Taiwan's National Health Insurance (NHI) Smart card as a key to receive healthcare

Introduction

The implementation of National Health Insurance (NHI) in Taiwan has made the accessibility of Taiwan’s medical care wellknownthroughout the world. The public has the freedom to go to any medical institution for medical care. Nevertheless, limitedcommunication regarding the patient’s medical information between medical institutions may cause medical negligence thatmay otherwise be avoided. The NHI utilizes the NHI IC card as the ID card of medical care. the adoption of Health Smart Cards(HSC) in 2004 as a means for the identification of patients, physicians and healthcare facilities, and medical affairs managementsystems that provide the DOH and local public-health agencies with a framework for managing medical, pharmaceutical, nursingand psychiatric rehabilitation institutions. The original design was to use it as a platform to keep track of all personal healthinformation and improve the continuance of medical care. The NHI IC card has been in use for 6 years, which has improved theefficiency of insurance declaration and reimbursement process and contributed significantly to the prevention of insurance fraud.However, no literatures have been published to discuss the accuracy and completeness of personal health information on the NHIIC card.

There is still room for improvement in terms of the accuracy and completeness of drug information on the current NHI ICcard. Due to the lack of a standard, there is a great divergence in the recording of patient allergies on the IC card. To date, thereare more than 9 different ways of recording “no known allergy” for patients. Neither has a standard been established in regardto the drug codes. To make information on the NHI IC card a useful tool to improve patient safety, it is necessary to formulate adrug allergy recording standard for the NHI IC card, establish relevant regulations, reinforce hospitals protocol to record patientallergies, and indicate “no known allergy” as it is on the IC card. As for drug use records, given the availability of daily upload at theNHI Central Database, it is more feasible to define the NHI IC card as a tool that can directly access the NHI database.

One advantage that Taiwan achieved in adopting the single payer system was easier adoption of HIT on a national scale.This has allowed the system to be more cost-effective by reducing administrative costs, and by generally increasing the quality ofinformation utilized by the healthcare system. It has improved collaboration between different providers, and helped unify publichealth and clinical medicine information systems and efforts. This provides strong evidence that the long held vision of usingHIT to transform healthcare systems, and make them operate more effective is achievable, and that increased benefits can beexpected in the future.