Even though the execution from the usually means in the existing creation is carried out as a result of an information program, this execution is around divided into two levels: a method planning phase and an operation phase.
The present invention pertains to transactions related to prescription and buy of ethical drugs among suppliers and prescribers including health-related institutions and insurance pharmacies and consumers which include assessment payers, insurers and insured people inside the pharmaceutical distribution marketplace. It results in being probable to make clear if There may be agreement concerning the events in serious time. Subsequently, the evaluation / payment establishment / insurer could have an opportunity to properly express their intentions regarding the number of drugs, which will allow them to increase their selections for drug prescriptions they motivation and strengthen their satisfaction and value success.
【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。
医療機関からの照会後、処方医薬品を確定した段階で医療機関から最終の処方内容が情報システムに送信される。保険薬局から処方箋記載の医薬品の保険適用の可否について照会があった場合には、医療機関との照会履歴の有無、結果を配信する。
結果として、医療サービス受給の公平性を保ちつつ、代替品が存在する医薬品の中で、被保険者・保険者や審査支払機関が、効果・価格等の観点から望ましいと考える医薬品を選択する機会が十分に提供されていない。
The central procedure features a calculation unit, a Show and output device, an input device, and an information storage device. An example of an information file to become referred to at some time of calculation is proven in FIG.
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Within the prescription information inquiry / distribution program As outlined by assert 1, once the prescription medication inquired through the professional medical establishment for every professional medical observe satisfies the designated situations in the insurer / examination / payment establishment, the handle of your medical institution or insured individual Drug prescription information inquiry / distribution program that accesses and confirms the handling information / inventory information of your drug at a number of insurance policies pharmacies close to the pharmacy.
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。
Very first, in FIG. one, the get-togethers linked to the information technique with the current invention will likely be clarified. This information program includes a healthcare institution that prescribes pharmaceuticals towards the insured, an insurance pharmacy that dispenses prescription drugs based upon a prescription issued with the health-related institution and delivers them on the insured, an insurer that bears healthcare insurance expenditures, and An examination / payment establishment that examines health-related rate information from healthcare establishments / insurance pharmacies is linked. Every single celebration supplies the information system using a number of vital information to become described later on.From the information process, (one) information on options and prescriptions in the insurance company for drugs prescribed because of the insurance healthcare institution for your insured Enter / hold wanted precedence information, (two) Enter / keep ailments / standards for approval of receipt assessment by assessment / payment Firm, (3) Inquire about availability of insurance policy for prescription drugs from health care establishments for every health-related apply According to personal information such as acceptance, insured's symptom, professional medical heritage, age, Brand vs generic medications and so forth.
have the probable of remaining abused, and that might produce properly being threats from Adverse effects if taken improperly,
最後に、一連の照会履歴を審査支払機関及び保険者に配信し、情報照会・判定の手順を終了する。