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Although the execution of your suggests from the existing creation is carried out as a result of an information program, this execution is about divided into two levels: a program planning phase and an Procedure stage.In fundamental conditions, the prescription is some paper which can be written from the registered health care practitioner (RMP) dependant on the consumer's ailment dilemma.
Once the inquiry in the clinical institution, the final prescription information is transmitted from the health care establishment towards the information technique when the prescription drug is decided. When an insurance plan pharmacy inquires about The provision of insurance policy for prescribed drugs explained in prescriptions, the existence / absence of the inquiry history Together with the clinical institution and the effects are dispersed. Lastly, a series of inquiry histories is distributed for the examination and payment institution plus the insurance company, plus the information inquiry / judgment technique is concluded.
In the system Procedure stage, the following processing is done in authentic time. In other words, inquiries about The supply of insurance policies coverage for prescription drugs from health treatment establishments are made via conversation lines in the course of each clinical follow, and these inquiries are in contrast with the input information and specified conditions on the assessment and payment institutions and insurers talked about over. Then, the examination having to pay institution as well as the insurance provider establish if to reject the insurance policy application, distribute the result into the health-related institution, and display it around the terminal in the health care establishment by an enter / output display screen as demonstrated in FIG. Due to the perseverance, If your written content of your inquiry does not conform for the input information and selected disorders with the evaluation and payment institution and the insurance provider, a pharmaceutical group satisfying these is searched and discovered and distributed towards the healthcare establishment.
従って、本発明の課題は、わが国の医療保険制度の中で、医療サービス受給の公平性を維持しつつ、被保険者・保険者もしくは審査支払機関が、代替品の中から最も強く処方を希望する医薬品を、医療機関・保険薬局が、他の代替品の中から優先的に採用する機会を提供することを可能にさせる、医療用医薬品処方情報照会・配信システムを提供することにある。
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Every time a prescription suggested medication is chosen by a health care establishment, the handling standing / stock status at a nearby coverage pharmacy is confirmed and the result is notified.
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As a result, although keeping the fairness of obtaining professional medical solutions, the insured / insurer / examination / payment establishment has the chance to find a drug that is considered attractive from the viewpoint of effectiveness, price, etcetera. Is not really furnished plenty of. For that reason, the challenge in the present creation is that the insured person / insurance provider or examination / payment establishment really wants to prescribe the strongest prescription amid options though retaining the fairness of receiving clinical providers in Japan's professional medical insurance plan method.
The existing invention for solving the above mentioned-mentioned troubles is made up of the following areas. (one) Enter and hold information on substitutes and prescription priority information of insurers for prescribed drugs prescribed by coverage healthcare institutions for insured individuals (two) Enter and retain the conditions and requirements for receipt overview acceptance because of the assessment and payment organization (3) Accepting inquiries from healthcare institutions concerning the availability of insurance policy for prescription drugs for each health-related follow, and generating inquiries determined by personalized information like the insured's indicators, health care historical past, age, and so on., and information on (one) and (2) over Judgment is made in real time to ascertain whether the content satisfies the situations specified from the insurance provider / evaluation and payment establishment (4) If the above mentioned inquiries don't fulfill the desired disorders, seek out other drugs that fulfill the desired conditions according to the insured's information for example signs or symptoms, etcetera. Notify medical establishments and inspire them to reselect prescription information.
Hereinafter, a flowchart of an illustration of an information inquiry / willpower method will be explained with reference to FIG. First, the mandatory information is acquired in the assessment payer / insurer / insurance professional medical institution / insurance coverage pharmacy. The information and specified disorders for being received from the evaluation payer plus the insurer are as described previously mentioned.
An illustration of the configuration of these an information process is revealed in FIG. In this instance of information process, not less than Display screen and output device / input unit / information storage for instance standard pc with conversation implies installed in click here Every of assessment spending institution, insurer, coverage clinical institution, coverage pharmacy Plus a central method that performs information inquiry / resolve are linked by using a communication line which include the online world.
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。