghi cac don vi khan trucmg thirrc hien c6 hieu qua.

Trong qua trinh trien khai neu co vuong mac, Thu truang cac don vi bao cao ve

Cue Cong nghe thong tin, BO Y to de xem xet, giai guy& kip th&i./.(7,,,

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BQYTE CVC CONG NGHt THONG TIN

S6: /CNTT-TTUD Ha Noi, ngay 27 thong 3 nom 2018 V/v giai thieu phan mem tra ciru danh

attic benh theoICD10

Kinh giri: - Cac dan vi sir nghiep true thu6c B6 Y te; - Cac Sa Y te tinh/thanh pho true thuec Trung trang

De too dieu kien thuan loi cho cac can be y to trong hoot gong kham benh, china benh, Clje Cong nghe thong tin - BO Y te da xay dung phan mem tra ciru danh muc benh va cac van de sire Ichoe c6 lien quan theo ICD10 ten smartphone cai (Tat he diet' hanh iOS, Android va ten Website. Cach tai va truy cap phan mem nhtr sau:

1. Tren dien thoai di d6ng cai dot ha dieu hanh iOS: truy cap vao Appstore go tir khoa tim kiem la: tra cuu icd de cai clot va sir dung.

2. Tren dien thoai di Ong cai at dieu hanh Android, truy cap vao Google Play go tix kh6a tim kiem la: tra cuu icd de cai dot va sir dung.

3., Tren website truy cap vao dia chi: http://icd10.ehealth.gov.vn/ a sir dung phan mem.

Cuc COng nghe thong tin tran trong thong boo den cac ca quan, clan vi biet, pho bien cho cac thay thuec sir dung phan mem nay (mien phi).

Trong qua trinh sir dung, tra ciru, nett c6 vtrang mac, de nghi lien he vai Ong Nguyen Van Tiem, s6 dien thoai ca quan: 0243.7368316 se may le 18; so dien thoai di d6rig: 0904.531780; Email: tiemnv.cntt@moh.gov.vn hoac tiemriv.cntt@gmail.com de duce giiip dO.

Cuc Cong nghe thong tin iron trong cam an su hop tac etia qu)% Dan vi./.

Noi nhOn: TRU'dNG - Niur tren;

- Cac don Id thuOc BO Y te; - Ltru: VT, TTUD.

- BO twang, cac Thir truerng (a bac coo);

P'cA)cciA 4;r/

ran QuST Tuoitg

Chang Um: 0,1c Cting ngt.t thong tin Ngay14: 27/03/2018 16:38:32 Hi; t hong VOffire 110 V T.,

CONG HOA XA HOI CHU NGHIA VItT NAM floc lap Tty do — Hanh phtic

BO Y TE CQNG HOA XA HQI CHU NGHIA MT NAM Dee Idp - Tu. do - Hanh phitc

s6;46 /BYT-BH Ha NOi, ngayon thong 3 nein? 2018 V/v huong dan giai quytt met s6 van de ye img dung cNyr trong

quan ly KCB va thanh Wan BHYT

KHAN

Kinh giri:

- Sof Y te cac tinh, thanh ph6 true thuec trung uang; - Cac Benh vien, Vien có giuOng benh trite thuec Be Y te; - Cac co s& kham benh, chita benh thuec cac Be, nganh.

(Sau day gat chung la cac clan w)

De giai quyet met s6 vu Ong mac trong qua trinh thuc hien tin hoc hoa trong quan 1/ kham berth, chaa benh (KBCB) va thanh toan chi phi KBCB boo hiem y t6 (BHYT), sau khi th6ng nhact vai Bao hiem xd hei Viet Nam, Be Y to htrong dan cac dan vi thuc hien met s6 nei dung sau:

