JP6911478B2 - Information provision program, information provision method and information provision device - Google Patents

Description

An embodiment of the present invention relates to an information providing program, an information providing method, and an information providing device.

The increase in medical expenses of the people is a serious social problem, and due to future uncertainties, almost all households now have medical insurance or cancer insurance (hereinafter referred to as insurance) sold by private life insurance companies. Further, conventionally, a technique for efficiently managing insurance has been known. For example, a terminal of a medical institution, a terminal of an insurance company, and a terminal of a financial institution are connected by a network, and a transfer request is made from the insurance company's account to the medical institution's account based on the medical data of the patient and information on insurance. There is a known system for terminals of financial institutions.

Japanese Unexamined Patent Publication No. 2004-126793 Japanese Unexamined Patent Publication No. 2013-003750 Japanese Unexamined Patent Publication No. 2013-164757

However, with the above-mentioned prior art, the policyholder may not be able to effectively utilize the insurance. It is difficult for policyholders to make effective use of insurance because the conventional technology streamlines the procedure after an insurance company receives a claim.

On the one hand, it aims to enable policyholders to make effective use of insurance.

In the first plan, when the information providing program accepts the input of the user identification information, the information providing program transmits the insurance information to the first server that manages the insurance information contracted by the user corresponding to the user identification information. Ask. In addition, the information providing program causes a computer to execute a process of requesting a second server that manages medical information based on a medical examination at the user's medical institution to transmit the medical information. In addition, the information providing program causes the computer to execute the process of receiving the insurance information from the first server and receiving the medical information from the second server. Further, the information providing program causes the computer to execute a process of comparing the received insurance information with the medical information and outputting the payment items to which the insurance can be applied included in the medical information.

According to one embodiment of the present invention, the policyholder can effectively utilize the insurance.

FIG. 1 is an explanatory diagram illustrating an information providing system according to an embodiment. FIG. 2 is a block diagram showing a functional configuration example of the user terminal according to the embodiment. FIG. 3 is a block diagram showing a functional configuration example of the information providing device according to the embodiment. FIG. 4 is an explanatory diagram for explaining the authentication information. FIG. 5 is an explanatory diagram for explaining insurance information. FIG. 6 is an explanatory diagram for explaining insurance information. FIG. 7 is an explanatory diagram for explaining medical information. FIG. 8 is an explanatory diagram for explaining injury / illness information. FIG. 9 is an explanatory diagram illustrating surgical information. FIG. 10 is an explanatory diagram illustrating the matching process. FIG. 11 is a diagram showing an example of a portal screen. FIG. 12 is a diagram showing an example of a post-medical treatment screen. FIG. 13 is a diagram showing an example of a post-treatment screen. FIG. 14 is a diagram showing an example of a post-treatment screen. FIG. 15 is a sequence diagram showing an example of processing related to information provision. FIG. 16 is a block diagram showing a hardware configuration example of the information providing device according to the embodiment.

Hereinafter, the information providing program, the information providing method, and the information providing apparatus according to the embodiment will be described with reference to the drawings. Configurations having the same function in the embodiment are designated by the same reference numerals, and duplicate description will be omitted. The information providing program, the information providing method, and the information providing device described in the following embodiments are merely examples, and the embodiments are not limited. In addition, the following embodiments may be appropriately combined within a consistent range.

FIG. 1 is an explanatory diagram illustrating an information providing system according to an embodiment. As shown in FIG. 1, the information providing system 1 includes a user terminal 10a, a user terminal 10b, and an information providing device 20 connected to each user terminal. Further, the information providing device 20 is connected to the insurance information management system 30 and the medical information management system 40. In the information providing system 1, the user terminal 10, the information providing device 20, the insurance information management system 30, and the medical information management system 40 are connected to each other so as to be communicable with each other via a communication network such as the Internet or a LAN (Local Area Network). There is.

Specifically, a PC (Personal Computer), a smartphone, a tablet terminal, or the like can be applied to the user terminal 10a and the user terminal 10b. Further, the information providing device 20 can apply a server device on the cloud. Further, the insurance information management system 30 and the medical information management system 40 can apply the server device. In the following description, when the user terminal 10a and the user terminal 10b are not distinguished from each other, they are simply referred to as the user terminal 10.

