JP2004126894A - Medicine determination support system and medicine determination support program - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To perform a further efficient preparation by providing information for original medicine and generic medicine in the preparation. <P>SOLUTION: The medicine price, pharmacologic effect and the like of each of original medicine and generic medicine are preliminarily recorded in a medicine database, and a generic medicine corresponding to the original medicine inputted by a doctor is automatically retrieved and displayed on a display. When the total number of the inputted medicine exceeds a number (6) determined by insurance medical care, the generic medicine is retrieved so that the drug price of the group of the same usage is a prescribed amount or less. <P>COPYRIGHT: (C)2004,JPO

Description

【００３２】

【００３３】
上述の例では、複数の後発薬品を検索結果として出力しているが、単一の後発薬品のみを出力表示するようにしても良い。例えば、当該病院に納入されている後発薬品を出力することも可能である。また、複数の後発薬品を表示し、それらのうちの実際に納品されており処方可能なもののみを異なる色（例えば赤）で表示しても良い。更に複数の後発薬品を予め製薬会社名や医薬学的判断に基づき定められた優先順位別に表示することも可能である。
【００３４】
以上のようにして、すべての処方薬の入力が終了すると（Ｓ１０４でＹＥＳ）、サーバ１０は入力された処方薬の数および合計金額を算出する（Ｓ１０５）。また、サーバ１０は処方薬の数が６剤以内か否かを判断し（Ｓ１０７）、医師用端末２０は判断結果に基づき図８に示されたような処方薬全リストをタッチパネルディスプレイ２０２に表示する。処方薬の数が６剤以内であれば（Ｓ１０７でＹＥＳ）、ステップ１２６以降の処理が実行される。
【００３５】
一方、処方薬の数が６剤を越えた場合（Ｓ１０７でＮＯ）には、医師用端末２０は処方薬全リストの画面下部に処方薬数が保険医療で定められた制限を越えた旨のメッセージを表示する。同時に、サーバ１０は入力された処方薬を服用法毎にグループ化し（Ｓ１０８）、定期処方または臨時処方を入力する（Ｓ１０９）。このようにしてグループ化された処方薬は図９に示された服用グループ別処方薬リストとしてタッチパネルディスプレイ２０２上に表示される。また、サーバ１９はグループ毎の薬価を算出し、同様に服用グループ別処方リストの画面上に表示する（Ｓ１１０）。例えば、図９に示されたように、朝１回の服用の処方薬Ａ、Ｂ、Ｄが１つのグループとしてまとめられ、これらの処方薬の薬価の合計２６５円が表示される。
【００３６】
続いて、サーバ１０は保健医療で同服用法で１剤として扱われている額Ｘ円を超えるグループがあるか否かを判断する（Ｓ１１１）。現在、定期処方では同服用法の薬品については、薬価合計が２０５円以内ならば１剤として扱われ、また、臨時処方の場合には保険医療で規定されている薬価（１００円以内）、投薬日数（２週間以内）、および臨時投薬間隔（１度、臨時処方の連続投薬を２週間行った場合には次の１週間はあけなければならない）を越えているか否かが判断される。そして、これらの制限が全て充足されるとサーバ１０が判断した場合には（Ｓ１１１でＮＯ）、ステップＳ１２６以降の処方完了処理が実行される。一方、ステップＳ１１２でＹＥＳと判断された場合には、ステップＳ１２０以降の薬品変更処理が実行される。例えば、処方薬Ａ、Ｂ、Ｄの薬価の合計が２６５円である場合には、医療保険で定められた２０５円を超えているため、サーバ１０は処方薬変更処理を実行する。
【００３７】
ステップ１２０において、サーバ１０は先後発薬品テーブル４３から処方薬Ａ、Ｂ、Ｄのそれぞれについて安価な後発商品および先発商品を検索する（Ｓ１２０、Ｓ１２１）。そして、サーバ１０は検索された後発商品等に変更した場合における薬価の再計算および表示を行い（Ｓ１２２，Ｓ１２３）、再計算額が保険医療で定めれた額の範囲内に収まるかを判断する（Ｓ１２４）。再計算額がこの範囲内に収まらなかった場合には（Ｓ１２４でＮＯ）、当該範囲に収まるまでサーバ１０はステップＳ１２０〜Ｓ１２４の処理を繰り返し実行する。
【００３８】
例えば、処方薬Ａの後発薬品ａが検索された場合には、薬価４０円の薬品ａに変更した場合の薬価合計金額１０５円が求められる。変更後の合計金額１０５円は保険医療で定められた２０５円より低いので、医師用端末２０は薬品ａを処方薬Ａの代替品の候補として医師に提示する。
【００３９】
医師は提示された薬品を処方薬として決定するか否かを判断し（Ｓ１２５）、判断の結果がＮＯであれば医師は服用グループ別処方薬リストの下部の「ＮＯ」のボタンをクリックし、ステップＳ１２０〜Ｓ１２５の処理が繰り返し実行される。一方、医師が変更後の薬品を処方すると判断した場合（Ｓ１２５でＹＥＳ）には、「ＹＥＳ」のボタンをクリックし、ステップＳ１２６以降の処方完了処理が実行される。
【００４０】
ステップＳ１２６において、サーバ１０は変更後の薬品ａを含む処方薬全リストを改めて作成し、これをタッチパネルディスプレイ２０２上に表示する（図１０参照）。また、サーバ１０は変更後の処方薬全リストの下部に処方薬が保健医療範囲内である旨のメッセージを表示し、医師に処方の確認を促す。医師が処方薬の最終確認を行い、同画面下部の「ＹＥＳ」のボタンをクリックすると、サーバ１０は処方薬の情報を記録する（Ｓ１２６）。また、この情報はサーバ１０から医療事務用端末３０に送信され、プリンタ３０３から処方箋および請求書等が印刷され、処理が終了する。
【００４１】
以下に、上述のステップＳ１０７〜Ｓ１２５において示された処方薬の変更処理を具体例を用いてさらに詳細に説明する。ステップＳ１０１〜Ｓ１０４の薬品検索処理によって、以下に示す処方薬全リストがタッチパネルディスプレイ２０２に表示される。
【００４２】

