そして個々の診療行為毎に医療機関から医薬品処方につき照会を受けると、照会時に医療機関から提示される被保険者情報（医療保険関連情報、傷病・症状等の情報等）と、予め取得した情報とを照合し、被保険者が加入している保険者並びに担当の審査支払機関の指定条件を満たしているか否かをリアルタイムで判定する。
The current invention pertains to transactions connected to prescription and buy of moral drugs amongst suppliers and prescribers for instance health-related establishments and insurance coverage pharmacies and individuals like examination payers, insurers and insured folks in the pharmaceutical distribution market place. It gets to be attainable to clarify if There may be agreement between the functions in genuine time. Consequently, the evaluation / payment establishment / insurance provider could have an opportunity to properly Categorical their intentions regarding the number of drugs, which will allow them to increase their choices for drug prescriptions they drive and boost their gratification and value effectiveness.
以下に、図４を用いて情報照会・判定の手順の一例のフローチャートを説明する。まず審査支払機関・保険者・保険医療機関・保険薬局から必要な情報を取得する。審査支払機関及び保険者から取得する情報・指定条件は前述の通りであり、医療機関・保険薬局からは所在地等の基本情報に加え、使用希望薬剤情報・医薬品取扱情報・同在庫情報等を取得し、取得したデータを格納する。
At present, an information procedure that replaces the creation and application of the above mentioned-mentioned receipt with the Digital process from a conventional composed system has already been put into useful use. Conversely, in America, Pharmacy Benefit Management (“PBM”) is a business that manages dispensing expenses for policyholders.
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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。
システムの運用段階では、以下の処理をリアルタイムで実施する。すなわち、個々の診療行為に際して保健医療機関からの処方医薬品の保険適用の可否の問い合わせが通信回線を介して行われ、この問い合わせを前述の審査支払機関及び保険者の入力情報や指定条件に照らし合わせて、審査支払機関及び保険者が保険適用を却下しないか否かを判定し結果を医療機関に配信し、図６に示されるような入出力画面によって医療機関の端末に表示される。尚、判定の結果、問い合わせ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。併せて、指定条件を満たした医薬品については、医療機関や被保険者の住所の近くに存在する保険薬局数軒での当該医薬品の取扱情報・在庫情報を保険薬局のデータベースにアクセスし確認を行う。また、保険薬局が、医療機関が発行した処方箋に記されている医薬品の保険適用につき照会を行う場合には、処方箋発行医療機関との照会履歴の有無、結果について配信する。
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) presented from the health-related institution at some time of inquiry and information obtained beforehand And in genuine-time whether or not the required ailments on the insurer to whom the insured is affiliated and also the assessment and payment Firm in charge are contented.
Concurrently, for prescribed drugs that meet the required problems, access the coverage pharmacy database and Look at the dealing with and stock information on the pharmaceuticals at many insurance coverage pharmacies near the handle from the professional medical institution or even the insured. . On top of that, when an insurance policy pharmacy would make an inquiry with regard to the insurance policy software of the drugs explained in a prescription issued by a health-related institution, the presence or absence of an inquiry historical past Along with the prescription issuing medical establishment and The end result are dispersed.
図１は、本発明の医薬品処方情報照会・配信方法を活用したビジネスモデルの一例の概略を示す図面であり、図２は、当該ビジネスモデルをより具体的に示す図面であり、図３は、情報システム構成の一例を示す図面であり、図４は、情報照会・判定の一例を示すフローチャートであり、図５は、本発明の医薬品処方情報照会・配信のための情報システム内のデータファイルの一例を示す図面であり、図６は、当該情報システムと接続した医療機関の端末の入出力イメージの一例を示す図である。
This A Portion of the prescription contains Instructions for that pharmacist, inside the celebration of the drug if it should be compounded in the pharmacy.
Though Every single line has a definite character, together they kind an entire medication choice support Resolution, serving a big range of healthcare marketplaces and offering steady information and aligned methods encompassing each drug reference and drug info.
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