CN109523401A - Medicine method of specifying error and terminal device are taken based on data processing - Google Patents
Medicine method of specifying error and terminal device are taken based on data processing Download PDFInfo
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- 238000004590 computer program Methods 0.000 claims description 5
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- 229940120638 avastin Drugs 0.000 description 4
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Abstract
The present invention provides a kind of to take medicine method of specifying error and terminal device based on data processing.This method comprises: obtaining the corresponding body surface area information of target user, determine that the target user corresponds to the Standard dose amount of target medicine in default billing cycle according to the body surface area information.The identity information and the corresponding resource settlement information of the target medicine for obtaining the target user, determine accumulative medicine taking amount of the target user in the default billing cycle according to the identity information and the resource settlement information.When the accumulative medicine taking amount is greater than the Standard dose amount, determine that the target user takes medicine abnormal, and issue and take medicine abnormity prompt.Using the present invention, the Claims Resolution efficiency and Claims Resolution accuracy rate of Medical Insurance Organizations can be promoted.
Description
Technical field
The present invention relates to field of computer technology, more particularly to take medicine method of specifying error and terminal based on data processing
Equipment.
Background technique
With the development of society and the continuous promotion of living standards of the people, people gradually start to receive miscellaneous insurance
Project is especially valued by the people especially for ensureing the medical insurance of basic medical demand.Existing medical insurance is main
There are two types of, the commercial medical insurance including the profitability that the social medical insurance established by state and society and enterprise are established.It is right
For the user for having participated in medical insurance, when its illness, user can be produced disease according to the Claims Resolution rule of medical insurance
Raw medical expense is submitted an expense account, to alleviate the economic pressures that user generates by illness to a certain extent.But with
The uncoordinated development of the popularity and Claims Review mechanism of medical insurance, insurance fraud phenomenon take place frequently, to government offices and enterprise etc.
Medical Insurance Organizations bring unnecessary loss.
In the prior art, it for certain special drugs for being included into Claims Resolution range, is usually being verified by medical institutions
After the identity and medical insurance qualification of illness user, take medicine requirement by these special drugs according to what illness user extracted
Be supplied to user, then again from medical institutions according to the medicine taking amount of illness user to the corresponding Medical Insurance Organizations of illness user
Request Claims Resolution.Thus occur the problem that illness user is unreasonable take medicine in the case where, medical institutions to medical treatment protect
The unreasonable expense for taking medicine to generate of user can be still included in its Claims Resolution request range when dangerous mechanism is settled a claim, be deceived to constitute
Guarantor's behavior.This brings the risk that excess is paid to the Claims Resolution clearing of Medical Insurance Organizations, while also reducing medical insurance machine
The Claims Resolution efficiency of structure.
Summary of the invention
The embodiment of the present invention provides a kind of takes medicine Information abnormity to determine method and terminal device based on data processing.It can mention
Rise the Claims Resolution efficiency and Claims Resolution accuracy rate of Medical Insurance Organizations.
In a first aspect, the present invention provide it is a kind of medicine method of specifying error is taken based on data processing, this method comprises:
The corresponding body surface area information of target user is obtained, determines that the target user exists according to the body surface area information
The Standard dose amount of target medicine is corresponded in default billing cycle.
The identity information and the corresponding resource settlement information of the target medicine for obtaining the target user, according to the body
Part information and the resource settlement information determine accumulative medicine taking amount of the target user in the default billing cycle.
When the accumulative medicine taking amount is greater than the Standard dose amount, it is abnormal to determine that the target user takes medicine, and issue
Take medicine abnormity prompt.Wherein, described to take medicine abnormity prompt for prompting the target user to there is measurement medicine behavior.
In the embodiment of the present invention, terminal device first can determine that target user exists according to the body surface area information of target user
Corresponding Standard dose amount in default billing cycle, then target user is got in default billing cycle for target medicine
Accumulative medicine taking amount.Then, when determining that above-mentioned accumulation medicine taking amount is greater than above-mentioned standard dosage, it may be determined that the target user deposits
The behavior for measuring medicine is being crossed, and is issuing and takes medicine abnormity prompt.What is issued takes medicine abnormity prompt that can prompt to bear in medical insurance structure
The personnel of duty clearing notice this abnormal conditions, so as to verify the actual conditions, prevent sufferer or medical treatment
Mechanism insurance fraud.In this way, the complexity for process of settling a claim caused by can reducing because of insurance fraud behavior, promotes the Claims Resolution effect of Medical Insurance Organizations
Rate and Claims Resolution accuracy rate.
With reference to first aspect, in one possible implementation, described according to body surface area information determination
The Standard dose amount that target user corresponds to target medicine in default billing cycle includes:
It obtains the corresponding standardized amount of target medicine and indicates information.Wherein, the standardized amount instruction information includes unit
Body surface area Standard dose amount and Standard dose temporal information.
The target user couple is determined according to the body surface area information and the unit bodies Surface area SD Standard dosage
The single Standard dose amount answered.
Determine the target user in default knot according to the single Standard dose amount and the Standard dose temporal information
Calculate the Standard dose amount that the target medicine is corresponded in the period.
With reference to first aspect, in one possible implementation, described according to body surface area information determination
The Standard dose amount that target user corresponds to target medicine in default billing cycle includes:
Obtain the corresponding doctor's advice information of the target user.Wherein, the doctor's advice information includes unit bodies surface area doctor's advice
Dosage and doctor's advice administration time information.
The target user couple is determined according to the body surface area information and the unit body surface area doctor's advice dosage
The single doctor's advice dosage answered.
Determine the target user described pre- according to the single doctor's advice dosage and the doctor's advice administration time information
If corresponding to the Standard dose amount of the target medicine in billing cycle.
With reference to first aspect, in one possible implementation, the corresponding body surface area letter of the acquisition target user
Breath includes:
Obtain the corresponding height information of target user and weight information.
The corresponding body surface area information of the target user is determined according to the height information and the weight information.
With reference to first aspect, in one possible implementation, described according to the identity information and the resource knot
It calculates information and determines that accumulative medicine taking amount of the target user in the default billing cycle includes:
The corresponding target resource of the target user is determined from the resource settlement information according to the identity information
Information.
The drug unit price information for obtaining the target medicine, according to the target resource information and the drug unit price information
Determine accumulative medicine taking amount of the target user in the default billing cycle.
With reference to first aspect, in one possible implementation, described according to the identity information and the resource knot
It calculates information and determines that accumulative medicine taking amount of the target user in the default billing cycle includes:
The corresponding target resource of the target user is determined from the resource settlement information according to the identity information
Information.
The drug unit price information for obtaining the target medicine, according to the drug unit price information and the target resource information
Determine first medicine taking amount of the target user in the default billing cycle.Wherein, first medicine taking amount is described
The quantity for the target medicine that target user is extracted in the default billing cycle based on resource clearing.
The corresponding free Rule Information of the target medicine is obtained, medicine is taken according to the free Rule Information and described first
Amount determines second medicine taking amount of the target user in the default billing cycle.Wherein, second medicine taking amount is institute
State the quantity for the target medicine that target user freely extracts in the default billing cycle.
