In the traditional payment examination process, a medical institution issues a prescription and prescribes and pays for the drug towards the patient at an insurance policy pharmacy, etc., after which you can the assessment request for the healthcare practice is built to your assessment payment establishment. Even so, it is impossible to judge the suitability of the applying contents in advance for clinical institutions. Also, the insured / insurance company (health coverage Affiliation, and many others.) that bears the expense of pharmaceuticals will not be totally educated about information on drugs such as efficacy and cost, and it is totally knowledgeable with regards to the existence of many alternate options. It is often not finished. For this reason, the selection of medicines is solely remaining for the judgment of the health care establishment, and it is actually tough to exercise the appropriate to decide on medicines as a value bearer and a purchaser.
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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。
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The current creation pertains to a pharmaceutical prescription information inquiry / distribution device, a pharmaceutical prescription information inquiry / distribution process, and also a pharmaceutical prescription information inquiry / distribution strategy.
Hereinafter, a flowchart of an illustration of an information inquiry / determination procedure will likely be explained with reference to FIG. To start with, the required information is received with the assessment payer / insurance provider / coverage health-related establishment / insurance plan pharmacy. The information and specified circumstances for being attained with the evaluation payer as well as the insurer are as explained over.
医療機関による医薬品の処方に際しては、被保険者（患者）が保健医療機関で医師の診察を受け、その診断結果をもとに医師が処方箋を発行、同処方箋に基づき保険薬局にて医薬品が調剤、提供される、という流れになっている。保険が適用される医薬品の費用請求については、被保険者による一部費用負担を除くと、医療機関・保険薬局などが、レセプトと呼ばれる診療報酬明細書に、診療、検査、投薬、手術など医療行為の内容を記入し、月ごとに審査支払機関に提出、医療費を請求する。審査は、社会保険診療報酬支払基金と都道府県支部、国民健康保険中央会と各都道府県の国民健康保険団体連合会にて実施され、かかった医療費をそのまま医療保険から支払う「出来高払い制」を採用されている。
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Because of this, while preserving the fairness read more of getting health care services, the insured / insurance provider / evaluation / payment institution has the opportunity to choose a drug that is considered appealing from your viewpoint of success, value, etc. Is not delivered sufficient. Consequently, the situation from the current creation is that the insured individual / insurer or assessment / payment establishment would like to prescribe the strongest prescription among the solutions whilst sustaining the fairness of getting healthcare solutions in Japan's medical insurance policies process.
The prescription should be signed via the prescriber by his / her hand. His/her tackle and registration variety genuinely ought to be well prepared in the situation of perilous and actions-forming medicines.
指定条件を満たしていると判定した場合には、次に、医療機関・保険者の住所から近くに存在する複数の保険薬局に対して、処方対象医薬品の取扱状況・在庫状況を確認、結果をあわせて医療機関へ配信する。一方、指定条件を満たしていないと判定した場合には、審査支払機関及び保険者の指定条件に合致する範囲内で医療機関が提示した被保険者情報をもとに導出される処方推奨対象となる医薬品のリストを医療機関に配信、医療機関にて再選択を促す。医療機関にて処方推奨医薬品が選択されると、近隣の保険薬局での取扱状況・在庫状況を確認、結果を通知する。
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(b) Adjuvants: They are really integrated possibly to spice up the motion of your drug or to supply the preparing added palatable.