JP2019207522A - Data structure for prescription audit processing terminal - Google Patents

Abstract

To allow an efficient use of a prescription audit.SOLUTION: There is provided a data structure for use in a prescription audit processing terminal in which prescription audit information on the prescription for a person insured is input. The data structure includes the prescription audit information and sending approval information showing whether the prescription audit information is to be permitted to be sent to a medical facility terminal, and is used for processing of sending the prescription audit information to the medical facility terminal when the sending approval information shows an approval of sending.SELECTED DRAWING: Figure 3

Description

  The present invention relates to a data structure for a prescription inspection processing terminal used in a prescription inspection processing terminal that performs prescription inspection processing.

  A pharmacist prepares a drug according to a prescription issued by a medical institution such as a hospital. At that time, the pharmacist conducts a prescription audit by checking the contents of the prescription to check whether the dosage is appropriate, whether it is a double dose, or whether there is a risk of polypharmacy due to multidrug administration. There must be.

  For this reason, many apparatuses which can perform prescription inspection easily are proposed (for example, patent documents 1).

JP 2014-67104 A

  As a result of the prescription audit, the medical institution may be asked to propose a review of the prescription or make a question. Such a proposal for reviewing a prescription or a question inquiry is made by telephone or FAX, or by a report that is a paper medium. For this reason, there was a case where a record was not left, and even if a record was left, it was filed and could not be read afterwards. In such a case, the prescription audit is not reflected in the preparation of the next prescription, and it is necessary to make a proposal for reconsidering the same prescription or make a question inquiry again. In other words, prescription audits were not fully utilized.

  In the prior art exemplified in Patent Document 1, no such problem is recognized.

  The present invention has been made to solve such a problem, and an object of the present invention is to provide a data structure for a prescription inspection processing terminal that can effectively use prescription inspection.

  To achieve the above object, the data structure for the prescription audit processing terminal of the present invention is a data structure used in the prescription audit processing terminal to which prescription audit information for the insured person's prescription is input, Information and transmission permission information indicating whether or not transmission of the prescription audit information to a medical institution terminal is permitted, and when the transmission permission information indicates permission of transmission, the prescription inspection information is the medical Used for processing sent to the engine terminal.

  According to the present invention, prescription inspection can be effectively utilized.

The schematic diagram which shows the whole structure of the prescription inspection processing system of one Embodiment The schematic diagram which shows the structure of the pharmacy terminal of one Embodiment. The schematic diagram which shows the structure of the personal information of the insured person which the insurance pharmacy of one embodiment has The flowchart which shows an example of prescription inspection processing of one embodiment

  Embodiments of the present invention will be described below with reference to the drawings. The following embodiment is merely an example, and does not exclude various modifications and technical applications that are not explicitly described in the following embodiment. In addition, each configuration of the embodiments can be implemented with various modifications without departing from the spirit of the embodiments. Furthermore, each structure of embodiment can be selected as needed.

  Note that components having the same function are denoted by the same reference symbols throughout the drawings for describing the embodiment, and the description thereof may be omitted.

[1. Prescription audit processing system]
Hereinafter, the overall configuration of the prescription inspection processing system 1 of one embodiment will be described with reference to FIG. FIG. 1 is a schematic diagram showing the overall configuration of the prescription inspection processing system 1.

  The prescription inspection processing system 1 includes a prescription drug information database server (hereinafter also referred to as “database server”) 3, an operation terminal 4 (insured person terminal) operated by an insured person, and a pharmacy terminal 5 (prescription inspection process terminal). And a medical institution terminal 6. The prescription drug information database server 3 acquires various information from the insurer database server 2 via a predetermined network. The information of the insurer database server 2 may be stored in a recording medium, and the prescription drug information database server 3 may be read from the recording medium.

  The insurer database server 2 is a database server managed by an insurer such as a municipality or a health insurance association, and is configured by a personal computer, for example. The insurer database server 2 stores a database in which various types of information associated with claims for medical fees from medical institutions and insurance pharmacies are recorded for each insured. Specifically, personal information such as the age of the insured person, information related to the insured person's consultation such as the name of the disease and hospital history, and information related to the prescription drug such as the type and dose of the prescription drug are stored. Hereinafter, information related to consultation is referred to as “consultation information”, information related to prescription drugs is referred to as “prescription drug information”, and “medical consultation information” and “prescription drug information” are collectively referred to as “medical prescription information”.

