CN109636650A - Recognition methods, device, terminal and the readable storage medium storing program for executing of therapeutic regimen exception - Google Patents

Recognition methods, device, terminal and the readable storage medium storing program for executing of therapeutic regimen exception Download PDF

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Publication number
CN109636650A
CN109636650A CN201811531071.9A CN201811531071A CN109636650A CN 109636650 A CN109636650 A CN 109636650A CN 201811531071 A CN201811531071 A CN 201811531071A CN 109636650 A CN109636650 A CN 109636650A
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detail
prescription
drug
medicine
insured people
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陈明东
黄越
胥畅
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Ping An Medical and Healthcare Management Co Ltd
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Ping An Medical and Healthcare Management Co Ltd
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Publication of CN109636650A publication Critical patent/CN109636650A/en
Priority to PCT/CN2019/097445 priority patent/WO2020119131A1/en
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    • GPHYSICS
    • G06COMPUTING; CALCULATING OR COUNTING
    • G06QINFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
    • G06Q40/00Finance; Insurance; Tax strategies; Processing of corporate or income taxes
    • G06Q40/08Insurance

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Abstract

The present invention provides recognition methods, device, terminal and the readable storage medium storing program for executing of a kind of therapeutic regimen exception.The recognition methods of therapeutic regimen exception includes the identity information for obtaining insured people, and according to the identity information of insured people obtain the purchase medicine detail and the purchase medicine detail of insured people in the target time period corresponding to prescription detail;With the presence or absence of the drug for being not belonging to prescription detail in judgement purchase medicine detail;If it exists, whether the drug that prescription detail is not belonging to described in judgement is prescription medicine;If it is not, then marking insured people, there are the behaviors of therapeutic regimen exception.The present invention is based on the related datas that artificial intelligence technology can obtain insured people from medical organization management system, to judge that insured people whether there is the behavior of therapeutic regimen exception, be conducive to reinforce to exercise supervision to the behavior of insured people, pharmacy, medical institutions, it safeguards that drug market is stablized, avoids the waste of outpatient service risk-pooling fund.

Description

Recognition methods, device, terminal and the readable storage medium storing program for executing of therapeutic regimen exception
Technical field
The present invention relates to the recognition methods of medical insurance technical field more particularly to a kind of therapeutic regimen exception, device, set Standby and readable storage medium storing program for executing.
Background technique
In the medical field, there are many frauds, such as individual insured people apply false prescription and go pharmacy's purchase and its The drug that the state of an illness is not suited the medicine to the illness completely.Alternatively, patient buys the medicine different from the drug variety in prescription detail, it is easy so that part Ethical goods is in short supply, and then causes drug market chaotic, and the insured people illegally extracts outpatient service risk-pooling fund, seriously endangers to public affairs Many interests.
It, can not although relevant drugs consumption record can be inquired according to the information of insured people in the prior art Determine whether the insured people takes part in purchase medicine in violation of rules and regulations and illegally extract the behavior of outpatient service risk-pooling fund.
Summary of the invention
The main purpose of the present invention is to provide a kind of recognition methods of therapeutic regimen exception, device, equipment and readable deposit Storage media, it is intended to realize that there are the behaviors of therapeutic regimen exception in the purchase medicine behavior for identifying insured people.
To achieve the above object, the present invention provides a kind of recognition methods of therapeutic regimen exception, and the recognition methods includes Following steps:
The identity information of insured people is obtained, and insured people is obtained in target time section according to the identity information of the insured people Prescription detail corresponding to interior purchase medicine detail and the purchase medicine detail;
Judge in the purchase medicine detail with the presence or absence of the drug for being not belonging to the prescription detail;
If there is the drug for being not belonging to the prescription detail in the purchase medicine detail, it is bright to be not belonging to the prescription described in judgement Whether thin drug is prescription medicine;
If the drug for being not belonging to the prescription detail is prescription medicine, marks the insured people there are therapeutic regimens and is different Normal behavior.
Preferably, the identity information for obtaining insured people, and insured people is obtained according to the identity information of the insured people The step of prescription detail corresponding to purchase medicine detail and the purchase medicine detail in the target time period, comprising:
The purchase medicine detail of insured people in the target time period is obtained according to the identity information of insured people;
Time interval is issued according to prescription detail based on the first preset rules acquisition target purchase medicine detail;
The insured people is obtained in the diagnosis records of each hospital according to the time interval of issuing;
The prescription detail of the insured people is obtained according to the diagnosis records.
Preferably, described that the time is issued according to prescription detail based on the first preset rules acquisition target purchase medicine detail The step of section includes:
It obtains the day of earliest purchase medicine behavior generation in the target time period and purchases the day of medicine behavior generation the latest;
According to the day for subtracting preset time period day and being issued earliest of the earliest purchase medicine behavior generation, wherein described open Tool time interval is the time interval formed to the day for purchasing medicine behavior generation the latest the day issued earliest.
Preferably, the step that time interval is issued according to and obtains diagnosis records of the insured people in each hospital After rapid, further includes:
It determines the history disease of the insured people according to the diagnosis records, and analyzes the drug in the purchase medicine detail Disease to the ill;
Judge whether the history disease and the disease of suiting the medicine to the illness are identical;
If the history disease and the disease of suiting the medicine to the illness be not identical, the corresponding adjuvant drug model of the history disease is obtained It encloses, judges in the purchase medicine detail with the presence or absence of the drug for belonging to the adjuvant drug range;
If there is no the drugs for belonging to the adjuvant drug range in the purchase medicine detail, the insured people is marked to exist The behavior of therapeutic regimen exception.
Preferably, the step of in the judgement purchase medicine detail with the presence or absence of the drug for being not belonging to the prescription detail, Include:
A prescription detail in the more parts of prescription details is successively selected as target prescription according to the second preset rules Detail;
If the drug in the purchase medicine detail all belongs to the target prescription detail, determine in the purchase medicine detail not In the presence of the drug for being not belonging to the prescription detail;
If the drug moiety purchased in medicine detail is all not belonging to the target prescription detail, the purchase medicine is determined There is the drug for being not belonging to the prescription detail in detail.