Determine the target user in the default billing cycle according to first medicine taking amount and the second medicine taking amount
Accumulative medicine taking amount.
With reference to first aspect, in one possible implementation, the identity information includes following at least any one: body
Part card number, face feature information, fingerprint feature information, iris feature information.
With reference to first aspect, in one possible implementation, medicine exception is taken in the determination target user
Afterwards, the method also includes:
Determine the difference of the accumulative medicine taking amount and the Standard dose amount.When the difference is greater than preset goal discrepancy
When value, determine that the resource settlement information there are risk exception, issues risk abnormality alarm.
With reference to first aspect, different when determining the resource settlement information there are risks in a kind of feasible implementation
Often, the method also includes:
Freeze or refuse the corresponding resource settlement request of the resource settlement information.
Second aspect, the embodiment of the invention provides a kind of terminal device, which includes:
Standard dose amount determination unit, for obtaining the corresponding body surface area information of target user, according to the body surface face
Product information determines that the target user corresponds to the Standard dose amount of target medicine in default billing cycle.
Accumulative medicine taking amount determination unit, the identity information and the target medicine for obtaining the target user are corresponding
Resource settlement information determines the target user in the default knot according to the identity information and the resource settlement information
Calculate the accumulative medicine taking amount in the period.
Medicine exception processing unit is taken, the accumulative medicine taking amount for determining when the accumulative medicine taking amount determination unit is greater than
When the Standard dose amount that the Standard dose amount determination unit determines, it is abnormal to determine that the target user takes medicine, and issue
Take medicine abnormity prompt, wherein described to take medicine abnormity prompt for prompting the target user to there is measurement medicine behavior.
In conjunction with second aspect, in one possible implementation, the Standard dose amount determination unit is used for:
It obtains the corresponding standardized amount of target medicine and indicates information, wherein the standardized amount instruction information includes unit
Body surface area Standard dose amount and Standard dose temporal information.
The target user couple is determined according to the body surface area information and the unit bodies Surface area SD Standard dosage
The single Standard dose amount answered.
Determine the target user in default knot according to the single Standard dose amount and the Standard dose temporal information
Calculate the Standard dose amount that the target medicine is corresponded in the period.
In conjunction with second aspect, in one possible implementation, the Standard dose amount determination unit is used for:
Obtain the corresponding doctor's advice information of the target user.Wherein, the doctor's advice information includes unit bodies surface area doctor's advice
Dosage and doctor's advice administration time information.
The target user couple is determined according to the body surface area information and the unit body surface area doctor's advice dosage
The single doctor's advice dosage answered.
Determine the target user described pre- according to the single doctor's advice dosage and the doctor's advice administration time information
If corresponding to the Standard dose amount of the target medicine in billing cycle.
In conjunction with second aspect, in one possible implementation, the Standard dose amount determination unit is used for:
Obtain the corresponding height information of target user and weight information.
The corresponding body surface area information of the target user is determined according to the height information and the weight information.
In conjunction with second aspect, in one possible implementation, the accumulative medicine taking amount determination unit is used for:
The corresponding target resource of the target user is determined from the resource settlement information according to the identity information
Information.
The drug unit price information for obtaining the target medicine, according to the target resource information and the drug unit price information
Determine accumulative medicine taking amount of the target user in the default billing cycle.
In conjunction with second aspect, in one possible implementation, the accumulative medicine taking amount determination unit is used for: according to institute
It states identity information and determines the corresponding target resource information of the target user from the resource settlement information.
The drug unit price information for obtaining the target medicine, according to the drug unit price information and the target resource information
Determine first medicine taking amount of the target user in the default billing cycle.Wherein, first medicine taking amount is described
The quantity for the target medicine that target user is extracted in the default billing cycle based on resource clearing.
The corresponding free Rule Information of the target medicine is obtained, medicine is taken according to the free Rule Information and described first
Amount determines second medicine taking amount of the target user in the default billing cycle.Wherein, second medicine taking amount is institute
State the quantity for the target medicine that target user freely extracts in the default billing cycle.
Determine the target user in the default billing cycle according to first medicine taking amount and the second medicine taking amount
Accumulative medicine taking amount.
In conjunction with second aspect, in one possible implementation, the identity information includes following at least any one: body
Part card number, face feature information, fingerprint feature information, iris feature information.
It is in one possible implementation, described that medicine exception processing unit is taken to be also used in conjunction with second aspect:
Determine the difference of the accumulative medicine taking amount and the Standard dose amount.When the difference is greater than preset goal discrepancy
When value, determine that the resource settlement information there are risk exception, issues risk abnormality alarm.
It is in one possible implementation, described that medicine exception processing unit is taken to be also used in conjunction with second aspect:
Freeze or refuse the corresponding resource settlement request of the resource settlement information.
The third aspect, the present invention provides a kind of electronic equipment, the electronic equipment include processor, memory and
Input-output apparatus, the processor, memory and the input-output apparatus are connected with each other, wherein the memory is used
In storage program code, the processor and the input-output apparatus are for calling said program code to execute above-mentioned first
The method of aspect.
Fourth aspect, the present invention provides a kind of computer readable storage medium, the computer readable storage medium is deposited
Computer program is contained, the computer program includes program instruction, and described program instruction makes described when being executed by a processor
The method that processor executes above-mentioned first aspect.
In the embodiment of the present invention, Standard dose amount and accumulative medicine taking amount in billing cycle are being preset by target user
After judging that target user had measurement medicine behavior, it can be prompted to medical insurance structure, so that Medical Insurance Organizations
The personnel of interior responsible clearing notice this abnormal conditions, so as to verify the actual conditions, prevent target user
Or medical institutions' insurance fraud.In this way, the complexity for process of settling a claim caused by can reducing because of insurance fraud behavior, promotes Medical Insurance Organizations
Claims Resolution efficiency and Claims Resolution accuracy rate.
Detailed description of the invention
It to describe the technical solutions in the embodiments of the present invention more clearly, below will be to needed in the embodiment
Attached drawing is briefly described, it should be apparent that, drawings in the following description are only some embodiments of the invention, for ability
For the those of ordinary skill of domain, without creative efforts, it can also be obtained according to these attached drawings other attached
Figure.
Fig. 1 is a kind of flow diagram for taking medicine method of specifying error based on data processing that inventive embodiments provide;
Fig. 2 is another process signal for taking medicine method of specifying error based on data processing provided in an embodiment of the present invention
Figure;
Fig. 3 is a kind of composed structure schematic diagram of terminal device provided in an embodiment of the present invention;
Fig. 4 is the composed structure schematic diagram of a kind of electronic equipment provided in an embodiment of the present invention.
Specific embodiment
Following will be combined with the drawings in the embodiments of the present invention, and technical solution in the embodiment of the present invention carries out clear, complete
Site preparation description, it is clear that the described embodiment is only a part of the embodiment of the present invention, instead of all the embodiments.Based on this
Embodiment in invention, every other reality obtained by those of ordinary skill in the art without making creative efforts
Example is applied, shall fall within the protection scope of the present invention.
