BARS. Health-TFOM

BARS. Health Care-TFOMS - is designed to automate the processing and exchange of data between participants in the compulsory health insurance system when making payments for medical care.

Description

The system ensures the implementation of the FFOMS Order dated 07.04.2011 No. 79 "On the approval of the General Principles for the Construction and Functioning of Information Systems and the Procedure for Information Interaction in the Field of Compulsory Medical Insurance."

• The work of TFCMI and all medical organizations in the region in a single information space.
• Centrally and securely store information.
• Possibility of remote operation of medical organization through a web-room.
• Convenient forms of providing information with the ability to change and preserve the appearance for each user.
• The possibility of automatic medical and economic examinations, which allows to reduce the load on TFCMI personnel.

"BARS. Health Protection-TFOMS" is a single complex that includes several functional units (subsystems) designed to solve various problems.

In the Administration subsystem, you set up access differentiation at the user role level. In turn, each user has the ability to perform different roles in the system.

It is possible to create the roles "Specialist of an insurance company," "Operator of a medical organization," "Economist of TFCMI," "Medical," "Operator of NSI," "Manager," etc.

Only a user with system administrator privileges (Administrator role) has access to this subsystem.

The "NSI" subsystem provides the ability to maintain directories and classifiers used in the System (both federal and regional).

The MTR subsystem provides automation of raschѐtov tasks for medical assistance provided by medical organizations of the region to insured persons outside the territory of a subject of the Russian Federation, as well as for medical assistance provided to insured persons of the region outside the territory of the subject.

The Processing Center subsystem provides automation of the tasks of financial settlements of TFCMI for medical care provided by medical organizations of the subject of the Russian Federation.

The system is organized according to the principle of trѐkhzvennoy architecture:

• Thin client at users' workplaces (web browser)
• an application server that processes requests from client workstations and implements all business logic of the system;
• A database server that provides nadѐzhnoye data storage and retrieval.

Structure

Module "Inter-territorial settlements" (between territorial funds of compulsory medical insurance of the constituent entities of the Russian Federation). The module allows you to:

• process the received registers of invoices for medical care provided to the insured population outside the territory of insurance of the subject of the Russian Federation;
• create a register of accounts in the context of TFCMI (basic and correctional);
• To settle with medical organizations on the submitted register of accounts for the provided medical care to patients insured outside the subject of the Russian Federation, taking into account the results of medical and economic control, medical and economic expertise and/or examination of the quality of medical care at the request of TFCMI;
• To conduct settlements with the TFCMI of the constituent entities of the Russian Federation for medical care provided by medical organizations of the constituent entity of the Russian Federation to patients insured outside the constituent entity of the Russian Federation;
• process the records of the account register processing in electronic form and generate printed forms of the account register and the account register;
• to form write-off acts and printed forms for them, report forms (including accompanying letters) and verification acts.

Module "Register of insured population"

Designed to automate the processes of maintaining the regional segment of the register of insured, receiving information about insured from insurance companies and transferring the regional segment to the MHIF.

Module "MO Passport"

Solves a set of tasks related to the collection and analysis of the resource potential of a medical organization and the maintenance of a register of medical organizations. The passports of medical institutions are maintained in the following sections:

• General information on the institution;
• administrative information;
• squares and buildings;
• organizational structure;
• licenses, technologies, services;
• staffing;
• equipping the institution.

Processing Center Module

The object of automation is the system of compulsory medical insurance, formed by participants in the field of compulsory medical insurance: TFCMI of the constituent entities of the Russian Federation, medical organizations and insurance medical organizations operating in the field of compulsory medical insurance in the territory of the constituent entity of the Russian Federation.

Module "Processing Center" is designed to carry out:

• collecting and processing personalized information on medical care provided to insured persons, ensuring their safety and confidentiality, exchanging these information between compulsory medical insurance subjects and participants in compulsory medical insurance in accordance with Federal Law No. 326-FZ of November 29, 2010  ;
• monitoring of the obѐmov, timing, quality and conditions of medical care;
• complex solution of financial settlements for medical care provided by medical organizations of the subject of the Russian Federation;
• applying a unified approach of participants in the field of compulsory medical insurance in the territory of the subject of the Russian Federation during medical and economic control, medical and economic expertise and examination of the quality of medical care.

Module "NSI"

Automates the maintenance of federal directories in accordance with Order of the Federal Compulsory Medical Insurance Fund dated April 7, 2011 No. 79 (as amended by Order of the Federal Federal Medical Insurance Service dated August 22, 2011 No. 154), as well as regional classifiers that are used in the work of the "MO Passport" and "Processing Center" subsystems.

2019: Transition to GOST encryption R34.10-2012

On December 3, 2019, BARS Group announced that it had introduced GOST encryption R34.10-2012 in its information systems in the areas of healthcare and housing and communal services. More details here.

2014

BARS.Monitoring hospitalization

On February 25, 2014, BARS Group announced the release of the new BARS module. Monitoring hospitalization "as part of the decision" BARS. Health Care-TFOMS. "

The module is focused on the use of the mandatory medical insurance system by participants - LPU providing inpatient and outpatient care, insurance medical organizations (SMO) and TFCMI.

The module is a single online information resource with web rooms for each participant in the information interaction.

The service was performed as part of the fulfillment of the requirements of federal legislation - "On approval of the procedure for information interaction in the implementation of information support for insured persons when organizing medical assistance for them by insurance medical organizations in the field of compulsory medical insurance"^[1].

Insurance medical organizations in their own web office will receive information on the implementation of the volume of medical care in cases of hospitalization in the context of the medical care profile: the status of hospitalization of insured persons, the number of free beds in the LPU, etc. The system will notify you of the timeout of a valid timeout. It is possible to receive operational reports and certificates for insured persons. The personal account for the LPU will allow you to quickly manage information about the hospitalization of patients sent to the hospital, about waiting times and the state of referral.

Module "BARS. Monitoring of hospitalization "can both be part of the BARS.NVEZDNVTFOMS system and separately. Integration with the regional fragment of EGIS and with any medical information systems is possible.

Update of LAR module. Monitoring hospitalization

On June 4, 2014, BARS Group announced the release of the new BARS module. Monitoring hospitalization "as part of the decision" BARS. Health Care-TFOMS. "

The module is aimed at participants in the compulsory medical insurance system - LPU providing inpatient and outpatient care, insurance medical organizations (SMO) and TFCMI. It is a single online information resource with web rooms for each participant in the information interaction.

The new service was carried out as part of the implementation of the requirements of Federal Law - Order FFOMS of 20.12.2013 N 263 "On approval of the procedure for information interaction in the implementation of information support for insured persons when organizing medical assistance for them by insurance medical organizations in the field of compulsory medical insurance."

Insurance medical organizations in their own website can get information on the execution of the volume of medical care in cases of hospitalization in the context of medical care profiles: the status of hospitalization of insured persons, the number of free beds in the LPU, etc. The system will notify you of the timeout of a valid timeout. It is possible to receive operational reports and certificates for insured persons. The personal account for the LPU will allow you to quickly manage information about the hospitalization of patients sent to the hospital, about waiting times and the state of referral.

Notes