Preferably, described successively to select the work of a prescription detail in the more parts of prescription details according to the second preset rules Include: for target prescription detail step
First object prescription detail is selected from the more parts of prescription details according to the second preset rules, judges the purchase medicine With the presence or absence of the drug for being not belonging to the first object prescription detail in detail;
If there is the drug for being not belonging to the first object prescription detail in the purchase medicine detail, to the purchase medicine detail In be not belonging to the drug of the first object prescription detail and be marked, and be labeled as pending drug;
Remaining target prescription detail is selected from the remaining prescription detail, and will be at the pending drug and remaining target The drug that square detail is recorded compares one by one.
Preferably, if the drug for being not belonging to the prescription detail is prescription medicine, the insured people is marked to deposit Include: in the step of behavior of therapeutic regimen exception
If the drug for being not belonging to the prescription detail is prescription medicine, obtain and the insured artificially shared medical insurance account The identity information of the indirect insured people of family relationship;
According to the identity information of insured people indirectly and it is described issue time interval, obtain each hospital with it is described between Connect the corresponding indirect prescription detail of insured people;
Whether the drug that the prescription detail is not belonging to described in judgement belongs to the indirect prescription detail;
If the drug of the prescription detail for being not belonging to insured people is also not belonging to the indirect prescription detail, mark There are the behaviors of therapeutic regimen exception by the insured people.
In addition, to achieve the above object, the present invention also provides a kind of identification devices of therapeutic regimen exception, comprising:
Module is obtained, for obtaining the identity information of insured people, and it is insured according to the acquisition of the identity information of the insured people Prescription detail corresponding to the purchase medicine detail and the purchase medicine detail of people in the target time period;
Judgment module, for judging in the purchase medicine detail with the presence or absence of the drug for being not belonging to the prescription detail;
Mark module, if for there is the drug for being not belonging to the prescription detail in the purchase medicine detail, by the ginseng Guarantor is labeled as there are the behaviors of therapeutic regimen exception.
In addition, to achieve the above object, the present invention also provides a kind of terminal, including processor, memory and it is stored in And it can be by the recognizer for the therapeutic regimen exception that the processor executes, wherein the therapeutic regimen is abnormal on the memory Recognizer when being executed by the processor, the step of realizing the recognition methods of therapeutic regimen exception as described above.
In addition, to achieve the above object, the present invention also provides a kind of readable storage medium storing program for executing, being deposited on the readable storage medium storing program for executing The recognizer of therapeutic regimen exception is contained, wherein realizing when the recognizer of therapeutic regimen exception is executed by processor The step of recognition methods of therapeutic regimen exception as described above.
The present invention obtains the purchase medicine detail of insured people in the target time period, and obtains institute according to the first preset rules Prescription detail based on stating purchase medicine detail judges in the purchase medicine detail with the presence or absence of the medicine for being not belonging to the prescription detail Object, and if it exists, then marking the insured people, there are the behaviors of therapeutic regimen exception.It can be from the present invention is based on artificial intelligence technology The related data that insured people is obtained in medical institutions' management system, whether there is in the purchase medicine detail by judging insured people and its The drug that drug documented by prescription detail is not consistent passes through to judge that insured people whether there is the behavior of therapeutic regimen exception Above-mentioned technical proposal is conducive to reinforce to exercise supervision to the behavior of insured people, pharmacy, medical institutions, and maintenance drug market is stablized, Outpatient service risk-pooling fund is avoided to be applied.
Detailed description of the invention
Fig. 1 is the hardware structural diagram of terminal involved in the embodiment of the present invention;
Fig. 2 is the flow diagram of the recognition methods first embodiment of therapeutic regimen exception of the present invention;
Fig. 3 is the refinement flow diagram for the step 10 that embodiment illustrated in fig. 2 is related to;
Fig. 4 is the refinement flow diagram for the step 12 that embodiment illustrated in fig. 3 is related to;
Fig. 5 is the flow diagram of the recognition methods second embodiment of therapeutic regimen exception of the present invention;
Fig. 6 is the flow diagram of the recognition methods 3rd embodiment of therapeutic regimen exception of the present invention;
Fig. 7 is the flow diagram of the recognition methods fourth embodiment of therapeutic regimen exception of the present invention;
Fig. 8 is the flow diagram of the 5th embodiment of recognition methods of therapeutic regimen exception of the present invention.
The embodiments will be further described with reference to the accompanying drawings for the realization, the function and the advantages of the object of the present invention.
Specific embodiment
It should be appreciated that the specific embodiments described herein are merely illustrative of the present invention, it is not intended to limit the present invention.
The present embodiments relate to the recognition methods of therapeutic regimen exception be mainly used in terminal, which can be The equipment that PC, portable computer, mobile terminal etc. have display and processing function.
Referring to Fig.1, Fig. 1 is terminal structure schematic diagram involved in the embodiment of the present invention.In the embodiment of the present invention, eventually End may include processor 1001 (such as CPU), communication bus 1002, user interface 1003, network interface 1004, memory 1005.Wherein, communication bus 1002 is for realizing the connection communication between these components;User interface 1003 may include display Shield (DISPLAY), input unit such as keyboard (KEYBOARD);Network interface 1004 optionally may include that the wired of standard connects Mouth, wireless interface (such as WI-FI interface);Memory 1005 can be high speed RAM memory, be also possible to stable memory (NON-VOLATILE MEMORY), such as magnetic disk storage, memory 1005 optionally can also be independently of aforementioned processor 1001 storage device.
It will be understood by those skilled in the art that hardware configuration shown in Fig. 1 does not constitute the restriction to equipment, can wrap It includes than illustrating more or fewer components, perhaps combines certain components or different component layouts.
With continued reference to Fig. 1, the memory 1005 in Fig. 1 as a kind of readable storage medium storing program for executing may include operating system, net The recognizer of network communication module and therapeutic regimen exception.
In Fig. 1, network communication module is mainly used for connecting server, carries out data communication with server;And processor 1001 can call the recognizer of the therapeutic regimen exception stored in memory 1005, and execute the identification of therapeutic regimen exception The step of method.
