A MEDICAL PRESCRIPTION TRANSMITTING SYSTEM AND MEDICAL PRESCRIPTION TRANSMITTING METHOD
TECHNICAL FIELD
This invention relates to systems and methods for transmitting prescriptions from hospitals to remote drugstores, and more particularly, which enable patients to select drugstores by using self-service terminals such as kiosks, and then to transmit prescription information, patient information and price of medicine information and/or payment thereof to the selected drugstore simultaneously issuing a prescription.
DESCRIPTION OF THE BACKGROUND ART
According to enforcement of the separation of pharmacy and clinic, several systems and methods have been used for transmitting prescription from hospitals to drugstores. This prior several systems and methods still give inconvenience to hospitals, drugstores and patients.
Followings are illustrations of various systems and methods related to prior several systems and methods for transmitting prescriptions, and the problem therein is described in detail.
FIG. 11 shows a commonly used well known method, i.e., patients receive prescriptions directly in hospitals, then visit drugstores ■ located in convenient place, and take the compounded medicine. According to this method, since a patient should visit a drugstore with bringing a prescription issued in a hospital, it takes a lot of time for the patient to reach the drugstore and wait until a medical compounding
is completed even after he/she submits the prescription. Moreover, if the visited drugstore does not possess the required medicines, the patient should wander in search of another drugstores. Therefore, this method is very inconvenient for patients and gives an economical loss such as waste of time and transportation expenses. Besides, it is possible for pharmaceutists to raise price of preparations unilaterally.
As another prior art, facsimiles have been used to transmit prescriptions. According to this method, after a patient sees a doctor, he/she transmits his/her prescription by facsimile to a desired drugstore for checking whether the drugstore possesses required medicines or not, and next, he/she visits the drugstore possessing the required medicines.
Though this method may reduce the waiting time for compounding of medicines that is needed for patients after arriving at drugstores, most of patients still feel inconvenience using this system because facsimile should be installed, and an ordinary person does not know how to use a facsimile. Another problems of this system is that fax transmissions frequently incurs transmission errors caused by interruption of a telephone line, and even in normal state, speed of transmission is not fast enough. In addition, this system needs phone calls for checking whether prescriptions are received or not.
Besides, since a fax transmission does not allow a conversation in both directions, it is impossible for phamaceutists to reply to patients in advance, even when the selected drugstores have not possessed medicines indicated in the prescriptions. Accordingly it needs a telephone call for checking the possession of medicines, and otherwise, patients may have to go in search of
several drugstores .
It is another problem of the above system that mis- compounding of medicines can be caused by unclear transmission of prescription due to the degradation of fax device. In respect of drugstores, if patients do not visit the drugstores after they have transmitted prescriptions, pharmaceutists may suffer a loss. Therefore, pharmaceutists may avoid compounding medicines even after they have received prescriptions via facsimile. As another prior art, it has been used that pharmaceutists down load prescriptions from the relevant web server of hospitals in on-line. In this system, prescriptions are saved in the web servers of hospitals and also issued to patients. A patient can visit convenient drugstore with a prescription and submit it to a pharmaceutist. The pharmaceutist then connects to the web server of a relevant hospital and down load the relevant prescription.
This method can on-line transmit the prescriptions but cannot solve another serious problem that arisen when the visited drugstore has not possessed the required medicines. This system also fails to reduce a waiting time in the drugstores until phamaceutists complete compounding, and patients should pay charges of medicines separately at drugstores. It has also practical problems related to security because hospital servers should be opened.
As another prior art, it has been used that doctors or staffs in charge of receipt in hospital transmit prescriptions via Internet to drugstores selected by patients .
According to this method, it needs a time to transmit prescriptions per patients because the doctors
or staffs should transmit prescriptions after they ask to patients about their desired drugstores. It is also impossible to check the status even though in case of that prescriptions are not transmitted by disorders of computer systems.
In the prior known Internet transmission system, it needs a time for reviewing information of prescriptions whenever pharmaceutists are receiving prescriptions since hospitals and drugstores are using different medicine codes respectively.
According to this method, since merely data are transmitted to drugstores and it is not guaranteed whether patients will visit the drugstores, phamaceutists may avoid compounding a medicine prior to arrival of patients. It has a possibility that staffs in hospital transmit to only specified drugstores and it may cause collusion between hospitals and drugstores.
Besides, there is no countermeasure for the case that doctors make out wrong prescriptions because the prior known Internet system cannot trace transmitted drugstores. From the hospital's point of view, it is hard to manage patients because doctors cannot know even when drugstores use substitute medicines instead of that indicated in prescriptions. None of these prior arts provide delivery means for conveying medicines to drugstores so that drugstores should have various kinds of medicines corresponding to every patient. It could be a great burden to drugstores.
In addition, all the prior arts fail to eliminate inconveniences of patients because patients should come back to hospitals after receiving an injection in drugstores in case injections are needed. It is a time consumable and is not economical for patients. Moreover,
since patients are moving their injection themselves, it may bring about accidents caused by careless treatment of the injection.
SUMMARY OF THE INVENTION
In accordance with the present invention, a patient may select a drugstore via a self-service terminal such as a kiosk which is displaying drugstores that may make up medical compounding as indicated in the prescription, and pay the charge for medicine; a prescription is online transmitted to the selected drugstore and also issued to a patient simultaneously so as that a patient may receive a preparation as soon as he/she visits the drugstore to submit the prescription; drugstores may treat various prescriptions without possessing great deal of medicines because pharmaceutists may order a delivery of medicines from warehouses in case of absence of prescribed medicines. The system and method of the present invention can eliminate waiting time of patients required for compounding medicines after they arrived of drugstores and provides pre-settlement means preventing the loss of a compounding cost that is arisen a patient does not call at the drugstore after transmitting a prescription.
An object of the invention is to eliminate a possibility of mutual consent between hospitals and drugstores by providing selecting means by which patients may select drugstores by themselves. Another object of the invention is to shorten the moving distance to drugstores and minimize a waiting time spends in hospital by issuing prescription via terminals
(for example, kiosks) immediately after patients pay
doctors bills. According to the invention, prescriptions are transmitted to the desired drugstores and phamaceutists prepare medicines in advance before patients arrive at a remote drugstore so as to eliminate the waiting time required in the drugstore for compounding of medicines. In addition, according to the invention, patients need not to go in search for the drugstore possessing the medicines indicated in prescriptions . Another object of the invention is to provide a prescriptions tracing system by which doctors may know the selected drugstores so that when there is an error in a prescription, they can inform the error to the drugstore so to correct it before a phamaceutist prepares medicines.
