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 present invention pertains to transactions related to prescription and buy of moral drugs among suppliers and prescribers for example health care institutions and insurance coverage pharmacies and customers such as assessment payers, insurers and insured people inside the pharmaceutical distribution marketplace. It results in being feasible to explain whether There's settlement in between the get-togethers in actual time. Subsequently, the evaluation / payment establishment / insurer could have a possibility to properly Categorical their intentions regarding the variety of drugs, which enables them to increase their selections for drug prescriptions they wish and make improvements to their satisfaction and cost efficiency.
The prescription should be signed by using the prescriber by his / her hand. His/her deal with and registration selection actually must be well prepared in the case of perilous and conduct-forming medicines.
At present, an information program that replaces the development and software of the above-pointed out receipt having an electronic approach from a standard written approach has by now been set into sensible use. On the flip side, in America, Pharmacy Benefit Management (“PBM”) is a business that manages dispensing expenses for policyholders.
Develop into. As a result, for example, the examination / payment company raises the prescription precedence order of more effective medicines so that many clinical institutions can prescribe the medicines. Due to this fact, the quality of health care services along with the fairness of expenses amid insured people Promoted. In addition, an increase in prescription of the cheapest drug between a plurality of drugs possessing the exact same outcome can also be obtained, including reduction in drug fees for insurers and insured individuals.
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。
The professional medical prescription information inquiry / distribution program In keeping with claim 1, whereby the medical prescription is acquired from the professional medical establishment for every healthcare follow, and insured information (clinical insurance coverage relevant information, harm and health issues) introduced from the healthcare institution at the time of inquiry.
Decide on a default timezone, and allow very well being expertise syncs and placement facts. This earlier part is important for somebody trying to deal with indications linked to their neighborhood weather and pollen.
If it is set that the required circumstances are fulfilled, future, Examine the dealing with standing / stock position of prescription drugs towards a number of coverage pharmacies close to the address from the health care establishment / insurance company, and procure the final results. Also produce to professional medical establishments. On the other hand, if it is determined that the required disorders are not achieved, the prescription advice subject matter derived based upon the insured particular person's information offered through the healthcare institution inside of a array that matches the desired circumstances of your evaluation payer as well as the insurer Distribute an index of medicines to health care institutions and persuade them to reselect.
And when you receive an inquiry about medical prescriptions from the clinical institution for every personal medical exercise, insured particular person information (medical coverage relevant information, information on sickness / signs and symptoms, and many others.
It must be developed beneath the supervision inside the health care Specialist or in accordance with pharmacopoeia or formulary Instructions. It may be essential to fill the containers Using the ready compounds. The container really should be clearly marked by using a label.
An example of the configuration of this sort of an information technique is demonstrated in FIG. In this example of information technique, no less than Exhibit and output device / input unit / data storage like normal personal computer with interaction means mounted in each of assessment shelling out establishment, insurer, insurance coverage medical establishment, insurance policy pharmacy Along with a central procedure that performs information inquiry / perseverance are connected by using a communication line which include the world wide web.
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