The embodiment of the invention provides a kind of recognition methods of therapeutic regimen exception.
Referring to Fig. 2, in the embodiment of the present invention, the recognition methods of therapeutic regimen exception comprising steps of
Step S10 obtains the identity information of insured people, and obtains insured people in mesh according to the identity information of the insured people Mark prescription detail corresponding to the purchase medicine detail and the purchase medicine detail in the period;
Insured people's diagnosis and treatment detail in the embodiment of the present invention can be executed by terminal, and terminal can be counted with server According to communication, communicated to connect between server and multiple medical institutions' management systems or drugstore management system.Insured people is in therapeutic machine Structure perhaps pharmacy's drug purchase when insured people purchase medicine detail by settle accounts interface end be uploaded to medical institutions' management system or Drugstore management system.When insured people uses medical insurance account settlement medical bills, clearing end can be according to the prescription of insured people offer Detail, and carry out taking medicine and clearing.
Terminal passes through server from each doctor according to the identity information of insured people by obtaining the identity information of insured people It treats and obtains purchase medicine detail corresponding with the insured people of target in the management system of mechanism or pharmacy.In other embodiments, terminal is also It can be directly connected to the management system of medical institutions or pharmacy, to realize self-supervision inside medical institutions or pharmacy Management.
When getting the purchase medicine detail of insured people in the target time period, while being obtained and being purchased according to the identity information of insured people Prescription detail corresponding to medicine detail.Insured people when buying prescription medicine, what pharmacy or pharmacy needed to be provided according to insured people Prescription detail carries out.At this point, the staff of pharmacy or pharmacy is when settling accounts each time, while will be based on insured people Prescription detail is uploaded to management system, and terminal is obtained while obtaining the purchase medicine detail of insured people based on this time purchase medicine detail Prescription detail.Or other modes is taken to obtain prescription detail corresponding with the purchase medicine detail of insured people.
Step S20 judges in the purchase medicine detail with the presence or absence of the drug for being not belonging to the prescription detail;
Insured people is when purchasing effective prescription medicine, it is desirable to provide based on prescription detail or offer can obtain accordingly The staff of the source of square detail, pharmacy or pharmacy settles accounts according to prescription detail for insured people.When the purchase medicine of insured people is bright When detail has the drug for the prescription detail for being not belonging to its offer, then there may be violation operations in the purchase medicine behavior of insured people. Therefore, it is necessary to judge in the purchase medicine detail of insured people with the presence or absence of the drug for being not belonging to prescription detail.
After terminal gets the purchase medicine detail and prescription detail of insured people, according to presupposition analysis mechanism obtain purchase medicine detail and Drug type in prescription detail obtains the language that identification model can identify.Presupposition analysis mechanism can be by for terminal The purchase medicine detail and prescription detailed data that (such as people society core system) obtains, using existing NLP process flow, by cleaning mould The matching to field standard is realized in the processing of type.Groundwork mechanism is, to nonstandard field, both to indicate word itself Again it is contemplated that under the requirement of semantic distance, using the longer more complicated content of text of RNN model analysis, such as diagnosis and treatment data, medicine Product data, disease data etc..After text is indicated with the sequence of a vector, it is by vector coding using two-way RNN model One sentence vector matrix.Every a line of this matrix can be understood as term vector --- their context-sensitives to sentence. Final step is referred to as attention mechanism.This can be by sentence matrix compression at a sentence vector, for predicting.By to doctor Tool diagnostic message, medicine information, disease information matches are born into corresponding standardization field.
Analyze the standardization word of each drug in the standardization field and prescription detail of each drug in obtained purchase medicine detail Duan Hou forms the standardization detail list of the standardization detail list and prescription detail of purchase medicine detail.The standardization for purchasing medicine detail is bright Thin table and the standardization detail list of prescription detail pass through observation interface respectively and are input to anomalous identification model referring to interface, abnormal Identification model passes through operation for the standardization detail of drug (observed value) and prescription detail in the standardization detail list for purchasing medicine detail The drug (reference point) of table is compared one by one, and is exported as a result, output result includes the match condition of observed value and reference point. If all observed values and one of reference point successful match, illustrate to be not belonging to prescription detail in purchase medicine detail Drug illustrates to purchase the drug for existing in medicine detail and being not belonging to prescription detail if observed value and all reference points mismatch.
The mechanism of anomalous identification model can be based on existing separate-blas estimation model, and deviation refers specifically in classification samples Unusual example, the special case for being unsatisfactory for rule or observed result and model predication value is inconsistent and value for changing with time etc. Deng.The elementary object of separate-blas estimation is to find difference significant between observed result and reference point, the main deviation being related to Technology has cluster, sequence variation, nearest-neighbors method, multidimensional data analysis etc..The abnormal algorithm of this model identification is mainly based upon The abnormal point method of determining and calculating of distance.Wherein main core algorithm is the algorithm based on index, that is, gives a data acquisition system, base Multi-dimensional index structures R- tree, K-D tree etc., to search neighbours of each object within the scope of radius D are used in the algorithm of index.It is false If M is the largest object number in the field D of abnormal point numerical.If the M+L neighbours of object O are found, object O is just not It is abnormal point.The complexity of this algorithm in the worst cases is O (K*N2), and K is dimension, and N is the number of object in data acquisition system Mesh.When K increases, the algorithm based on index has good scalability.
Step S30 is not belonging to institute described in judgement if there is the drug for being not belonging to the prescription detail in the purchase medicine detail Whether the drug for stating prescription detail is prescription medicine.
Since insured people is when purchasing medicine, effective prescription medicine and non-prescribed medicine may be purchased simultaneously, and the purchase medicine of non-prescribed medicine does not need Prescription detail can also be bought, therefore non-prescribed medicine is not contained in prescription detail.In order to ensure that insured people purchases the power of medicine non-prescribed medicine Benefit, when there is the drug for being not belonging to prescription detail in judgment result displays purchase medicine detail, judgement is not belonging to the medicine of prescription detail Whether object is non-prescribed medicine.
