A Presentation of Electronic System Pattern of Medical Records Management for Insurance Companies

Introduction: Organizations must collect, process, and analyze the types of information they need. The aim of this study was to evaluate the needs of managers and employees and to present an electronic pattern of medical records management in insurance companies.                                                                                                          

Methods: The research method was quantitative and qualitative. Twelve senior staff members of the medical records department were interviewed. Analysis of interview data was carried out using qualitative content analysis method. According to the findings of the interview, the primary model of the electronic medical records management system was presented. To determine the validity of the proposed model, all managers and staff of the unit were questioned about the capabilities obtained in the proposed model through a questionnaire. Descriptive statistics were used to analyze the data.                                                                                               

Results: Requirements of the mentioned system include: Data logging, classification, maintenance, security, electronic communications, display, access to various users, access to information resources - required knowledge, logging, user interface, speed, control, management and search. The results of the questionnaire was as follow:  the highest percentage of positive answers about registration and data entry capabilities(%93/2), classification(%85/6), maintenance (%81/9), Security and Access(%91/2), telecommunications (%96/5), display(%92/3), different users access(%72/5), access to required information-knowledge (%84/6), reporting(%90/1), speed (%84/2), control and management(%97/4), search(%78/9), user interface(%94/7).                                                                                             

Conclusion: In this study, a model for the capabilities of the electronic system of medical records management for insurance companies was presented, which deals with the management of the work of the Medical Doctors Medical Insurance Company electronically.