Besides, in a position of drugstores they are provided with a method to secure a medicine rapidly and stably at necessary point without preparing prescribed medicine previously so medicine stock can be minimized. The drug stores that the electronic prescription are transmitted to, search medicine stock and judge whether they can prepare the medicine. Without medicine stock, they have to order the medicine using a medicine code. In case of insurance medicine, they can use medicine code provided by the institute of inspection and estimation. If the medicine is not the insurance medicine, they have to convert the non-insurance medicine to a publicized code because of not having standardized code. Since an insurance medicine code used in drugstore is different from package unit code used in distribution in many cases, drugstores have to refer to these codes. Also, drugstores must ascertain medicine stock in materials distributor, the materials distributor provides means to manage credit
limit within which drug stores can order the medicine.
Another object of this invention, in case of a children patient and a geriatric patient who are difficult to move, low frequency prescribed medicine and an injection prescription, the medicine ordered in prescription is delivered from drug store and administrated to the patient in hospital. Thus, in order to reduce time loss of the patient and previously prevent accidents as the patient directly transports the medicine, a patient-centered, prescription transmitting method to embody a delivery service is provided.
To achieve the above described objects, the invention provides the transmission system of prescription. In the transmission system of prescription, the patient selects drug store personally and prescription is automatically transmitted to selected drug store on line. The transmission system of prescription comprises a kiosk system, wherein it consists of a hospital server and terminal fitted up at each part and has a separate prescription transmission server endowed with IP address permitted to access to the hospital server for the protection of various information of hospital, it is equipped with hospital computer system to process every computation operation of hospital, a central controlling device, a image display part for providing a image display and a function to input by finger touch simultaneously, a card reader for performing identification and receipt, a cash treatment part, a communication module for network interface for performing network connection, it performs automatic transmission function of prescription; a prescription relay system with commercial communication firm for relaying prescription between drugstore and materials distributor
via public communication network; a pharmacy management system for performing all pharmacy management affairs, wherein it has an separate pharmacy server, and pharmacy terminal to deliver the contents of prescription to pharmacist or for pharmacist to input preparation results; a materials distribution system equipped in materials distribution center such as a drug wholesale house, wherein it has a separate installed materials distribution server for transmitting via network the informations ordered from drugstore and status of medicine stock kept in the materials distributor to drug store, and materials distribution terminal for performing a common business of the materials distributor and pharmacy management; a separate installed prescription transmission server wherein it has a program manager to control start and stop of program and to have various construction information, a special distribution processing part for distributing a transmitted and received telegraphic message from internal and external network of hospital and for distributing transmission mode of prescription according to receiving mode of drug store, a log manager for storing the prescription data temporarily in log data base when abnormality of network is occurred and retransmitting the prescription data when the network is normalized, a hospital network I/F module for I/F with various computer equipment, and a external network I/F changing type of telegraphic message according to communication protocol, it is connected with a kiosk via network and connected with computer system of hospital; and a server connected with a financial company for performing electronic settlement.
Besides, a patient-centered, prescription transmitting method to directly select a drug store and
to automatically transmit prescription to the selected drug store on line, comprises: a step for identifying patient identities by the aid of the menu mode information displayed on the monitor of terminal such as a kiosk and sound information, wherein the step consists of inputting ID number or resident registration number of patient, or inputting patient's information by inserting the hospital card to terminal such as a kiosk, demanding the medical information about the patient to hospital server by terminal such as kiosk using the inputted information of patient, and transmitting patient information, medical treatment information, and prescription information of the patient from DB of hospital server; a step for selecting preparation mode wherein the step consists of demanding the information about the ordered drug in a prescription to prescription transmission server, transmitting medicine price and conversion data from medicinal DB and conversion DB to terminal such as a kiosk, calculating total price of medicine with using prescription information and data from transmission server, converting it to a unit of prescription in practice, changing it to standard medicine public code for prescription medicine, displaying prescription item and calculated price of medicine on monitor display, displaying a information menu for selecting prescription way of medicine if the patient push [confirmation] button; a step for selecting
* a pharmacy in the pharmacy selection menu displayed on the monitor wherein the step consists of demanding the information about the patient's address or drug store holding the ordered medicine to prescription transmission server if the patient selects directly receiving the medicine in drug store, and plurally searching
information of the nearest drug store to the demand condition in DB of a membership drugstores to inform it in a type of picture on a monitor display; a step for paying cost of medicine preparation consisted of selecting payment way of preparation price and directly paying the bill on manless; a step for transmitting an electronic prescription combined with prescription and pre-receipt data to the drugstore selected by the patient, wherein the step consists of demanding transmission of electronic prescription, encoding telegraphic message according to predetermined protocol by prescription transmission server asked for information transmission of electronic prescription, and converting the type according to communication protocol corresponding to drug store to be transmitted among the external network I/F module through message distribution process module to transmit automatically to pharmacy management system connected with network on remote via communication network; and a step for issuing the prescription wherein terminal such as a kiosk automatically prints and issues the item of prescription to the patient.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a block diagram of a prescription transmitting system and method for patients' convenience in accordance with the present invention.
FIG. 2 is a H/W diagram of a kiosk system in accordance with the present invention. FIG. 3 is a S/W diagram of a kiosk system in accordance with the present invention.
FIG. 4 is a flow diagram showing a process of issuing prescriptions using a prescription transmitting system
and method in accordance with the present invention.
FIG. 5 is an operating flow diagram illustrating each step of the process of issuing prescriptions in detail.
FIG. 6. shows conversion and flow of prescription information in accordance with the present invention.
FIG. 7 is a S/W diagram of a prescription transmission server in accordance with the present invention.
FIG. 8 is a S/W diagram of a drugstore management system in accordance with the present invention. FIG. 9 is a S/W diagram of a distribution management information system for medicines in accordance with the present invention.
FIG. 10a illustrates a display sample showing the step for establishing the identity in accordance with the present invention.
FIG 10b illustrates a display sample showing the step for selecting a compounding mode in accordance with the present invention.
FIG. 10c illustrates a display sample showing the step of selecting a drugstore in accordance with the present invention.
