After the inquiry with the health-related establishment, the ultimate prescription material is transmitted within the health-related establishment into the information program if the prescription drug is decided. When an insurance policies pharmacy inquires about The provision of insurance coverage for prescribed drugs described in prescriptions, the existence / absence with the inquiry record Along with the clinical establishment and the outcomes are distributed. Ultimately, a series of inquiry histories is distributed towards the examination and payment institution and also the insurance company, along with the information inquiry / judgment technique is concluded.
Initial, in FIG. 1, the parties linked to the information procedure on the present invention will likely be clarified. This information technique includes a health-related institution that prescribes prescription drugs to your insured, an coverage pharmacy that dispenses prescribed drugs determined by a prescription issued through the healthcare establishment and supplies them for the insured, an insurance provider that bears health care insurance policy costs, and An evaluation / payment establishment that examines health care fee facts from health-related establishments / insurance coverage pharmacies is linked. Each get together presents the information method that has a number of essential information to get explained afterwards.In the information technique, (one) information on alternatives and prescriptions from the insurance company for drugs prescribed because of the insurance healthcare institution to the insured Enter / maintain sought after priority information, (2) Enter / hold circumstances / requirements for approval of receipt review by review / payment organization, (three) Inquire about availability of insurance plan for prescription drugs from clinical institutions for every clinical follow Determined by individual information such as acceptance, insured's symptom, professional medical heritage, age, and so forth.
At the same time, for prescription drugs that satisfy the required problems, access the insurance plan pharmacy database and Check out the handling and inventory information of your prescribed drugs at quite a few coverage pharmacies near the tackle of the health care institution or maybe the insured. . Additionally, when an insurance plan pharmacy makes an inquiry with regard to the insurance coverage software of the drugs explained in a prescription issued by a healthcare institution, the presence or absence of the inquiry record with the prescription issuing healthcare institution and The end result are dispersed.
It can be composed of assumed professional medical price points calculated for every injury and symptom labeled In accordance with circumstance, drug value Online pharmacy conventional of employed drugs, insurance points, other facts needed for evaluation of professional medical charge facts, etc. Pharmaceutical prescription information inquiry and distribution program.
以下に、図４を用いて情報照会・判定の手順の一例のフローチャートを説明する。まず審査支払機関・保険者・保険医療機関・保険薬局から必要な情報を取得する。審査支払機関及び保険者から取得する情報・指定条件は前述の通りであり、医療機関・保険薬局からは所在地等の基本情報に加え、使用希望薬剤情報・医薬品取扱情報・同在庫情報等を取得し、取得したデータを格納する。
Because of this, although preserving the fairness of receiving medical products and services, the insured / insurance company / examination / payment establishment has the chance to pick a drug that is certainly considered desirable from your viewpoint of performance, value, etc. Will not be offered enough. Thus, the issue with the present invention would be that the insured person / insurance company or assessment / payment institution would like to prescribe the strongest prescription among alternate options while preserving the fairness of obtaining professional medical providers in Japan's health care insurance method.
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【解決手段】保険医療機関が処方する医薬品について、代替品情報、保険者の処方希望優先順位情報を入力・保持する手段、審査支払機関によるレセプト審査承認のための条件・基準を入力・保持する手段、医療機関から診療行為毎に、処方医薬品の保険適用可否に関する照会を受付け、被保険者の症状等の個人情報に基づき、照会内容が保険者・審査支払機関の指定条件に合致しているか否かを判定する手段、上記照会内容が指定条件に合致していない場合は、保険者が指定する医薬品の中から、症状等の被保険者の情報に基づき指定条件を満たす他の医薬品を検索し代替品として医療機関に通知、医療機関にて処方内容の再選択を促す手段を有するシステム。
また、医薬品費用を負担する被保険者・保険者（健康保険組合等）が、効能・価格等の医薬品に関する情報を十分に知らされていない、複数の代替品の存在に関する情報を十分には知らされていない、といった場合が多い。このため、医薬品の選択に際しては医療機関の判断に全面的に委ねており、費用負担者及び需要者としての医薬品選択の権利が行使しにくい状況が生まれている。
Cautions Notify: U.S. Boxed Warning - The FDA-accredited labeling includes a boxed warning. See Warnings/Safety measures area for any concise summary of the information. For verbatim wording from the boxed warning, consult the merchandise labeling or . Warnings/Safety measures - Precautionary considerations, dangerous circumstances related to use with the drug, and ailment states or patient populations through which the drug ought to be cautiously made use of. Boxed warnings, when current, are Evidently recognized and therefore are tailored from your FDA-approved labeling. Talk to the item labeling for the exact black box warning from the manufacturer's or even the FDA Web-sites. Checking Parameters - Laboratory assessments and patient Actual physical parameters that ought to be monitored for safety and efficacy of drug therapy Pregnancy Danger Issue - 5 types founded from the FDA to indicate the prospective of a systemically absorbed drug for creating risk for the fetus Pregnancy Considerations - A summary of human and/or animal information pertinent to or affiliated with using the drug mainly because it pertains to medical effects on the fetus, new child, or pregnant girl Lactation - Indicates If your drug stated from the monograph is current in breast milk as well as the producer's advice for use when breast-feeding (when suggestion of American Academy of Pediatrics differs, notation is created) Patient Education - Particular information pertinent for the patient
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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。
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、医療機関から診療行為毎に照会される処方医薬品が、保険者・審査支払機関の指定条件を満たす場合、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ことを特徴とする医薬品処方情報照会・配信システム。