【００４３】
この場合には、薬剤数が保険医療で定められた６剤を超えているため、医師用端末２０は処方薬の変更の要否を医師に確認する。医師が処方薬を変更すると判断した場合には、サーバ１０は同じ服用法の薬品のグループの薬価の合計を算出する。各々のグループ別所用薬リストは以下のようになる。
【００４４】

【００４５】
以上の算出結果に基づき、サーバ１０は薬価合計金額が保険医療で定められた額２０５円を超えるグループがあるか否かを判断する（Ｓ１１１）。グループ２，３の薬価合計は２０５円以内であるが、グループ１の薬価合計は２０５円を超えているため、サーバ１０はグループ１の薬品変更処理を行う（ステップＳ１２０〜Ｓ１２５）。
【００４６】
サーバ１０は、グループ１の各々の商品の後発商品を薬品データベースから検索する。検索結果を以下に示す。なお、この例では、後発商品を複数表示しているが、上述のように、実際に病院に納品されている単一の後発商品のみを表示しても良い。

【００４７】
先発商品テノーミンの薬価７６．４０円に対して、後発商品トーワミンの薬価は１４．８０円となり、その差額は５１．６０円となる。よって、サーバ１０はトーワミンを選択し、グループ１の薬価を再計算する（Ｓ１２２）。計算結果は以下のようになる。
【００４８】

【００４９】
グループ１の薬価合計が保険医療で定められた額２０５円以内、すなわち１６９．２０円となり、グループ１の３剤を１剤として扱うことが可能となる。よって、グループ１、２、３の各々が保健医療上においては１剤として扱われるため、全体の薬剤数は３剤とみなされ、また、各グループの薬価合計は２０５円以内となる（ステップＳ１２４でＹＥＳ）。変更後の処方薬全リストは以下のようになる。
【００５０】

【００５１】
なお、先発商品に対応する後発商品がない場合には、先発商品と同様の薬理効果を有する薬品を検索することも可能である。例えば、先発商品ブロプレス（４）（薬価１０５．１０円）はアンギオテンシンＩＩ受容体阻害薬としての薬理効果を有しており、サーバ１０は薬理学的情報テーブル４４から同様の主作用を有する他の薬品を検索することができる。
【００５２】

