Parente Stephen T, Mandelbaum Karen, Hanson Susan P, Cassidy Bonnie S, Simborg Donald W
Department of Finance, Carlson School of Management, University of Minnesota, Minneapolis, USA.
J Healthc Inf Manag. 2008 Summer;22(3):42-51.
In his 2004 State of the Union Address, President Bush called for the adoption of the electronic health record (EHR) to increase efficiency and improve the quality of healthcare. This system could reduce healthcare costs by 20 percent or more per year. Some of those savings would be attributed to a dramatic reduction in losses due to fraud. Though IT by itself cannot solve the problem of healthcare fraud, developing an interoperable National Health Information Network (NHIN) can provide a platform to implement real-time anti-fraud controls. In this paper we inventory the costs and benefits of fraud detection from the NHIN and conclude that such an infrastructure investment has the potential to produce significant national savings.
在2004年国情咨文中,布什总统呼吁采用电子健康记录(EHR)以提高效率并改善医疗保健质量。该系统每年可降低20%或更多的医疗保健成本。其中一些节省将归因于欺诈造成的损失大幅减少。虽然信息技术本身无法解决医疗保健欺诈问题,但开发一个可互操作的国家健康信息网络(NHIN)可以提供一个实施实时反欺诈控制的平台。在本文中,我们盘点了从NHIN进行欺诈检测的成本和收益,并得出结论,这样的基础设施投资有可能为国家带来显著的节省。