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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。

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。

After the inquiry within the health care establishment, the final prescription articles is transmitted from the health care institution towards the information system if the prescription drug is decided. When an insurance policies pharmacy inquires about The provision of coverage for prescribed drugs described in prescriptions, the presence / absence in the inquiry history Along with the medical institution and the outcomes are distributed. Last but not least, a number of inquiry histories is dispersed on the evaluation and payment institution plus the insurance provider, as well as information inquiry / judgment procedure 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。

The existing creation pertains to a pharmaceutical prescription information inquiry / distribution device, a pharmaceutical prescription information inquiry / distribution method, in addition to a pharmaceutical prescription information inquiry / distribution technique.

Future, the flow in which the means of the existing creation is executed is going to be described in time collection with reference to FIG.

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At present, There's an example that aims to Enhance the get the job done efficiency by digitizing the healthcare charge assessment request rather than crafting, but This is certainly aimed toward labor saving of Business office work with the healthcare institution.

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Because of this, when maintaining the fairness of getting professional medical solutions, the insured / insurance company / evaluation / payment institution has read more the opportunity to select a drug which is considered appealing through the viewpoint of performance, rate, etcetera. Is not delivered enough. Hence, the condition of your current invention would be that the insured man or woman / insurance company or examination / payment establishment wants to prescribe the strongest prescription among possibilities even though preserving the fairness of getting medical products and services in Japan's clinical insurance policies method.

The existing invention for resolving the above-stated difficulties is made up of the following areas. (one) Enter and maintain information on substitutes and prescription precedence information of insurers for pharmaceuticals prescribed by insurance plan healthcare institutions for insured folks (two) Enter and sustain the disorders and criteria for receipt assessment approval because of the assessment and payment Business (3) Accepting inquiries from health-related establishments regarding the availability of insurance policies for prescription drugs for every clinical observe, and making inquiries determined by personalized information like the insured's indicators, clinical heritage, age, etcetera., and information on (one) and (2) over Judgment is produced in genuine time to find out whether the written content satisfies the problems specified with the insurer / assessment and payment institution (four) If the above inquiries do not meet up with the specified ailments, seek out other drugs that meet the desired conditions based upon the insured's information like indications, and so on. Notify professional medical institutions and really encourage them to reselect prescription content material.

It ought to be produced beneath the supervision during the health care Qualified or in accordance with pharmacopoeia or formulary Instructions. It could be important to fill the containers Utilizing the Prepared compounds. The container really should be Evidently marked by using a label.

Each time a healthcare establishment prescribes medicines, the insured (patient) is examined by a health care provider within the health medical establishment, the doctor issues a prescription based on the analysis consequence, plus the medication is dispensed in the insurance coverage pharmacy based on the prescription , Delivered. Regarding declaring the price of medicines coated by insurance, professional medical institutions and insurance pharmacies, and many others.

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