Further, the information providing device 20 provides information to the user terminal 10 based on the information acquired from the insurance information management system 30 and the medical information management system 40. As an example, the information providing device 20 provides insurance information and medical information to a father living in a rural area who is an insurance policyholder and a son living in Tokyo who is a family member of the policyholder. In this way, the information providing device 20 makes it possible to share information between the policyholder and the family.

The insurance information management system 30 is a system of a life insurance company or the like, and is used for managing information of policyholders and the like. Further, information is input to the insurance information management system 30 from, for example, a terminal operated by an employee of an insurance company. The insurance information management system 30 stores policyholder information 301, insurance product information 302, and the like. For example, the policyholder information 301 stores an ID that identifies the policyholder, a securities number for each policyholder, an insurance product, a history of insurance payments, and the like. Further, for example, the insurance product information 302 stores an ID for identifying the insurance product, the coverage contents for each insurance product, and the like.

The medical information management system 40 is a system of a medical institution or the like, and is used for managing patient information or the like. In addition, information is input to the insurance information management system 30 from, for example, hospitals, pharmacies, and other institutions, as well as measuring instruments and the like. The medical information management system 40 stores patient information 401, medical record information 402, and the like. For example, the patient information 401 stores an ID that identifies the patient, a health insurance number for each patient, information on the height, weight, and blood of the patient. Further, for example, the medical record information 402 stores the medical treatment date, the medical examination content, the disease name, the operation name, and the like for each medical treatment history of the patient. In addition, the information stored in the medical information management system 40 may further include a receipt, a medical examination result, a medicine notebook, vital information, living information, and the like.

FIG. 2 is a block diagram showing a functional configuration example of the user terminal according to the embodiment. As shown in FIG. 2, the user terminal 10 includes an input unit 11, a display unit 12, a communication unit 13, a storage unit 14, and a control unit 15.

The input unit 11 is a UI (user interface) that receives a user's operation input from an input device or the like. In addition, the display unit 12 displays the screen on a monitor or the like. Further, the communication unit 13 is a device that executes data communication with another external device via a network. The storage unit 14 is, for example, a semiconductor memory or the like, and stores various information. The control unit 15 controls various operations on the user terminal 10.

The control unit 15 has a request unit 151. The control unit 15 can be realized by a CPU (Central Processing Unit), an MPU (Micro Processing Unit), or the like. The control unit 15 can also be realized by hard-wired logic such as an ASIC (Application Specific Integrated Circuit) or an FPGA (Field Programmable Gate Array).

The request unit 151 requests the information providing device 20 to execute the user authentication process. At this time, the request unit 151 transmits the user identification information to the information providing device 20. The user identification information is, for example, a user ID and a password. Further, the user identification information may be input by the user or may be stored in the storage unit 14. Further, the user identification information may be My Number.

FIG. 3 is a block diagram showing a functional configuration example of the information providing device according to the embodiment. As shown in FIG. 3, the information providing device 20 includes a communication unit 21, a storage unit 22, and a control unit 23.

The communication unit 21 is a device that executes data communication with another external device via a network. The storage unit 14 is, for example, a semiconductor memory or the like, and stores authentication information 221, insurance information 222, medical information 223, injury / illness information 224, and surgery information 225.

FIG. 4 is an explanatory diagram for explaining the authentication information. As shown in FIG. 4, the authentication information 221 stores a user ID, password, nickname, securities number, health insurance number, and the like. The nickname may be displayed in place of the user's name on a screen, printed matter, or the like related to the user terminal 10, the insurance information management system 30, the medical information management system 40, or the like. The securities number is a number that identifies a user in the insurance information management system 30. The health insurance number is a number that identifies a user in the medical information management system 40.

As shown in FIG. 4, the authentication information 221 stores, for example, that the password of the user whose user ID is "U111222" is "xxxxxx" and the nickname is "Tsuruhiko". Further, the authentication information 221 stores, for example, that the securities number of the user whose user ID is "U111222" is "S777788888" and the health insurance number is "K44444555555".

