as well as the information in (one) and (2) higher than, whether the inquiry content fulfills the specified ailments from the insurance company / examination / payment in authentic time (four) If the above inquiries will not match the specified situations, try to find other drugs that satisfy the desired disorders depending on the insured's information for instance symptoms through the drugs specified via the insurance provider. Notify healthcare institutions as a substitute, Prompting reselection prescription at engine managing these process, immediately and competently, the selection of formulation medicament, for the possibility of insurance plan protection, obtain consensus amongst the functions.
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。
The prescription need to be signed by way of the prescriber by his / her hand. His/her tackle and registration assortment genuinely really should be geared up in the situation of perilous and conduct-forming medicines.
Inside the program operation stage, the subsequent processing is done in authentic time. Basically, inquiries pertaining to The supply of insurance policies coverage for prescription drugs from health treatment institutions are made by using conversation lines all through Just about every clinical follow, and these inquiries are compared Using the enter information and specified problems on the examination and payment institutions and insurers pointed out over. Then, the evaluation shelling out institution as well as the insurance provider determine whether or not to reject the insurance plan software, distribute the result towards the health care establishment, and Exhibit it over the terminal of the healthcare institution by an enter / output monitor as revealed in FIG. On account of the determination, if the content material from the inquiry doesn't conform to the enter information and specified situations from the assessment and payment establishment plus the insurance company, a pharmaceutical group enjoyable these is searched and determined and distributed to the professional medical institution.
また、医薬品費用を負担する被保険者・保険者（健康保険組合等）が、効能・価格等の医薬品に関する情報を十分に知らされていない、複数の代替品の存在に関する情報を十分には知らされていない、といった場合が多い。このため、医薬品の選択に際しては医療機関の判断に全面的に委ねており、費用負担者及び需要者としての医薬品選択の権利が行使しにくい状況が生まれている。
The prescription information inquiry / distribution method according to declare one, accepting inquiries from insurance policy pharmacies for coverage coverage of prescribed drugs explained in prescriptions issued by healthcare establishments, and presence of inquiry history with prescription issuing clinical establishments Pharmaceutical prescription information inquiry and distribution method characterized by distributing effects.
【選択図】図３[Challenges] To provide a technique for furnishing an opportunity for the professional medical institution / insurance policies pharmacy to preferentially undertake a medicine that an insured / insurer or examination / payment institution desires to prescribe within the health care insurance plan procedure. Provided. [Indicates FOR SOLVING Issues] Entering / Keeping information on options, prescription precedence order information of the insurance company, and problems / expectations for acceptance of the receipt evaluation by an examination / payment institution for just a medication prescribed by an insurance policies health-related institution Inquiries regarding whether or not coverage for prescription drugs is accessible for Every single healthcare observe from your means and health care establishment, and whether the inquiries match the desired conditions on the insurance provider / assessment and payment Business dependant on individual information for instance symptoms in the insured Signifies to determine if the above inquiry content material isn't going to match the required disorders, look for other drugs that meet the specified circumstances from your drugs specified through the insurance company depending on the insured's information including signs A program possessing indicates for notifying a healthcare establishment instead and prompting the health care institution to reselect prescription contents. [Selection] Determine 3 Description
Notice: It will likely be encouraged that to help lessen more info the quantity of medication blunders, prescription crafting actually ought to be a hundred% English, without having Latin abbreviations. I will show you about equally and allow you to make your study much more intellect up.
) introduced via the medical establishment at enough time of inquiry and information acquired in advance As well as in authentic-time whether the specified circumstances in the insurer to whom the insured is affiliated and the assessment and payment Firm in charge are glad.
If it is determined that the desired disorders are satisfied, upcoming, Verify the dealing with standing / stock position of prescription drugs towards many insurance coverage pharmacies near the deal with with the medical institution / insurer, and obtain the outcome. Also provide to clinical establishments. Conversely, if it is decided that the required ailments are usually not achieved, the prescription advice subject matter derived based upon the insured man or woman's information presented by the medical establishment in just a array that matches the desired situations from the evaluation payer as well as the insurer Distribute an index of medicines to health care institutions and persuade them to reselect.
The current creation for solving the above-described problems is composed of the next parts. (1) Enter and maintain information on substitutes and prescription precedence information of insurers for prescription drugs prescribed by insurance policy professional medical institutions for insured persons (2) Enter and keep the disorders and conditions for receipt evaluation approval through the evaluation and payment Group (three) Accepting inquiries from medical establishments regarding the availability of insurance coverage for prescription drugs for each medical practice, and creating inquiries depending on private information such as the insured's signs and symptoms, healthcare history, age, etcetera., and information on (one) and (2) above Judgment is built in authentic time to find out whether the written content fulfills the circumstances specified via the insurance company / examination and payment institution (four) If the above inquiries will not satisfy the required situations, search for other drugs that satisfy the required situations dependant on the insured's information including indications, and so forth. Notify professional medical institutions and motivate them to reselect prescription information.
To start with, in FIG. one, the functions linked to the information technique on the current invention will probably be clarified. This information method includes a healthcare establishment that prescribes prescription drugs to your insured, an insurance policies pharmacy that dispenses prescribed drugs depending on a prescription issued by the professional medical establishment and offers them to the insured, an insurance company that bears health-related insurance expenditures, and An examination / payment establishment that examines healthcare cost specifics from professional medical institutions / insurance plan pharmacies is connected. Just about every celebration delivers the information system by using a number of necessary information for being explained afterwards.During the information method, (1) information on alternate options and prescriptions of your insurance provider for drugs prescribed by the insurance policy health care institution to the insured Enter / maintain sought after priority information, (2) Enter / hold circumstances / specifications for acceptance of receipt overview by overview / payment Firm, (3) Inquire about availability of insurance coverage for prescription drugs from medical establishments for each health-related apply Based on own information for instance acceptance, insured's symptom, health care background, age, etc.
possess the probable of remaining abused, and which could cause nicely staying threats from Unfavorable effects if taken incorrectly,
This A A part of the prescription also attributes the power of one's drug (the quantity of milligrams, as an example) plus the pill, capsule, or other form where your Health treatment support company would really like you to definitely consider it. A Take Take note determined as "Disp" refers to this information about how the drug need to be dispensed.