) offered by the health-related institution at time of inquiry and information acquired upfront And in genuine-time if the specified circumstances of the insurer to whom the insured is affiliated as well as the examination and payment Corporation in demand are content.
Initially, in FIG. 1, the parties linked to the information procedure of your existing invention will likely be clarified. This information program includes a medical establishment that prescribes prescribed drugs on the insured, an coverage pharmacy that dispenses pharmaceuticals based on a prescription issued from the clinical institution and offers them on the insured, an insurer that bears medical insurance plan fees, and An assessment / payment institution that examines healthcare rate specifics from professional medical institutions / insurance coverage pharmacies is linked. Every occasion provides the information technique with a series of needed information to be explained later.Within the information system, (1) information on alternate options and prescriptions with the insurance provider for drugs prescribed by the insurance policy clinical establishment for that insured Enter / maintain sought after priority information, (2) Enter / hold circumstances / specifications for approval of receipt evaluate by review / payment Corporation, (three) Inquire about availability of insurance policies for prescription drugs from health care institutions for every clinical exercise Based upon personalized information including acceptance, insured's symptom, healthcare history, age, etcetera.
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。
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、個々の診療行為毎に医療機関から医薬品処方につき照会を受付け、照会時に医療機関から提示される被保険者情報（医療保険関連情報、傷病・症状等の情報等）と、予め取得した情報とを照合し、被保険者が加入している保険者並びに担当の審査支払機関の指定条件を満たしているか否かをリアルタイムで判定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。
While in the system operation stage, the next processing is done in real time. Quite simply, inquiries about the availability of insurance policies protection for prescription drugs from health treatment institutions are made by means of interaction strains throughout Each and every clinical observe, and these inquiries are compared Using the input information and specified circumstances of your evaluation and payment institutions and insurers talked about over. Then, the examination shelling out establishment along with the insurance company figure out if to reject the coverage application, distribute The end result to your professional medical institution, and Exhibit it about the terminal from the professional medical institution by an enter / output display as shown in FIG. Due to the dedication, Should the content material of the inquiry won't conform towards the input information and selected circumstances from the evaluation and payment establishment and also the insurance company, a pharmaceutical team gratifying these is searched and determined and dispersed towards the health care establishment.
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、医療機関が発行した処方箋に記されている医薬品の保険適用につき、保険薬局からの照会を受付け、処方箋発行医療機関との照会履歴の有無、結果について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。
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。
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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。
Cautions ALERT: U.S. Boxed Warning - The FDA-authorized labeling features a boxed warning. See Warnings/Precautions section for a concise summary of the information. For verbatim wording on the boxed warning, check with the solution labeling or . Warnings/Precautions - Precautionary considerations, dangerous situations relevant to use of the drug, and disorder states or patient populations through which the drug ought to be cautiously made use of. Boxed warnings, when present, are Plainly identified and so are adapted from the FDA-accredited labeling. Seek the advice of the product or service labeling for the precise black box warning with the producer's or perhaps the FDA Internet websites. Checking Parameters - Laboratory checks and patient physical parameters that should be monitored for safety and efficacy of drug therapy Pregnancy Possibility Variable - Five categories set up via the FDA to indicate the prospective of a systemically absorbed drug for resulting in hazard to the fetus Pregnancy Considerations - A summary of human and/or animal information pertinent to or linked to the usage of the drug because it relates to clinical effects around the fetus, newborn, or pregnant female Lactation - Signifies if the drug outlined within the monograph is current in breast milk plus the maker's suggestion for use though breast-feeding (when advice of yankee Academy of Pediatrics differs, notation is produced) Patient Education - Specific information pertinent with the patient
In the traditional payment evaluation approach, a health care establishment challenges a prescription and prescribes and pays with the drug into the patient at an insurance pharmacy, etcetera., after which you can the evaluation request with the health-related practice is built to your examination payment establishment. However, it can be not possible to evaluate the suitability of the applying contents upfront for clinical institutions. Also, the insured / insurance company (health insurance coverage Affiliation, etcetera.) that bears the cost of prescribed drugs will not be totally knowledgeable about information on drugs which include efficacy and value, which is absolutely informed with regard to the existence of numerous alternate options. It is commonly not done. Because of this, the selection of medicines is totally still left for the judgment of a health-related institution, and it is hard to workout the best to select medicines as a value bearer along with a customer.
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It is often advisable that just one prescription be nicely prepared at only one time. Cleanse up surfaces needs to be used by compounding. Just about every bit of equipment should be carefully cleaned and dried ahead of use.
・ It's not meant to develop the options for prescription drugs of insurers and cut down the expense of prescribed drugs. Moreover, PBM in the United States provides drug Value management solutions for corporations which include corporations as the primary customers and would not go over all citizens. is not really.