臺灣博碩士論文加值系統

現行醫療保險理賠申請流程相當繁複，被保險人需要向醫療機構申請診斷證明，填具理賠申請書向保險公司提出理賠申請，再由保險公司進行審核。若遇到無法從診斷書直接審核之個案，保險公司需先取得被保險人簽署之調閱病歷同意書後，方能至醫療機構調閱病歷，以利後續理賠審核。這樣的流程，對保險公司來說，需耗費大量人工成本；對被保險人來說，則也有資訊不夠透明的疑慮。
區塊鏈的運作有著公開透明，且難以造假的不可否認性。智能合約是在區塊鏈平台上執行的協議落實程式，既能確保程式不會被竄改，又可保留所有執行紀錄。若能透過這些特性來做為醫療保險理賠傳遞訊息的媒介，除了能提昇保險公司審核流程的時效性，被保險人也能獲得公開透明的資訊。
本論文提出了一套基於智能合約來實現快速醫療保險理賠的方案，我們在以太坊上實作智能合約，我們的方案除了能改善現有的問題，也建構出一套公開透明，且兼顧病人隱私的理賠系統，並考量實際狀況，讓保險公司的業務邏輯可以重用，在理想與現實之間取得一個適當之平衡點。

Current medical insurance claims application process is complex. It requires the insured to apply for medical diagnosis, and to fill out an application form to the insurance company. The insurance company then reviews the case. If they are unable to approve the claims, they must first obtain the consent form from the insured in order to access to his or her medical records to facilitate subsequent claims review. Throughout the process, the insurance company needs to pay a lot of labor costs; while the insured will have many concerns of information transparency.
Blockchain operates in an open and transparent manner and maintains its data in a tamper-free way. Smart contracts are programs executed on a blockchain platform to enforce an agreement such that the program will not be tampered with, and all records of execution will be kept from modification. These characteristics of a smart contract make it very good as a tool for streamlining the medical insurance claims process, as it will greatly reduce the human efforts involved on the insurance company side while increase the information transparency from the perspective of the insured.
This thesis presents a smart contract based solution for streamlining the medical insurance claims process. We design and implement the con-tract on the Ethereum platform. In addition to improving the existing problems, our solution builds an open and transparent claims system that takes into account the patient privacy and the practical requirement of re-using the existing claims processing system of the insurance company, thus achieving a proper balance between the ideal and reality.

第一章 緒論 1
第一節 研究動機 1
第二節 研究目的 1
第四節 論文架構 1
第二章 相關研究與技術背景 3
第一節 比特幣 3
第二節 區塊鏈 5
第三節 以太坊 13
第四節 智能合約 16
第五節 ÐApp 17
第六節 非對稱加密 18
第七節 電子病歷 19
第八節 診斷碼 21
第三章 系統架構與設計 24
第一節 名詞解釋 24
3.1.1 Ethereum 24
3.1.2 Git 24
3.1.3 Node.js 24
3.1.4 React 26
3.1.5 Babel 27
3.1.6 React-Bootstrap 27
第二節 系統架構 27
第三節 系統設計 28
3.3.1 調用攔截 28
3.3.2 履約保證 29
3.3.3 病歷上傳 30
3.3.4 理賠審核 31
3.3.5 事件通知 32
3.3.6 補償機制 33
3.3.7 必要時檢驗 33
第四節 智能合約實作 35
3.4.1 合約資訊 35
3.4.2 調用攔截 36
3.4.3 銷毀合約 36
3.4.4 儲存結構 36
3.4.5 判斷病歷是否重複上傳 37
3.4.6 事件通知 38
3.4.7 調用父類別的建構子 38
3.4.8 取得儲存結構長度 38
3.4.9 變更醫療機構帳號 39
3.4.10 上傳病歷 39
3.4.11 以太幣理賠 40
3.4.12 理賠審核 41
3.4.13 補償機制 41
第五節 ÐApp實作 42
3.5.1 以太幣轉帳 42
3.5.2 區塊內容解碼 43
3.5.3 變更醫療機構帳號 44
3.5.4 上傳病歷 45
3.5.5 理賠審核 48
3.5.6 理賠記錄 49
3.5.7 補償機制 50
第四章 系統特色及預期效益 51
第一節 系統特色 51
第二節 預期效益 51
第五章 結論與未來研究方向 54
參考文獻 56

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[2] Genesis Block (Block #0), from: https://blockchain.info/block/000000000019d6689c085ae165831e934ff763ae46a2a6c172b3f1b60a8ce26f
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[9] Solidity Docs, from: https://solidity.readthedocs.io/en/latest/