It should be noted that provided in an embodiment of the present invention take medicine method of specifying error to be suitable for mesh based on data processing
Mark user or medical institutions carry out Claims Resolution to Medical Insurance Organizations and settle accounts this implement scene.Wherein, above-mentioned target user is
Medical insurance qualification is enjoyed, and has the illness user for take from healthcare structure medicine behavior.Above-mentioned medical institutions can be doctor
Guarantor fixed hospital, medical insurance fixed point pharmacy etc., which have, sells the qualification of drug to illness user and has cooperation with Medical Insurance Organizations
The mechanism of relationship.Above-mentioned Medical Insurance Organizations, which refer to, to be specifically responsible for undertaking the cost of medical insurance in medical insurance active procedure
The structure and tissue for the medical insurances business such as raising, managing and paying, are the insurers in Hospitalization insurance system.In order to facilitate reason
Solution and description carry out Claims Resolution to Medical Insurance Organizations with target user or medical institutions and settle accounts this in embodiments of the present invention
It is described for one implement scene.In addition, the technical solution of the embodiment of the present invention is particularly suitable for dosage and target user
Body surface area is related and the information process request monitoring of Management of special drugs that is included into medical insurance Claims Resolution range.
Embodiment one
It is a kind of process for taking medicine method of specifying error based on data processing that inventive embodiments provide referring to Fig. 1, Fig. 1
Schematic diagram.In the present embodiment, it is described by executing subject of terminal device.As shown in Figure 1, this method comprises:
S101 obtains the corresponding body surface area information of target user, determines the target according to the body surface area information
User corresponds to the Standard dose amount of target medicine in preset target period.
In some possible embodiments, when target user or medical institutions carry out Claims Resolution knot to Medical Insurance Organizations
When calculation, terminal device can first get the corresponding body surface area information of above-mentioned target user.Above-mentioned body surface area information refers specifically to
The body surface area size of target user is shown.Then, terminal device can get the corresponding standardized amount of above-mentioned target medicine and refer to
Show information.Above-mentioned target medicine is the drug defined in medical insurance clause in Claims Resolution range, can pass through medical insurance
Carry out the drug of expense reimbursement.The standardized amount instruction information of target medicine refers to the detailed directions of the target medicine, dosage
Information and specification information, specifically may include the target medicine Standard dose temporal information (standard i.e. hereafter use the time between
Every), the information such as specification information and unit bodies Surface area SD Standard dosage.Then, terminal device can be according to the target medicine
Standard determines target medicine in above-mentioned default billing cycle using time interval and unit bodies Surface area SD Standard dosage
(Standard dose amount here counts corresponding Standard dose amount according to the minimum measurement unit of target medicine, such as Standard dose
Amount is 30).Above-mentioned standard dosage is that target user is based on the corresponding reasonable employment of target medicine in default billing cycle
Method uses the quantity of the target medicine.It is understood that the corresponding dosage of target user would generally be according to target medicine
The concrete specification of product is counted, and therefore, terminal device, can be according to above-mentioned target medicine after determining above-mentioned standard dosage
Specification information the above-mentioned Standard dose amount counted according to minimum measurement unit is handled, to obtain according to specific
The Standard dose amount that specification is counted.For example, target medicine is Avastin, it is assumed that the standardized amount of target medicine indicates information
Are as follows: two weeks/time, 5mg/kg body surface area, 100mg/ branch, presetting billing cycle is 8 weeks.Then illustrating the use interval of Avastin is
Biweekly, the dosage of Avastin is first use 5mg/kg body surface area, and specification is 100mg/ branch.Assuming that target is used
The body surface area information at family determines that target user's body surface area is 80kg, then can determine that target user corresponds to Avastin within 8 weeks
Standard dose amount be 5mg/kg body surface area * 80kg* (8/2)=1600mg, counted according to concrete specification and namely marked
Mutatis mutandis dose is 16.
Here, it should be noted that concretely target user or medical institutions and the medical treatment of above-mentioned default billing cycle
Insurance institution negotiates the Claims Resolution period of the drug expenditure of confirmation.When above-mentioned default billing cycle reaches, target user or doctor
It treats the drug expenditure that mechanism can be generated just within the period and initiates Claims Resolution request to Medical Insurance Organizations, it is complete in medical insurance structure
After corresponding Claims Resolution operation, the corresponding target resource information of above-mentioned target user can be classified as information of having settled a claim.Next
After a default billing cycle starts, the corresponding target resource information of target user can be cleared and restart to add up.
S102 obtains the identity information and the corresponding resource settlement information of the target medicine of the target user, root
Accumulation medicine taking amount of the target user in the default billing cycle is determined according to above-mentioned identity information and resource settlement information.
In some possible embodiments, terminal device can get the identity information and target medicine pair of target user
The resource settlement information answered.Optionally, the identity information of target user and the corresponding resource settlement information of target medicine may include
In a medicine information processing request for target medicine, above-mentioned medicine information processing request can for target user or
The drug expenditure Claims Resolution settlement request that person medical institutions initiate to Medical Insurance Organizations.Above-mentioned identity information may include it is following at least
Any one: ID card No., face feature information, fingerprint feature information, iris feature information.Above-mentioned resource settlement information is specific
It can be the settlement information of drug expenditure.
Optionally, in the specific implementation, terminal device can get target by input equipments such as its external keyboards
Then the user operation instruction of user or the staff of medical institutions input is being generated according to above-mentioned user operation instruction
State the identity information and the corresponding resource settlement information of target medicine of target user.
Terminal device after the corresponding resource settlement information of identity information and target medicine for getting above-mentioned target user,
It can determine that target user is tired in default billing cycle according to the identity information and resource settlement information of above-mentioned target user
Count medicine taking amount.Here, it should be noted that include one or more user in above-mentioned resource settlement information for above-mentioned mesh
Mark the target resource information of drug.Above-mentioned target resource information is that user extracts what target medicine generated in default billing cycle
Drug expenditure information.Above-mentioned resource settlement information can be provided by medical institutions.May include in above-mentioned resource settlement information one group or
Person's multiple groups target resource information, the identity information of one user of each target resource information unique association.
In the specific implementation, terminal device is getting the corresponding identity information of above-mentioned target user and above-mentioned resource clearing letter
After breath, terminal device can match in above-mentioned resource settlement information according to the corresponding identity information of target user, if inquiry
Identity information to the identity information of a certain group of target resource information association and target user's input matches, then illustrates this group of mesh
Mark resource information is the target resource information that target user is directed to target medicine.Terminal device is getting above-mentioned target user
After corresponding target resource information, the corresponding drug unit price information of above-mentioned target medicine can be also got.Then, terminal device can
Determine target user in default clearing according to the corresponding target resource information of above-mentioned target user and above-mentioned drug unit price information
Accumulation medicine taking amount in period.For example, it is assumed that above-mentioned target medicine is Jin Keli.Its drug unit price information is 3800 yuan/box.If
Terminal device determines that target user's corresponding drug expenditure in default billing cycle is 38000 yuan, then can determine that target
Accumulation medicine taking amount of the user in default billing cycle is 38000 yuan/(3800 yuan/box)=10 boxes.