  The prescription drug information database server 3 is a database server managed by a service provider, and is constituted by a personal computer, for example. The prescription drug information database server 3 can acquire information I1 including personal information and medical prescription information from the insurer database server 2 at an appropriate timing according to a contract with the insurer. A database in which information and medical prescription information are recorded for each insurer is stored. The prescription drug information database server 3 performs a service of appropriately providing the user's medical prescription information I2 to the operation terminal 4 (hereinafter referred to as “user terminal”) of the user who has contracted with the service provider among the insured.

  Specifically, the database server 3 extracts users who satisfy a specific extraction condition from the database. For example, the database server 3 extracts users who are 75 years of age or older and prescribed six or more types of drugs for three months or more as users who are likely to have polypharmacy due to multidrug administration. The database server 3 notifies the extracted user terminal 4 of each user to consult with a pharmacist about prescription of the drug because there is a risk of polypharmacy. In addition to this notification, the database server 3 transmits the medical prescription information I2 of the user to the user terminal 4. The timing for transmitting the medical prescription information I2 to the user terminal 4 is exemplified when a specific extraction condition is reviewed or when a request is received from the user terminal 4.

  The user terminal 4 is configured by, for example, a smartphone, a personal computer, or a tablet personal computer. In the embodiment, the user terminal 4 is configured by a smartphone.

  A user can receive a predetermined service from a service provider that manages the database server 3 by using a dedicated application for the user terminal 4.

  Specifically, as described above, when the user satisfies a specific extraction condition, the user uses the user terminal 4 to notify the pharmacist from the database server 3 and the medical prescription information I2 of the user. And can receive.

  Then, the user can use the user terminal 4 to transfer the medical prescription information I2 to the pharmacy terminal 5 of a desired insurance pharmacy installed with the dedicated application program P (hereinafter referred to as “program”). Specifically, the user operates the user terminal 4 with the touch panel 4a to select a desired insurance pharmacy to which a family pharmacist belongs from among previously registered insurance pharmacies. The user terminal 4 acquires a permission flag D15a in the personal information (hereinafter referred to as “pharmacy data”) I4 of the insured person stored in the pharmacy terminal 5 managed by the insurance pharmacy, and the permission flag D15a is “ If it is “1”, the medical prescription information I2 is transmitted to the pharmacy terminal 5 (this will be described in detail later).

  In the insurance pharmacy that manages the pharmacy terminal 5 to which the medical prescription information I2 is transmitted, a prescription audit is performed based on the medical prescription information I2, and the result I3 (hereinafter referred to as “prescription audit information”) of the prescription audit is the user terminal. 4 is transmitted.

  In addition, when the user visits the prescription audit information I3, it is recommended that the user visit the insurance pharmacy and receive a more detailed explanation about the prescription audit from the pharmacist.

  Then, the user can use the user terminal 4 to transfer the prescription inspection information I3 to the medical institution terminal 6 of a desired medical institution in which the dedicated application is installed. Specifically, the user operates the user terminal 4 with the touch panel 4a to select a desired medical institution such as a family doctor belonging to the medical institution registered in advance. When the permission flag D15a acquired from the pharmacy terminal 5 is “1”, the user terminal 4 transmits prescription inspection information I3 to the medical institution terminal 6 (this will be described in detail later).

  Further, the user can transfer the prescription audit information I3 from the user terminal 4 to the database server 3 and back up the prescription audit information I3 in the database server 3.

  In addition, the user can receive various services from the service provider. For example, the user takes a prescription issued by a medical institution by the user terminal 4 and sends a photographic image of the prescription to the insurance pharmacy using a dedicated application, so that the dispensing precedes the arrival at the insurance pharmacy. And get started.

  The pharmacy terminal 5 is managed by an insurance pharmacy, and is configured by, for example, a smartphone, a personal computer, a tablet personal computer, or the like. In the present embodiment, the pharmacy terminal 5 is configured by a personal computer.

