Even though the execution of the signifies from the current invention is performed through an information procedure, this execution is roughly divided into two phases: a technique preparation stage and an Procedure stage.
In fundamental conditions, the prescription is a little paper that's published throughout the registered health care practitioner (RMP) based upon the consumer's ailment trouble.
【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。
Examine has verified that the percentage of patients with various medications is expanding. So has the requirement for numerous caregivers and/or Experienced clinical help personnel for the equipped personal.
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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[Complications] To provide a technique for furnishing an opportunity for the clinical establishment / insurance coverage pharmacy to preferentially adopt a medication that an insured / insurance company or evaluation / payment institution would like to prescribe in the healthcare insurance policy program. Presented. [Indicates FOR SOLVING Issues] Entering / Keeping information on alternatives, prescription precedence order information of an insurance provider, and ailments / criteria for approval of a receipt assessment by an evaluation / payment institution for just a medicine prescribed by an insurance coverage healthcare establishment Inquiries with regards to irrespective of whether insurance policies for prescription drugs is obtainable for Every single healthcare observe through the signifies and health-related establishment, and whether the inquiries match the desired disorders in the insurance provider / evaluation and payment Corporation depending on own information like signs or symptoms of the insured Means to determine whether or not the above inquiry articles won't match the required conditions, try to find other drugs that fulfill the required disorders from the drugs specified from the insurer determined by the insured's information for example indicators A technique obtaining signifies for notifying a health-related institution as a substitute and prompting the health-related establishment to reselect prescription contents. [Collection] Figure three Description
During the preparation stage in the system, the examination payer plus the insurer enter required information and specify disorders. Examples of information entered via the examination payer along with the insurance provider and the required circumstances are determined by information to the insurer topic to examination, situations like the insured's age, gender, constitution and past historical past You'll find assumed health care price factors calculated for each person sickness and symptom divided, drug value specifications of used drugs, insurance coverage details, and various details expected for evaluation of health-related fee aspects.
) offered because of the clinical establishment at time of inquiry and information acquired beforehand And in genuine-time if the desired problems in the insurer to whom the insured is affiliated as well as examination and payment Corporation in cost are happy.
Concurrently, for prescribed drugs that meet the specified disorders, entry the insurance coverage pharmacy databases and Examine the managing and inventory information with the prescription drugs at many insurance policies pharmacies near the tackle in the professional medical institution or the insured. . Also, when an insurance coverage pharmacy will make an inquiry with regards to the insurance coverage application of a drugs explained inside a prescription issued by a medical institution, the presence or absence of an inquiry historical past with the prescription issuing healthcare institution and the result are distributed.
Inside the pharmaceutical prescription information inquiry / distribution system As outlined by assert 1, if the result of perseverance is that the inquiry articles does more info not conform on the enter information and selected disorders from the evaluation and payment establishment and the insurer, lookup and establish the pharmaceutical team that satisfies these Pharmaceutical prescription information inquiry / distribution procedure characterised by distribution to clinical establishments.
Moreover, the assessment and payment establishment and the insurer will specify the medicines that they wish to preferentially prescribe. The designation method is as follows: (1) Specify the identify of a selected group of drugs for each injury and symptom classified In accordance with different situations such as the insured's age, gender, constitution and medical record. Or use (two) the upper Restrict on the health-related remuneration score / used drug insurance rating and allow the prescription of your drug providing the upper Restrict just isn't exceeded. These enter information and specified circumstances are saved as information during the information technique.
An illustration of the configuration of these types of an information system is shown in FIG. In this instance of information system, a minimum of Show and output device / enter unit / information storage like normal personal computer with communication means mounted in Just about every of evaluation paying out establishment, insurer, insurance professional medical establishment, insurance coverage pharmacy And a central procedure that performs information inquiry / willpower are connected by means of a communication line for instance the web.
Need to your health care health practitioner desires the pharmacist to give you a selected brand of medication, they have got to precisely note this or sign-up the Area sent.