S103 determines that the target user takes the mesh when the accumulative medicine taking amount is greater than the Standard dose amount
It is excessive to mark drug, and issues and takes medicine abnormity prompt.
In some possible embodiments, terminal device is getting above-mentioned accumulation medicine taking amount and above-mentioned standard dosage
Later, it can be determined that whether above-mentioned accumulation medicine taking amount is greater than above-mentioned standard dosage.If terminal device judges that above-mentioned accumulation takes
Dose is greater than above-mentioned standard dosage, it is determined that above-mentioned target user takes above-mentioned target medicine excess, and terminal device is capable of emitting
Take medicine abnormity prompt.Here, described to take medicine abnormity prompt for prompting the target user to there is measurement medicine behavior.It is optional
, terminal device can take medicine to mention extremely by prompting modes sendings such as auditory tone cues, page pop-up prompt, distinguishing mark prompts
It wakes up.For example, terminal device is by taking medicine information to determine that the target user needs to obtain drug Ah reaching in default billing cycle
The target medicine taking amount of the wooden monoclonal antibody injection is 80 milligrams, and the accumulation medicine taking amount of target user is 100 milligrams, then terminal device can
Determine that the target user crosses measurement medicine.Further, terminal device can pop up a window in its display interface, and in window
" xxx user crosses measurement medicine " is prompted in mouthful.
In the embodiment of the present invention, terminal device first can determine that target user exists according to the body surface area information of target user
Corresponding Standard dose amount in default billing cycle, then target user is got in default billing cycle for target medicine
Accumulative medicine taking amount.Then, when determining that above-mentioned accumulation medicine taking amount is greater than above-mentioned standard dosage, it may be determined that the target user deposits
The behavior for measuring medicine is being crossed, and is issuing and takes medicine abnormity prompt.What is issued takes medicine abnormity prompt that can prompt to bear in medical insurance structure
The personnel of duty clearing notice this abnormal conditions, so as to verify the actual conditions, prevent sufferer or medical treatment
Mechanism insurance fraud.In this way, the complexity for process of settling a claim caused by can reducing because of insurance fraud behavior, promotes the Claims Resolution effect of Medical Insurance Organizations
Rate and Claims Resolution accuracy rate.
Embodiment two
Referring to fig. 2, Fig. 2 is another stream for taking medicine method of specifying error based on data processing that inventive embodiments provide
Journey schematic diagram.In the present embodiment, it is described by executing subject of terminal device.As shown, this method comprises:
S201 obtains the corresponding body surface area information of target user, determines the target according to the body surface area information
User corresponds to the Standard dose amount of target medicine in default billing cycle.
In some possible embodiments, when target user or medical institutions carry out Claims Resolution knot to Medical Insurance Organizations
When calculation, terminal device can first obtain the corresponding body surface area information of above-mentioned target user.Then, terminal device can be got
Target medicine is stated for the standardized amount instruction information or doctor's advice information of above-mentioned target user.Finally, terminal device can basis
Above-mentioned body surface area information and above-mentioned standard dosage instruction information determine target user's corresponding mesh in default billing cycle
Mark medicine taking amount.Alternatively, terminal device can determine target user pre- according to above-mentioned body surface area information and above-mentioned doctor's advice information
If corresponding target medicine taking amount in billing cycle.Above-mentioned target medicine be medical insurance clause defined in Claims Resolution range in
Drug can carry out the drug of expense reimbursement by medical insurance.Above-mentioned default billing cycle is target user or therapeutic machine
Structure and Medical Insurance Organizations negotiate the Claims Resolution period of the drug expenditure of confirmation.When above-mentioned default billing cycle reaches, target is used
The drug expenditure that family or medical institutions can just generate within the period initiates Claims Resolution request to Medical Insurance Organizations, protects in medical treatment
Dangerous structure is completed after corresponding Claims Resolution operates, and the corresponding target resource information of above-mentioned target user can be classified as letter of having settled a claim
Breath.After next default billing cycle starts, the corresponding target resource information of target user can be cleared and restart
It is accumulative.
Optionally, it in the specific implementation, terminal device can get the corresponding case history of the target user, and is mentioned from the case history
Take out the body surface area information of the target user.Optionally, terminal device can also be detected from connected body surface area and be set
The body surface area information of the target user is got in standby.For example, terminal device can pass through wired or wirelessly donor
Surface area detection device sends body surface area detection instruction, and receives the body surface of the target user of body surface area detection device feedback
Area information.Optionally, terminal device can also get the corresponding height parameter of the target user and body weight parameters, then basis
Above-mentioned height parameter, body weight parameters and preset computation rule determine the corresponding body surface area information of the target user.Wherein,
Above-mentioned preset computation rule can are as follows: body surface area=0.0061* height parameter+0.0128* body weight parameters -0.1529.For example,
The raising for the target user that terminal device obtains is 180cm, weight 80kg, then can determine the target according to above-mentioned rule
The body surface area s=0.0061*180+0.0128*80-0.1529=1.9691m2 of user.
Optionally, after terminal device gets the target user corresponding body surface area information, terminal device can basis
The nomenclature of drug of above-mentioned target medicine gets the corresponding standardized amount instruction information of above-mentioned target medicine.Here, target medicine
The standardized amount instruction information of target medicine refer to the detailed directions and dosage information of the target medicine, specifically may include this
Standard dose temporal information (i.e. standard uses time interval), drug specifications and the unit bodies Surface area SD Standard of target medicine are used
The information such as dose.Wherein, the standard of target medicine referred to using time interval between the time using the drug twice when
Between be spaced, the unit body surface area of target medicine is referred to every time with standard dose using target user's every list when the target medicine
The dose that the body surface area of position needs.Then, terminal device can according to above-mentioned body surface area information, standard using time interval,
Drug specifications and above-mentioned unit bodies Surface area SD Standard dosage determine target medicine corresponding standard in default billing cycle
Dosage.Above-mentioned standard dosage is that target user is based on the corresponding reasonable employment method of target medicine in default billing cycle
Use the quantity of the target medicine.In the specific implementation, terminal device can be first according to above-mentioned body surface area information, unit bodies surface
Product Standard dose amount determines the single Standard dose amount (the single Standard dose amount not being rounded) of above-mentioned target user, then eventually
End equipment can be rounded the above-mentioned single Standard dose amount not being rounded according to above-mentioned drug specifications and the default rule that is rounded, with
Single Standard dose amount after being rounded.Here, the single Standard dose amount and drug for being rounded rule as that ought not be rounded are preset
When the Shang Buwei integer of specification, only retain integer, then plus 1, be then not added 1 if integer.For example, above-mentioned body surface area information instruction
Body surface area parameter be 75.3kg, above-mentioned unit norm body surface area dosage be 5mg/kg, then the single standard not being rounded
Dosage is 376.5mg.If the drug specifications of target medicine be 60mg/ branch, the above-mentioned single Standard dose amount not being rounded with
The quotient of drug specifications is 6.3, is 6+1=7 branch after rounding.Then, terminal device can be by single Standard dose after above-mentioned rounding
Amount is determined as target medicine corresponding single Standard dose amount in default billing cycle.Terminal device can make according to above-mentioned standard
Determine target user in default billing cycle using above-mentioned target medicine with time interval and above-mentioned default billing cycle
It is right in default billing cycle to be finally determined as target medicine by number for the product of above-mentioned single Standard dose amount and above-mentioned number
The Standard dose amount answered.