Step S40 marks the insured people to exist and uses if the drug for being not belonging to the prescription detail is prescription medicine The behavior of prescription case exception.
When judgment result displays are above-mentioned, to be not belonging to the drug of prescription detail be not non-prescribed medicine, that is, illustrates above-mentioned to be not belonging to locate The drug of square detail is prescription medicine, then insured people is not meet rule in the behavior for the related prescription detail purchase prescription medicine that has no basis Fixed, then marking insured people, there are the behaviors of therapeutic regimen exception, so that terminal is convenient for identification unlawful practice.
Step S60 marks the insured people not deposit if the drug for being not belonging to the prescription detail is not prescription medicine In the behavior of therapeutic regimen exception.
If the above-mentioned drug for being not belonging to prescription detail is non-prescribed medicine, due to medical insurance there is no to the purchase of non-prescribed medicine into Row limits, therefore when the above-mentioned drug for being not belonging to prescription detail is non-prescribed medicine, then the purchase medicine behavior of insured people meets correlation Violation operation behavior is not present in regulation, and terminal executes END instruction at this time, and by insured people labeled as normal purchase medicine behavior.
The present invention obtains the purchase medicine detail of insured people in the target time period, and obtains the purchase according to the first preset rules Prescription detail based on medicine detail judges that described purchase whether there is the drug for being not belonging to the prescription detail in medicine detail, if In the presence of then marking the insured people, there are the behaviors of therapeutic regimen exception.The present invention is based on artificial intelligence technologys can be from medical treatment The related data that insured people is obtained in organization management system, whether there is in the purchase medicine detail by judging insured people and its prescription The drug that drug documented by detail is not consistent, to judge that insured people whether there is the behavior of therapeutic regimen exception, by above-mentioned Technical solution is conducive to reinforce to exercise supervision to the behavior of insured people, pharmacy, medical institutions, and maintenance drug market is stablized, and avoids Outpatient service risk-pooling fund is applied.
Referring to Fig. 3, Fig. 3 is the refined flow chart of step S10 in first embodiment of the invention, step S10 comprising steps of
Step S11 obtains the purchase medicine detail of insured people in the target time period according to the identity information of insured people;
The purchase medicine detail of the available certain time period internal reference guarantor of terminal, for example, terminal obtains insured people April 1 The purchase medicine detail or terminal that the same day occurs obtain the purchase medicine detail that insured people occurs in early April.The quantity for purchasing medicine detail can Think one or more.When there is multiple purchase medicine details in the target time period, terminal obtains to be remembered in each purchase medicine detail The drug of load is simultaneously aggregated to form total purchase medicine detail.Step S12 is obtained based on target purchase medicine detail according to the first preset rules Prescription detail issues time interval.
It obtains after individually purchasing medicine detail or total purchase medicine detail, it is (single to obtain target purchase medicine detail according to the first preset rules A purchase medicine detail or total purchase medicine detail) based on prescription detail issue time interval.First preset rules regulation: it obtains It the day for taking the purchase medicine of single purchase medicine detail or total purchase medicine detail, is obtained after then calculating preset time period forward from purchasing medicine To the day issued earliest, time interval is issued by the day issued earliest and the day co-determination of purchase medicine.Purchase the determination side of the day of medicine Formula can be the day for choosing earliest purchase medicine behavior generation, or day or the earliest purchase medicine row of purchase medicine behavior generation the latest It day for the day of generation and the average value of the day of purchase medicine behavior generation the latest as purchase medicine, does not limit herein.In addition, when default Between section according to prescription term of validity determine, can be 1 month, 2 months etc..For example, when preset time period is 2 months.
Step S13 obtains the insured people in the diagnosis records of each hospital according to the time interval of issuing;
Step S14 obtains the prescription detail of the insured people according to the diagnosis records.
Determine prescription detail issue time interval after, obtained from each hospital relevant to insured people positioned at issuing the time Diagnosis records in section.If marking the diagnosis records related issuing in time interval there are the diagnosis records of insured people Hospital be objective hospital.Ginseng is obtained from the management system of objective hospital according to the information for issuing time interval and insured people The prescription detail of guarantor.It is understood that the quantity of the prescription detail of acquired insured people is one or more.It gets It is relevant to insured people be located at issue multiple prescription details in time interval after, the drug of each prescription detail is converged Always.The quantity of objective hospital may be one or more.Optionally, the home address according to objective hospital apart from insured people away from It determines from size from the successive of the acquisition prescription detail of objective hospital, i.e., first obtains apart from nearest objective hospital and insured people It is relevant to be located at the prescription detail issued in time interval, obtain prescription detail one by one according to distance, and compare judgement mesh With the presence or absence of the drug for being not belonging to multiple prescription details in buying tender medicine detail.
Referring to Fig. 4, Fig. 4 is the refined flow chart of step S12 in above-described embodiment, step S12 the following steps are included:
Step S121, obtain earliest purchase medicine behavior generation in the target time period day and purchase medicine behavior the latest occurs it Day;
Step S122, according to it is described it is earliest purchase medicine behavior generation the day for subtracting preset time period day and being issued earliest, Wherein the time interval of issuing is the time interval formed to the day for purchasing medicine behavior generation the latest the day issued earliest.
In order to improve the accuracy of recognition result, the determination for issuing time interval is particularly important.Preferably, the first default rule Then regulation is issued time interval and is carried out in accordance with the following steps: obtaining the earliest purchase medicine behavior recorded in target purchase medicine detail and it occurs Day and the day for purchasing medicine behavior generation the latest, when issuing earliest of the day for purchasing medicine behavior generation earliest is determined according to preset time period Between, issuing the time earliest with the time interval that is formed by day for purchasing medicine behavior generation is that prescription based on target purchase medicine detail is bright Thin issues time interval, and the preset time period that subtracts day of purchase medicine behavior generation is issuing the time earliest for prescription detail.It is default Period determines according to prescription term of validity, can be 1 month, 2 months etc..For example, when preset time period is 2 months, when When obtaining individually purchasing medicine detail, purchase medicine detail earliest and generations the latest day be April 1, then target purchase medicine detail according to According to the time interval of issuing of prescription detail be 1 day 2 months to April 1;When obtaining multiple purchase medicine details, medicine behavior is purchased earliest The day of generation is April 1, and the day for purchasing medicine behavior generation the latest is April 5, then prescription detail based on target purchase medicine detail Time interval of issuing be 1 day 2 months to April 5.