1. Ve viec tra ciru thong tin the BHYT

Bao hiem xa hei (BHXH) Viet Nam da cung cap cac ding cu tra ant tren Cong tiep nhdn (dia chi https://gdbhyt.baohiemxahoi.gov.vn/) hodc ang thong tin dien tir (dja chi https://baohiemxahoi.gov.vn) hodc tra cixu tn,rc tiep thong +a cac ham giao dien Idp trinh img dung - API (Application Programming Interface) theo Cong van s6 366/BI-DCH-CNTT ngay 31/01/2018, cac ca so KBCB thrc hien tra ciru thong tin the BHYT khi don tiep ngubi có the BHYT den KBCB bang met trong cac cong cu nay. Rieng cac d6i tugng Quin nhdn, Cong an nhan dan, Ca yeu (Cac the BHYT có ma aoi tuTmg QN, CA, Cr): trung hop tra ciru bang cac ding cu neu teen ma khong có thong tin the BHYT thi chi kiem tra the BHYT va giay t& tit), than co anh de thuc hien KBCB theo qui djnh.

Cac Ca ser KBCB sir dung thong tin tra ciru bang met trong cac cong cu tra ciru not teen cua ca quan BHXH tai thOi diem nguOi benh den KBCB lam co- so a xac djnh KBCB doi vai ngued benh theo the de BHYT hodc khong theo !he de BHYT. Tru&ng hop tai thai diem nguoi benh den KBCB ma ket qua tra c có thong bac the BHYT het thai han sir dung thi ca so KBCB dive hien KBCB dei voi nguari do 'thong theo the de BHYT va giai thich de ngtrad benh hodc tilan nhan nguiri benh biet. Tn.rang hop tai thai diem ngueri benh den KBCB ma het qua tra ciru co thong bdo the BHYT can thai han sir dung va hop le thi co' s& KBCB thuc hien KBCB dtSi vOi nguoi do theo the de BHYT. Ca quan B H chju trach nhiem truac phap ludt tinh chinh xac dm thong tin tren theng.

Chirng thu: Bp Y te ( Ngdy Icjr. 28/03/2018 14:51:33 Vf? He thong VOffice BO Y Te

Tnrong hyp c6 su c6 ky thuat ma ca so. KBCB khOng tra thu duac thong tin, cac co so. KBCB lien he ngay den ca quan BHXH nai ky hqp deng hoac qua Terg dai hO try khach hang (so dien thoai 1900.969668) de phihyp xix ly kip th&i. Tnreng hyp ca sO KBCB khong lien he dtrgc vai co. quan BHXH hoac Tong dai he' try khach hang thi co quan BHXH c6 trach nhiem ltru town bk5 ljch sir tra c dm co s& KBCB, co s& KBCB ltru hinh anh lei tra thu va cung cap ngay cho BQ1Y to (qua dia chi email: quoctoanbhyt@gmaiLcom) de kip tiled phivai BI-9H Viet Nam giai quyet. Neu do yeu to khach quan till co quan BHXH khong tir thanh toan chi phi KBCB del v6i trtRmg hqp do.

2, Ve vied thay del thong tin tren the BHYT

Bao hiem xa hei Viet Nam dang thuc hien cap, dei the BHYT theo ma 66 an sinh xa hqi, trong qua trinh ra soat, dong be du lieu c6 met s6 thong tin dtpc cap nhat, thay dOi khac vai thong tin teen the BHYT ma nguai benh sir dung di KBCB, nhu: hy va ten, ngay, thong, nam sinh, ma the, mire huo.ng, thai hp sir dung, nai dang ky KBCB ban du...do vay:

- Trutrng hqp thOng tin tier' the BHYT hoac thong tin kiern tra qua ham API dm co quan BHXH cung cap khac thong tin tra cim tai thai diem nguai c6 the BHYT den KBCB (lc/long bao gum sai khac thong tin mt-c hufmg, hgn szi dung the BHYT) thi cac co sar KBCB chi lap 01 (mOt) Bang ke chi phi KBCB ban hanh kern theo Quyet dinh se 3455/QD-BYT ngdy 15/10/2013 dm 130 tru&ng BO Y to va 01 (mOt) file dfir lieu dien tir, hieu chinh theo thong tin da ra thu lan cuoi ding, deng thai thong bao cho ngu&i benh hoac than nhan lien the ngay v6i ca quan BHXH de thay dei the BHYT phir hyp yen th8ng tin da chicle co quan BHXH cap nhat;