The insurance information 222 is information about the insurance of the authenticated user. For example, when the user authentication is successful, the information providing device 20 acquires information on insurance from the insurance information management system 30 using the user's securities number as a key, and temporarily stores the acquired information as insurance information 222. Store in 22. Insurance information 222 includes information about policyholders and information about insurance products. The insurance information 222 may have separate tables corresponding to information on policyholders and information on insurance products.

FIG. 5 is an explanatory diagram for explaining insurance information. FIG. 5 is a diagram for explaining information about the policyholder in the insurance information 222 in particular. The insurance information 222 stores user ID, securities number, product code, hospitalization benefit conditions, daily hospitalization amount, and the like as information about the policyholder. The user ID and securities number are information for identifying the user. The product code is a code that identifies the insurance product that the user has subscribed to. The hospitalization benefit conditions and the daily hospitalization amount are the conditions and the daily amount of insurance money to be paid at the time of hospitalization, and are examples of the basic coverage of the user.

In the following description, "payment" shall mean that the insurance money is paid to the policyholder. In addition, "expense" shall refer to medical expenses incurred by receiving medical services. The "payment item" is an item in the history of medical services to which insurance may be applied.

For example, if a policyholder is examined at a medical institution, the medical institution charges the policyholder for the cost. At this time, if the payment item of medical examination is covered by insurance, the insurance company pays a predetermined percentage of the cost to the policyholder as insurance money.

As shown in FIG. 5, in the information about the policyholder of insurance information 222, for example, the securities number of the user whose user ID is "U111222" is "S777788888", and the product code of the subscribed product is "S77778888". It is remembered that it is "999". Further, in the information about the policyholder of the insurance information 222, for example, it is remembered that the hospitalization benefit condition of the user whose user ID is "U111222" is "1" and the daily hospitalization amount is "15,000". Has been done. The conditions for hospitalization benefits are represented by predetermined categories for each content. For example, if the hospitalization benefit condition is "1", the hospitalization benefit will be paid from the first day regardless of the name of the disease.

FIG. 6 is an explanatory diagram for explaining insurance information. FIG. 6 is a diagram for explaining information related to insurance products among insurance information 222 in particular. The insurance information 222 stores a product code, a surgery code, a surgery benefit rate, and the like as information on insurance contract products. The product code is a code that identifies an insurance product. The surgery code is a code that identifies the surgery. The surgery benefit rate is the benefit rate for the daily hospitalization amount for each surgery. In addition, the number of items of the operation code and the operation benefit rate of the insurance information 222 may be variable. This is because the number of surgical codes varies depending on the insurance product.

As shown in FIG. 6, in the information regarding the insurance product of the insurance information 222, for example, the surgery code (1) of the insurance product whose product code is "999" is "K0462", and the surgery benefit rate (1) is It is remembered that it is "500". Further, in the information regarding the insurance product of the insurance information 222, for example, the surgery code (2) of the insurance product whose product code is "999" is "K0463", and the surgery benefit rate (2) is "500". Is remembered.

The medical information 223 is information related to the medical treatment of the authenticated user. For example, when the user authentication is successful, the information providing device 20 acquires medical information from the medical information management system 40 using the user's health insurance number as a key, and temporarily stores the acquired information as medical information 223. It is stored in the part 22.

FIG. 7 is an explanatory diagram for explaining medical information. The medical information 223 stores a user ID, a health insurance number, a medical examination date, an injury / illness code, a name, contents, costs, surgery candidates, hospitalization days candidates, and the like. The user ID and health insurance number are information for identifying the user. The date of examination, injury / illness code, name, content and cost are the history of the user receiving medical services at a medical institution. In addition, the surgery candidates and the hospitalization days candidates are the surgery code and the hospitalization days of the surgery presented as candidates by the hospital or the like based on the medical examination results and the like. Medical services include medical examinations, hospitalization for surgery, prescription of medicines, and the like. In addition, the number of items of the surgery candidate and the length of hospital stay candidate in the medical information 223 may be variable. This is because the number of surgical candidates varies depending on the injury or illness and the results of medical examinations.