It is the flow diagram of the recognition methods second embodiment of therapeutic regimen exception of the present invention referring to Fig. 5, Fig. 5.It is based on It is further comprised the steps of: after Fig. 3, step S13
Step S15, the history disease of the insured people is determined according to the diagnosis records, and is analyzed in the purchase medicine detail Drug suit the medicine to the illness disease;
After diagnosis records relevant to insured people are got from each medical institutions, insured people is determined according to diagnosis records History disease.Diagnosis records include insured people's information, insured people's disease, insured people's state of an illness and processing doctor etc. letter Breath.It is analyzed simultaneously according to the drug type recorded in purchase medicine detail and purchases disease of suiting the medicine to the illness corresponding to medicine detail.
Step S16 judges whether the history disease and the disease of suiting the medicine to the illness are identical;
Before the disease suited the medicine to the illness according to purchase medicine detail, the prescription medicine in purchase medicine detail is determined, by determining that it is controlled according to prescription medicine The disease for the treatment of.According to the history disease of the insured people of acquisition and disease to the ill, judge whether history disease is identical as disease to the ill. History disease and disease to the ill preferably correspond to disease major class, rather than state of an illness mechanism.As history disease be by congenital heart disease, And disease is rheumatic heart disease to the ill, and as long as being attributed to heart disease class, i.e., it is believed that history disease is identical as disease to the ill, with Reduce error in judgement.If the history disease is identical as the disease of suiting the medicine to the illness, S14 is thened follow the steps, according to the diagnosis records Obtain the prescription detail of the insured people.
It is corresponding auxiliary to obtain the history disease if the history disease and the disease of suiting the medicine to the illness be not identical by step S17 Scope of medication is helped, is judged in the purchase medicine detail with the presence or absence of the drug for belonging to the adjuvant drug range;
It should be noted that adjuvant drug of often arranging in pairs or groups is in order to improve the therapeutic effect for curing mainly drug to help its curative effect. However, some adjuvant drugs other than the adjuvant drug use that can be used as a department, are also used as the common of a certain department Therapeutic agent uses, if injection omeprazole sodium is that Gastroenterology dept. often uses therapeutic agent, but it is also included into adjuvant drug one kind. Therefore, when history disease with disease is not identical to the ill when, need further judge purchase medicine detail in whether the master with history disease The corresponding adjuvant drug of drug is controlled, the case where to avoid judging by accident.If there is the auxiliary for belonging to history disease in purchase medicine detail The drug of scope of medication then illustrates to purchase the drug that there is treatment history disease in medicine detail, and there is no therapeutic regimen is different by insured people Normal behavior, if illustrating that insured people may there is no the drug for the adjuvant drug range for belonging to history disease in purchase medicine detail There are the behaviors of therapeutic regimen exception.It should be noted that due to when the history disease of insured people and the purchase medicine detail of insured people Suit the medicine to the illness disease when being different from, and when purchasing the adjuvant drug that history disease is not present in medicine detail, then can directly mark insured People without carrying out the lookup of prescription detail again, is conducive to accelerate identification progress, continues to hold there are the behavior of therapeutic regimen exception Row step S40, marking the insured people, there are the behaviors of therapeutic regimen exception.
It is the flow diagram of the recognition methods 3rd embodiment step of therapeutic regimen exception of the present invention referring to Fig. 6, Fig. 6. Based on the above embodiment, step S20 comprising steps of
Step S21 successively selects a prescription detail conduct in the more parts of prescription details according to the second preset rules Target prescription detail;
Since there may be multiple prescription details, get more parts relevant to insured people from multiple target medical institutions from After square detail, a prescription detail is filtered out from more parts of prescription details according to the second preset rules as target prescription detail. Second preset rules are preferably, and the home address according to target medical institutions apart from insured people determines first object apart from size Hospital issues a prescription of time the latest according to the time selection prescription detail of issuing of prescription detail from first object hospital Detail is as target prescription detail.Distance, prescription detail when issuing of second preset rules in addition to considering target medical institutions Between except, it is also contemplated that medical frequency of the insured people in target medical institutions.Medical frequency of the insured people in certain medical institutions Bigger, the chance which issues prescription detail based on insured people's purchase medicine is bigger.
Step S22 determines the purchase medicine if the drug in the purchase medicine detail all belongs to the target prescription detail The drug of the prescription detail is not belonging in detail;
Step S23 determines if the drug moiety or whole in the purchase medicine detail are not belonging to the target prescription detail There is the drug for being not belonging to the prescription detail in the purchase medicine detail.
After getting target prescription detail according to above-mentioned second preset rules, judging, which whether there is in purchase medicine detail, is not belonging to The drug of target prescription detail.If there is the drug for being not belonging to the target prescription detail in the drug in the purchase medicine detail, Then determine to exist in the purchase medicine detail and be not belonging to the drug of the prescription detail, execute step S30, need further to identify and Judgement is not belonging to whether the drug of target prescription detail is prescription medicine.If the drug in the purchase medicine detail all belongs to the mesh Prescription detail is marked, then determines the drug for being not belonging to the prescription detail in the purchase medicine detail, executes step S60, mark Remember that the behavior of therapeutic regimen exception is not present in the insured people.
Referring to the process signal that Fig. 7, Fig. 7 are the recognition methods fourth embodiment step of therapeutic regimen exception of the present invention Figure.Based on the above embodiment, step S21 comprising steps of
Step S211 selects first object prescription detail from the more parts of prescription details according to the second preset rules, sentences With the presence or absence of the drug for being not belonging to the first object prescription detail in the purchase medicine detail of breaking;;
It is bright as first object prescription that a prescription detail is filtered out from more parts of prescription details according to the second preset rules After thin, judge in the purchase medicine detail with the presence or absence of the drug for being not belonging to the first object prescription detail.Second preset rules Preferably, the home address according to target medical institutions apart from insured people apart from size determines first object hospital, from first A prescription detail of time the latest is issued as mesh according to the time selection prescription detail of issuing of prescription detail in objective hospital Mark prescription detail.