FIG. lOd illustrates a display sample showing the step of a foregoing receipt in accordance with the present invention . FIG. lOe illustrates a display sample showing the step of issuing a prescription in accordance with the present invention .
FIG 11 is a flow diagram for illustrating a manual transmission system of prescription in accordance with a prior art.
FIG. 12 is a flow diagram for illustrating a fax transmission system of prescription in accordance with a prior art.
10 - hospital computer system, 20 - kiosk system,
30 - public network, 40 - prescription relay system, 50 - drugstore management system, 60 - warehouse system,
70 - prescription transmission server, 80 - electronic settlement server, 90 - financial company, 110 - hospital server,
120-1--120-N - hospital terminals, 220,220-l~220-N - kiosks,
221 - central control device,
222 - monitor display, 223 - card reader, 224 - cash handler,
225 - fingerprint recognition device,
226 - printer,
227 - certification module,
228 - communication module, 229 - receipt printer,
230-1-230-N - manned prescription transmission terminals,
410 - prescription relay server,
420-1-420-N - relay center terminals,
510 - drugstore server, 520-l~520-N - drugstore terminals
610 - warehouse server,
620-1-420-N - warehouse terminals
1101 - hospital server I/F, 1102 - hospital DB
2201 - hospital server I/F, 2202 - credit card payment Lib
2203 - prescription telegram processing module,
2204 - kiosk AP,
5010 - prescription transmission/reception module,
5011 - prescription receiving server,
5012 - prescription remote controller,
5013 - EDI I/F, 5014 - MSG I/F, 5015 - prescription DB,
5020 - remote control module,
5021 - automatic version management module,
5022 - automatic DB management module,
5023 - remote control I/F, 5030 - external network I/F module,
5031 - order I/F module,
5032 - stock I/F module,
5033 - EDI I/F module,
5034 - warehouse I/F server, 5040 - drugstore AP,
5041 - medicine DB, 5042 - customer DB,
6010 - transmission module for order of medicine,
6011 - receiving server,
6012 - safety stock management module, 6013 - EDI I/F,
6014 - drugstore I/F module,
6015 - business connection DB, 6016 - stock DB,
6020 - remote control module,
6021 - automatic version management module, 6022 - automatic DB management module,
6023 - remote control I/F, 6040 - warehouse AP,
6041 - medicine DB,
6042 - business connection DB, 6043 - unit cost DB, 7010 - program manager, 7020 - telegram distribution processing module,
7030 - log manager, 7031 - log DB,
7040 - hospital network I/F,
7041 - hospital server I/F, 7042 - kiosk I/F,
7043 - DB I/F,
7050 - external network I/F, 7051 - HTML converter,
7052 - email I/F, 7053 - EDI I/F,
7054 - MSG I/F, 7055 - drugstore state I/F, 7061 - medicine DB,
7062 - conversion DB,
7063 - membership drugstore DB,
8001 - credit card settlement server,
8002 - credit card DB.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT
(First Embodiment)
Referring to FIG. 1, there is shown a block diagram of prescription transmission system for executing a prescription transmitting method for patients' convenience in accordance with this invention. The present system comprises a hospital computer system (10), a kiosk system (20) transmitting prescription automatically, a prescription relay system (40) relaying prescription between drugstores and warehouses via public network (30), a drugstore management system (50) provided in a drugstore for executing managing work of the drugstore, a warehouse system (60), an independent prescription transmission server (70) which is connected with a series of kiosks (220-1 ~ 220-N) consisting the kiosk system (20) via a network and also connected with the hospital computer system (10), an electronic settle server (80) connected with financial companies for electronic payment.
After this, it will be described in detail about each unit consisting the prescription transmission system
in accordance with a first embodiment of the present invention.
Referring now to FIG. 1, there is shown a hospital computer system (10) generally comprising a hospital ' server (110) , hospital terminals (120-1 ~ 120-N) provided in several places, an independent prescription transmission server (70) having an allowed IP address which can access to said hospital server (110) to protect information of the hospital. As shown in FIG. 7, the prescription transmission server (70) comprising a program manager (7010) controlling starting and closing of the program and having information regarding constitution, a telegram distribution processing station (7020) for correct dispensing of telegram transmitted in an internal network and an external network of a hospital, and also dispensing transmission methods in accordance with receiving methods of drugstores, a log manager (7030) for saving the prescription data temporarily in log DB (7031) when the network is in troubles and retransmitting prescriptions after normalization of the network, various computer equipments (not shown) and a hospital network I/F module (7040) for I/F.
The hospital I/F module (7040) comprising a hospital server I/F (7041) recording a compounding state and/or whether or not indicated medicines are substitute by recording the result of medicines compounding conducted at drugstores in the hospital server (110) as shown in FIG. 1, a kiosk I/F (7042) communicating patient information fetched from the hospital server (110) and selected information by patients using a kiosk, a DB I/F (7043) for I/F of various data bases in order to unify different information between a hospital and a drugstore.
The external network I/F (7050) changing types of telegrams in accordance with a communication protocol for I/F to drugstores using various communication protocol, comprises a e-mail I/F module (7052) sending prescriptions which should be transmitted to the membership drugstores to be received e-mail prescriptions via HTML converter (7051) after converting the prescription to a HTML file, a EDI I/F module (7053) transmitting electronic prescription after converting it to EDI file, encoding prescriptions and certifying whether or not the prescription is forged or alternated, MSG I/F module (7054) for transmitting prescription data at a minimum size after encoding to the drugstores required high quality services having a certify function in order to know whether or not prescription is forged or alternated while encoding the prescriptions with increasing transmitting rate and reducing transmission error by using TCP/IP protocol, a drugstore state I/F module (7055) periodically checking the status of drugstores whether they can receive prescription data or not in order to inform a patient when he/she selects a drugstore to which prescription cannot be transmitted.
The data bases used in the prescription transmission server (70) are a medicine DB (7062) memorizing price information of medicine, a conversion DB (7062) of prescription unit standards and price calculation that are used in hospitals and drugstores differently, a customer drugstore DB (7063) memorizing the list of membership drugstores. The kiosk system (20) is the advanced information providing system by which ordinary patients and customers who do not familiar with computer may transmit a prescription with a help of voice guidance and menu type
buttons displayed on a monitor. It adopts a next generation information processing mode input by finger touch on monitor, so it eliminates the keyboard input manual used in existing personal computer. To achieve the advanced information processing function, this invention adopts the H/W construction of the kiosk system (20) shown in FIG. 2.