  The pharmacy terminal 5 can receive the user's medical prescription information I2 from the user terminal 4 as described above. The medical prescription information I2 received by the pharmacy terminal 5 is used for prescription audits of pharmacists belonging to the insurance pharmacy.

  The medical prescription information I2 includes not only prescription drug information related to prescriptions handled by insurance pharmacies or specific medical institutions that manage this pharmacy terminal 5, but also prescription drugs related to prescriptions handled by other insurance pharmacies and unspecified medical institutions. Contains information. Therefore, the user can receive a comprehensive prescription audit without being limited to prescriptions handled by a specific insurance pharmacy and a specific medical institution.

  When the pharmacist inputs the prescription inspection information I3 to the pharmacy terminal 5, the prescription inspection information I3 is transmitted to the medical institution terminal 6 of a desired medical institution via the user terminal 4 as described above.

  The medical institution terminal 6 is managed by a medical institution, and is configured by, for example, a smartphone, a personal computer, a tablet personal computer, or the like. In the present embodiment, the medical institution terminal 6 is configured by a personal computer.

  As described above, the medical institution terminal 6 can receive the user's prescription inspection information I3 from the user terminal 4. The medical institution terminal 6 stores an electronic medical record C in which the user's medical information is digitized. Upon receiving the prescription audit information I3, the medical institution terminal 6 adds the prescription audit information I3 to the electronic medical record C. To do.

  Hereinafter, the pharmacy terminal 5 will be further described with reference to FIGS. 2 and 3. FIG. 2 is a schematic diagram showing the configuration of the pharmacy terminal 5. FIG. 3 is a schematic diagram showing a configuration of insured pharmacy data I4 stored in the pharmacy terminal 5. As shown in FIG.

  As shown in FIG. 2, the pharmacy terminal 5 includes an input device 50, a communication device 51, an output device 52, a storage device 53, and a control device 54.

  The output device 52 is a display or a printer. The output device 52 outputs or displays the medical prescription information I2 of the user so that the pharmacist can refer to it by displaying or printing out the medical prescription information I2 under the control of the control device 54. The pharmacist performs prescription inspection based on the output medical prescription information I2. That is, it is investigated whether it is not administered twice, there is no risk of polypharmacy due to multidrug administration, or it is not contraindicated.

  The input device 50 includes at least one of a touch panel, a keyboard, and a mouse, for example. The pharmacist uses the input device 50 to input the prescription inspection information I3 to the control device 54. Further, the input device 50 receives an operation for causing the user terminal 4 to transmit the prescription inspection information I3.

  The communication device 51 includes a transmission circuit, a reception circuit, and the like. The communication device 51 performs bidirectional communication with the user terminal 4 directly or via a predetermined network under the control of the control device 54. Specifically, the communication device 51 receives the above-described medical prescription information I2 from the user terminal 4, and transmits the above-described prescription inspection information I3 to the user terminal 4.

  The storage device 53 is a storage device such as a memory or a hard disk device, and stores various information. For example, the program P for performing prescription inspection processing and the above-described various information I2, I3, I4 are stored.

  The control device 54 is a control device such as a processor, and executes each process performed by the pharmacy terminal 5. The prescription inspection process is executed by the control device 54 by executing the program P stored in the storage device 53.

  As will be described later, when the medical prescription information I2 is transmitted from the user terminal 4 to the pharmacy terminal 5 and when the prescription inspection information I3 is transmitted from the user terminal 4 to the medical institution terminal 6, the user's permission is required. The user's permission is performed by referring to the pharmacy data I4.

  In this embodiment, a user determines whether or not to permit the transmission in an insurance pharmacy by answering an inquiry using, for example, a tablet personal computer. This tablet personal computer is wirelessly connected to the pharmacy terminal 5, for example, and various data input from the tablet personal computer is recorded in the pharmacy terminal 5 as a part of the pharmacy data I4 shown in FIG. Note that the tablet personal computer itself used for the inquiry may be used as the pharmacy terminal 5.

  The pharmacy data I4 includes inquiry data D1, medication instruction history information D2, medication history image estimation information D3, medication information D4, examination information D5, and medical prescription information D6, as shown in FIG.

  The inquiry data D1 is information acquired from the insured by the inquiry, and is subdivided into height / weight information D11, allergy information D12, past history information D13, insurance card number D14, and utilization control information D15.