Step S212, if there is the drug for being not belonging to the first object prescription detail in the purchase medicine detail, to institute It states and is not belonging to the drug of the first object prescription detail in purchase medicine detail and is marked, and be labeled as pending drug;
If whole drugs of purchase medicine detail belong to first object prescription detail, S60 is thened follow the steps, insured people is marked not deposit In the behavior of therapeutic regimen exception.
If purchase medicine detail in exist be not belonging to first object prescription detail drug, illustrate insured people there may be with The behavior of prescription case exception needs further to identify the drug for being not belonging to target prescription detail in purchase medicine detail.And to being not belonging to The drug of target prescription detail is marked, and is labeled as pending drug.After obtaining pending drug, the conjunction of pending drug is advised Property is differentiated.
Step S213, selects remaining target prescription detail from the remaining prescription detail, and will the pending drug and The drug that remaining target prescription detail is recorded compares one by one.
Step S22 is executed with the presence or absence of the drug that remaining target prescription detail is recorded is not belonging to according in pending drug, I.e. with the presence or absence of the drug for being not belonging to target prescription detail in judgement purchase medicine detail, and if it exists, then continue to execute step S30, sentence It is not belonging to whether the drug of prescription detail is prescription medicine described in disconnected, if it does not exist, thens follow the steps S60, insured people is marked not deposit In the behavior of therapeutic regimen exception.
Obtain remaining target prescription detail one by one according to the second preset rules, and pending drug and remaining target prescription is bright The drug carefully recorded compares one by one, until all comparison finishes end to pending drug or remaining target prescription detail is whole Comparison finishes end.Specifically, second target prescription detail is determined from remaining prescription detail according to the second preset rules, it will The drug recorded in pending drug and second target prescription detail compares, if pending drug all belongs to second target Prescription detail, then all comparison finishes pending drug, needs not continue to obtain remaining target prescription detail.If being deposited in pending drug In the drug for being not belonging to second target prescription detail, then the medicine that second target prescription detail is not belonging in pending drug is marked Object, and it is labeled as the second pending drug.Continue in the remaining target prescription detail never compared according to the second preset rules really Determine third target prescription detail, the drug recorded in the second pending drug and third target prescription detail compared, If the second pending drug all belongs to third target prescription detail, all comparison finishes the second pending drug, do not need after It is continuous to obtain remaining prescription detail.If there is the drug for being not belonging to third target prescription detail in the second pending drug, mark It is not belonging to the drug of third target prescription detail in pending drug, and is labeled as the pending drug of third.And so on, until complete Portion's prescription detail terminates when all comparison finishes by the drug for comparing or purchasing in medicine detail.
Judge with the presence or absence of the drug being not belonging in the remaining target prescription detail in the pending drug, even all Prescription detail when the drug recorded in purchase medicine detail is still marked as pending drug, then illustrates pending after comparison Exist in drug and be not belonging to drug in remaining prescription detail, there may be the behaviors of therapeutic regimen exception by insured people.If pending medicine When object is with remaining prescription detail contrast, all comparison finishes pending drug, then illustrates to be not belonging to residue in pending drug The behavior of therapeutic regimen exception is not present in the drug of prescription detail, insured people.Therefore, sentenced according to the pending drug not compared With the presence or absence of the drug for being not belonging to the target prescription detail in disconnected purchase medicine detail.
It is the flow diagram of the 5th embodiment of recognition methods of therapeutic regimen exception of the present invention referring to Fig. 8, Fig. 8.It is based on Above-described embodiment, step S40 are further comprised the steps of: before
Step S51 is obtained and described insured artificial total if the drug for being not belonging to the prescription detail is prescription medicine With the identity information of the indirect insured people of medical insurance account relationship;
If the above-mentioned drug for being not belonging to prescription detail is prescription medicine, obtain and insured artificial shared medical insurance account relationship The identity information of potential insured people.It shares medical insurance account and refers to that the medical insurance account for being able to use insured people is insured people's purchase indirectly The case where drug.Such as insured people is the father or mother of target patient, then is that can share between insured people and target patient The relationship of medical insurance account.
Step S52, according to it is described indirectly insured people identity information and it is described issue time interval, obtain each hospital Indirect prescription detail corresponding with the insured people indirectly;
After determining potential insured people, according to the identity information of indirect insured people and what is obtained issue time interval, from each It obtains corresponding with the insured people indirectly in a hospital and is located at the indirect prescription detail for issuing time interval.
Whether step S53, the drug that the prescription detail is not belonging to described in judgement belong to the indirect prescription detail;
Step S54, if to be also not belonging to the indirect prescription bright for the drug of the prescription detail for being not belonging to insured people Carefully, then marking the insured people, there are the behaviors of therapeutic regimen exception, execute step S40.
If the drug of the prescription detail for being not belonging to insured people belongs to the indirect prescription detail, described in label The behavior of therapeutic regimen exception is not present in insured people, executes step S60.
The drug labelling that will not belong to the prescription detail of insured people comes out, and is denoted as to drugs compared, will to drugs compared with The drug recorded in indirect prescription detail compares, and judges whether belong to indirect prescription detail to drugs compared, if it is described to Drugs compared is also not belonging to the indirect prescription detail simultaneously, then does not illustrate with the incongruent drug of prescription detail of insured people also not Belong to insured drug used in everybody indirectly, then marking the insured people, there are the behaviors of therapeutic regimen exception.If it is described to Drugs compared belongs to the indirect prescription detail simultaneously, then illustrates that with the incongruent drug of prescription detail of insured people be to join indirectly Drug used in guarantor people then illustrates that the insured behavior of insured people is normal.
