Taiwan, like Korea, is experiencing financial pressure on health insurance. Taipei, unlike Seoul, has found a way to save health budget in IT, however. The island country has improved the healthcare system, by sharing treatment records through the cloud, preventing overlapping checkups, and confirming personal health records real time, according to a Taiwanese health official.

Director-General Hsueh-Yung Tai of Taiwan’s Central Health Insurance Agency made a presentation on his country’s health insurance systems and future reform plans, at an international symposium to strengthen the coverage of health insurance, organized by Korea Health Insurance Service.

According to Tai, Taiwan is an aged society in which 14.1 percent of its population of 23.5 million is 65 years or older. Korea, too, is an aged society where 14.3 percent of the population is 65 or older as of July.

The accumulated reserve at Taiwan’s National Health Insurance Administration (NHI) amounted to $7.96 billion last year. If the medical costs for the senior citizens increase at the current pace, however, its fiscal balance will likely turn to a deficit soon, he said.

The average medical expenditure of Taiwanese people 65 or older stands at $2,703, more than four times higher than the $682 for people under 64.

To save budget, Taiwan set about to reform the health insurance system by making the most of IT. The Taipei government set up Pharma Cloud in 2014, and Medi-Cloud in 2015.

On the Medi-Cloud screens are a wide variety of data, such as three months’ medical records, six months’ operation and checkup records, 24 months’ teeth treatment records, checkup results, situations when leaving hospitals, rehabilitation records, and specific medicines’ treatment records.

In the case of images, the results of six kinds or checkups – MRI, X-ray, ultrasonic tests, dental X-ray and microscopes – can be shared for two months.

The agency offers incentives to hospitals that submit medical records to Medi-Cloud.
Since the introduction of the Medi-Cloud system, the health insurance agency has been able to save $10 million in the drug costs to treat six diseases, including high blood pressure and diabetes, and reduced $38.9 million in conducting 20 major checkups, including those using CT and MRI.

Taiwan also established My Health Bank – the collection of personal information and records -- in 2014 and has since used it. In the bank are the three years’ medical records in diagrams. Individuals can see their medical records and checkup results for the past three years by accessing the system with NHI’s IC card or their own certification number and password.

“It is a convenient system that supplies individualized information. People can confirm their parents’ medical records and know whether hospital treatments are necessary or not,” Director-General Tai said. “It has similar information to Medi-Cloud, but the former’s data is much older. Medi-Cloud stores information for three to six months but My Health Bank reserve them for three years.”

Taiwan has also enhanced the Referral System. It has done so by raising the financial burdens of patients who do not come to hospitals through this system while cutting 2 percent of reimbursements as penalties for tertiary hospitals that treat outpatients while not conforming to specific standards.

“In Taiwan, patients’ coinsurance rate is relatively low, at 10 percent. Therefore, we increase the financial burdens of patients who do not receive treatments through the referral system, while providing incentives for those who use this system,” Tai said.

The Taiwanese official went on to say, “Medi-Cloud has been the biggest factor in saving the overall medical costs. Medi-Cloud stores information for two to six months, but has streamlined and stored the information of the past two decades by using other systems.”
NHIC officials expressed surprise with the Taiwanese system.

“I was astonished by Taiwan’s examples. Taiwan has already put into action what Korea is pursuing and examining,” said Suh Nam-kyu, head of the medical cost analysis office at NHIS’s insurance policy think tank. “Particularly, it is surprising they are sharing treatment information using the medical cloud system.”

Hyun Jae-ryong, chief of the NHIS reimbursement and coverage office, also said, “In Korea, there are limitations to exchanging imaging information among hospitals. The nation has a long way to go before exchanging image examination results, including the standardization issue. Taiwan seems to have resolved these problems and is making the most of them.”