  The medication guidance history information D2 is the specific content of the guidance regarding how to use the medicine received so far. The medication history image estimation information D3 is obtained by taking a patient's brought medicine with a camera of a tablet computer, recognizing the image of the obtained medicine by AI or the like, and using the drug history DB of the pharmacy, This is information on the estimated (specified) medication history. The medicine information D4 is a precaution for medicines maintained and managed by the pharmacy, and records contraindicated drugs and symptoms at the time of taking the medicine. The inspection information D5 is information on the inspection results received so far. In the medical prescription information D6, the medical prescription information I2 transferred to the pharmacy terminal 5 is stored as it is. That is, the medical prescription information D6 is a copy of the medical prescription information I2. The height / weight information D11 is each information of the insured's height and weight. The allergic information D12 is information on the presence or absence of the allergy of the insured person, the type of allergen, the allergic symptom for each allergen, and its degree. The past history information D13 is the type of illness that the insured has had so far, the time and period of trouble, and the like.

  By comparing the medical prescription information D6 and the medication history image estimation information D3, it is possible to compare the prescription by the medical institution with the dispensing information actually prescribed after the review, making it easier to review the prescription audit and hence the subsequent prescription. .

  The utilization control information D15 is further subdivided into a permission flag D15a, a disclosure range D15b, and name patient identification information D15c (name patient ID). In the present embodiment, the permission flag (transmission permission information) D15a allows the insured person to transmit the medical prescription information I2 to the pharmacy terminal 5 and to transmit the prescription audit information I3 to the medical institution terminal 6. “1” is input, otherwise “0” is input. In the disclosure range D15b, the type of data that the insured permits the disclosure to a third party among the inquiry data D1 to the insurance card number D14 is input. The name patient identification information D15c is the name or patient ID of the insured person, but when it is blank, the pharmacy data I4 is utilized as anonymous insured person data.

  Then, the permission flag D15a is transmitted from the pharmacy terminal 5 to the user terminal 4. When the received permission flag D15a is “1”, the user terminal 4 transfers the medical prescription information I2 acquired from the database server 3 to the pharmacy terminal 5 and acquires it from the pharmacy terminal 5 without accepting a specific operation from the user. The prescription inspection information I3 is transferred to the medical institution terminal 6.

  Instead of storing the medical prescription information I2 transferred to the pharmacy terminal 5 in the medical prescription information D6 as described above, the medical prescription information I2 may be appropriately classified and stored in the medicine information D4 and the examination information D5. In this case, the medical prescription information D6 can be omitted.

[2. Control flow]
The prescription inspection processing method by the prescription inspection processing system 1 of one embodiment will be described with reference to FIG. FIG. 4 is a flowchart showing an example of a control flow of the prescription inspection processing method according to the embodiment of the present invention. In this control flow, processing performed by the pharmacy terminal 5 is performed by the control device 54 of the pharmacy terminal 5 executing the program P.

  First, in step S10, the database server 3 extracts users who are likely to have polypharmacy from the database. Next, in step S20, the database server 3 transmits to the extracted user terminal 4 the user's medical prescription information I2 and a notification that prompts the pharmacist to consult about the review of the prescription.

  In step S40, the user terminal 4 obtains the permission flag D15a from the pharmacy terminal 5, and based on whether the permission flag D15a is “1” or “0”, the medical prescription information I2 is stored in the pharmacy terminal 5. Determine whether or not to transfer.

  If the permission flag D15a is “1” in step S40, that is, if the transfer is permitted, the user terminal 4 transmits the medical prescription information I2 to the pharmacy terminal 5 in step S50.

  On the other hand, when the permission flag D15a is “0” in step S40, that is, when the transfer is prohibited, the user terminal 4 does not perform the transmission. The prescription inspection process is terminated as it is. However, when the transfer of the medical prescription information I2 is prohibited, the user terminal 4 transmits information to that effect to the database server 3. Upon receiving this information, the database server 3 transmits a mail to the user terminal 4 in step S45. By this mail, it is recommended to repeat the inquiry and perform the transfer, or a questionnaire regarding the prohibition of the transfer is performed. The contents of the questionnaire include, for example, an inquiry about the reason for prohibiting the transfer, and an inquiry as to whether or not there is a desire to make the transfer to another insurance pharmacy.

