Following the inquiry from the clinical institution, the final prescription written content is transmitted from your medical institution towards the information process when the prescription drug is determined. When an coverage pharmacy inquires about The provision of insurance for pharmaceuticals described in prescriptions, the existence / absence from the inquiry history Using the health-related establishment and the outcome are distributed. Last but not least, a series of inquiry histories is dispersed for the assessment and payment establishment and also the insurance provider, as well as information inquiry / judgment method is concluded.
When the health-related Experienced would really like the pharmacist to supply you with a particular brand of drugs, they must Primarily See this or sign-up the Put furnished.
次に、図２を用いて本発明の手段が実行されるフローを時系列で説明する。本発明の手段の実行は情報システムを通じて行われるが、この実行は大別して、システムの準備段階及び運用段階の二段階に分けられる。
Hereinafter, a flowchart of the example of an information inquiry / willpower treatment will probably be explained with reference to FIG. To start with, the required information is received from the assessment payer / insurer / insurance coverage professional medical institution / insurance pharmacy. The information and specified problems to be received from the examination payer and the insurer are as described above.
The current creation pertains to transactions relevant to prescription and purchase of ethical drugs concerning suppliers and prescribers like medical establishments and insurance policies pharmacies and shoppers such as assessment payers, insurers and insured persons within the pharmaceutical distribution market. It turns into possible to explain whether There exists settlement between the get-togethers in serious time. Because of this, the assessment / payment institution / insurance company will have an opportunity to proficiently Categorical their intentions regarding the array of drugs, which enables them to expand their selections for drug prescriptions they want and increase their fulfillment and price efficiency.
医療機関による医薬品の処方に際しては、被保険者（患者）が保健医療機関で医師の診察を受け、その診断結果をもとに医師が処方箋を発行、同処方箋に基づき保険薬局にて医薬品が調剤、提供される、という流れになっている。保険が適用される医薬品の費用請求については、被保険者による一部費用負担を除くと、医療機関・保険薬局などが、レセプトと呼ばれる診療報酬明細書に、診療、検査、投薬、手術など医療行為の内容を記入し、月ごとに審査支払機関に提出、医療費を請求する。審査は、社会保険診療報酬支払基金と都道府県支部、国民健康保険中央会と各都道府県の国民健康保険団体連合会にて実施され、かかった医療費をそのまま医療保険から支払う「出来高払い制」を採用されている。
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【解決手段】保険医療機関が処方する医薬品について、代替品情報、保険者の処方希望優先順位情報を入力・保持する手段、審査支払機関によるレセプト審査承認のための条件・基準を入力・保持する手段、医療機関から診療行為毎に、処方医薬品の保険適用可否に関する照会を受付け、被保険者の症状等の個人情報に基づき、照会内容が保険者・審査支払機関の指定条件に合致しているか否かを判定する手段、上記照会内容が指定条件に合致していない場合は、保険者が指定する医薬品の中から、症状等の被保険者の情報に基づき指定条件を満たす他の医薬品を検索し代替品として医療機関に通知、医療機関にて処方内容の再選択を促す手段を有するシステム。
図１は、本発明の医薬品処方情報照会・配信方法を活用したビジネスモデルの一例の概略を示す図面であり、図２は、当該ビジネスモデルをより具体的に示す図面であり、図３は、情報システム構成の一例を示す図面であり、図４は、情報照会・判定の一例を示すフローチャートであり、図５は、本発明の医薬品処方情報照会・配信のための情報システム内のデータファイルの一例を示す図面であり、図６は、当該情報システムと接続した医療機関の端末の入出力イメージの一例を示す図である。
Finish the shape and afterwards click on the bins to point the sort of information you would like to acquire.
On top of that, the examination and payment establishment and also the insurance company will specify the medicines that they would like to preferentially prescribe. The designation approach is as follows: (1) Specify the name of a certain group of drugs for every injuries and symptom labeled In keeping with numerous disorders such as the insured's age, gender, constitution and medical history. Or use (2) the upper Restrict in the health-related remuneration rating / applied drug insurance plan rating and permit the prescription of your drug assuming that the higher limit isn't exceeded. These enter information and specified ailments are saved as facts inside the information method.
The professional medical prescription information inquiry / distribution process In accordance with claim one, wherein the health-related prescription is obtained from the health-related institution for each clinical follow, and check here insured information (health care insurance policies connected information, damage and illness) offered from your healthcare establishment at the time of inquiry.
Up coming, the flow in which the suggests on the present creation is executed are going to be described in time collection with reference to FIG.
Look into has proven that the percentage of patients with many medications is increasing. So has the necessity for numerous caregivers and/or Specialist medical support staff for your equipped specific.