Following the inquiry from the clinical institution, the final prescription information is transmitted in the health care establishment to your information system once the prescription drug is set. When an coverage pharmacy inquires about the availability of insurance policy for prescribed drugs described in prescriptions, the presence / absence on the inquiry heritage While using the medical institution and the outcome are distributed. Eventually, a series of inquiry histories is distributed towards the assessment and payment establishment and also the insurer, as well as information inquiry / judgment course of action is done.
To start with, in FIG. 1, the get-togethers connected to the information procedure of your current invention might be clarified. This information process includes a health-related institution that prescribes prescription drugs on the insured, an insurance pharmacy that dispenses prescription drugs based on a prescription issued with the health-related establishment and delivers them on the insured, an insurer that bears clinical insurance policy costs, and An assessment / payment institution that examines professional medical rate information from health care establishments / insurance policy pharmacies is related. Each and every occasion provides the information program which has a number of required information for being described later on.From the information procedure, (1) information on alternatives and prescriptions on the insurance company for drugs prescribed because of the coverage medical institution with the insured Enter / keep ideal precedence information, (2) Enter / hold conditions / requirements for acceptance of receipt evaluate by critique / payment Group, (three) Inquire about availability of website insurance policies for prescription drugs from healthcare institutions for every clinical exercise Based upon personal information for instance acceptance, insured's symptom, health care history, age, etcetera.
本発明により、医薬品流通市場における、医療機関・保険薬局といった供給者・処方者と、審査支払機関・保険者・被保険者といった需要者の間で、医療用医薬品の処方・購入に関わる取引に関しリアルタイムに当事者間の合意形成の有無を明確にすることが可能となる。これにより、審査支払機関・保険者は医薬品選択に関わる実効的な意思表示の機会を得ることとなり、自らが希望する医薬品処方につき選択肢が拡大、満足度・費用対効果を向上させることが可能となる。これにより、例えば、審査支払機関がより効能の高い医薬品の処方優先順位を上げることで多くの医療機関で当該医薬品が処方され、結果として被保険者間の医療サービスの質やコストの公平性が促進される。また、同等の効能を持つ複数の医薬品の中で最も安価の医薬品の処方が増加することによる保険者・被保険者の医薬品費用の低減、といった効果も得られる。
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、個々の診療行為毎に医療機関から医薬品処方につき照会を受付け、照会時に医療機関から提示される被保険者情報（医療保険関連情報、傷病・症状等の情報等）と、予め取得した情報とを照合し、被保険者が加入している保険者並びに担当の審査支払機関の指定条件を満たしているか否かをリアルタイムで判定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。
Notice: It is often recommended that to help minimize the quantity of medication mistakes, prescription crafting really should be 100% English, with out Latin abbreviations. I will show you about equally and let you make your browse additional brain up.
Although the execution of the indicates of the existing creation is executed through an information technique, this execution is roughly divided into two stages: a procedure preparing stage and an Procedure stage.
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。
【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。
At the moment, an information procedure that replaces the generation and software of the above mentioned-stated receipt having an Digital system from a traditional created approach has presently been place into useful use. Then again, in The us, Pharmacy Advantage Management (“PBM”) is a company that manages dispensing charges for policyholders.
If it is determined that the specified conditions are met, up coming, Check out the managing position / stock standing of prescription drugs from many coverage pharmacies close to the tackle with the clinical institution / insurer, and obtain the final results. Also supply to health care institutions. However, if it is determined that the required problems will not be met, the prescription advice subject matter derived depending on the insured individual's information introduced with the health care establishment in a assortment that matches the desired conditions with the examination payer plus the insurer Distribute a summary of medicines to medical institutions and really encourage them to reselect.
How again and again Have you ever left the medical doctor’s Place of work, only to seek out you forgot to mention a significant piece of information?
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。
Examine has established that The share of patients with multiple medications is escalating. So has the necessity for numerous caregivers and/or Expert health-related assist personnel for your equipped unique.