When insured people is marked as there are when the behavior of therapeutic regimen exception, therapeutic regimen exception reporting is generated, and to doctor It treats mechanism or pharmacy sends information warning, information warning includes the information such as prescription case exception reporting, punishment scheme.Therapeutic regimen Exception reporting includes the purchase medicine information of insured people, purchase medicine location information etc..In this way, medical insurance work personnel are had found by alarm and reminding After the object of therapeutic regimen exception, information warning is sent to related medical machine in a manner of for mail, bulletin or letter etc. Structure or pharmacy.
In addition, the embodiment of the present invention also provides a kind of identification device of therapeutic regimen exception.The identification of therapeutic regimen exception Device includes:
Module is obtained, for obtaining the identity information of insured people, and it is insured according to the acquisition of the identity information of the insured people Prescription detail corresponding to the purchase medicine detail and the purchase medicine detail of people in the target time period;
Judgment module, for judging in the purchase medicine detail with the presence or absence of the drug for being not belonging to the prescription detail;
Mark module, if for there is the drug for being not belonging to the prescription detail in the purchase medicine detail, by the ginseng Guarantor is labeled as there are the behaviors of therapeutic regimen exception.
Further, the identification device of therapeutic regimen exception further include:
Analysis module, for obtaining when issuing of prescription detail based on target purchase medicine detail according to the first preset rules Between section;
Module is obtained, it is bright to be also used to obtain the purchase medicine of insured people in the target time period according to the identity information of insured people Carefully, the insured people is obtained in the diagnosis records of each hospital, and according to the medical note according to the time interval of issuing Record obtains the prescription detail of the insured people.
Further, analysis module is also used to obtain day and the latest of earliest purchase medicine behavior generation in the target time period Purchase medicine behavior generations day, according to it is described it is earliest purchase medicine behavior generation the day for subtracting preset time period day and being issued earliest, Wherein, the time interval of issuing is the time interval formed to the day for purchasing medicine behavior generation the latest the day issued earliest.
Further, analysis module is also used to determine the history disease of the insured people according to the diagnosis records, and divides Analyse the disease of suiting the medicine to the illness of the drug in the purchase medicine detail;
Judgment module is also used to judge whether the history disease and the disease of suiting the medicine to the illness are identical;
Mark module, if be also used to the history disease and it is described suit the medicine to the illness disease it is not identical, mark the insured people to deposit In the behavior of therapeutic regimen exception.
Further, analysis module is also used to successively select one in the more parts of prescription details according to the second preset rules Part prescription detail is as target prescription detail;
Judgment module is also used to judge in the purchase medicine detail with the presence or absence of the medicine for being not belonging to the target prescription detail Object;
Mark module marks if the drug being also used in the purchase medicine detail all belongs to the target prescription detail The behavior of therapeutic regimen exception is not present in the insured people.
Further, module is obtained to be also used to select the first mesh from the more parts of prescription details according to the second preset rules Mark prescription detail;
Mark module, if being also used to there is the drug for being not belonging to the first object prescription detail in the purchase medicine detail, Then the drug for being not belonging to the first object prescription detail in the purchase medicine detail is marked, and is labeled as pending drug;
Analysis module, selects remaining target prescription detail from the remaining prescription detail, and will the pending drug and The drug that remaining target prescription detail is recorded compares one by one;
Judgment module is also used to judge in the purchase medicine detail with the presence or absence of being not belonging to the first object prescription detail Drug.
Further, it if obtaining module to be also used to the drug for being not belonging to the prescription detail is prescription medicine, obtains With the identity information of the indirect insured people of the insured artificial shared medical insurance account relationship, and according to the body of the insured people indirectly Part information and the indirect prescription detail corresponding with the indirectly insured people issued time interval, obtain each hospital;
It is bright to be also used to judge whether the drug for being not belonging to the prescription detail belongs to the indirect prescription for judgment module Carefully;
Mark module, if the drug for being also used to the prescription detail for being not belonging to insured people be also not belonging to it is described indirectly Prescription detail, then marking the insured people, there are the behaviors of therapeutic regimen exception.
Wherein, the function of modules is realized and above-mentioned therapeutic regimen exception in the identification device of above-mentioned therapeutic regimen exception Recognition methods embodiment in each step it is corresponding, function and realization process no longer repeat one by one here.
In addition, the embodiment of the present invention also provides a kind of readable storage medium storing program for executing.Therapeutic regimen is stored on readable storage medium storing program for executing Abnormal recognizer realizes any of the above-described embodiment when wherein the recognizer of therapeutic regimen exception is executed by processor The step of recognition methods of therapeutic regimen exception.
Wherein, the recognizer of therapeutic regimen exception, which is performed realized method, can refer to the more therapeutic regimens of the present invention Each embodiment of abnormal recognition methods, details are not described herein again.
It should be noted that, in this document, the terms "include", "comprise" or its any other variant are intended to non-row His property includes, so that the process, method, article or the system that include a series of elements not only include those elements, and And further include other elements that are not explicitly listed, or further include for this process, method, article or system institute it is intrinsic Element.In the absence of more restrictions, the element limited by sentence "including a ...", it is not excluded that including being somebody's turn to do There is also other identical elements in the process, method of element, article or system.
The serial number of the above embodiments of the invention is only for description, does not represent the advantages or disadvantages of the embodiments.
Through the above description of the embodiments, those skilled in the art can be understood that above-described embodiment side Method can be realized by means of software and necessary general hardware platform, naturally it is also possible to by hardware, but in many cases The former is more preferably embodiment.Based on this understanding, technical solution of the present invention substantially in other words does the prior art The part contributed out can be embodied in the form of software products, which is stored in one as described above In storage medium (such as ROM/RAM, magnetic disk, CD), including some instructions are used so that terminal device (it can be mobile phone, Computer, server, air conditioner or network equipment etc.) execute method described in each embodiment of the present invention.
The above is only a preferred embodiment of the present invention, is not intended to limit the scope of the invention, all to utilize this hair Equivalent structure or equivalent flow shift made by bright specification and accompanying drawing content is applied directly or indirectly in other relevant skills Art field, is included within the scope of the present invention.