Optionally, it is corresponding can also to get the target user after getting above-mentioned body surface area information for terminal device
Doctor's advice information.Wherein, above-mentioned doctor's advice information is the target medicine by determining to the doctor that above-mentioned target user is diagnosed
Using instruction information, specifically may include the target medicine determined by doctor doctor's advice administration time information (i.e. doctor's advice use the time
Interval), drug specifications, the information such as unit body surface area doctor's advice dosage.In the specific implementation, if the target user or medical treatment knot
Structure can provide the prescription list that doctor provides, then terminal device can pass through optical character identification (Optical Character
Recognition, OCR) etc. technologies the doctor's advice information recorded in prescription list is identified from prescription list.If the target user or
Medical institutions can not provide doctor's prescription list provided, and terminal device can also get the target from other equipment by networking and use
The corresponding electronic prescription list in family.Here, above-mentioned electronic prescription list is that the operational order that above-mentioned other equipment are inputted based on doctor is true
That makes is used to indicate the data resource using rule of target medicine.Optionally, in practical applications, it is possible that target
User carries out the case where taking medicine to different medical institutions, if without carrying out above-mentioned electronic prescription list between different medical institutions
If shared, then terminal device can not get the electronic prescription list of target user by way of networking.Therefore, it can set in advance
A fixed prescription information cloud database associated with above-mentioned terminal device.One is stored in above-mentioned prescription information cloud database
Or the electronic prescription list of multiple target users.Terminal device in all healthcare structures that can provide above-mentioned target medicine
It is connected with the prescription information cloud database, as long as in this way, target user sees a doctor to a certain healthcare structure and opened by attending physician
After having electronic prescription list, electronic prescription list corresponding with the target user will be by more in above-mentioned prescription information cloud database
Newly, it can thus make terminal device associated with above-mentioned prescription information cloud database that can get a certain target user at any time
Newest electronic prescription list.Then, terminal device can extract doctor's advice information from above-mentioned electronic prescription list.
For terminal device after getting above-mentioned doctor's advice information, the doctor's advice that can extract target medicine uses time interval, medicine
Product specification information and unit body surface area doctor's advice dosage.Then, terminal device can be according to the body surface area information and described
Unit body surface area doctor's advice dosage determines the corresponding single doctor's advice dosage of the target user.Then further according to the list
Secondary doctor's advice dosage and the doctor's advice administration time information determine that the target user corresponds to institute in the default billing cycle
State the Standard dose amount of target medicine.Specific true ground process, which can be found in, above-described uses time interval, unit according to standard
Body surface area Standard dose amount is determining, the corresponding drug specifications of target medicine determines above-mentioned target medicine in default billing cycle
The process of interior corresponding target medicine taking amount, just repeats no more herein.
S202 obtains the identity information and the corresponding resource settlement information of the target medicine of the target user, root
Accumulative medicine taking amount of the target user in default billing cycle is determined according to above-mentioned identity information and above-mentioned resource settlement information.
In some possible embodiments, terminal device can get the identity information and target medicine of target user
The corresponding resource settlement information of product.Optionally, the identity information of target user and the corresponding resource settlement information of target medicine can
It is contained in a medicine information processing request for target medicine, above-mentioned medicine information processing request can be target user's sheet
The drug expenditure Claims Resolution settlement request that people or medical institutions initiate to Medical Insurance Organizations.Above-mentioned identity information may include following
Any one of at least: ID card No., face feature information, fingerprint feature information, iris feature information.Above-mentioned resource settlement information
The concretely settlement information of drug expenditure.Above-mentioned target medicine is the medicine defined in medical insurance clause in Claims Resolution range
Product can carry out the drug of expense reimbursement by medical insurance.
Optionally, in the specific implementation, terminal device can get target by input equipments such as its external keyboards
Then the user operation instruction of user or the staff of medical institutions input is being generated according to above-mentioned user operation instruction
State the identity information and the corresponding resource settlement information of target medicine of target user.
Optionally, in the specific implementation, terminal device can be also directly obtained from connected other equipment is directed to
The medicine information of target medicine handles request, and onestep extraction of going forward side by side goes out the identity information of above-mentioned target user and target medicine corresponds to
Resource settlement information.For example, terminal device can be directly directly obtained from the storage equipment such as USB flash disk it is above-mentioned for target medicine
Medicine information handle request, then extract the identity information and target medicine corresponding resource clearing letter of above-mentioned target user
Breath.Here, terminal device can be not construed as limiting herein by wired or be wirelessly connected with above-mentioned other equipment.
Optionally, in the specific implementation, in the above-mentioned identity information only comprising above-mentioned ID card No., fingerprint feature information,
When a certain item in face feature information, iris feature information, in order to guarantee target user identity information integrality and
The accuracy of subsequent match, terminal device can also directly acquire the target user's by connected information collecting device
Identity information.For example, terminal device can also be by taking the photograph when in above-mentioned identity information only including the ID card No. of target user
As head directly acquires the facial image of the target user, face is then carried out by facial image of the image algorithm to the target user
The extraction of portion's feature, to get the face feature information of the target user.Here, above-mentioned image processing algorithm may include line
Feature extraction, Shape Feature Extraction etc. are managed, is not construed as limiting herein.Alternatively, terminal device can also get the pupil of target user
Then image gets the iris feature information of the target user by image processing method from above-mentioned pupil image.Here,
It should be noted that above-mentioned identity information can also include that above-mentioned identification number, face feature information and fingerprint are special simultaneously
Reference breath, can specifically determine according to practical situations comprising content, can promote the matched accuracy rate of follow-up data in this way.
After getting the corresponding identity information of above-mentioned target user and above-mentioned resource settlement information, terminal is set terminal device
It is standby to be matched in above-mentioned resource settlement information according to the corresponding identity information of target user, if inquiring a certain group of target
The associated identity information of resource information and the identity information of target user's input match, then illustrate this group of target resource information i.e.
The target resource information of target medicine is directed to for target user.Terminal device is getting the corresponding target money of above-mentioned target user
After source information, the corresponding drug unit price information of above-mentioned target medicine can be also got.Then, terminal device can be according to above-mentioned target
The corresponding target resource information of user and above-mentioned drug unit price information determine accumulation of the target user in default billing cycle
Medicine taking amount.For example, it is assumed that above-mentioned target medicine is Jin Keli.Its drug unit price information is 3800 yuan/box.If terminal device determines
Target user's corresponding drug expenditure in default billing cycle is 38000 yuan out, then can determine that target user in default knot
Calculating the accumulation medicine taking amount in the period is 38000 yuan/(3800 yuan/box)=10 boxes.