The H/W construction of the kiosk (20) comprises a
CPU (221), a monitor display having the functions of display and input by finger touch, a credit card reader
(223) for identification and receipt, a cash handler
(224) for handling cash, and a communication module (228) for network interface for network connection. The H/W construction may further comprises a printer (226) to print out prescriptions, a certification module (227) for physical certification when the certification of an issuing hospital is needed, and printer (229) for printing out receipts, and optionally, the kiosk system
(20) may comprise a fingerprint recognition device (225) or a security module such as monitoring cameras .
The S/W construction of the kiosk system (20) shown in FIG 3, comprises a hospital server I/F module (2201) for referring information recorded in hospital data bases and recording new results via the I/F module (1101) of the hospital server (110) , a lib module (2202), for settlement with credit cards which is conducting allowance and cancellation of credit cards via the I/F module of the electronic settlement server (80), a prescription telegram processing module (2203) to exchange necessary information with the prescription transmitting server (70), and a kiosk AP (2204) providing medical treatment information per step and supporting self-service processes such as self receipts of medical
fees, transmission of prescriptions, reservations of next time medical examination and treatment, reference of a hospitalized patient, receipt of hospital charges and information of hospital etc. The hospital server (110) is a master system of a whole business conducted in a hospital, consists of OCS, hospital running system, personnel management system and account system. The DB (1102) of the hospital server (110) memorizes recordings of treatment per patients, treatment data and calculation information of medical fees .
The recordings for medical treatments of patients and prescriptions data and calculation information for medical fees are recorded in the DB (1102) of the hospital server (110).
The prescription transmitting server (70) is managing the databases for medical prices/converting codes/common codes requested from the kiosk and transmitting the electronic information transmitted from the kiosk to drugstore (50) or prescription relay system
(40) via the external network. And the prescription transmission server (70) is also conducting a feedback function by returning the status of the drugstore management information system, and protecting the patient information from the hacker by encoding the electronic prescription information when the prescriptions are transmitted via Internet. The server (70) also conducts a function to prevent from hacking outside.
As shown in FIG. 1, ADSL provided by communication company, TCP/IP network like an exclusive line for Internet, and communication protocol can be used as the network (30) .
The prescription relay system (40) shown in FIG. 1,
is a relay system of the company providing a commercial communication service. The relay system (40) can be adopted in case that the prescriptions are transmitted via the communication line of the company. According to the present invention, the primary method for transmitting prescriptions is a direct transmission to a drugstore management system (50) or a warehouse system (60) via the commercial network (30).
The drugstore management information system (50) shown in FIG. 1, can be an existing PC system or software used in a drugstore. As shown in FIG. 1, to maximize the efficiency of the present system, present invention comprises an independent drugstore server (510) and drugstore terminals (520-1-520-N) by which pharmaceutists input the results of compounding.
The S/W construction of the drugstore management information system (50) comprises a prescription transmitting server (70)'; a prescription transmitting module (5010) for transmitting and receiving the information of prescriptions and others; a remote control module (5020) which is updating the program, and checking and controlling the status of the drugstore management system; a warehouse I/F module (5030) providing I/F with the warehouse (60) ; a drugstore AP (5040) supporting the businesses such as management of prescription information, management of stored goods, running of a drugstore, EDI request, and management of medicines; a medicine DB
(5041) having medicine information; and customer DB
(5042) memorizing customer information. The transmitter module (5010) shown in FIG. 8, comprises a prescription receiving server (5011) for receiving prescriptions transmitted from the prescriptions transmitting server (70) , decoding a
encoded prescriptions and certifying in order to record in the prescription DB (5015) automatically; a prescription remote control module (5012) having an automatic on/off function between the prescription receiving server (5011) and a drugstore PC, an automatic recovery function when the network is in trouble, and an automatic recovery function with a back up telecommunication line when a drugstore program is in trouble; EDI I/F module (5013) for receiving EDI type electronic prescriptions; MSG I/F module (5014) for receiving the MSG type electronic prescriptions; and a prescription DB management module (5022) for storage of received prescriptions.
The remote control module (5020) comprises an automatic version management module (5021) for updating a program at regular intervals or at the desired time, an automatic DB management module (5022) for updating a medicine DB information at a remote distance and a remote control I/F. Also, the warehouse I/F module (external I/F module; 5030) comprises a automatic ordering module
(5031) for informing the information of goods in stock in a drugstore, making up prescriptions in accordance with the prescriptions transmitted from a hospital, supporting an urgent ordering when the required medicines are not possessed, and referring the stock provided in the warehouse for regular ordering; and a stock I/F module
(5032) for referring the stock information of a drugstore or status of EDI request; a EDI I/F module; and a warehouse I/F server.
The warehouse management information system (60) shown in FIG 1, comprises an independent warehouse server (610) for transmitting medicine information possessed in
warehouse and ordering information from drugstores to drugstores via network, warehouse terminals (620-1 ~ 620- N) conducting ordinary business of the warehouse such as receiving and ordering, account management, medicine management and drugstore management .
The S/W construction of warehouse management information system (60) shown in FIG. 9, comprises a medicine order transmitting module (6010) by which membership drugstores may order necessary medicines by electronic order; a remote management module (6020) for observing and controlling the status of the warehouse management system (60) and updating DB and program when they have been changed; a warehouse AP (6040) supporting the business managing the receiving and ordering/ stock/delivery and storage of medicines/accounts/membership drugstores; a medicines DB
(6041) storing medicine information handled in warehouse/drugstores; and customer DB (6042) storing customer information; and a unit cost DB (6043) memorizing information related to medical fees.
The medicine order transmission module (6010) comprises an order receiving server module (6011) for receiving electronic orders, a safety stock managing module (6012) providing a function of managing safety stock to provide ordered medicines smoothly; a EDI I/F module (6013) for transmitting itemized statement of business of medicines or receiving electronic orders in EDI type; a drugstore I/F module (6014) for referring the status of EDI requests and stock in the drugstore; a customer DB (6015) providing information to prevent issuing of a faulty debenture; and a stock DB (6016) for referring the medicines of stock in a warehouse when a drugstore wants to order some medicines.
The remote control module (6020) comprises an automatic version management module (6021) for updating a changed program at a settled time or wanted time; an automatic DB management module (6022) for updating medicine DB information which is changed frequently; and a remote control I/F module.
Information used in the present invention will be described as follows.