As shown in FIG. 7, the medical information 223 stores, for example, that the health insurance number of the user whose user ID is "U111222" is "K44444555555" and that "20170225" received the medical service. .. In addition, the medical information 223 remembers that the injury / illness code, name, content, and cost at the time of medical examination were "S4201", "Fuji Hospital", "surgical hospitalization", and "40,000", respectively. There is. Further, the medical information 223 stores that the surgery candidate (1) is "K0463" and the hospitalization date candidate (1) is "4". Further, the medical information 223 stores that the surgery candidate (2) is "K0443" and the hospitalization date candidate (2) is "4". Further, in the medical information 223, it is stored that the surgery candidate (3) is "K0472" and the hospitalization date candidate (3) is "10".

Injury and illness information 224 is information on injury and illness. FIG. 8 is an explanatory diagram for explaining injury / illness information. The injury / illness information 224 stores an injury / illness code, an injury / illness name, a corresponding surgery code, an average medical expense, and the like. The injury / illness code is information for identifying the injury / illness. The injury / illness name is the name of the injury / illness for each injury / illness code. The corresponding surgical code is a candidate for the surgical code corresponding to the injury or illness. The average medical cost is a preset average medical cost for each injury or illness.

As shown in FIG. 8, in the injury / illness information 224, for example, the injury / illness code of the injury / illness code is “S4201”, the injury / illness name is “left clavicle distal radius fracture”, and the corresponding surgical code is “K0463, K0443, K0472”. It is remembered that. Further, in the injury / illness information 224, for example, it is stored that the injury / illness name of the injury / illness with the injury / illness code "S8501" is "cerebral infarction" and the average medical cost is "2.5 million yen / year". ..

The injury / illness information 224 may not be stored in the information providing device 20. For example, the information providing device 20 may acquire the injury / illness information 224 from the insurance information management system 30, the medical information management system, or another system, if necessary. Further, the surgery candidates (1) to (3) of the medical information 223 may be corresponding surgery codes acquired from the injury / illness information 224 using the injury / illness code as a key.

Surgery information 225 is information about surgery. FIG. 9 is an explanatory diagram illustrating surgical information. The operation information 225 stores the operation code, the operation name, the operation cost, and the like. The surgery code is information for identifying the surgery. The operation name is the name of the operation for each operation code. Surgical costs are the costs for each surgical code.

As shown in FIG. 9, in the operation information 225, for example, the operation name of the operation whose operation code is "S0463" is "fracture open surgery [clavicle]", and the operation cost is "20,000". It is remembered that there is.

The control unit 23 controls various operations in the information providing device 20. The control unit 23 includes an authentication unit 231, a request unit 232, a reception unit 233, a creation unit 234, a calculation unit 235, and an output unit 236. The control unit 23 can be realized by a CPU, an MPU, or the like. The control unit 23 can also be realized by hard-wired logic such as ASIC or FPGA.

The authentication unit 231 authenticates the user based on the user identification information transmitted from the user terminal. The authentication unit 231 authenticates by determining whether or not the combination of the user ID and the password included in the user identification information is stored in association with the authentication information 221. After that, the authentication unit 231 inputs the user identification information to the request unit 232.

When the requesting unit 232 accepts the input of the user identification information, the requesting unit 232 requests the first server that manages the insurance information contracted by the user corresponding to the user identification information to transmit the insurance information. The insurance information management system 30 is an example of the first server.

When the requesting unit 232 receives the input of the user identification information, the requesting unit 232 requests the second server that manages the medical information based on the medical examination at the user's medical institution to transmit the medical information. The medical information management system 40 is an example of a second server.

The receiving unit 233 receives insurance information from the first server and medical information from the second server. Here, the receiving unit 233 stores the received insurance information and medical information in the storage unit 22 as insurance information 222 and medical information 223, respectively. Further, the output unit 236 compares the received insurance information 222 with the medical information 223, and outputs the payment items to which the insurance can be applied included in the medical information.

Here, with reference to FIG. 10, the matching process performed when the output unit 236 compares the insurance information 222 and the medical information 223 will be described. FIG. 10 is an explanatory diagram illustrating the matching process. First, the output unit 236 refers to the medical information 223 and acquires surgery candidates and hospitalization days candidates. Here, as shown in FIG. 7, it is assumed that the surgery candidates (1) to (3) and the hospitalization days candidates (1) to (3) are stored in the medical information 223. Hereinafter, the surgery candidates (1) to (3) and the hospitalization days candidates (1) to (3) will be the payment items.

