In the standard payment evaluation system, a professional medical institution troubles a prescription and prescribes and pays for your drug to the patient at an insurance pharmacy, etcetera., and then the assessment ask for to the health-related observe is built for the evaluation payment institution. Having said that, it really is not possible to guage the suitability of the appliance contents upfront for medical institutions. Moreover, the insured / insurance provider (health insurance coverage association, and so forth.) that bears the expense of prescription drugs is not totally informed about information on drugs like efficacy and price tag, and is also entirely knowledgeable with regard to the existence of multiple choices. It is commonly not performed. This is why, the selection of medicines is fully still left towards the judgment of the professional medical establishment, and it really is hard to exercising the correct to choose medicines as a price bearer as well as a customer.
Come to be. Consequently, for example, the examination / payment agency raises the prescription priority order of more practical medicines so that a lot of healthcare establishments can prescribe the medicines. Therefore, the quality of health care providers along with the fairness of costs amid insured people Promoted. Furthermore, an increase in prescription of The most cost effective drug amongst a plurality of drugs getting precisely the same effect may also be received, like reduction in drug expenses for insurers and insured people.
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As an alternative, notify the professional medical institution, and really encourage the health care establishment to reselect prescription information, Pharmaceutical prescription information inquiry / distribution process characterised by comprising
To start with, in FIG. one, the get-togethers linked to the information procedure of your existing invention might be clarified. This information process includes a clinical institution that prescribes pharmaceuticals to your insured, an insurance policy pharmacy that dispenses pharmaceuticals based on a prescription issued through the clinical establishment and presents them to here your insured, an insurance company that bears health care insurance plan charges, and An examination / payment institution that examines medical charge specifics from health-related institutions / insurance coverage pharmacies is connected. Each social gathering gives the information procedure using a number of necessary information to get described afterwards.While in the information method, (1) information on options and prescriptions of the insurer for drugs prescribed because of the insurance policy clinical institution for that insured Enter / maintain wished-for priority information, (2) Enter / keep disorders / standards for approval of receipt critique by evaluation / payment Business, (3) Inquire about availability of coverage for prescription drugs from healthcare institutions for each professional medical apply Determined by own information like acceptance, insured's symptom, medical background, age, etc.
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医療機関からの照会後、処方医薬品を確定した段階で医療機関から最終の処方内容が情報システムに送信される。保険薬局から処方箋記載の医薬品の保険適用の可否について照会があった場合には、医療機関との照会履歴の有無、結果を配信する。
At present, an information system that replaces the creation and application of the above mentioned-described receipt having an Digital method from a traditional penned method has previously been put into realistic use. On the other hand, in the United States, Pharmacy Gain Management (“PBM”) is a business that manages dispensing prices for policyholders.
It can be composed of assumed professional medical price details calculated for each harm and symptom classified In accordance with circumstance, drug value regular of applied drugs, insurance policy factors, other details necessary for evaluation of medical charge facts, etc. Pharmaceutical prescription information inquiry and distribution program.
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In standard terms, the prescription is a little paper which happens to be composed through the registered health treatment practitioner (RMP) based upon the client's ailment challenge.
The central system includes a calculation unit, a Exhibit and output device, an enter device, and an information storage unit. An example of an information file for being referred to at time of calculation is shown in FIG.
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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。