【００５３】
以上説明したように、本発明によれば、処方の際に先発薬品および後発薬品等の情報を提供するとともに、より安価な後発薬品を自動的に検索することにより、効率的な処方を行うことが可能となる。また、薬理作用等に基づき薬品を検索することも可能となるので、医療現場において迅速に処方薬を決定することができる。
【００５４】
また、処方薬数が保険医療で定められた数を超えた場合には、同服用法のグループの薬品をより安価な後発薬品に自動的に変更することにより、経済的な処方を行うことが可能となる。
【００５５】
さらに、保険医療下において経済的な処方を行うことができ、医療機関の経営に役立つと同時に過剰投薬の予防や患者の薬の負担額を軽減する効果も合わせ持つ。更には研修医や学生の実践処方の教育にも役立ち、後発品を取り扱う製薬会社の重要性を再認識させ業界の支援にもなる。
【００５６】
なお、本発明は上述の実施形態に限定されるものではなく、本発明の趣旨を逸脱しない範囲において変更適用され得るものである。
【図面の簡単な説明】
【図１】本発明の一実施形態に係る薬品決定支援システムの概略構成図である。；
【図２】本発明の一実施形態に係る薬品データベースの構造を表す図である。
【図３】本発明の一実施形態に係るマスターテーブルを表す図である。
【図４】本発明の一実施形態に係る薬品データベースを表す図である。
【図５】本発明の一実施形態に係る先後発薬品テーブルを表す図である。
【図６】本発明の一実施形態に係る薬理学的情報テーブルを表す図である。
【図７】本発明の一実施形態に係る薬剤検索メニューを表す図である。
【図８】本発明の一実施形態に係る処方薬全リストを表す図である。
【図９】本発明の一実施形態に係る服用グループ別処方薬リストを表す図である。
【図１０】本発明の一実施形態に係る変更後の処方薬全リストを表す図である。
【図１１】本発明の一実施形態に係る薬品決定支援システムの動作を表すフローチャートである。
【図１２】本発明の一実施形態に係る薬品決定支援システムの動作を表すフローチャートである。
【符号の説明】
１０　サーバ（検索手段、制御手段）
１０１　サーバ本体
２０　医師用端末（指定手段）
２０２　タッチパネルディスプレイ（表示手段）
３０　医療事務用端末
４１　マスターテーブル
４２　薬品テーブル
４３　先後発薬品テーブル
４４　薬理学的情報テーブル[0001]
TECHNICAL FIELD OF THE INVENTION
The present invention relates to a drug decision support system, a drug decision support method, and a drug decision support program. More specifically, the present invention provides medical personnel with information on drugs necessary for proper prescription at a medical site based on a database stored in a computer. The present invention relates to a drug determination support system and a drug determination support program for simply and accurately determining a drug by doing so.
[0002]
[Prior art]
At present, a huge variety of medicines are distributed in medical practice, and medical staff are required to accurately determine and prescribe the most appropriate medicine from these. At the same time, in order to reduce the burden of medical expenses on patients and the like, it is desirable to prescribe drugs that reduce medical expenses as much as possible. However, in the current medical system, it is difficult to prescribe a medicine that reduces medical costs for the following reasons.
[0003]
First, there are expensive new drugs (innovative products) and drugs having similar pharmacological actions (generic drugs) made of similar compounds after the expiration of the patent period of the new drugs, and are low in price. It is possible to reduce medical costs by prescribing generic drugs. However, in general, physicians are often familiar with the pharmacological effects and indications of original products, but often do not have sufficient knowledge of newly developed generic products. In the medical field, it is required to determine a prescription drug in a short time, and at present, there is no time to search for a cheaper generic drug in a new drug dictionary every time a prescription is made. For this reason, despite the existence of low-priced generic drugs, doctors tend to continue prescribing expensive original drugs, which contributes to an increase in the burden of medical expenses on the patient side. In addition, innovator drugs are not only expensive, but also because the difference between the amount delivered and the drug price is small, the profits on the medical side are easily squeezed.
[0004]
Second, because there is no room to prescribe while sufficiently examining the medical insurance system, the prescription exceeds the limit of the insurance claim, which may cause an unexpected loss to the medical institution. In the current medical insurance system, there is a limit of six drugs within 205 yen per drug, and if this limit is exceeded, 10% of the drug price claim will be reduced. However, there is a rule that a plurality of drugs having the same dosing method and falling within 205 yen are regarded as one drug, and even if a prescription exceeding six drugs is made, it is treated as a prescription of six drugs or less. It is difficult for healthcare professionals to prescribe while always considering these regulations, often resulting in loss to medical institutions. Most of the public high-ranking medical institutions, especially the National University Hospital, which is heading for independence, are in the red. High.
[0005]
[Problems to be solved by the invention]
The present invention has been made in view of the above-described problems, and a first object of the present invention is to provide an efficient prescription by providing information such as an original drug and a generic drug at the time of prescription. It is in.
[0006]
It is a further object of the present invention to be able to determine the most efficient prescription in insurance medicine.
[0007]
[Means for Solving the Problems]
SUMMARY OF THE INVENTION In order to solve the above-described problem, the present invention provides a storage unit that stores a database of pharmacological actions and drug prices for a plurality of drugs, a specifying unit that specifies a drug, and a pharmacological action similar to the pharmacological action of the specified drug. The storage device includes a search unit that searches the storage unit for another medicine that the storage unit has, a display unit that displays information of the other medicine, and a change unit that changes the designated medicine to the other medicine.
[0008]
Further, the present invention further comprises control means for classifying the plurality of medicines designated by the designation means into groups for each dosing method, and for calculating the sum of drug prices for each group, and wherein the search means comprises: When the number of agents of the given drug exceeds a predetermined number, the other drugs having the same pharmacological effect as the pharmacological effect of the drugs in the group so that the total drug price of the group is equal to or less than a predetermined amount. Retrieve from storage means.
[0009]
The control unit considers the group including the other medicine after the change as one medicine, calculates the number of medicines of the designated medicine, and the display means displays the number of medicines.
[0010]
Further, the other drug is (1) released after the drug,
