In the conventional payment examination strategy, a medical institution troubles a prescription and prescribes and pays with the drug into the patient at an insurance plan pharmacy, and many others., and then the assessment ask for with the professional medical exercise is built on the assessment payment establishment. Nonetheless, it can be not possible to evaluate the suitability of the appliance contents in advance for healthcare institutions. Furthermore, the insured / insurance company (health insurance policies Affiliation, and so forth.) that bears the expense of pharmaceuticals is just not absolutely informed about information on drugs for instance efficacy and price, and it is fully knowledgeable with regards to the existence of several solutions. It is usually not done. Due to this, the choice of medicines is entirely left to the judgment of a health care institution, and it truly is tricky to training the correct to decide on medicines as a cost bearer and a client.
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。
Once the inquiry with the health care establishment, the ultimate prescription articles is transmitted in the clinical institution for the information system once the prescription drug is determined. When an insurance policies pharmacy inquires about The provision of insurance policies for prescribed drugs described in prescriptions, the existence / absence in the inquiry record with the health care institution and the final results are distributed. Lastly, a number of inquiry histories is dispersed into the evaluation and payment institution and also the insurer, and also the information inquiry / judgment technique is completed.
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。
結果として、医療サービス受給の公平性を保ちつつ、代替品が存在する医薬品の中で、被保険者・保険者や審査支払機関が、効果・価格等の観点から望ましいと考える医薬品を選択する機会が十分に提供されていない。
Upcoming, the movement by which the suggests in the present creation is executed are going to be explained in time series with reference to FIG.
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During the preparing stage on the procedure, the examination payer and the insurance company enter vital information and specify ailments. Examples of information entered from the evaluation payer along with the insurance company and the specified circumstances are dependant on information to the insurer issue to examination, situations including the insured's age, gender, Structure and previous background There are assumed clinical price factors calculated for each specific sickness and symptom divided, drug cost requirements of applied drugs, insurance plan details, and other facts expected for evaluation of medical cost specifics.
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The pharmaceutical prescription information inquiry / distribution system In line with claim one, wherein a number of inquiry histories manufactured by way of the procedure is dispersed to an assessment payment Group and an insurer.
Prescriptions is a kind utilized to store prescribed medication. The form is helpful for it can help you observe side effects and temper swings associated with the conversation of some medications you are already prescribed.
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