Claims (10)

1. a kind of recognition methods of therapeutic regimen exception, which is characterized in that the recognition methods the following steps are included:
It obtains the identity information of insured people, and insured people is obtained in the target time period according to the identity information of the insured people Purchase prescription detail corresponding to medicine detail and the purchase medicine detail;
Judge in the purchase medicine detail with the presence or absence of the drug for being not belonging to the prescription detail;
If there is the drug for being not belonging to the prescription detail in the purchase medicine detail, the prescription detail is not belonging to described in judgement Whether drug is prescription medicine;
If the drug for being not belonging to the prescription detail is prescription medicine, marking the insured people, there are therapeutic regimen exceptions Behavior.
2. the recognition methods of therapeutic regimen exception as described in claim 1, which is characterized in that the identity for obtaining insured people Information, and insured people purchase medicine detail in the target time period and the purchase medicine are obtained according to the identity information of the insured people Corresponding to detail the step of prescription detail, comprising:
The purchase medicine detail of insured people in the target time period is obtained according to the identity information of insured people;
Time interval is issued according to prescription detail based on the first preset rules acquisition target purchase medicine detail;
The insured people is obtained in the diagnosis records of each hospital according to the time interval of issuing;
The prescription detail of the insured people is obtained according to the diagnosis records.
3. the recognition methods of therapeutic regimen exception as claimed in claim 2, which is characterized in that described according to the first preset rules Prescription detail includes: the step of issuing time interval based on acquisition target purchase medicine detail
It obtains the day of earliest purchase medicine behavior generation in the target time period and purchases the day of medicine behavior generation the latest;
According to the day for subtracting preset time period day and being issued earliest of earliest purchase medicine behavior generations, wherein described in when issuing Between section be the time interval formed to the day for purchasing medicine behavior generations the latest day for issuing earliest.
4. the recognition methods of therapeutic regimen exception as claimed in claim 2, which is characterized in that described to issue the time according to After section obtains the insured people the diagnosis records of each hospital the step of, further includes:
The history disease of the insured people is determined according to the diagnosis records, and analyze it is described purchase medicine detail in drug suit the medicine to the illness Disease;
Judge whether the history disease and the disease of suiting the medicine to the illness are identical;
If the history disease and the disease of suiting the medicine to the illness be not identical, the corresponding adjuvant drug range of the history disease is obtained, Judge in the purchase medicine detail with the presence or absence of the drug for belonging to the adjuvant drug range;
If marking the insured people, there are medications there is no the drug for belonging to the adjuvant drug range in the purchase medicine detail The behavior of scheme exception.
5. the recognition methods of therapeutic regimen exception as described in any one of claims 1 to 4, which is characterized in that the judgement institute The step of stating in purchase medicine detail with the presence or absence of the drug for being not belonging to the prescription detail, comprising:
A prescription detail in the more parts of prescription details is successively selected as target prescription detail according to the second preset rules;
If the drug in the purchase medicine detail all belongs to the target prescription detail, determine to be not present in the purchase medicine detail It is not belonging to the drug of the prescription detail;
If the drug moiety purchased in medicine detail is all not belonging to the target prescription detail, the purchase medicine detail is determined It is middle to there is the drug for being not belonging to the prescription detail.
6. the recognition methods of therapeutic regimen exception as claimed in claim 5, which is characterized in that described according to the second preset rules A prescription detail successively selected in the more parts of prescription details includes: as the step of target prescription detail
First object prescription detail is selected from the more parts of prescription details according to the second preset rules, judges the purchase medicine detail In with the presence or absence of being not belonging to the drug of the first object prescription detail;
Be not belonging to the drug of the first object prescription detail if existing in the purchase medicine detail, in the purchase medicine detail not The drug for belonging to the first object prescription detail is marked, and is labeled as pending drug;
Remaining target prescription detail is selected from the remaining prescription detail, and the pending drug and remaining target prescription is bright The drug carefully recorded compares one by one.
7. the recognition methods of therapeutic regimen exception according to any one of claims 1 to 4, which is characterized in that if the institute Stating and being not belonging to the drug of the prescription detail is prescription medicine, then marking the insured people, there are the steps of the behavior of therapeutic regimen exception Suddenly include:
If the drug for being not belonging to the prescription detail is prescription medicine, obtains and closed with the insured artificially shared medical insurance account The identity information of the indirect insured people of system;
According to the identity information of insured people indirectly and it is described issue time interval, it is obtaining each hospital with the indirect ginseng The corresponding indirect prescription detail of guarantor;
Whether the drug that the prescription detail is not belonging to described in judgement belongs to the indirect prescription detail;
If the drug of the prescription detail for being not belonging to insured people is also not belonging to the indirect prescription detail, described in label There are the behaviors of therapeutic regimen exception by insured people.
8. a kind of identification device of therapeutic regimen exception characterized by comprising
Module is obtained, for obtaining the identity information of insured people, and insured people is obtained according to the identity information of the insured people and is existed Prescription detail corresponding to purchase medicine detail and the purchase medicine detail in target time section;
Judgment module, for judging in the purchase medicine detail with the presence or absence of the drug for being not belonging to the prescription detail;
Mark module, if for there is the drug for being not belonging to the prescription detail in the purchase medicine detail, by the insured people Labeled as there are the behaviors of therapeutic regimen exception.
9. a kind of terminal, which is characterized in that including processor, memory and be stored on the memory and can be described The recognizer for the therapeutic regimen exception that processor executes, wherein the recognizer of therapeutic regimen exception is by the processor When execution, the step of realizing the recognition methods of therapeutic regimen exception as described in any one of claims 1 to 7.
10. a kind of readable storage medium storing program for executing, which is characterized in that be stored with the identification of therapeutic regimen exception on the readable storage medium storing program for executing Program, wherein realizing any one of claims 1 to 7 institute when the recognizer of therapeutic regimen exception is executed by processor The step of recognition methods for the therapeutic regimen exception stated.
CN201811531071.9A 2018-12-13 2018-12-13 Recognition methods, device, terminal and the readable storage medium storing program for executing of therapeutic regimen exception Pending CN109636650A (en)

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Application publication date: 20190416