At least one of the following conditions is satisfied: (2) the drug is released before the drug, (3) the drug price is lower than the drug price of the drug, and (4) the drug price is higher than the drug price of the drug.
[0011]
According to the present invention, a step of storing a database of pharmacological actions and drug prices relating to a plurality of drugs, a step of specifying a drug, and retrieving another drug having the same pharmacological action as the pharmacological action of the specified drug from the database. A step of displaying information of the other medicine, and a step of changing the designated medicine to the other medicine.
[0012]
The present invention also includes a step of classifying the plurality of designated medicines into groups for each dosing method and calculating a total of drug prices for each group, wherein the number of medicines of the designated medicines exceeds a predetermined number. In this case, the method further comprises a step of searching the database for another drug having the same pharmacological effect as the pharmacological effect of the drug in the group so that the total drug price of the group is equal to or less than a predetermined amount.
[0013]
BEST MODE FOR CARRYING OUT THE INVENTION
Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings.
[0014]
FIG. 1 is a schematic diagram of a medicine determination support system according to the present embodiment. The medicine determination support system includes a server 10, a doctor terminal 20, and a medical office terminal 30. The doctor terminal 20 is arranged at a place where a doctor is engaged, such as a consultation room, and the medical office terminal 30 is arranged at a medical office at a location remote from the doctor terminal 20.
[0015]
The server 10 includes a server main body 101, an external storage device 102, a scanner 103, a modem 104, and a local network hub 105, and provides information regarding medicine to the doctor terminal 20 and the medical office terminal 30. The server main body 101 is composed of a processor, a memory, a hard disk, and the like, and has a function of searching a database relating to medicines in response to a request from the doctor terminal 20 or the medical office terminal 30, and presenting the result. The external storage device 102 is used as a backup of a database or the like, and is composed of an MO, a CD-R, a DVD-RAM, and the like. The scanner 103 is for optically reading book information, a patient's chart, and the like for constructing a medicine database, and storing the information as electronic data in the server main body 101. The modem 104 connects the Internet and the server main body 101 via an external line 106 such as an optical fiber or DSL. Thus, by connecting the Internet and the server main body 101, it is possible to always update the medicine database to the latest one. The local network hub 105 enables connection with a plurality of terminals, and constructs a local network such as Ethernet.
[0016]
The doctor terminal 20 includes a terminal body 201, a touch panel display 202, a handwritten character recognition unit 203, and a printer 204. The terminal body 101 is configured by a processor, a memory, and the like, and has a function of accessing a medicine database transmitted from the server 10. The touch panel display 202 includes a liquid crystal display or a CRT display and a touch panel attached to a display surface. The doctor can quickly perform operations such as searching the database while directly touching buttons on the display screen. The handwritten character recognition unit 203 has a sensor that electromagnetically reads the XY coordinates of the pen tip, and is for storing characters written on a paper chart as an electronic chart. The printer is used to print a search result of the medicine database, information of a medical record, and the like.
[0017]
The medical office terminal 30 includes a terminal body 301, a display 302, a printer 303, and a handwritten character recognition unit 303. The terminal main body 301 is for performing processing such as insurance claims based on the prescription created by the doctor terminal 20 via the server 10. The printer 303 prints prescriptions, bills, and the like, and the handwritten character recognition unit 303 is used when a medical clerk inputs bills.
[0018]
FIG. 2 is a diagram illustrating a structure of the medicine database. This medicine database is recorded in the server main body 101, and constitutes a relational database including a master table 41, a medicine table 42, a generic medicine table 43, and a pharmacological information table 44. The master table 41 is associated with the medicine table 42 via a group code unique to the group name.
[0019]
The medicine table 42 indicates main information of the medicine, and has data fields of a product name, a unit, a dosage form, a drug price, a pharmacological information code, an indication disease, a pharmaceutical company name, and a drug type. The medicine table 42 is associated with the advanced medicine table 43 via a medicine code, and is associated with the pharmacological information table 44 via a pharmacological information code. By configuring a plurality of tables as a relational database in this way, it is possible to easily change each table.
[0020]
FIG. 3 shows details of the master table 41. The master table 41 includes a group name and a group code unique to the group name. A group name can be set when a hospital-specific database is constructed or when a different database is constructed for each department. For example, it is possible to construct a dedicated database for each different group, such as A clinic internal medicine, A clinic surgery, A clinic pediatrics, B clinic dermatology, B clinic otolaryngology, and the like.
[0021]
FIG. 4 shows details of the medicine table 42. The medicine code and the pharmacological information code in the medicine table 42 are assigned unique values for each data record in the medicine table 42. In addition, “001” is added to the data field of the group code, and it can be confirmed that the database is for the clinic A. In the data field of the product name, for example, names such as “Eyglucon” and “Pamilcon” are recorded, and information on the drug is data unit, dosage form, drug price, applicable disease, pharmaceutical company name, and drug type data field. Recorded in. It should be noted that the unit of the drug price can be represented by a medical insurance score or a circle.