Optionally, in the specific implementation, certain drugs may be corresponded to by free Rule Information, above-mentioned free Rule Information is
The corresponding free pickup information of above-mentioned target medicine.For example, the corresponding free rule of target medicine gives a box to buy three boxes.Also
Say it is to say, in addition target user can also obtain one box of present after having bought three boxes.In practical application, terminal device can first root
According to it is above-mentioned get the corresponding identity information of above-mentioned target user and above-mentioned resource settlement information after, terminal device can be according to target
The corresponding identity information of user matches in above-mentioned resource settlement information, if inquiring a certain group of target resource information association
Identity information and target user input identity information match, then illustrate that this group of target resource information is target user's needle
To the target resource information of target medicine.Terminal device is after getting the corresponding target resource information of above-mentioned target user, also
The corresponding drug unit price information of above-mentioned target medicine can be got.Then, terminal device can be corresponding according to above-mentioned target user
Target resource information and above-mentioned drug unit price information determine first medicine taking amount of the target user in default billing cycle.This
In, first medicine taking amount is the target medicine that the target user is bought in the default billing cycle by fund
Quantity.Then, terminal device can also get above-mentioned target medicine corresponding free Rule Information in default billing cycle,
Determine the target user in the default billing cycle further according to the free Rule Information and first medicine taking amount
The second medicine taking amount.Here, the second medicine taking amount target user freely extracts in the default billing cycle
The quantity of the target medicine.Finally, terminal device can determine mesh according to above-mentioned first medicine taking amount and above-mentioned second medicine taking amount
Mark accumulation medicine taking amount of the user in default billing cycle.For example, the corresponding free rule of target medicine gives a box to buy three boxes,
The first medicine taking amount that terminal device determines is 9 boxes, then by above-mentioned free rule it is found that above-mentioned second medicine taking amount is 3 boxes.Then terminal
Equipment can determine that accumulation medicine taking amount of the target user in default billing cycle is 15 boxes.
S203 determines that target user takes target medicine mistake when above-mentioned accumulative medicine taking amount is greater than above-mentioned standard dosage
Amount, and issue and take medicine abnormity prompt.
In some possible embodiments, terminal device is getting accumulation of the target user in default billing cycle
In default billing cycle after corresponding Standard dose amount, terminal device can determine whether above-mentioned accumulative take for medicine taking amount and target medicine
Whether dose is greater than above-mentioned standard dosage.If terminal device judges that above-mentioned accumulative medicine taking amount is greater than above-mentioned standard dosage,
It then can determine that target user had measurement medicine behavior.Then, terminal device can by auditory tone cues, the page pop-up prompt,
The prompting modes sending such as distinguishing mark prompt takes medicine abnormity prompt.It is described to take medicine abnormity prompt for the work to Medical Insurance Organizations
Making personnel prompts the target user to there is measurement medicine behavior.For example, terminal device determines the target user in default knot
Calculating and using the Standard dose amount of drug adalimumab injection in the period is 80 milligrams, and target user is in target period
Accumulating medicine taking amount is 160 milligrams, then terminal device can determine that the target user crosses measurement medicine.Further, terminal device can
A window is popped up in its display interface, and prompts " xxx user crosses measurement medicine " in the window.
Optionally, terminal device is after determining that the target user crosses measurement medicine, then terminal device produces and above-mentioned mesh
User is associated takes medicine abnormality mark information for mark.The exception takes medicine flag information to be used to indicate existing for the target user
Exception takes medicine behavior.For example, producing one after terminal device determines that Lee target user three crosses measurement medicine and taking medicine abnormality mark
Information, such as: Lee three, xx xx month xx day, cross measurement medicine, medicine taking amount xxx.In this way, when next default billing cycle reaches,
Terminal device can take medicine abnormality mark information to be adjusted the corresponding target medicine taking amount of the target user based on above-mentioned, to prevent
The target user carries out insurance fraud by frequently crossing measurement medicine.
S204 determines the difference of accumulative medicine taking amount and Standard dose amount, when difference is greater than preset target difference, really
Fixed above-mentioned resource settlement information issues risk alert there are risk exception.
In some possible embodiments, terminal device is getting above-mentioned accumulative medicine taking amount and above-mentioned standard dosage
Later, the difference of above-mentioned accumulative medicine taking amount and Standard dose amount can be got.Then, when terminal device determines that above-mentioned difference is big
When preset target difference, determine that above-mentioned resource settlement information there are risk exception, then issues risk alert.Here, on
Stating preset target difference is the dose that can be extracted in advance determined according to actual medical situation.For example, it is assumed that target medicine
It needs to take for a long time, therefore in view of target user frequently takes medicine bring inconvenient, target user is allowed to extract one in advance
Point dose, take medicine number with reduce target user.But the accumulation medicine taking amount as target user in default billing cycle
Above-mentioned preset target difference is had exceeded with the difference of Standard dose amount, then illustrates that the target user's takes medicine unreasonable, belongs to
The behavior for measuring medicine then insurance fraud is crossed, it is thus determined that there are risk exceptions for above-mentioned resource settlement information.In the specific implementation, terminal is set
The detailed process that preparation goes out risk alert can be found in above-described terminal device and issue the process for taking medicine abnormity prompt, herein just
It repeats no more.
Optionally, terminal device is determining that above-mentioned resource settlement information there are after exception, can also freeze or refuse and is above-mentioned
The corresponding resource settlement request of resource settlement information.In the specific implementation, terminal device is determining that the target user crosses measurement medicine
Afterwards, it can postpone, perhaps suspend or the directly corresponding resource settlement request of the above-mentioned resource settlement information of refusal execution is generated
Claims Resolution settlement operations.Above-mentioned Claims Resolution settlement operations be used to submit an expense account for target user or medical institutions target medicine part or
The operation of person's full payment.
In the embodiment of the present invention, terminal device first can determine that target user exists according to the body surface area information of target user
Corresponding Standard dose amount in default billing cycle, then target user is got in default billing cycle for target medicine
Accumulative medicine taking amount.Then, when determining that above-mentioned accumulation medicine taking amount is greater than above-mentioned standard dosage, it may be determined that the target user deposits
The behavior for measuring medicine is being crossed, and is issuing and takes medicine abnormity prompt.What is issued takes medicine abnormity prompt that can prompt to bear in medical insurance structure
The personnel of duty clearing notice this abnormal conditions, so as to verify the actual conditions, prevent sufferer or medical treatment
Mechanism insurance fraud.In this way, the complexity for process of settling a claim caused by can reducing because of insurance fraud behavior, promotes the Claims Resolution effect of Medical Insurance Organizations
Rate and Claims Resolution accuracy rate.