Next, the output unit 236 refers to the insurance information 222 and confirms whether or not the surgery codes of the surgery candidates (1) to (3) are included in the coverage of the insurance product contracted by the user. .. Further, the output unit 236 refers to the insurance information 222 and confirms whether or not the hospitalization benefit condition of the user is that the insurance money is paid at the time of admission.

Then, the output unit 236 determines that the surgical candidates (1) to (3) whose surgical code is included in the coverage are "applicable". On the other hand, the output unit 236 determines that the surgical candidates (1) to (3) whose surgical code is not included in the coverage are "not applicable".

In addition, when the user's hospitalization benefit condition is that the insurance money is paid at the time of hospitalization, it is determined that the hospitalization days candidates (1) to (3) are "applicable". In addition, if the user's hospitalization benefit conditions are not such that insurance money is paid at the time of hospitalization, it is determined that the hospitalization days candidates (1) to (3) are "not applicable".

In the example of FIG. 10, since the operation code “K0463” is included as the operation code (2) in the insurance information 222 as shown in FIG. 6, the output unit 236 “applicable” the operation candidate (1). Is determined. Further, as shown in FIG. 5, the hospitalization benefit condition of the user is "1", and the hospitalization benefit is paid from the first day regardless of the disease name. Therefore, the output unit 236 is a candidate for the number of hospitalization days (1). ) Is judged as "applicable".

In addition, the output unit 236 calculates the payment amount of the payment item determined to be "applicable" by a predetermined calculation formula. For example, the output unit 236 calculates the payment amount of the surgery candidate (1) by multiplying the daily hospitalization amount of the insurance information 222 by the surgery benefit rate (2). In this case, as shown in FIG. 10, the output unit 236 calculates the payment amount of the surgery candidate (1) as "daily amount 15,000 x 500% = 75,000".

Further, the output unit 236 may output not only the payment items to which the insurance can be applied but also all the payment items together with the applicability of the insurance. At this time, the creation unit 234 creates a list of the history of medical services received by the user at the medical institution based on the medical information. The output unit 236 compares the history list with the insurance information, and outputs the payment items corresponding to the history list together with the applicability of insurance. Further, the output unit 236 outputs the payment items to which the insurance can be applied together with the information indicating whether or not the insurance money has been paid. The output unit 236 acquires from the policyholder information 301 of the insurance information management system 30 whether or not the insurance money has been paid for each payment item.

The calculation unit 235 calculates a score indicating the risk that the user takes for each specific disease, which is predetermined, based on the medical information 223. Further, the output unit 236 further outputs a list of specific illnesses having a score equal to or higher than the threshold value together with information indicating whether or not the insurance for each illness is applicable, which is obtained from the insurance information 222. Here, the specific illness is, for example, a illness included in the injury / illness information 224. In addition, the calculation unit 235 may calculate the score using an existing calculation model provided by a medical institution or an insurance company. Further, the calculation unit 235 may perform a calculation using a calculation model constructed by using a predetermined method based on the information acquired from the medical information management system 40 or the like.

Here, the output unit 236 outputs the information regarding the result of the matching process and the information regarding the list of diseases whose score is equal to or higher than the threshold value to the user terminal 10. Then, the display unit 12 of the user terminal 10 displays the information output by the output unit 236 on the portal screen. FIG. 11 is a diagram showing an example of a portal screen.

As shown in FIG. 11, the display unit 12 displays the user's nickname and the latest health status in the health status display area 121 on the portal screen. Health status includes, for example, values such as blood glucose, blood pressure, uric acid, and body weight. When the icon of the right-pointing arrow is clicked, the display unit 12 displays a detailed screen regarding the user's health condition.

In addition, the display unit 12 displays information regarding the result of the matching process by the output unit 236 in the medical history display area 122 of the portal screen. The display unit 12 displays the date, name, content, and cost for each history in the medical history display area 122 of the portal screen. In addition, the icon in the detailed click column indicates information or the like based on the matching result. When the icon of the right-pointing arrow is clicked, the display unit 12 displays the entire history.