  When the medical prescription information I2 is transmitted to the pharmacy terminal 5 in step S50, the pharmacy terminal 5 displays or prints this medical prescription information I2 in step S60. And the pharmacy terminal 5 receives the input of the prescription audit information I3 with respect to this medical prescription information I2 at step S70, and transmits this prescription audit information I3 to the user terminal 4 at step S80.

  The user terminal 4 that has received the prescription audit information I3 displays the prescription audit information I3 in step S90, and displays a message asking the user whether to back up the prescription audit information I3. In step S100, the user terminal 4 determines which operation has been accepted by the user to permit backup and to prohibit backup.

  The user terminal 4 outputs the prescription audit information I3 to the database server 3 when receiving an operation for backup. In step S110, the database server 3 stores the prescription audit information I3 so that the prescription audit information I3 is backed up. Then, the process proceeds to step S120.

  On the other hand, if the user terminal 4 accepts an operation not to back up in step S100, the process proceeds to step S120 without prescription audit information I3 being backed up.

  In step S120, the user terminal 4 determines whether or not to transfer the prescription inspection information I3 to the medical institution terminal 6 based on whether the permission flag D15a acquired in step S40 is “1” or “0”. To do.

  In step S120, when the permission flag D15a is “0”, that is, when the transfer is prohibited, the user terminal 4 does not transmit the prescription inspection information I3 to the medical institution terminal 6. As a result, the prescription audit process ends without the result of the prescription audit being notified to the medical institution. However, when the transfer of the medical institution terminal 6 is prohibited, the user terminal 4 transmits information to that effect to the database server 3. Upon receiving this information, the database server 3 transmits a mail to the user terminal 4 in step S125. By this mail, it is recommended to repeat the inquiry and perform the transfer, or a questionnaire regarding the prohibition of the transfer is performed. The contents of the questionnaire include, for example, an inquiry about the reason for prohibiting the transfer, and an inquiry as to whether or not there is a desire to perform the transfer to another medical institution.

  On the other hand, if the permission flag D15a is “1” in step S120, that is, if the transfer is permitted, the user terminal 4 transmits the prescription inspection information I3 to the medical institution terminal 6 in step S130. .

  In step S140, the medical institution terminal 6 that has received the prescription inspection information I3 displays the prescription inspection information I3 on a monitor or the like. In step S150, the medical institution terminal 6 accepts, from an input device such as a keyboard, an operation of permitting the addition of the prescription audit information I3 to the electronic medical record C and an operation of prohibiting the addition. It is determined.

  If the medical institution terminal 6 accepts the permission operation in step S150, the medical institution terminal 6 adds the prescription inspection information I3 to the electronic medical chart C in step S160. Thereby, the prescription inspection process ends.

  On the other hand, when the medical institution terminal 6 accepts the prohibition operation in step S150, the prescription audit process ends without the prescription audit information I3 being recorded in the electronic medical chart C.

[3. Action / Effect]
According to one embodiment of the present invention, the prescription audit information I3 is transmitted to the medical institution terminal 6, and this prescription audit information I3 is recorded in the electronic medical record C recorded in the medical institution terminal 6, so that the prescription audit information I3 is recorded. Oversight can be suppressed and prescription audits can be used effectively.

  In addition, since prescription audits are appropriately reviewed by medical institutions when prescription audits are fully utilized, it is possible to suppress the occurrence of drug double administration, contraindicated prescriptions, and polypharmacy.

  Further, the transmission of the medical prescription information I2 to the pharmacy terminal 5 and the transmission of the prescription audit information I3 to the medical institution terminal 6 each require user permission. No is set in advance using the permission flag D15a. Therefore, each time a prescription audit is performed, confirmation of the user's intention is not required, and the processing procedure necessary for transmitting the medical prescription information I2 and the prescription audit information I3 can be simplified.

  When the medical prescription information I2 is transmitted to the pharmacy terminal 5 and when the prescription inspection information I3 is transmitted to the medical institution terminal 6, the user permits the transmission by setting the permission flag D15a to “1”. Is recorded in advance. Therefore, the permission flag D15a is set to “1” indicating that the medical prescription information I2 or prescription audit information I3 including the user's personal information has been transmitted to the pharmacy terminal 5 or the medical institution terminal 6 under the user's permission. It can be recorded as a record.