[0022]
FIG. 5 shows details of the generic drug code. In this figure, the drug code has a unique value for each data record, and for example, “AX0001” indicates that it relates to the data record of “Eiglecon” in the drug table 42. Then, the original drug and the new drug of “Eyglucon” are recorded in the respective data fields. The generic drug names "Damsel", "Hizoglaside", and "Pamilcon" of "Eyglucon" are written in the data field of the generic product. By writing the drug code together with each product name, information on the searched generic drug can be quickly read from the drug table 42.
[0023]
FIG. 6 is a diagram showing details of the pharmaceutical information table. The data record of the pharmacological information table 44 is associated with the medicine table 42 via a pharmacological information code unique to the medicine. The pharmacological information table 44 includes main actions, side effects, interactions, precautions, action time, half-life, mechanism of action, pharmacological effects and treatment methods due to gene mutation, and pharmacological effects and treatment methods due to protein function. , And the data fields of the dosage regimen. In the present embodiment, it is also possible to search based on any of these data fields. For example, it is possible to search for a drug having a main effect of “low blood glucose level”.
[0024]
Next, an operation screen according to the present embodiment will be described with reference to FIGS. FIG. 7 is a diagram illustrating an example of a screen of the drug search menu. The drug search menu is displayed on the doctor's terminal 20. The doctor can select a drug from any of the following items: product name, original product, generic product, type of drug, main effect, indication, drug price, and pharmaceutical company name. It is possible to search for For example, by inputting "Oi Glucon" in the item of the product name and clicking a button for starting the search, each information of the Oi Glucon drug table 42, the advanced drug table 43, and the pharmacological information table 44 is stored in the doctor terminal 20. Will be displayed. The doctor can determine a prescription drug while referring to the information.
[0025]
FIG. 8 shows an example of a screen of a list of all prescription drugs. This list of all prescription drugs is a screen for displaying all the prescription drugs sequentially determined using the above-described drug search menu. On the screen, the patient's name, product name, drug price, dosing method, etc. are displayed, and if the number of prescription drugs exceeds the number prescribed by insurance medical care, that fact is displayed. To change the displayed prescription drug, by clicking the “NO” button at the bottom of the screen, the prescription drug list for each dose group shown in FIG. 9 is displayed. In addition, it is also possible to configure so that the following automatic change processing is performed by the computer without the doctor inputting the possibility of the change.
[0026]
The prescription medicine list for each administration group shown in FIG. 9 is for displaying the medicine of the same administration method, the medicine price, the medicine of the change candidate, and the like from the medicines shown in the entire prescription medicine list. In this screen example, the medicines A, B, D taken once in the morning, the drug price, and the total drug price of 265 yen are shown. In addition, a change candidate drug a whose total amount is within 205 yen specified by insurance medical care is displayed, and a total amount of 105 yen of the dose group when the change is made to this drug a is presented to the doctor. You. If the doctor determines that the presented drug is appropriate, the doctor clicks the “YES” button at the bottom of the screen to determine the changed drug.
[0027]
FIG. 10 is a diagram illustrating an example of a screen of the prescription medicine all list after change. If it is determined that the prescription drug containing the changed product a is compatible with health care, a message as shown in the figure is displayed at the bottom of the screen.
[0028]
Subsequently, the operation of the drug determination support system according to the present embodiment will be described with reference to FIGS.
[0029]
When the patient comes to the hospital, the medical clerk inputs the patient's name and the like to the medical clerk terminal 30, and the server 10 reads out the patient information (S101). When an IC card or the like is used as the consultation ticket, the patient information can be automatically read out by inserting the IC card into a card reader. If the patient is a new patient, a data file of the patient is newly created on the server 10.
[0030]
In the consultation room, the doctor inputs the product name, the dose, the dosing method (the number of times of medication per day, the medication time), and the number of days of medication that are considered appropriate as a result of the patient's diagnosis. The input product name and the like are transmitted from the doctor terminal 20 to the server 10. At this time, the doctor can access the medicine database and search for a desired medicine (S102). For example, it is possible to search for a cheaper generic drug by inputting a product name in the drug search menu shown in FIG. Further, it is also possible to input a patient's indication disease and search for a drug suitable for the indication disease. When the desired medicine is found, the doctor inputs the medicine to the touch panel display 202 as a prescription medicine (S103). The doctor repeatedly executes the processing of steps S102 to S103 until all necessary prescription drugs have been input to the patient.
[0031]
The following is a specific example of the result searched in step S102.