Further, in the example of FIG. 11, the display unit 12 displays one payment item for one history, but a plurality of payment items may be displayed for one history. For example, when both a medical examination and a surgical hospitalization are received in one visit, the display unit 12 may display the total cost by setting the content as "medical examination and surgery" or the like, and corresponds to the medical examination and surgery. The costs may be displayed on different lines.

When the medical information 223 has a candidate for surgery or a candidate for hospitalization days corresponding to the payment item, the display unit 12 displays the icon 122a on the line corresponding to the payment item. When the icon 122a is clicked, the display unit 12 displays the screen after the examination. Further, when the result of the matching process is "applicable" and the insurance money has been paid, the display unit 12 displays the icon 122b on the line corresponding to the payment item. When the icon 122b is clicked, the display unit 12 displays the post-treatment screen. If the result of the matching process is "applicable" and the insurance money has not been paid, the display unit 12 displays the icon 122c on the line corresponding to the payment item. When the icon 122c is clicked, the display unit 12 displays the post-treatment screen. Further, when the result of the matching process is "not applicable", the display unit 12 does not display any of the icons 122a, 122b and the icon 122c on the line corresponding to the payment item.

For example, the portal screen of FIG. 11 shows that the cost of hospitalization for surgery received by the policyholder at Fuji Hospital on October 12 is 70,000 yen, and the insurance money has already been paid. In addition, the portal screen of FIG. 11 shows that the cost of hospitalization for surgery received by the policyholder at Fuji Hospital on February 25 is 40,000 yen, and the insurance money has not been paid.

In addition, the display unit 12 displays a list of diseases output by the output unit 236 and information indicating whether or not insurance can be applied for each disease in the disease risk display area 123 on the portal screen. The display unit 12 displays the disease name, risk, and medical expenses for each disease in the medical history display area 122 of the portal screen. In addition, the icon in the detail click column indicates whether or not insurance is applicable. When the icon of the right-pointing arrow is clicked, the display unit 12 displays a list of all diseases. The risk is a value based on the score calculated by the calculation unit 235. In addition, the medical expenses are the average medical expenses of the injury / illness information 224.

The display unit 12 displays the icon 123a when insurance for illness can be applied. When the icon 123a is clicked, the display unit 12 displays a simulation screen of insurance application conditions and payment amount. In addition, the display unit 12 displays the icon 123b when insurance for illness cannot be applied. When the icon 123b is clicked, the display unit 12 introduces recommended products applicable to the disease and displays a simulation screen of insurance coverage conditions and payment amount.

For example, the portal screen shown in FIG. 11 shows that the risk of cerebral infarction for policyholders is 1.25 times, the medical cost in case of cerebral infarction is 2.5 million yen / year, and insurance can be applied. Shown. In addition, the portal screen shown in FIG. 11 shows that the policyholder has a 1.16 times higher risk of developing diabetes, and the medical expenses in the case of developing diabetes are 36,000 yen / month, and insurance can be applied. Is shown.

When the icon 124 is clicked, the inquiry function by e-mail, chat, telephone, etc. is activated. For example, when the icon 124 is clicked, the mail client is started with the insurance company's mail address entered as the contact information. Further, the contact for the inquiry function that is activated when the icon 124 is clicked may be a medical institution or a family member of the policyholder.

FIG. 12 is a diagram showing an example of a post-medical treatment screen. As shown in FIG. 12, the display unit 12 displays a list of surgical candidates of medical information 223 on the post-medical treatment screen. In addition, the display unit 12 displays the cost and guarantee for each of the surgery and hospitalization for each surgery candidate on the screen after the medical treatment. Guarantee is the amount of insurance paid for surgery and hospitalization. As a result, the policyholder can consider the treatment method in consideration of the insurance. For example, on the post-treatment screen of FIG. 12, the cost when the policyholder is treated by fracture open surgery [clavicle] is 40,000 yen, and the guarantee at that time is 135,000 yen. Is shown.

FIG. 13 is a diagram showing an example of a post-treatment screen. FIG. 13 is an example of a post-treatment screen when the insurance money has been paid. As shown in FIG. 13, when the insurance money has been paid, the display unit 12 displays the cost and the guarantee on the screen after the treatment, and the display unit 12 shows the financial institution or the financial institution where the insurance money was paid. Display information about the amount. For example, on the post-treatment screen of FIG. 13, the cost when the policyholder is treated by the intractable fracture ultrasonic treatment method is 70,000 yen, and at that time, the insurance money of 150,000 yen is paid. It shows that.

