How persistently have you remaining the health practitioner’s Business, only to seek out you forgot to say a vital piece of information?
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。
Full the form and after that click on the bins to point the kind of information you would like to acquire.
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。
【選択図】図３[Issues] To supply a program for delivering an opportunity for your health-related institution / coverage pharmacy to preferentially undertake a medicine that an insured / insurance company or evaluation / payment institution wishes to prescribe from the healthcare insurance policies program. Supplied. [Signifies FOR Resolving Troubles] Coming into / Keeping information on possibilities, prescription precedence order information of an insurance company, and problems / criteria for acceptance of a receipt evaluation by an assessment / payment institution for any drugs prescribed by an insurance policy medical establishment Inquiries relating to no matter if insurance plan for prescription drugs is accessible for each health-related exercise through the indicates and medical establishment, and whether the inquiries match the specified situations from the insurer / assessment and payment Business dependant on personal information like signs in the insured Implies to ascertain whether the above mentioned inquiry material doesn't match the desired disorders, search for other drugs that satisfy the desired circumstances from the drugs specified by the insurance provider depending on the insured's information for instance signs and symptoms A system possessing indicates for notifying a medical establishment instead and prompting the clinical establishment to reselect prescription contents. [Choice] Figure three Description
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医療機関による医薬品の処方に際しては、被保険者（患者）が保健医療機関で医師の診察を受け、その診断結果をもとに医師が処方箋を発行、同処方箋に基づき保険薬局にて医薬品が調剤、提供される、という流れになっている。保険が適用される医薬品の費用請求については、被保険者による一部費用負担を除くと、医療機関・保険薬局などが、レセプトと呼ばれる診療報酬明細書に、診療、検査、投薬、手術など医療行為の内容を記入し、月ごとに審査支払機関に提出、医療費を請求する。審査は、社会保険診療報酬支払基金と都道府県支部、国民健康保険中央会と各都道府県の国民健康保険団体連合会にて実施され、かかった医療費をそのまま医療保険から支払う「出来高払い制」を採用されている。
Presently, There is certainly an illustration that aims to Enhance the do the job performance by digitizing the medical charge assessment request instead of writing, but This really is geared toward labor saving of Workplace work at get more info the professional medical establishment.
and the information in (one) and (two) previously mentioned, whether or not the inquiry content material satisfies the required problems on the insurance provider / evaluation / payment in serious time (four) If the above mentioned inquiries usually do not match the specified disorders, seek for other drugs that fulfill the required disorders determined by the insured's information including indicators in the drugs specified through the insurer. Notify clinical establishments instead, Prompting reselection prescription at engine jogging this kind of process, promptly and effectively, the choice of formulation medicament, for the opportunity of insurance policy protection, accomplish consensus in between the get-togethers.
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、判定の結果、照会内容が審査支払機関及び保険者の入力情報や指定条件に適合しない場合には、これらを満たす医薬品群を検索・同定し、医療機関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。
指定条件を満たしていると判定した場合には、次に、医療機関・保険者の住所から近くに存在する複数の保険薬局に対して、処方対象医薬品の取扱状況・在庫状況を確認、結果をあわせて医療機関へ配信する。一方、指定条件を満たしていないと判定した場合には、審査支払機関及び保険者の指定条件に合致する範囲内で医療機関が提示した被保険者情報をもとに導出される処方推奨対象となる医薬品のリストを医療機関に配信、医療機関にて再選択を促す。医療機関にて処方推奨医薬品が選択されると、近隣の保険薬局での取扱状況・在庫状況を確認、結果を通知する。
Next, the move by which the suggests on the present creation is executed are going to be described in time sequence with reference to FIG.
Inside the preparation phase from the system, the assessment payer along with the insurance provider enter needed information and specify circumstances. Samples of information entered with the assessment payer along with the insurer and the desired conditions are determined by information around the insurance company subject to evaluation, disorders such as the insured's age, gender, constitution and previous historical past There are actually assumed health-related cost details calculated for every specific sickness and symptom divided, drug rate benchmarks of used drugs, insurance policies details, and also other facts essential for evaluation of health care cost specifics.