) offered via the professional medical establishment at time of inquiry and information obtained beforehand And in real-time if the desired circumstances of the insurance company to whom the insured is affiliated as well as the assessment and payment Firm in demand are content.
In case the professional medical Expert would really like the pharmacist to offer you a certain brand of medicine, they must Specifically Recognize this or sign-up the Spot furnished.
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。
Hereinafter, a flowchart of the example of an information inquiry / perseverance course of action will be explained with reference to FIG. Initially, the required information is acquired from your examination payer / insurance provider / insurance plan professional medical establishment / coverage pharmacy. The information and selected situations to generally be attained through the examination payer as well as insurance company are as explained previously mentioned.
Within the process Procedure phase, the subsequent processing is performed in serious time. To put it differently, inquiries about the availability of insurance coverage coverage for prescription drugs from health care institutions are created via communication lines for the duration of Each and every clinical observe, and these inquiries are compared With all the input information and specified situations of the assessment and payment establishments and insurers stated previously mentioned. Then, the examination having to pay establishment as well as insurance provider decide if to reject the insurance policies application, distribute The end result towards the medical establishment, and Show it on the terminal with the health care institution by an enter / output display screen as shown in FIG. On account of the dedication, if the information in the inquiry would not conform for the enter information and designated problems on the assessment and payment establishment and also the insurer, a pharmaceutical group gratifying these is searched and discovered and dispersed towards the healthcare establishment.
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、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、保険薬局からの照会を受付け、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ことを特徴とする医薬品処方情報照会・配信システム。
The prescription must be signed by using the prescriber by his / her hand. His/her tackle and registration variety genuinely ought to be geared up in the case of perilous and conduct-forming medicines.
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【選択図】図３[Issues] To deliver a process for delivering an opportunity for a professional medical institution / insurance plan pharmacy to preferentially adopt a medication that an insured / insurer or evaluation / payment establishment really wants to prescribe within the health care insurance process. Supplied. [Suggests FOR SOLVING Troubles] Moving into / Keeping information on solutions, prescription precedence order information of the insurance provider, and circumstances / criteria for acceptance of the receipt assessment by an assessment / payment establishment to get a medicine prescribed by an insurance policies professional medical establishment Inquiries with regards to no matter whether insurance plan for prescription drugs is obtainable for each medical practice from the suggests and clinical institution, and whether the inquiries match the desired situations from the insurance company / examination and payment organization determined by private information for instance indicators from the insured Usually means to find out if the above inquiry information will not match the required situations, search for other drugs that satisfy the required situations within the drugs specified via the insurer based upon the insured's information like indicators A system possessing suggests for notifying a clinical establishment instead and prompting the healthcare institution to reselect prescription contents. [Variety] Figure three Description
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Consider therapy modification - details exhibit that the required agents may perhaps interact with one another inside a clinically-major manner and patient-precise evaluation must be performed to ascertain whether or not the advantages of concomitant therapy outweigh the risks. Certain steps need to be taken in order to realize the benefits and/or reduce toxicity of concomitant use. Keep away from mix - details display that the desired agents might interact with each other in the clinically-considerable manner and the risk usually outweighs any prospective reward. Concurrent use of these brokers is usually considered contraindicated. Exam Interactions - Listing of assay interferences when pertinent
Develop into. Because of this, such as, the evaluation / payment agency raises the prescription priority order of more practical medicines so that lots of health-related establishments can prescribe the medicines. Subsequently, the caliber of professional medical solutions and the fairness of expenditures amongst insured persons Promoted. Furthermore, an increase in prescription of the cheapest drug amid a plurality of drugs having exactly the same outcome can also be attained, which include reduction in drug expenditures for insurers and insured persons.
Each time a prescription encouraged drugs is chosen by a healthcare institution, the handling status / stock standing at a read more nearby insurance policies pharmacy is confirmed and the result is notified.