[Table 1], [Table 2], [Table 3] and [Table 4] show various information saved in the DB of hospital server (110) . [Table 1] shows prescription information, [Table 2] shows patient information, [Table 3] shows particulars of prescribed medicine, and [table 4] shows particulars of prescribed injection.
[Table 1]
[Table 2]
Insurance No./ Industrial disaster realization No.
Union No./ Authorized medical institution No. for industrial disaster
Title of union/ Title of establishment
Union classification
Name of an insured .person / Name of establish ent
Resident registration No. of an insured person
Relationship with an . sured person
Date of occurrence of a disaster
[Table 3]
Classification of allowance/ no-allowance
Classification code of medicine
Code
Name of prescribed medicine
Medicine standard content
Standard content unit of medicine
Standard volume of medicine
Standard volume unit of medicine
Dose
Unit of a dose
Frequency of dosage for a day
Total days of medication
Usage
[Table 4]
[Table 5] and [Table 6] show medical price information of
the medicine DB (7061) of the present prescription transmitting server (70) and converting information of the converting DB (7062)
[Table 5]
[Table 6]
Hospital code
EDI code, common code
Converting value
[Table 7], [Table 8] and [Table 9] show information processed in terminals (220) such as kiosks. [Table 7] shows advanced information inputted by customers, [Table 8] shows calculating information for preparation fee which is calculated by combination of information of medicine DB (7061) and converting DB (7062) of the prescription transmitting server (70) and prescription data. [ Table 9] shows a detailed information for a selected drugstore by a patient.
[Table 7]
Settlement mean for payment gua]rantee
Prepayment
Kind of credit card
Credit card No.
Term of validity
Owner name of credit card
Member No .
Approval No.
Approval Date
Installment purchase or not
Period of installment
[Table 8]
Kiosk ID
Prescription ID
Medical fee applied insurance
Compounding fee applied insurance
Medical fee that is not applied insurance
Compounding fee that is not applied insurance
Personal expense
Insurance expense
National expense
Total amount of receipt
Nighttime compounding extra fare
Holiday compounding extra fare
[Table 9]
Sanatorium symbol
Name of drugstore
Email of drugstore
Name of pharmaceuti. 3t Telephone No. of drugstore
Fax No. of a drugstore
Receiving method of medicine
Transmitting method of prescript .ion
Issuing procedure of prescriptions using the present prescription transmitting system and method will be described with reference of Fig. 4 and Fig 5.
As shown in Fig. 4, the present prescription transmitting method comprises an identity certifying step (SOI) with the aid of a phonetic guide and menu-type
information displayed on a monitor of a terminal (such as a kiosk) , a selecting step (S02) for compound method, a drugstore selecting step (S03) in which a patient selects a drugstore conducting medical compounding at his/her intention, a receiving step (S04) of preparing fees of medicine, a prescription transmitting step (S05) in which an electronic prescription containing prescription information and advanced receiving information is transmitted to a selected drugstore, and a prescription issuing step (S06) in which the terminal (for example, a kiosk) prints the particulars of the prescription to issue to a patient.
Followings are more detailed descriptions conducting each step consisting a first embodiment of the present invention.
Right after a doctor completes a medical examination to a patient, an itemized statement of a prescription is input in an existing prescription system. The patient who finished the medical examination moves to a terminal like a kiosk provided in a receipt window or a passage of a hospital, and inserts a hospital card or inputs a patient ID using in a hospital or a resident registration number according to the voice guidance of an initial menu so as to start present prescription transmission processes as shown in Fig. 5. The hospital card could be an IC type, a MS type or a barcode type having one's identity.
For example, In the identity certifying step (SOI), patients input their patient information by inputting their ID number used in the corresponding hospital or their resident registration number, or inserting their hospital card that are issued by the hospital. Wherein
* the hospital cards could be made in various types
according to the issuing hospitals (ex. IC type, MS type or barcode type) . Using the patient information input in the identifying step (SOU) , the terminals like a kiosk request a medical examination and a treatment information related to the corresponding patient so that the DB (1102) of the hospital server (110) transmits the corresponding patient information, examinations information, and prescription information showing prescribed medicines and injections as shown in the tables [1] ~ [4]
On the other hand, patients ascertain this identity certifying information, then if there is no abnormality, press a [certify] button and if there is abnormality, ask a question to the hospital official in charge therof to carry out the correction process.
Figure 10a represents a monitor sample to show an identity certifying step (S01) to which the present invention is applied.
Thereafter, the terminal such as a kiosk requests an information of medicine indicated in prescription to the prescription transmitting server (70) (S021), the prescription transmitting server (70) transmits the fee
[table 5] of the corresponding medicine and the data required for the conversion [table 6] from medicine DB (7061) and conversion DB (7062) to a terminal such as a kiosk.
Subsequently, the terminal such as a kiosk utilizes said data and prescription information transmitted from the prescription transmitting server (70) to calculate the total medicine cost including insurance cost, non- insurance cost, preparing fee, one's own burden cost and the association burden cost, converts (S023) to the preparing unit of the medicine which is dispensed
actually in the drugstore, changes (S024) to a code used commonly for standard medicine, and then displays (S025) the prescribed specification and the calculated medicine cost on the monitor display part (222) . On the other hand, the patient ascertains the specification, if there isn't abnormality in it, performs the next step by pressing [ascertain] button, but if there is abnormality, asks to person in charge of the hospital and carries out the correction procedure. On the said step, when the patient presses the [ascertain] button, the terminal such as a kiosk displays (S026) him the guide menu for selecting the medicine dispensing mode.
The medicine dispensing menu includes a variety of dispensing means such as the close drugstore-visit dispensing, the associated drugstore-visit dispensing, the non assign of drugstore (i.e. issuing of the prescription alone), and hospital-delivery.
In the figure 10b, an example is illustrated to show the dispensing mode selecting step (S02) applied to the present invention.
In the said compounding mode selecting step (S02), when patient selects the designated dispensing mode such as the close drugstore-visit dispensing and the associated drugstore-visit dispensing that patient directly visits the desired drugstore and receives the medicine, the step (S03) is proceeded, when he selects the non-designated dispensing mode that dose not designate the specific drugstore, the prescription issuing process of the step (S06) is proceeded to issue the only prescription, and when he selects the hospital- delivery, the cost pre-receipt step of step (S04) is proceeded.