- Truong hyp trong thai gian dieu trj, ngtr&i benh c6 thay dei thOng tin ,he BHYT khac voi thong tin da tra cum: Ca sO KBCB lap ho so thank town theo thong tin ve thong tin hanh chinh, mud huong cira the BHYT da lciem tra luc nguai co the BHYT den kham berth; deng th&i lap du lieu dien to theo thong 'tin da ghi nhan khi benh nhan den KBCB theo dung quy dinh cira Nghj djnh so 105/2014/ND-CP ngay 15/11/2014 dm Chinh phi'. Co sa KBCB co trach nhiem cung cap day du hoa don, chimg tir hyp phap de nguai benh lam thin tuc thanh town trirc flapvai ca quan BHXH theo quy djnh;

- Tru&ng hyp ngu&i benh dtryc cap Giay chuyen tuyen sir dung trong &rang ljch c6 ghi ma the BHYT khac ma the tra thu tren he thong dien tir thi nguai do khong can xin cap lei giay chuyen tuyen, co sa KBCB va ca quan BHXH c6 trach nhiem tiep nhan, third hien clang qui djnh nay, khong you cau nguai benh phai xin cap lai gidy chuyen tuyen.

3. Deli veri truang hyp the BHYT cua nguai benh g'an het gia trj sir dung khi KBCB, ca s& KBCB c6 trach nhiem thong ban cho ngtrOi benh hoac than nhan va ca quan BHXH nai ky hyp deng KBCB de nguai benh dugc giaxhp the BHYT co gia trj sir dung lien tuc. Co quan BHXH co trach nhiem thu tren d'ng

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BHYT cua nguai benh,(ho4c than nhan nguai benh) ngay tai co so KBCB trong vong 05 (nam) ngay ke tit ngay tiep nhan &roc thong tin tir ca s& KBCB hoc nguai benh a thvc hien viec gia han the BHYT. Truong hop ngu6i benh thain gia BHYT lan tiep theo bi ch4m (cach quang) nhung khong qua 05 (nam) ngay lane viec ke tir ngay het thi han sir dung dia the BHYT truck thi th6i gian ca?h quang do dugc tinh IA th6i gian CO tham gia BHYT lien tuc va nguai benh khoi?g phai tkr chi tra chi phi KBCB cua nhUng ngay cach quang gala the IL fru& ya the lan sau do. TnreIng hop dac biet ma nguai benh khOng the t%r tham gia BHYT tiep thi co sor KBCB thong bao va thang nhat vai ca quan BHXH nai ky hop dong KBCB de giai quyet phan chi phi KBCB cua nguai benh dO, nL koid khan, vtrang mac thi bao cao ca quan quail 13', cap teen trvc tiep.

4. DOi vai chi phi KBCB ma ngtr6i benh chi tra (bao gom cung chi tra wa ter tra) thi tai d6ng "St' tien nguai benh tra" trong Bieu ma.'u 01/BV, 02/BV c1a Bang ke chi phi KBCB cac co s& KBCB ghi ro so tien nguai berth ding chi tfa, se) tien ngu6i benh ter tra (cho ca hai tryong hop chi KBCB dung tuydn va KBTB khong citing tuyn) de xac djnh chinh xac quyen loi mien cang chi tra khi nguai benh da tham gia BHYT du 05 (nam) nam lien tic va co se) tien ciing chi tradu 06 (sau) thang Luang co s& doi vai cac truong hop KBCB dimg tuyen. Con truang hop KBCB IchOng &mg tuyen thi tong hop a the hien ra duoc se) then cUng chi tra cua nguai benh, nhtmg se, tien nay se khong dam tinh a cap Giay chirng nhan khong ding chi tra trong nam tai chinh. Cac ca sa KBCB chinh sira bieu mAu 01/BV, 02/BV theo huong dan tren va hoan thanh truac ngay 01/6/2018 a dap frng duoc yeu cau nay. BHXH Viet Nam CO trach nhiem dieu chinh cong thirc tinh tien ngtr6i benh ding chi tra va nguai benh to tra tren thOng cemg tiep nh4n de tiep nhan duoc da lieu theo hu&ng dan nay tir nay 01/6/2018. File XMLgiri da lieu dien tir theo Quyet djnh so 4210/QD-B L,T ngay 20/9/2017 vai MA_LYDO_VVIEN = 3 thi T_BNCCT # 0 dung vai se) tien ngubi benh ciing chi tra tren phai thanh toan.