FIG. 14 is a diagram showing an example of a post-treatment screen. FIG. 14 is an example of a post-treatment screen when the insurance money has not been paid. As shown in FIG. 14, when the insurance money has not been paid, the display unit 12 displays the cost and the guarantee on the post-treatment screen, and also displays a message indicating that the insurance money has not been paid. In addition, the display unit 12 displays a button on the post-treatment screen to activate the function of requesting payment of insurance money. For example, the post-treatment screen of FIG. 14 shows that the cost when the policyholder receives treatment by nail removal is 40,000 yen, and the insurance money of 135,000 yen is unpaid.

FIG. 15 is a sequence diagram showing an example of processing related to information provision. As shown in FIG. 15, the user terminal 10 accepts the input of the user identification information by the user (S101). The user identification information includes the user ID and password of the user. The user may be, for example, a policyholder or a family member of the policyholder. Next, the request unit 151 of the user terminal 10a transmits the user identification information to the information providing device 20 and requests authentication (S102).

Here, when the authentication unit 231 of the information providing device 20 receives an authentication request from the user terminal 10, it authenticates using the user ID and password included in the user identification information (S103).

Here, when the authentication unit 231 does not authenticate (S104: No), the information providing device 20 notifies the user terminal 10 and does not perform the subsequent processing. On the other hand, when the authentication unit 231 authenticates (S104: Yes), the request unit 232 requests the insurance information management system 30 to transmit insurance information (S105). Then, the insurance information management system 30 transmits insurance information to the information providing device 20 (S106). Here, the receiving unit 233 receives the insurance information (S107) and stores the received insurance information in the storage unit 22 (S108).

Further, the requesting unit 232 requests the medical information management system 40 to transmit medical information (S109). Then, the medical information management system 40 transmits medical information to the information providing device 20 (S110). Here, the receiving unit 233 receives the medical information (S111) and stores the received medical information in the storage unit 22 (S112).

Next, the output unit 236 performs a matching process using the insurance information and the medical information (S113). Then, the output unit 236 outputs the result of the matching process to the user terminal 10 (S114). Then, the user terminal 10 displays the result of the matching process output by the output unit 236 (S115). In addition, the user terminal 10 can activate a function for making inquiries and contacts to medical institutions, insurance companies, and the family members of policyholders, and a function for requesting payment of insurance claims, in response to user operations. ..

As described above, when the information providing device 20 receives the input of the user identification information, the information providing device 20 requests the first server that manages the insurance information contracted by the user corresponding to the user identification information to transmit the insurance information. .. When the information providing device 20 receives the input of the user identification information, the information providing device 20 requests the second server that manages the medical information based on the medical examination at the user's medical institution to transmit the medical information. In addition, the information providing device 20 receives insurance information from the first server and medical information from the second server. Further, the information providing device 20 compares the received insurance information with the medical information, and outputs the payment items to which the insurance can be applied included in the medical information. Therefore, according to the information providing device 20, the policyholder can effectively utilize the insurance. For example, the policyholder browses the information output by the information providing device 20 on the user terminal 10 and consults with a doctor and his / her family, confirms that the insurance money has not been paid, and consults with the insurance company to review the insurance. As a result, you will be able to make effective use of insurance.

The information providing device 20 can create a list of the history of medical services received by the user at the medical institution based on the medical information. At this time, the information providing device 20 can compare the history list with the insurance information and output the payment items corresponding to the history list together with the applicability of insurance. Therefore, according to the information providing device 20, the user can easily confirm the payment items to which the insurance can be applied.

The information providing device 20 can output payment items to which insurance can be applied, together with information indicating whether or not the insurance money has been paid. Therefore, according to the information providing device 20, the policyholder can easily confirm the unpaid insurance.

The information providing device 20 can create a list of treatment method candidates that can be selected by the user based on medical information. Further, the information providing device 20 compares the list of candidates with the insurance information, and outputs the payment items corresponding to the list of candidates together with the applicability of insurance. Therefore, according to the information providing device 20, the policyholder can consider the treatment method in consideration of the insurance.