[0032]

[0033]
In the above example, a plurality of generic drugs are output as search results, but only a single generic drug may be output and displayed. For example, it is possible to output a generic drug delivered to the hospital. Alternatively, a plurality of generic drugs may be displayed, and only those actually delivered and prescribeable among them may be displayed in a different color (for example, red). Further, it is also possible to display a plurality of generic drugs by priorities determined in advance based on the name of the pharmaceutical company and medical judgment.
[0034]
When the input of all prescription drugs is completed as described above (YES in S104), server 10 calculates the number of prescription drugs and the total price (S105). Further, the server 10 determines whether or not the number of prescription drugs is within six (S107), and the doctor terminal 20 displays a list of all prescription drugs as shown in FIG. 8 on the touch panel display 202 based on the determination result. I do. If the number of prescription drugs is less than or equal to six (YES in S107), the processing from step 126 onward is executed.
[0035]
On the other hand, if the number of prescription drugs exceeds six drugs (NO in S107), the doctor's terminal 20 displays a message at the bottom of the screen of the list of all prescription drugs indicating that the number of prescription drugs has exceeded the limit prescribed by insurance medical care. Display a message. At the same time, the server 10 groups the inputted prescription medicines for each dosing method (S108), and inputs a regular prescription or a temporary prescription (S109). The prescription drugs grouped in this way are displayed on the touch panel display 202 as a prescription drug list for each dose group shown in FIG. Further, the server 19 calculates the drug price for each group and similarly displays it on the screen of the prescription list for each dose group (S110). For example, as shown in FIG. 9, prescription drugs A, B, and D taken once in the morning are grouped as one group, and a total price of 265 yen of these prescription drugs is displayed.
[0036]
Subsequently, the server 10 determines whether or not there is a group exceeding the amount X yen treated as one medicine in the same dosage method in health care (S111). At present, in the case of regular prescription, drugs with the same dosage method are treated as one drug if the total drug price is less than 205 yen, and in the case of temporary prescription, the drug price (within 100 yen) prescribed by insurance medical care, medication It is determined whether the number of days (within two weeks) and the temporary medication interval (one consecutive medication of the temporary prescription for two weeks must be opened for the next week) are exceeded. Then, when the server 10 determines that all of these restrictions are satisfied (NO in S111), the prescription completion processing from step S126 is executed. On the other hand, if YES is determined in the step S112, the medicine changing process from the step S120 is executed. For example, when the sum of the drug prices of the prescription drugs A, B, and D is 265 yen, the server 10 executes prescription drug change processing because it exceeds 205 yen specified by medical insurance.
[0037]
In step 120, the server 10 searches the generic drug table 43 for inexpensive generic products and generic products for each of the prescription drugs A, B, and D (S120, S121). Then, the server 10 recalculates and displays the drug price in the case of changing to the searched generic product (S122, S123), and determines whether or not the recalculated amount falls within the range defined by the insurance medical care. (S124). If the recalculated amount does not fall within this range (NO in S124), the server 10 repeatedly executes the processing of steps S120 to S124 until it falls within the range.
[0038]
For example, when the generic drug a of the prescription drug A is searched, the total drug price of 105 yen when the drug a is changed to the drug price of 40 yen is obtained. Since the total amount of 105 yen after the change is lower than 205 yen specified in the medical insurance, the doctor terminal 20 presents the medicine a to the doctor as a candidate for a substitute for the prescription medicine A.
[0039]
The doctor determines whether or not to determine the presented drug as a prescription drug (S125). If the determination result is NO, the doctor clicks the "NO" button at the bottom of the prescription drug list by dose group, Steps S120 to S125 are repeatedly executed. On the other hand, if the doctor determines to prescribe the changed drug (YES in S125), the user clicks the “YES” button, and prescription completion processing in step S126 and subsequent steps is executed.
[0040]
In step S126, the server 10 newly creates a list of all prescription medicines including the medicine a after the change, and displays this on the touch panel display 202 (see FIG. 10). Further, the server 10 displays a message to the effect that the prescription drug is within the health care range at the bottom of the changed prescription drug list, and prompts the doctor to confirm the prescription. When the doctor makes a final check on the prescription drug and clicks the "YES" button at the bottom of the screen, the server 10 records the prescription drug information (S126). Further, this information is transmitted from the server 10 to the medical office terminal 30, the prescription and the bill are printed from the printer 303, and the process ends.
[0041]
Hereinafter, the prescription medicine changing process shown in steps S107 to S125 will be described in more detail using a specific example. By the medicine search processing in steps S101 to S104, the following list of all prescription medicines is displayed on the touch panel display 202.
[0042]

