HIRA Expands Lead Autonomous Analytical Screening Project to Include Colon Cancer
In an effort to improve healthcare services, HIRA (Health Insurance Review and Assessment Service) is expanding the scope of its lead autonomous analytical screening project to cover colon cancer. This project, which utilizes treatment performance and data analysis, aims to enhance the expertise of medical treatment and ensure the autonomy of medical institutions.
Improvements in Disease Areas
As part of this initiative, HIRA recently introduced a new colorectal cancer area in large hospitals, specifically targeting inpatient and outpatient treatment. Additionally, the stroke area has been expanded and renamed as the cerebrovascular disease area. These changes reflect the 11th revision of the Guidelines for Conducting Analytical Review Projects, which also involves enhancing standards for organizations focusing on acute myocardial infarction.
Value-based compensation is also being implemented, shifting from resource-input compensation to a model that emphasizes the quality of medical care in relation to input costs.
11th Revision of Analytical Review Guidelines
As part of their continuous effort to refine the lead projects for analysis review, HIRA is currently working on the 11th revision of the Guidelines. This revision aims to introduce new areas such as colorectal cancer, while also incorporating improvements to targets and indicators that can be implemented. The autonomous analytical review has been expanding since its introduction through the 4th review in June 2021, with subsequent expansions in December of the same year and October 2022.
Future Expansion into Outpatient Treatment
The lead autonomous analysis review project will continue to expand its coverage. It started with hospital stroke treatment and subsequently included hospitalization for severe trauma and acute heart infarction. The next phase of expansion is set to be in November 2023 with the inclusion of colon cancer treatment, both inpatient and outpatient.
Evaluation Criteria for Colorectal Cancer
In the evaluation of colorectal cancer adequacy for tertiary and general hospitals, certain criteria must be met. These include having a multidisciplinary integrated treatment fee bill, at least one colorectal surgeon and hematologic oncologist, and an average of more than 100 colorectal cancer surgeries per year. Only organizations that fulfill all these conditions and are approved as leading business organizations will be eligible.
Enhancements in Stroke Area and Target Institutions for Acute Myocardial Infarction
The stroke area will see an expanded scope and a new name, the cerebrovascular disease area. In addition, self-management monitoring indicators for stroke treatment will now include neuroimaging and ultrasound claims, as well as claims for specific treatment materials. Furthermore, the criteria for target institutions in the acute myocardial infarction area will be improved.
Hospitals that meet the requirements of having two or more circulating medicine specialists performing PCI procedures and carrying out more than 150 PCI procedures per year will be certified as tertiary and general hospitals by the Institute for Evaluation and Certification of Medical Institutions. These organizations will be approved as leading project organizations among level 1, level 2, or regional cardiovascular and cerebrovascular centers in the field of support activities.
HIRA’s efforts to expand their lead autonomous analytical screening project into the field of colon cancer will undoubtedly contribute to the improvement of medical care and benefit the public. These advancements in disease areas and evaluation criteria reflect a commitment to providing quality healthcare services to all individuals.
[Source: Health Insurance Review and Assessment Service]
HIRA is seeking to expand the scope of its lead autonomous analytical screening project into the field of ‘colon cancer’.
Starting in November, the colorectal cancer inpatient/outpatient treatment area among the severe disease areas in large hospitals was newly established in the major analysis review project, and the name of stroke was revised to cerebrovascular disease.
The Health Insurance Review and Assessment Service recently announced the introduction of a new colorectal cancer area, expanded the scope of the stroke area, changed the name to a cerebrovascular disease area, and improved standards for organizations targeting the acute myocardial infarction area through r ’11th revision of the Guidelines for Conducting Analytical Review Projects’.
The government is implementing a leading autonomous analytical review project, which is a review method based on treatment performance and data analysis, to guarantee the expertise of medical treatment and the autonomy of medical institutions and the provision of quality medical services to the public.
Value-based compensation has expanded from resource-input compensation that focuses on the quantity of medical services to value-based compensation that drives improvement in the quality of medical care relative to input costs.
HIRA announced, “We are proceeding with the 11th revision of the ‘Guidelines for Leading Projects for Analysis Review’ to introduce new areas of colorectal cancer and reflect improvements to targets and indicators in areas that’ n be implemented.”
Previously, autonomous analytical review was introduced through the 4th review in June 2021, and then new areas of autonomous analytical review were expanded in December of the same year and October 2022.
Starting with a leading autonomous analysis review project in the area of hospital stroke treatment among the severe disease areas in July 2021, hospitalization for severe trauma among the special areas in January 2022, hospitalization for acute heart infarction in December 2022, and hospitalization for colon cancer in November 2023. We continue to expand into outpatient treatment.
This 11th review is the 1st grade in the evaluation of the adequacy of colorectal cancer for tertiary and general hospitals, and ▲ multidisciplinary integrated treatment fee bill ▲ one or more colorectal surgeons and hematologic oncologists each ▲ an average of more than 100 colorectal cancer surgeries per year Among the organizations that meet all the conditions, those that have been approved as leading business organizations are eligible.
In addition, the scope of the stroke area will be expanded and the name will be changed to cerebrovascular disease area.
Neuroimaging and ultrasound claims, and treatment material claims for specific treatments were added to the self-management monitoring indicators.
For acute myocardial infarction, it was decided to improve the criteria for target institutions.
It is a tertiary and general hospital certified by the Institute for Evaluation and Certification of Medical Institutions with ‘two or more circulating medicine specialists performing PCI procedures and more than 150 PCI procedures per year.’ It was placed as an organization approved as a leading project organization among organizations designated as level 1, level 2, or regional cardiovascular and cerebrovascular centers in the field of support activities.
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