このような情報システムの構成の一例を図３に示す。本情報システム例では、審査支払機関・保険者・保険医療機関・保険薬局のそれぞれに設置される通信手段をそなえた通常のパーソナルコンピューターのような、少なくとも、表示及び出力部・入力部・データ格納部、を備えた端末、及び情報照会・判定を行う中央システムとが、インターネットのような通信回線を介して接続される。当該中央システムは、演算部・表示及び出力部・入力部・データ格納部から構成され、演算時に参照するデータファイルの例が図５に示される。
・ It is far from intended to extend the options for prescribed drugs of insurers and cut down the cost of prescribed drugs. Also, PBM in the United States gives drug Price tag management solutions for firms for instance companies as the key customers and won't address all citizens. is not.
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From the technique operation stage, the next processing is carried out in authentic time. To paraphrase, inquiries about The supply of coverage coverage for prescription drugs from health treatment institutions are created by way of interaction lines during Each individual health care practice, and these inquiries are as opposed While using the input information and specified situations on the assessment and payment institutions and insurers described above. Then, the examination spending establishment and also the insurance company identify whether or not to reject the insurance policies software, distribute The end result into the healthcare institution, and Show it within the terminal on the clinical establishment by an input / output display as demonstrated in FIG. Due to the perseverance, If your written content of your inquiry would not conform to your enter information and designated circumstances from the examination and payment establishment as well as insurance company, a pharmaceutical team gratifying these is searched and identified and dispersed for the healthcare establishment.
The current invention relates to a pharmaceutical prescription information inquiry / distribution device, a pharmaceutical prescription information inquiry / distribution procedure, and also a pharmaceutical prescription information inquiry / distribution system.
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。
Any time a prescription advisable medicine is selected by a medical institution, the managing status / inventory position at a nearby insurance policies pharmacy is verified and The end result is notified.
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If it is determined that the desired disorders are satisfied, upcoming, Verify the dealing with position / stock status of prescription drugs in opposition to various insurance coverage pharmacies near the tackle of your healthcare institution / insurer, and procure the outcome. Also supply to professional medical establishments. On the other hand, if it is decided that the required disorders are not met, the prescription recommendation subject derived according to the insured individual's information presented via the professional medical establishment in just a assortment that matches the specified disorders with the evaluation payer and also the insurance provider Distribute a listing of medicines to healthcare establishments and stimulate them to reselect.
The existing creation for fixing the above mentioned-outlined challenges is made up of the following sections. (one) Enter and hold information on substitutes and prescription priority information of insurers for prescribed drugs prescribed by insurance coverage clinical establishments for insured persons (2) Enter and sustain the ailments and conditions for receipt review approval from the examination and payment Business (3) Accepting inquiries from health care institutions pertaining to The provision of insurance plan for prescription drugs for every health care exercise, and building inquiries based upon particular information like the insured's indicators, health-related background, age, etc., and information on (one) and (2) over Judgment is produced in real time to ascertain whether the content satisfies the situations specified by the insurance provider / examination and payment establishment (four) If the above inquiries never satisfy the required situations, search for other drugs read more that satisfy the desired conditions based upon the insured's information like signs or symptoms, etc. Notify health care establishments and encourage them to reselect prescription material.
Hereinafter, a flowchart of the example of an information inquiry / dedication process will be described with reference to FIG. 1st, the required information is acquired from the evaluation payer / insurer / insurance clinical institution / insurance policies pharmacy. The information and selected problems to generally be attained from the evaluation payer along with the insurance company are as described earlier mentioned.
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