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。
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。
The prescription ought to be signed via the prescriber by his / her hand. His/her tackle and registration range seriously should be well prepared in the case of perilous and behavior-forming medicines.
While in the technique operation stage, the next processing is done in true time. To put it differently, inquiries concerning the availability of insurance plan coverage for prescription drugs from health care establishments are made via communication lines during each health-related observe, and these inquiries are in contrast Along with the enter information and specified disorders in the evaluation and payment institutions and insurers talked about over. Then, the assessment paying establishment and also the insurance provider figure out whether to reject the insurance policy application, distribute the result to the medical institution, and Show it within the terminal of the healthcare institution by an input / output monitor as shown in FIG. As a result of the dedication, if the content material of the inquiry would not conform towards the input information and selected disorders from the assessment and payment establishment and also the insurer, a pharmaceutical group gratifying these is searched and recognized and distributed for the professional medical establishment.
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Subsequent, the move through which the signifies on the current creation is executed is going to be explained in time sequence with reference to FIG.
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The professional medical prescription check here information inquiry / distribution system according to assert one, whereby the medical prescription is gained from the professional medical establishment for each healthcare exercise, and insured information (health care insurance coverage associated information, personal injury and illness) offered through the professional medical establishment at the time of inquiry.
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Interactions Drug Interactions - This area presents an outline on the interaction between the drug mentioned from the monograph and also other drugs or drug lessons. Pursuing a description with the conversation for a drug course, any drugs from that course which aren't likely to cause an identical conversation Together with the monograph drug are detailed as exceptions. Lastly, the significance from the conversation is determined as follows: Monitor therapy – knowledge display that the required brokers may perhaps interact with one another within a clinically-sizeable method, but the main advantages of concomitant use ordinarily outweigh any dangers. An suitable monitoring prepare must be implemented to discover likely destructive effects and dosage adjustments might be desired in a minority of patients.
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。
On top of that, the examination and payment institution along with the insurance provider will specify the medicines that they wish to preferentially prescribe. The designation approach is as follows: (1) Specify the title of a particular group of drugs for every injury and symptom classified As outlined by many conditions like the insured's age, gender, Structure and health care heritage. Or use (two) the higher limit on the health care remuneration score / applied drug insurance coverage score and permit the prescription from the drug providing the higher limit just isn't exceeded. These enter information and specified disorders are saved as details inside the information procedure.
The Pharmacists at Carnegie Sargents Pharmacy dispense prescription medications to patients and offer you abilities within the safe utilization of prescriptions. We perform right with doctors, other health specialists, and patients to make certain the medications prescribed for patients lead to the absolute best health results. We are going to present you with the information you need to make knowledgeable selections. We will likely make the effort to discuss along with you how to interpret the information in order to obtain an smart discussion with you Medical professionals.
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。