I 5. Cac dan vi, BHXH cac cap, cac co ser KBCB thvc hien nghiem tile Fac qui djnh tai Thong tu so 48/2017/TT-BYT ngay 28/12/2017 dm BO Y t6 ve tlich chuyen da lieu dien tir phic vu quan 15, va giam dinh, toan chi phi KBCB BHYT (Sau day viet tat la Thong tu so 48). Thong nhat tam th6i sir dung da ieu dien tir (dit lieu qui djnh tai Dieu 6 Thong tu so 48) do ca s& KBCB giri I len COng Tiep nhan da lieu he thong thong tin giam djnh BHYT cila BHXH Viet Nam (Sau day viet tat la COng Tiep nhan dir lieu) lam ca sir tam irng chi phi KBCB BHYT cho cac ca s& KBCB. Vi Vay, cac ca so KBCB can nghiem tiic thirc hien viec giri du lieu dien tit len Cong tiep nhA'n du lieu thu&ng xuyen, ien tic, theo quy dinh tai ThOng tu so 48 va ter chiu trach nhiem ve viec khong d qc tam img kinh phi KBCB nL khong giri day dii du lieu.

6. Cac co s& KBCB can nghiem tiic thvc hien quy djnh chuan va inh Bang du lieu dau ra sir dung trong quan 151, giam dinh va thanh toan chi' l phi KBCB BHYT ban hanh theo Quyet djnh so 4210/QD-BYT ngay 20/9/20171cUa

3

am Le TuAn

Bo Y to va cac van ban huong dan thtrc hien Quyet dinh nay. TruOng hop ch ra thuc hien ngay &roc viec giri thOng tin ma gitrong (MA_GIUONG), thong t in

thau (TT_THAU) can chil Ong phoi hop voi co quan BHXH de thong nhat g ai phap xir IY. Chain nhat, mak ngay 31/5/2018, cac co so KBCB phai hoan thi'n xong cac trueyng thOng tin:.MA_GIUONG trong bang XML3 va Ti' _THAU trong bang XML2, XML3 de giri dugc len ding tiep nhan du lieu. DCii voi viec thuc hien giri da lieu dm bang 4 va bang 5 ban hanh theo Quyet dinh 6 4210/QD-BYT, de nghi cac ca so KBCB trien khai thuc hien theo ke hoach bao cao ket qua thirc hien, de xuat kien nghi, giai phap trong truOng hop ch a giri dugc.

Tin hoc hoa trong quan ly KBCB, giam dinh va thanh toan BHYT la nhiem vu quan trong cua nganh y to va BHXH, gop phan minh bach thong t n, dam bao quyen lai cua cac ben có lien quan, nang cao hieu qua quanlY, sir dung quj, BHYT, BO Y to yeu cAu thu twang cac vi nghiem tile to chirc thirc hien, neu có kilo khan, vuong mac kip thOi bao cao By Y to (Vii Bao hiem y te) va BHXH Viet Nam (Trung tam Cong nghe thong tin) de dugc xem xet, huong dan giai quyet./w

Noi nhOn: - Nhu van; - 13() truerns (de bzio cao); - VAn phong Chinh WI (de b/c); - BHXH Viet Nam (d4 phoi h9p); - Cvc KCB, Cyc CNTT, Vti KHTC; - Luu: VT, BH.

KT. BO TRU JNG THir TRU'ONG

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