In addition, in the said compounding mode selecting step (S02), in case patient selects a designated compounding mode that he visits directly the drugstore he wants and receives the drug, then step (S03) is carried out, in case patient selects a non-designated mode not to designate a certain drugstore, then step (S06) , i.e. prescription issuing process is carried out to issue only prescription, and in case patient selects hospital- delivery, step (S04), i.e. the cost pre-receipt step of step (S04) is carried out.
Also, in the said compounding mode selecting step
(S02) , in case of non-designated mode, prescription is not transmitted to drugstore directly but transmitted to a prescription relay, server (40) of a communication provider directly and drugstore can connect to the prescription relay server (40) using the patient's ID or prescription no. at the time when patient visits drugstore, and can download the prescription information.
In the said step (S02), selecting the compounding mode that patient visits directly drugstore and receives drug, a terminal such as a kiosk requests the information of patient's address or drugstore that retains the prescribed drug to the prescription transmitting server
(70), which searches the closest associated drugstore in multiple and shows it in the form of map on monitor display part (222) (S032) .
In figure 10c, an example is illustrated to show the drugstore selecting step (S03) applied to the present invention. Therein, when patient selects a desired drugstore of drugstores displayed on the monitor, the cost pre- receipt step (S04) is followed.
At this time, for the said selecting the hospital-
delivery mode, when the electronic trouble in the computer occurs after the patient selects the drugstore, so that the prescription cannot be transmitted to the drugstore. Therefore, in order to avoid a patient's endless waiting, the mode additionally includes the retransmitting function at trouble and the deleting function deleting the drugstore from the monitor. The mode also include the function to transmit the prescription via fax, in case of the prescription relay server not transmitting the prescription.
The cost pre-receipt step (S04) described above, consists of a cost receipt mode selecting step (S041) and the receipt step (S042) for a direct unmanned receipt.
The cost receipt mode selecting step (S041) is carried out depending on the modes given by a drugstore and a hospital and the clearance mode given by a bank, such as a trust card clearance, a direct account transfer or a direct cash receipt (cash receipt).
In figure lOd, an example is illustrated to show the cost pre-receipt step (S04) applied to the present invention .
As described above, when the pre-receipt is completed, the terminal such as a kiosk as shown in figure 6 combines a drug compounding cost calculated using the information (a) of a patient and a prescription and the information (b) of a cost and a conversion about the corresponding drug read from conversion DB (7062), and the information having converted a medicine into compounding unit, and diverted a prescribed medicine to a standard medicine common cord and the pre-receipt information (c) , then reconstitutes to divert to electronic prescription information (e) , and requests the prescription transmitting server (70) to transmit the
information (S051).
The prescription transmitting server (70) requested the transmission of the electronic prescription information, carries out an encryption of the full text according to a given protocol (S052), then converts to transmit it automatically via a full text dispensing processing module (7020) in an external network I/F module (7050) according to the communication protocol, and transmits it automatically to the drug management system (50) of the corresponding drug remote-connected via communication network (30) to network.
Thereafter, after performing the prescription a transmitting step (S06) that the terminal such as said kiosk prints the content of prescription automatically and issues it to the patient, the terminal returns to the initial display.
In figure lOe, an example is illustrated to show the prescription issuing step (S06) applied to the present invention. After a patient got issued a prescription via the said steps, he should go to the drugstore he selected and receive the drug.
Meanwhile, when an electronic prescription information is transmitted to the drugstore, Drugstore Management Information System as shown in figure 8 converts to an electronic prescription information transmitted in the type of EDI (5013) and an chemical information transmitted in the type of MSG (5014) and used in a drugstore, and the electronic prescription information converted to a common chemical cord gets stored in prescription DB (5015) .
This converted prescription information can be used in prescription managing program without a pharmacist's
review, therefore the steps of reviewing and inputting an electronic prescription information by hand can be eliminated fundamentally to make a full automation of drugstore's work process. Further, upon receiving an electronic prescription, by classifying the prescription contents by the usage and printing in label, the pharmacists can in advance compound directly with a reference to the label, after compounding the label can be attached to the drug envelop to simplify and automatize the compounding process.
When completing a compound, by enabling pharmacist to verify the cost of preparing medicines or to instruct how to dose at the drugstore terminal (520-1 ~- 520-N) , the total drugstore work such as accept/input of prescription/review/compound/instruct how to dose, is automated.
Particularly, in case it is not possible to exchange to the chemical cord used in drugstore or to convert to a common cord, pharmacists should confirm all of the electronic prescription contents, .therefore there are a lot of unnecessary operations. Thus, this invention gives the pharmacist an indication by exchanging into the chemical cord used in drugstore or converting to a common cord. As a result, present invention is performed without a need to confirm all of the electronic prescription contents by pharmacists.
Meanwhile, when the order I/F module (5031) in an external I/F module (5030) receives an electronic prescription, it examines a prescription medicine list included in the electronic prescription, inquires amount of the stock that a drugstore retains presently in the medicine DB (5041) and transmits an automated order immediately, and if necessary in distribution field, it
is operated in order that the order is accepted after inquiring a drugstore stock inquiry (5032), drugstore EDI request status and the like to confirm whether the order is proper. Also, the drugstore management information system is operated so as to transmit a drugstore terminal status information (d) and a compounding result (e) to a terminal (20) (for example a kiosk) and a hospital server (110), respectively, as shown in figure 6. Meanwhile, in case of patient's selecting a delivery service, if the prescription does not be transmitted to the corresponding drugstore properly, the patient may wait endlessly in the hospital due to not delivery the medicine. To solve this problem, the fact of the trouble in drugstore system is transmitted to a terminal such as a kiosk (S07) , and then a selection window of the drugstore that the trouble is occurred is made inert for a patient in order not to select the drugstore . The distribution management information system as shown in figure 9, when a drugstore requests a stock inquiry for order, inquires a medicine DB (6041) in an order receipt server module (6011), transmits the existence of stock and the amount thereof to a drugstore, and supports a drugstore to order considering the existence of stock retained in distribution. When the order is received from the drugstore, it is first accepted in an order server module (6011) of the system, and is finally accepted by checking the credit rating of the drugstore to the business connections while confirming whether the stock retained for the requested order is proper in medicine DB (6041) . A stable stock amount management module (6012) manages
this accepted electronic order status integrating with the content ordered by telephone from the existed business connections, supplies the ordered medicine sufficiently using the data, renews the stable stock quantity periodically and automatically in order to minimize the stock, and uses the data when ordering a pharmaceutical company.
