) presented from the medical establishment at enough time of inquiry and information acquired in advance As well as in authentic-time whether the desired situations from the insurance provider to whom the insured is affiliated as well as evaluation and payment organization in cost are pleased.
To start with, in FIG. one, the get-togethers linked to the information process with the current invention is going to be clarified. This information technique includes a healthcare institution that prescribes pharmaceuticals towards the insured, an insurance policy pharmacy that dispenses pharmaceuticals based on a prescription issued via the clinical institution and provides them to your insured, an insurance company that bears medical insurance expenditures, and An examination / payment establishment that examines health-related fee facts from healthcare establishments / insurance coverage pharmacies is linked. Each social gathering provides the information process with a series of needed information to be described later.While in the information process, (one) information on options and prescriptions in the insurance company for drugs prescribed via the insurance health-related institution for your insured Enter / hold wanted priority information, (2) Enter / keep conditions / standards for acceptance of receipt evaluate by evaluate / payment Corporation, (three) Inquire about availability of insurance plan for prescription drugs from professional medical establishments for each healthcare apply According to personalized information for example acceptance, insured's symptom, health-related background, 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。
Hereinafter, a flowchart of the illustration of an information inquiry / willpower course of action will probably be described with reference to FIG. To start with, the mandatory information is received with the evaluation payer / insurance provider / insurance coverage medical institution / insurance pharmacy. The information and selected disorders to get acquired in the assessment payer plus the insurance company are as explained previously mentioned.
The present creation relates to transactions associated with prescription and buy of moral drugs among suppliers and prescribers like medical establishments and insurance policies pharmacies and customers which include evaluation payers, insurers and insured folks while in the pharmaceutical distribution market. It will become achievable to explain whether or not There may be agreement among the get-togethers in genuine time. Subsequently, the examination / payment institution / insurance company should have an opportunity to efficiently Convey their intentions concerning the selection of drugs, which will allow them to increase their choices for drug prescriptions they need and make improvements to their satisfaction and price effectiveness.
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。
Should your health care physician requirements the pharmacist to provide you with a specific brand of medication, they have to exactly Observe this or sign-up the Room sent.
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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。
At this time, an information procedure that replaces the creation and software of the above mentioned-talked about receipt using an electronic process from a standard published system has now been set into realistic use. On the other hand, in America, Pharmacy Profit Administration (“PBM”) is a business that manages dispensing expenditures for policyholders.
Male MD collects and vendors a variety of information as you use our Products and services. The particular styles of information we obtain will rely upon the Expert providers you employ, but may perhaps include the next: Individual Information and points: Person specifics implies specifics connected to or accustomed to determine or Get maintain of a particular gentleman or woman.
How persistently have you left the physician’s Business, only to find you forgot to mention an important piece of information?
Come to be. Consequently, for instance, the examination / payment company raises the prescription precedence order of simpler medicines so a large number of healthcare establishments can prescribe the medicines. Therefore, the standard of health-related services along with the fairness of expenditures amid insured persons Promoted. Also, a rise in prescription of the cheapest drug amongst a plurality of read more drugs possessing the exact same outcome will also be obtained, including reduction in drug fees for insurers and insured people.
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。