  Moreover, since the insured person can restrict the types of data permitted to be disclosed to a third party among the inquiry data D1 to the insurance card number D14 by the disclosure range D15b, the disclosure to a third party is necessary and sufficient. Can protect personal information.

  Furthermore, although the name patient identification information D15c is included in the inquiry data D1, the pharmacy data I4 is utilized as anonymous insured data by making the name patient identification information D15c blank (not entered). it can.

  Further, it is possible to determine whether or not the dose of the medicine prescribed to the insured person is appropriate with reference to the height / weight information D11, and a more accurate prescription audit is performed. The pharmacy terminal 5 may calculate an appropriate dose with reference to the height / weight information D11 and display the appropriate dose on the monitor. Based on this displayed dose, the pharmacist can strictly determine whether the prescribed dose of the drug is appropriate. Alternatively, the pharmacy terminal 5 compares the prescribed drug dose with the appropriate dose calculated with reference to the height and weight information D11 to determine whether the prescribed drug dose is appropriate, and The result may be displayed on the monitor.

  In addition, referring to the allergy information D12 and the past history information D13, it is possible to more strictly determine whether a contraindicated prescription has been made.

  Furthermore, since the insured can input the inquiry data using the waiting time until the insured is provided with the medicine at the dispensing pharmacy, the waiting time can be used effectively.

[4. Modified example]
(1) In the embodiment, when the permission flag D15a is “1”, the prescription inspection information I3 is transmitted from the pharmacy terminal 5 to the medical institution terminal 6 through the user terminal 4. On the other hand, when the permission flag D15a is “1”, the prescription inspection information I3 may be directly transmitted to the medical institution terminal 6 without using the user terminal 4.

  (2) In the above embodiment, permission for transmission of the medical prescription information I2 to the pharmacy terminal 5 and permission for transmission of the prescription audit information I3 to the medical institution terminal 6 are set by the common permission flag D15a. On the other hand, the permission flag for transmitting the medical prescription information I2 to the pharmacy terminal 5 and the permission flag for transmitting the prescription audit information I3 to the medical institution terminal 6 may be separately provided in the pharmacy data I4. .

  According to the present invention, it is possible to efficiently use a prescription audit that has been performed once, and it is possible to prevent the same prescription audit from being repeated unnecessarily. In addition, the data structure used in the prescription audit processing terminal includes transmission permission information indicating whether or not transmission of prescription audit information to the medical institution terminal is permitted. It is not necessary for the person to confirm the permission for the transmission, and the processing until the audit processing is provided to the medical institution terminal can be simplified. Therefore, the industrial applicability is great.

1 Prescription Audit Processing System 2 Insurer Database Server 3 Prescription Drug Information Database Server 4 Operation Terminal (Insured Terminal)
5 Pharmacy terminal (Prescription inspection processing terminal)
6 Medical Institution Terminal 50 Input Device 51 Communication Device 52 Output Device 53 Storage Device 54 Control Device P Program C Electronic Medical Record D1 Interview Data D11 Height Weight Information D12 Allergy Information D13 Past History Information D15a Permission Flag (Transmission Permission Information)
D15b Disclosure scope D15c Name Patient identification information D6 Medical prescription information I1 Information I2 Medical prescription information I3 Prescription audit information I4 Pharmacy data

Claims (4)

A data structure used in a prescription audit processing terminal into which prescription audit information for an insured person's prescription is input,
Including the prescription audit information and transmission permission information indicating whether to permit transmission of the prescription audit information to a medical institution terminal,
When the transmission permission information indicates permission for transmission, the prescription inspection information is used for processing to be transmitted to the medical institution terminal.
Data structure for the prescription audit processing terminal. Disclosure type information indicating the type of information permitted to be disclosed to the medical institution terminal is further included.
The data structure for the prescription inspection processing terminal according to claim 1. Further includes weight information of the insured,
The data structure for the prescription inspection processing terminal according to claim 1 or 2. Further includes at least one of allergy information and history information of the insured,
The data structure for the prescription inspection processing terminal according to any one of claims 1 to 3.

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