Also, the stable stock amount management module (6012) checks whether a drugstore retains a minimal stock in advance periodically to ensure the stock amount by delivering the needed quantity before a drugstore orders or ordering a pharmaceutical company in advance, and can minimize an absence from stock in drugstore. And it converts the dealings information with a drugstore and with a pharmaceutical company periodically to EDI type required by the government (6013) and transmits it in the form of an electronic data, to an auditor, as a result, eliminating the inconveniences to submit the slip filled in by hand. As illustrated above, the main features of the present invention is as follows.
At first, in prescription transmitting procedure, by changing the medicine cord used in the hospital and the medicine cord used in the drugstore same in order to exactly transmit the information required by a drugstore in compounding, converting the minimal prescription units that each hospital uses differently to the unit that a drugstore uses and, if the medicine cord used in hospital is different from that used in drugstore, utilizing converting quantity in a conversion table to transmit the exact quantity to the drugstore, a pharmacist needs not reconfirm all of the electronic prescription contents transmitting system before compounding the medicine and
then calculate the medicine so that a medicine-accident by a hand work may be prevented.
Also, since a non-insurance medicine that each hospital uses has no medicine cord, the medicine name is transmitted to a drugstore. Therefore, a pharmacist should always reconfirm the prescription content and if necessary should input the medicine by hand work. Accordingly, to solve this problem, when the hospital prescribes the non-insurance medicine, the present invention eliminates the problems of a discomfort from a hand input or a recalculation and the medicine-accidents by converting it using the common cords of conversion information described in table 6 and then transmitting it,
Meanwhile, although the drugstore receives a prescription electronically in advance, if the patient does not visit, the already prepared package should be unpacked and the powdered prescription is impossible to return the original condition. Thus, in spite of transmitting the electronic prescription to the drugstore in advance, the drugstore cannot compound the medicine peacefully, for this reason, the drugstore begins to compound after the patient arrives and so cannot shorten the waiting time of patient to disappear the effect of electronic prescription. To solve this problem, present invention provide the receipt means so that the patient may prepay in terminal such as a kiosk, as a result, when the patient prepays the medicine cost before he visits the drugstore, the pharmacist can compound for the prepaid prescription, freely in advance, thereby the patient can receive the medicine as soon as he arrives at drugstore .
Further, this invention combines the drugstore information and delivery means that the patient selects,
the results of calculated compounding cost and prepaid cost, and the patient information and prescription information, convert it to the electronic prescription information and transmit it, thereby the audit work such as re-certification of drugstore is not necessary, and the environment to compound the medicine freely is made to minimize the number of a unnecessary indirect person and the expense, and maximize the production, which is utilized in adjustment with a service businessman. Further, to maximize the effect according to embodiment of present invention, it makes possible to operate it adding a part or all of function described belo .
First, all of the data are displayed using the touch screen, all sorts of data are input, and the system is operated by a voice guide, thereby the customer can operate it easily.
Second, the identity certification of the patient can be carried out by medical treatment card, credit card, ID card or other media indicating an other identity information, in which one or more of security functions such as face recognition are applied as need of the hospital, wherein accomplishing the security functions, a fingerprint recognition device (225) or lookout camera etc. can be used.
Third, the present invention can accept every means such as cashes, a credit card, a cash card or other prepayment card in order to enabling the selection of a hospital . Forth, depending on the address of the patient and the sort of a prescribed medicine, a search function to search an optimal drugstore in server is added.
Fifth, for the purpose of a prevention of the
medicine accident and an evidence in the year and tax adjustment, in order to make sure the hospital that has issued a prescription and the doctor that has made a prescription, a part or all of the functions comprising printing doctor's signature in an image form, sealing an official seal of the hospital, and the physical seal function to issue after punching and stapling so as to ascertain the issued sheets same if the number of the sheets is 2 or more, can be applied selectively to this invention, depending on the hospital needs.
(Second embodiment)
As the configuration and process related to the second embodiment of this present invention were illustrated at the first embodiment, the detailed description thereof is omitted.
For the prescription transmitting system of this invention according to the above detailed first embodiment, in the unmanned guide system such as a kiosk (220) , the information which patients require was displayed on the monitor, the task to be treated is provided as a menu in form of button, as well as voice guide is provided, so that the task is treated by selecting via patient's hand touching the menu what he want.
In this case, the old and the weak, the disabled or common patients who don't know how to operate the computer may feel the uncomfort in using this present system, and it can be occurred that for they don't know the actual usage of the system, the assistant is needed. Thus, on the purpose of solving such a problems, the prescription transmitting system to use the manned terminal of the second embodiment of this invention, as
shown in Figure 1, by utilizing the same personal computer terminal as a traditional hospital terminal and disposing the manned prescription system (230) operated in the same manner as the unmanned program of this invention at the each place of hospital, can make a nurse etc. transmit the prescription to the drugstore which patient wants or pay off the cost of the drug on behalf of him if he demands.
The manned prescription transmitting terminal used in this case comes to be improved so that can use the hospital terminal (120) that has been used in an existing hospital as it is, but can add just programs, thereby minimizing the required expense, though identical with the unmanned guide system such as the kiosk (220) of this invention in terms of the operation procedure and the function .
(Third embodiment)
.As the configuration and process related to the third embodiment of the present invention were illustrated at the first embodiment, the detailed description thereof is omitted.
For the description transmitting method according to the first embodiment of this invention described above, when the patient selects the drugstore on the monitor of the unmanned description-issuing machine, he must take the two or three-step selection process, which causes a patient's uncomfort. Also, if the number of associated drugstores is large, there occurs the limitation to output all the drugstores on a small monitor, and causes to prolong the time required to operate the system, which functions as a factor to deteriorate the operation rate of the system.
Thus, on the purpose of solving such a problems, in the selecting method of the drugstore to use an associated drugstore membership card according to the third embodiment of this invention, at first the drugstore issues and distributes an associated drugstore membership card that the drugstore ID and the information of the patient are input in, to the patient coming to its shop, and therefore, after this, the patient can input the drugstore that he wants to the machine at one time easily by only inserting the membership card rather than selecting the drugstore that he wants via the complicated steps, at an unmanned system (ex. kiosk) or a manned prescription issuing counter.
