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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。
While in the technique operation phase, the next processing is performed in real time. In other words, inquiries pertaining to The supply of insurance policy protection for prescription drugs from health care establishments are made by using conversation strains for the duration of Every professional medical follow, and these inquiries are compared Along with the enter information and specified problems of the evaluation and payment establishments and insurers talked about higher than. Then, the evaluation paying institution and the insurer identify whether or not to reject the insurance plan software, distribute the result on the medical institution, and Screen it about the terminal with the professional medical establishment by an enter / output monitor as demonstrated in FIG. On account of the resolve, if the content of the inquiry would not conform into the input information and selected problems of the assessment and payment institution and the insurance provider, a pharmaceutical group satisfying these is searched and discovered and distributed to the professional medical establishment.
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請求項１に記載の医薬品処方情報照会・配信システムにおいて、本システムを介して為された一連の照会履歴を審査支払機関及び保険者に配信することを特徴とする医薬品処方情報照会・配信システム。
【選択図】図３[Troubles] To deliver a program for giving an opportunity for your medical institution / insurance plan pharmacy to preferentially undertake a drugs that an insured / insurance provider or assessment / payment establishment desires to prescribe inside the medical insurance policy process. Delivered. [MEANS FOR Resolving Complications] Getting into / holding information on options, prescription priority order information of an insurer, and situations / expectations for approval of a receipt examination by an assessment / payment institution to get a medicine prescribed by an coverage professional medical institution Inquiries relating to no matter whether insurance coverage for prescription drugs is obtainable for Every single healthcare observe through the indicates and professional medical institution, and if the inquiries match the required situations on the insurer / evaluation and payment Corporation determined by own information for example signs and symptoms on the insured Usually means to determine whether or not the above inquiry material isn't going to match the desired ailments, search for other drugs that meet the specified conditions from your drugs specified because of the insurance company based upon the insured's information which include indications A procedure more info owning usually means for notifying a clinical institution as an alternative and prompting the medical establishment to reselect prescription contents. [Variety] Figure 3 Description
During the planning stage in the technique, the assessment payer and the insurance provider enter needed information and specify ailments. Examples of information entered because of the examination payer along with the insurance provider and the required circumstances are based upon information on the insurer topic to evaluation, ailments including the insured's age, gender, constitution and previous history You can find assumed professional medical fee points calculated for every person sickness and symptom divided, drug price tag expectations of utilised drugs, insurance coverage points, and other data required for evaluation of health-related charge details.
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Interactions Drug Interactions - This field offers an outline with the conversation among the drug shown while in the monograph together with other drugs or drug courses. Adhering to a description of the conversation for the drug class, any drugs from that course which are NOT likely to cause an analogous interaction Using the monograph drug are listed as exceptions. Last of all, the significance from the conversation is recognized as follows: Monitor therapy – facts exhibit that the required agents may perhaps communicate with one another in the clinically-substantial way, but the benefits of concomitant use commonly outweigh any dangers. An acceptable checking plan need to be executed to recognize possible adverse effects and dosage changes may be essential in a minority of patients.
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。
This A A part of the prescription contains Guidance for that pharmacist, in the event of a drug if it has to be compounded within the pharmacy.
An illustration of the configuration of such an information procedure is revealed in FIG. In this instance of information process, no less than Exhibit and output unit / input device / knowledge storage for example regular laptop computer with interaction usually means put in in Every single of examination shelling out institution, insurer, coverage health care institution, coverage pharmacy Plus a central system that performs information inquiry / resolve are connected by using a communication line for instance the net.
請求項１に記載の医薬品処方情報照会・配信システムにおいて、判定の結果、照会内容が審査支払機関及び保険者の入力情報や指定条件に適合しない場合には、これらを満たす医薬品群を検索・同定し、医療機関に配信することを特徴とする医薬品処方情報照会・配信システム。