It is a kind of composed structure schematic diagram of terminal device provided in an embodiment of the present invention referring to Fig. 3, Fig. 3, which sets
It is standby to include:
Standard dose amount determination unit 10, for obtaining the corresponding body surface area information of target user, according to the body surface
Area information determines that the target user corresponds to the Standard dose amount of target medicine in default billing cycle.
Accumulative medicine taking amount determination unit 20, the identity information and the target medicine for obtaining the target user are corresponding
Resource settlement information, determine the target user described default according to the identity information and the resource settlement information
Accumulative medicine taking amount in billing cycle.
Medicine exception processing unit 30 is taken, the accumulative medicine taking amount for determining when the accumulative medicine taking amount determination unit 20
When the Standard dose amount determined greater than the Standard dose amount determination unit 10, determine that the target user takes medicine abnormal,
And it issues and takes medicine abnormity prompt.Wherein, described to take medicine abnormity prompt for prompting the target user to there is measurement medicine behavior.
In one possible implementation, the Standard dose amount determination unit 10 is used for:
It obtains the corresponding standardized amount of target medicine and indicates information, wherein the standardized amount instruction information includes unit
Body surface area Standard dose amount and Standard dose temporal information.
The target user couple is determined according to the body surface area information and the unit bodies Surface area SD Standard dosage
The single Standard dose amount answered.
Determine the target user in default knot according to the single Standard dose amount and the Standard dose temporal information
Calculate the Standard dose amount that the target medicine is corresponded in the period.
In one possible implementation, the Standard dose amount determination unit 10 is used for:
Obtain the corresponding doctor's advice information of the target user.Wherein, the doctor's advice information includes unit bodies surface area doctor's advice
Dosage and doctor's advice administration time information.
The target user couple is determined according to the body surface area information and the unit body surface area doctor's advice dosage
The single doctor's advice dosage answered.
Determine the target user described pre- according to the single doctor's advice dosage and the doctor's advice administration time information
If corresponding to the Standard dose amount of the target medicine in billing cycle.
In one possible implementation, the Standard dose amount determination unit 10 is used for:
Obtain the corresponding height information of target user and weight information.
The corresponding body surface area information of the target user is determined according to the height information and the weight information.
In one possible implementation, the accumulative medicine taking amount determination unit 20 is used for:
The corresponding target resource of the target user is determined from the resource settlement information according to the identity information
Information.
The drug unit price information for obtaining the target medicine, according to the target resource information and the drug unit price information
Determine accumulative medicine taking amount of the target user in the default billing cycle.
In one possible implementation, the accumulative medicine taking amount determination unit 20 is used for:
The corresponding target resource of the target user is determined from the resource settlement information according to the identity information
Information.
The drug unit price information for obtaining the target medicine, according to the drug unit price information and the target resource information
Determine first medicine taking amount of the target user in the default billing cycle.Wherein, first medicine taking amount is described
The quantity for the target medicine that target user is extracted in the default billing cycle based on resource clearing.
The corresponding free Rule Information of the target medicine is obtained, medicine is taken according to the free Rule Information and described first
Amount determines second medicine taking amount of the target user in the default billing cycle.Wherein, second medicine taking amount is institute
State the quantity for the target medicine that target user freely extracts in the default billing cycle.
Determine the target user in the default billing cycle according to first medicine taking amount and the second medicine taking amount
Accumulative medicine taking amount.
In one possible implementation, the identity information includes following at least any one: ID card No., face
Characteristic information, fingerprint feature information, iris feature information.
In one possible implementation, described that medicine exception processing unit 30 is taken to be used for: to determine described accumulative to take medicine
The difference of amount and the Standard dose amount determines the resource settlement information when the difference is greater than preset target difference
There are risk exceptions, issue risk alert.
In one possible implementation, described that medicine exception processing unit 30 is taken to be also used to: described in freezing or refusing
The corresponding resource settlement request of resource settlement information.
Each module, which is particularly used in, in above-mentioned terminal device executes base described in above-described embodiment one or embodiment two
In each step for taking medicine method of specifying error of data processing, it can also realize and above-mentioned take medicine extremely determining based on data processing
Beneficial effect brought by method, just repeats no more herein.
In the embodiment of the present invention, terminal device first can determine that target user exists according to the body surface area information of target user
Corresponding Standard dose amount in default billing cycle, then target user is got in default billing cycle for target medicine
Accumulative medicine taking amount.Then, when determining that above-mentioned accumulation medicine taking amount is greater than above-mentioned standard dosage, it may be determined that the target user deposits
The behavior for measuring medicine is being crossed, and is issuing and takes medicine abnormity prompt.What is issued takes medicine abnormity prompt that can prompt to bear in medical insurance structure
The personnel of duty clearing notice this abnormal conditions, so as to verify the actual conditions, prevent sufferer or medical treatment
Mechanism insurance fraud.In this way, the complexity for process of settling a claim caused by can reducing because of insurance fraud behavior, promotes the Claims Resolution effect of Medical Insurance Organizations
Rate and Claims Resolution accuracy rate.
Fig. 4 is referred to, Fig. 4 is the composed structure schematic diagram of a kind of electronic equipment provided in an embodiment of the present invention.The present invention
The electronic equipment that embodiment provides includes processor 401, memory 402 and bus system 403 and input-output apparatus 404.Its
In, above-mentioned processor 401, memory 402, input-output apparatus 404 are connected by bus system 403.
Above-mentioned memory 402 is for storing program.Specifically, program may include program code, and program code includes meter
Calculation machine operational order.Memory 402 include but is not limited to be random access memory (random access memory, RAM),
Read-only memory (read-only memory, ROM), Erasable Programmable Read Only Memory EPROM (erasable programmable
Read only memory, EPROM) or portable read-only memory (compact disc read-only memory, CD-
ROM).A memory is illustrated only in Fig. 4, certainly, memory also can according to need, and be set as multiple.
Memory 402 is also possible to the memory in processor 401, herein with no restrictions.
Memory 402 stores following element, executable modules or data structures perhaps their subset or
Their superset:
Operational order: including various operational orders, for realizing various operations.
Operating system: including various system programs, for realizing various basic businesses and the hardware based task of processing.
The operation of above-mentioned 401 controlling electronic devices of processor, processor 401 can be one or more central processing units
(central processing unit, CPU).In the case where processor 401 is a CPU, which can be monokaryon
CPU is also possible to multi-core CPU.
In above-mentioned input-output apparatus 404, input equipment may include camera, keyboard etc., and output equipment may include display
Device, indicator light etc..
In specific application, the various components of electronic equipment are coupled by bus system 403, wherein bus system
403 in addition to including data/address bus, can also include power bus, control bus and status signal bus in addition etc..But in order to clear
For the sake of Chu's explanation, various buses are all designated as bus system 403 in Fig. 4.To be only schematically drawn in Fig. 4 convenient for indicating.
What the embodiment of the present invention disclosed takes medicine method of specifying error to can be applied to processor 401 based on output processing
In, or realized by processor 401.Processor 401 may be a kind of IC chip, the processing capacity with signal.