[0043]
In this case, since the number of medicines exceeds six medicines prescribed in the medical insurance, the doctor terminal 20 checks with the doctor whether it is necessary to change the prescription medicine. If the doctor determines that the prescription should be changed, the server 10 calculates the sum of the drug prices of the groups of drugs of the same dosage regimen. The list of medications for each group is as follows.
[0044]

[0045]
Based on the above calculation results, the server 10 determines whether or not there is a group whose total drug price exceeds 205 yen specified by insurance medical care (S111). The total drug price of the groups 2 and 3 is within 205 yen, but the total drug price of the group 1 exceeds 205 yen, so the server 10 performs the drug change process of the group 1 (steps S120 to S125).
[0046]
The server 10 searches the drug database for a generic product of each product of the group 1. The search results are shown below. In this example, a plurality of subsequent products are displayed. However, as described above, only a single subsequent product actually delivered to the hospital may be displayed.

[0047]
While the drug price of the original product Tenormin is 76.40 yen, the drug price of the generic product Towamin is 14.80 yen, and the difference is 51.60 yen. Therefore, the server 10 selects towamin and recalculates the drug price of group 1 (S122). The calculation result is as follows.
[0048]

[0049]
The total drug price of Group 1 is less than the amount prescribed by insurance medical care of 205 yen, that is, 169.20 yen, and the three drugs of Group 1 can be treated as one drug. Accordingly, since each of the groups 1, 2, and 3 is treated as one drug in health care, the total number of drugs is regarded as three drugs, and the total drug price of each group is within 205 yen (step S124). YES). The full list of prescription drugs after the change is as follows.
[0050]

[0051]
If there is no subsequent product corresponding to the first product, it is also possible to search for a drug having the same pharmacological effect as the first product. For example, the original product Blopress (4) (pharmaceutical price 105.10 yen) has a pharmacological effect as an angiotensin II receptor inhibitor, and the server 10 has another pharmacological effect from the pharmacological information table 44. You can search for drugs.
[0052]