In this case, if, in addition to a drugstore ID and a patient's basic information, the various information such as the social security nos. of the patient and the insurant is further recorded, the work including the patient's information search, the selection of drugstore, the reservation of clinic or the account transfer of clinic fee can be treated at one time, thereby to enhance the comfort in terms of use and shorten an use time.
(Forth embodiment) As the configuration and process related to forth embodiment of the present invention was illustrated at the first embodiment, the detailed description thereof is omitted.
The prescription transmitting system according to the first and second embodiments detailed above, is composed of, when the patient's prescription is transmitted to the drugstore that the patient designates through an unmanned terminal such as a kiosk or a manned
terminal, transmitting the prescription via a prescription transmitting server (70) and then through a communication network directly to drugstore; storing an each prescription transmittal record whenever a description is transmitted; and, afterwards, charging automatically the prescription transmittal service fee and the system fee etc. to drugstores and distributors via the bank (90) being connected via an electronic settling server(80). However, in the above case, in terms of charging a service fee and a system fee, another burden such as the communication line using fee and the certification and the transfer service fee of a VAN corporation or a financial institution come to add, which can act as a factor to make a declination in profitability of providers.
Therefore, on the purpose of solving such a problems, the electronic description transmitting system and the description transmitting method through a communication provider according to the forth embodiment of this invention, can make the prescription transmitted, in association with the existing communication provider such as KTA (Korea Telecommunication Authority) or Daco , and in connection with and by way of the prescription relay system (40) of the communication provider, as shown in Figure 1.
In this case, when the transmitting server transmits the electronic prescription data (d) of Figure 6 which is made in the prescription transmitting server of this invention (70) to the prescription relay server (410) of the associated communication corporation (S053) , the prescription relay server (410) of the corporation
receives the full text, stores it at a separate place (S054), and then transmits it to the corresponding drugstore (S055).
In the above case, a communication corporation bears all of the communication line maintenance work and expense thereof required for transmitting the electronic prescription information, calculates the prescription transmittal fee and system using fee with the prescription relay system (40) , collects the fees in addition to a telephone fee from corresponding customer and then makes a transfer to the prescription transmitting provider of this invention, thereby establishing the communication network required for transmitting a prescription, eliminating a burden of fee for maintenance and use of the communication line, as well as solving the problems according to collecting a commission and a system using fee to accomplish a significant improvement in terms of administrative efficiency. While the invention has been described in the forgoing description, the same is to be considered as not restrictive in the illustrative embodiments, it being understood that all changes and modifications that come within the spirit of the invention are desired to be protected.
For example, not a patient but a doctor or a pharmacist can provide a transmitting service to the drugstore the patient designated by the service program of this invention. Also, a dispensing auction system wherein pharmacists exhibit to the patient the optimal dispensing conditions such as the kind, the cost and the efficacy of the medicament to be used depending on the content
of the description transmitted to the drugstore, and the patient compares the dispensing conditions exhibited from the various drugstores directly and selects a drugstore among them, can be added as an additional service to the main prescription transmitting system of this invention.
Also, there is a case required to be able to select a drugstore on the kiosk monitor and to merely issue the prescription without transmitting the electronic prescription. Such a case can also apply when the patient wishes to change the drugstore desired voluntarily or the drugstore desired in the neighborhood does not accept the prescription transmitting system of this invention. Also, a pre-receipt can embody a divided processing system that without the pre-receipt depending on *the hospital regulations, only the request for the dispensing of medication is treated in the description transmitting system of this invention. As described so far, according to this invention, it is possible to make the process to transmit the description from hospital to outdoor drugstore automated and unmanned while the patient can select the drugstore he wants by himself, so that the possibility for doctors to interpose is eliminated and the centralization towards the drugstores in front of hospitals is dispersed to exclude a possible collusion between pharmacists and doctors or a preponderance phenomenon into certain drugstores. As a result, an inherent purpose of the division between pharmacists and doctors can be accomplished sufficiently.
In addition, the transmission of the prescription to the computer systems can prevent the pharmaceutical
accidents due to the fax transmission, and enables all the clinic information to be computerized and the description data transmitted to be pursuit-managed, so that the efficient manages such as the immediate correction and inspection when errors occur in the prescription, can be made.
Also, in a patient's position, he can obtain a right that he can select the drugstore he wants by himself, can have the prescription be transmitted to the drugstore desired in advance while pre-pay the medication fee. Therefore, when the patient visits the drugstore, he can receive the medicaments immediately without unnecessary wandering several drugstores for shortage of the medicament or unnecessary long time-waiting required for preparation of medicament, thereby minimizing the hourly and the economical loss due to the division between pharmacists and doctors.
In addition, in a drugstore's position, when the patient visits and presents the prescription, instead of taking the complicated hand works that comprise the information input to the administrative information system to check whether the stock of medicament is or not, the subsequent calculation of the medicament fee and then the preparation of the medicament etc., the drugstore can receive the prescription electronically by the prescription transmitting system of this invention, prepare the medicament with a reference to the transmitted prescription data and automatically calculate the medicament fee, and also in case that the fee is prepaid, prepare the medicament in advance with relief. As a result, the patient's waiting time can be saved to
enhance the convenience service for the consumer, as well as the expense loss that occurs on account of not taking the medicament can be minimized. Also, when the drugstore does not have the medicament filled in the prescription, it can order the medicament to get a home delivery of it swiftly before the patient arrives at the drugstore, therefore the economical burden for purchasing a rare medicament in advance can be reduced, the amount of the dead stock by a suitable inventory management can be minimized. Furthermore, the drugstore can come to treat automatically the various works such as EDI automatic charge to rationalize the administration of the drugstore and reduce the cost caused by the hand work greatly to improve the administration of the drugstore greatly.
Furthermore, in a distributor's position, the distributor can deal with the contingency order from the drugstore effectively, can always grasp the suitable amount of a stock to optimize the period for the medicament delivery, reducing the distribution expense and can ensure the associated drugstores to run the complex prescription transmitting system steadily, to accommodate an increase of revenue stably, and unify the distribution chain while by defining the kind of the prescription medicament in advance with computer system, an economical burden due to an excessive secure of the unnecessary medicament can be lessened greatly and by supplying the medicament for the appropriate inventory level of the drugstore, the high return rate that caused by ordering the excessive amounts of medicaments at random and returning it back after a certain period has passed conventionally, can be
reduced minimizing the expense loss to improve the administrative effect greatly.