A kind of computer readable storage medium is provided in the embodiment of the present invention, is deposited in the computer readable storage medium
Instruction is contained, when the instruction is run on computers, it can be achieved that base described in above-described embodiment one or embodiment two
Medicine method of specifying error is taken in data processing.
Above-mentioned computer readable storage medium can be the storage inside list of terminal device described in aforementioned any embodiment
Member, such as the hard disk or memory of terminal device.Above-mentioned computer readable storage medium is also possible to the outside of above-mentioned terminal device
The plug-in type hard disk being equipped in storage equipment, such as the terminal device, intelligent memory card (Smart Media Card, SMC),
Secure digital (Secure Digital, SD) card, flash card (Flash Card) etc..Further, above-mentioned computer-readable to deposit
Storage media can also both including above-mentioned terminal device internal storage unit and also including External memory equipment.It is above-mentioned computer-readable
Storage medium is for other programs and data needed for storing above-mentioned computer program and above-mentioned terminal device.Above-mentioned computer
Readable storage medium storing program for executing can be also used for temporarily storing the data that has exported or will export.
The above disclosure is only the preferred embodiments of the present invention, cannot limit the right model of the present invention with this certainly
It encloses, therefore equivalent changes made in accordance with the claims of the present invention, is still within the scope of the present invention.
Claims (10)
1. a kind of take medicine method of specifying error based on data processing, which is characterized in that the described method includes:
The corresponding body surface area information of target user is obtained, determines the target user default according to the body surface area information
The Standard dose amount of target medicine is corresponded in billing cycle;
The identity information and the corresponding resource settlement information of the target medicine for obtaining the target user, according to the body
Part information and the resource settlement information determine accumulative medicine taking amount of the target user in the default billing cycle;
When the accumulative medicine taking amount is greater than the Standard dose amount, determine that the target user takes medicine abnormal, and issue and take medicine
Abnormity prompt, wherein described to take medicine abnormity prompt for prompting the target user to there is measurement medicine behavior.
2. the method according to claim 1, wherein described determine the target according to the body surface area information
The Standard dose amount that user corresponds to target medicine in default billing cycle includes:
It obtains the corresponding standardized amount of target medicine and indicates information, wherein the standardized amount instruction information includes unit bodies table
Area standard dosage and Standard dose temporal information;
Determine that the target user is corresponding according to the body surface area information and the unit bodies Surface area SD Standard dosage
Single Standard dose amount;
Determine the target user in default clearing week according to the single Standard dose amount and the Standard dose temporal information
The Standard dose amount of the target medicine is corresponded in phase.
3. method according to claim 1 or 2, which is characterized in that the corresponding body surface area letter of the acquisition target user
Breath includes:
Obtain the corresponding height information of target user and weight information;
The corresponding body surface area information of the target user is determined according to the height information and the weight information.
4. method according to claim 1-3, which is characterized in that described according to the identity information and the money
Source settlement information determines that accumulative medicine taking amount of the target user in the default billing cycle includes:
The corresponding target resource information of the target user is determined from the resource settlement information according to the identity information;
The drug unit price information for obtaining the target medicine is determined according to the target resource information and the drug unit price information
Accumulative medicine taking amount of the target user in the default billing cycle out.
5. method according to claim 1-3, which is characterized in that described according to the identity information and the money
Source settlement information determines that accumulative medicine taking amount of the target user in the default billing cycle includes:
The corresponding target resource information of the target user is determined from the resource settlement information according to the identity information;
The drug unit price information for obtaining the target medicine is determined according to the drug unit price information and the target resource information
First medicine taking amount of the target user in the default billing cycle out, wherein first medicine taking amount is the target
The quantity for the target medicine that user is extracted in the default billing cycle based on resource clearing;
The corresponding free Rule Information of the target medicine is obtained, it is true according to the free Rule Information and first medicine taking amount
Make second medicine taking amount of the target user in the default billing cycle, wherein second medicine taking amount is the mesh
The quantity for the target medicine that mark user freely extracts in the default billing cycle;
Determine that the target user is tired in the default billing cycle according to first medicine taking amount and the second medicine taking amount
Count medicine taking amount.
6. method according to claim 1-5, which is characterized in that the identity information includes following at least any
: ID card No., face feature information, fingerprint feature information, iris feature information.
7. method according to claim 1-6, which is characterized in that in the determination, the target user takes medicine different
After often, the method also includes:
Determine the difference of the accumulative medicine taking amount and the Standard dose amount;
When the difference is greater than preset target difference, determine that the resource settlement information there are risk exception, issues risk
Abnormality alarm.
8. a kind of terminal device, which is characterized in that the terminal device includes:
Standard dose amount determination unit is believed for obtaining the corresponding body surface area information of target user according to the body surface area
Breath determines that the target user corresponds to the Standard dose amount of target medicine in default billing cycle;
Accumulative medicine taking amount determination unit, for obtaining the identity information and the corresponding resource of the target medicine of the target user
Settlement information determines the target user in the default clearing week according to the identity information and the resource settlement information
Accumulative medicine taking amount in phase;
Medicine exception processing unit is taken, the accumulative medicine taking amount for determining when the accumulative medicine taking amount determination unit is greater than described
When the Standard dose amount that Standard dose amount determination unit determines, determine that the target user takes medicine abnormal, and issue and take medicine
Abnormity prompt, wherein described to take medicine abnormity prompt for prompting the target user to there is measurement medicine behavior.
9. a kind of electronic equipment, which is characterized in that the electronic equipment includes processor, memory and input-output apparatus,
The processor, memory and the input-output apparatus are connected with each other, wherein and the memory is used to store program code,
The processor and the input-output apparatus are executed as described in claim any one of 1-7 for calling said program code
Method.
10. a kind of computer is into readable storage medium storing program for executing, which is characterized in that the computer-readable recording medium storage has computer
Program, the computer program include program instruction, and described program instruction when being executed by a processor executes the processor
The method according to claim 1 to 7.
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Citations (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN104182824A (en) * | 2014-08-08 | 2014-12-03 | 平安养老保险股份有限公司 | Rule checking system and rule checking method for recognizing medical insurance reimbursement violations |
CN107133437A (en) * | 2017-03-03 | 2017-09-05 | 平安医疗健康管理股份有限公司 | The method and device that monitoring medicine is used |
CN108022160A (en) * | 2017-12-26 | 2018-05-11 | 泰康保险集团股份有限公司 | Method, apparatus, medium and the electronic equipment of efficient drugs supply |
-
2018
- 2018-10-27 CN CN201811265680.4A patent/CN109523401A/en active Pending
Patent Citations (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN104182824A (en) * | 2014-08-08 | 2014-12-03 | 平安养老保险股份有限公司 | Rule checking system and rule checking method for recognizing medical insurance reimbursement violations |
CN107133437A (en) * | 2017-03-03 | 2017-09-05 | 平安医疗健康管理股份有限公司 | The method and device that monitoring medicine is used |
CN108022160A (en) * | 2017-12-26 | 2018-05-11 | 泰康保险集团股份有限公司 | Method, apparatus, medium and the electronic equipment of efficient drugs supply |
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