[0053]
As described above, according to the present invention, it is possible to provide information such as an initial drug and a generic drug at the time of prescription, and to perform an efficient prescription by automatically searching for a cheaper generic drug. Becomes possible. In addition, since it becomes possible to search for a drug based on a pharmacological action or the like, a prescribed drug can be quickly determined at a medical site.
[0054]
Also, if the number of prescription drugs exceeds the number prescribed by insurance medicine, economical prescriptions can be made by automatically changing the drugs in the same dosage group to cheaper generic drugs. It becomes possible.
[0055]
Furthermore, it can provide economical prescribing under medical insurance, which is useful for the management of medical institutions, and also has the effect of preventing overdose and reducing the burden on patients. It will also help train residents and students in practicing prescribing, helping the industry to reaffirm the importance of pharmaceutical companies handling generics.
[0056]
Note that the present invention is not limited to the above-described embodiment, and can be modified and applied without departing from the gist of the present invention.
[Brief description of the drawings]
FIG. 1 is a schematic configuration diagram of a medicine determination support system according to an embodiment of the present invention. ;
FIG. 2 is a diagram illustrating a structure of a medicine database according to an embodiment of the present invention.
FIG. 3 is a diagram illustrating a master table according to an embodiment of the present invention.
FIG. 4 is a diagram showing a medicine database according to one embodiment of the present invention.
FIG. 5 is a diagram illustrating a generic drug table according to an embodiment of the present invention.
FIG. 6 is a diagram showing a pharmacological information table according to one embodiment of the present invention.
FIG. 7 is a diagram showing a medicine search menu according to one embodiment of the present invention.
FIG. 8 is a diagram showing a list of all prescription drugs according to an embodiment of the present invention.
FIG. 9 is a diagram showing a prescription medicine list by dose group according to an embodiment of the present invention.
FIG. 10 is a diagram showing a list of all prescription drugs after change according to an embodiment of the present invention.
FIG. 11 is a flowchart illustrating an operation of the medicine determination support system according to the embodiment of the present invention.
FIG. 12 is a flowchart showing the operation of the drug determination support system according to one embodiment of the present invention.
[Explanation of symbols]
10 server (search means, control means)
101 server body 20 doctor terminal (designation means)
202 Touch panel display (display means)
30 Medical office terminal 41 Master table 42 Drug table 43 Generic drug table 44 Pharmacological information table

Claims (6)

Storage means for storing a database of pharmacological actions and drug prices for a plurality of drugs,
A designation means for designating a medicine to be prescribed;
Search means for searching the storage means for another drug having the same pharmacological action as the pharmacological action of the specified drug,
Display means for displaying information of the other drug,
Changing means for changing the designated medicine to the other medicine. Control means for classifying the plurality of medicines designated by the designation means into groups for each dosage regimen, and calculating the sum of drug prices for each group,
The retrieving means is configured to provide a pharmacological effect similar to the pharmacological effect of the medicines in the group such that when the number of medicines of the designated medicine exceeds a predetermined number, the sum of the drug prices of the group is equal to or less than a predetermined amount. 2. The medicine determination support system according to claim 1, wherein another medicine having the following is retrieved from the storage unit. The control unit regards a group including another drug after the change as one drug, calculates the number of drugs of the designated drug,
3. The medicine determination support system according to claim 2, wherein the display unit displays the number of the medicines. The other drug is
(1) released after the drug,
(2) released before the drug,
(3) the drug price is lower than the drug price of the drug;
(4) the drug price is higher than the drug price of the drug;
The drug decision support system according to claim 1, wherein at least one of the following conditions is satisfied. Storing a database of pharmacological actions and drug prices for the plurality of drugs;
Specifying a drug;
A step of searching the database for another drug having the same pharmacological action as the pharmacological action of the specified drug, replacing the specified drug with the other drug, and displaying information of the other drug. Support program for making a computer execute the program. Classifying the plurality of specified medicines into groups for each dosage method, and calculating a total of drug prices for each group;
Another drug having the same pharmacological effect as the pharmacological effect of the drug in the group so that when the number of drugs of the specified drug exceeds a predetermined number, the sum of the drug prices of the group is equal to or less than a predetermined amount. The drug determination support program according to claim 5, further comprising a step of retrieving from the database.

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