Patient education for Dummies
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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。
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。
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[Challenges] To provide a technique for supplying a chance for the health-related establishment / insurance pharmacy to preferentially adopt a medicine that an insured / insurance company or assessment / payment institution really wants to prescribe during the healthcare insurance policy process. Delivered. [MEANS FOR SOLVING Issues] Moving into / Keeping information on possibilities, prescription precedence order information of an insurance provider, and conditions / standards for acceptance of the receipt examination by an assessment / payment establishment for the medication prescribed by an insurance policy health-related institution Inquiries about whether or not insurance for prescription drugs is obtainable for Every single healthcare observe through the indicates and clinical institution, and if the inquiries match the required situations of your insurance company / assessment and payment Business based upon individual information for instance symptoms on the insured Usually means to determine whether or not the above inquiry articles would not match the required circumstances, hunt for other drugs that fulfill the required disorders from the drugs specified from the insurer according to the insured's information like signs and symptoms A program possessing implies for notifying a health-related institution instead and prompting the medical establishment to reselect prescription contents. [Assortment] Figure three Description
In the planning phase from the process, the examination payer plus the insurer enter needed information and specify conditions. Examples of information entered with the assessment payer and the insurer and the desired ailments are determined by information on the insurance company subject to evaluation, conditions like the insured's age, gender, Structure and previous background There are actually assumed healthcare payment points calculated for each person sickness and symptom divided, drug value specifications of utilised drugs, insurance policies factors, along with other info needed for examination of medical rate specifics.
次に、図２を用いて本発明の手段が実行されるフローを時系列で説明する。本発明の手段の実行は情報システムを通じて行われるが、この実行は大別して、システムの準備段階及び運用段階の二段階に分けられる。
The pharmaceutical prescription information inquiry / distribution procedure Based on declare one, wherein a number of inquiry histories made through the program is dispersed to an assessment payment organization and an insurer.
It's composed of assumed clinical fee points calculated for each harm and symptom categorized In line with case, drug cost common of applied drugs, insurance coverage factors, other data necessary for evaluation of professional medical fee particulars, and so forth. Pharmaceutical prescription information inquiry and distribution technique.
Drug Search by Condition/Symptom - Find out what a drug is utilized for, or if an adverse response could be because of a certain drug.
Observe: It is usually recommended click here that to aid Reduce down the quantity of medication complications, prescription making really should be 100% English, without having Latin abbreviations. I'll teach you the two and let you arrive at a choice.
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。