The information providing device 20 can calculate a score indicating the risk that a user takes for each specific disease, which is predetermined, based on medical information. The information providing device 20 can further output a list of specific diseases having a score equal to or higher than a threshold value together with information indicating whether or not insurance is applicable for each disease obtained from the insurance information. Therefore, according to the information providing device 20, the policyholder can review the insurance.

It should be noted that each component of each of the illustrated devices does not necessarily have to be physically configured as shown in the figure. That is, the specific form of distribution / integration of each device is not limited to the one shown in the figure, and all or part of the device is functionally or physically dispersed / physically distributed in arbitrary units according to various loads and usage conditions. Can be integrated and configured.

Further, the various processing functions performed by the information providing device 20 may execute all or any part thereof on the CPU (or a microcomputer such as an MPU or an MCU (Micro Controller Unit)). Further, various processing functions may be executed in whole or in any part on a program analyzed and executed by a CPU (or a microcomputer such as an MPU or MCU) or on hardware by wired logic. Needless to say, it's good. Further, various processing functions performed by the information providing device 20 may be executed by a plurality of computers in cooperation by cloud computing.

By the way, various processes described in the above-described embodiment can be realized by executing a program prepared in advance on a computer. Therefore, an example of a computer (hardware) that executes a program having the same function as that of the above embodiment will be described below. FIG. 16 is a block diagram showing a hardware configuration example of the information providing device according to the embodiment.

As shown in FIG. 16, the information providing device 20 includes a CPU 501 that executes various arithmetic processes, an input device 502 that receives data input, a monitor 503, and a speaker 504. Further, the information providing device 20 includes a medium reading device 505 that reads a program or the like from a storage medium, an interface device 506 for connecting to various devices, and a communication device 507 for communicating with an external device by wire or wirelessly. Have. Further, the information providing device 20 has a RAM 508 that temporarily stores various information and a hard disk device 509. Further, each part (501 to 509) in the information providing device 20 is connected to the bus 510.

The hard disk device 509 stores a program 511 for executing the authentication unit 231, the request unit 232, the reception unit 233, the creation unit 234, the calculation unit 235, and the output unit 236 described in the above embodiment. Further, various data 512 (authentication information 221 and insurance information 222, medical information 223, etc.) referred to by the program 511 are stored in the hard disk device 509. The input device 502 receives, for example, an input of operation information from the operator of the information providing device 20. The monitor 503 displays, for example, various screens operated by the operator. For example, a printing device or the like is connected to the interface device 506. The communication device 507 is connected to a communication network such as a LAN (Local Area Network), and exchanges various information with an external device via the communication network.

The CPU 501 reads the program 511 stored in the hard disk device 509, expands it into the RAM 508, and executes it to perform various processes. The program 511 may not be stored in the hard disk device 509. For example, the information providing device 20 may read and execute the program 511 stored in the readable storage medium. The storage medium that can be read by the information providing device 20 includes, for example, a portable recording medium such as a CD-ROM, a DVD disk, or a USB (Universal Serial Bus) memory, a semiconductor memory such as a flash memory, a hard disk drive, or the like. Further, the program 511 may be stored in a device connected to a public line, the Internet, a LAN, or the like, and the information providing device 20 may read the program 511 from these and execute the program 511.

The following additional notes will be further disclosed with respect to the above embodiments.

(Appendix 1) When the input of the user identification information is accepted, the first server that manages the insurance information contracted by the user corresponding to the user identification information is requested to transmit the insurance information, and the user's Request the second server that manages medical information based on medical examinations at a medical institution to send the medical information.
The insurance information is received from the first server, and the medical information is received from the second server.
The received insurance information is compared with the medical information, and payment items included in the medical information to which insurance can be applied are output.
An information providing program characterized by having a computer execute processing.

(Appendix 2) Based on the medical information, the computer is further executed to create a list of the history of medical services received by the user at the medical institution.
The information provision described in Appendix 1 is characterized in that the output process compares the history list with the insurance information and outputs the payment items corresponding to the history list together with the applicability of insurance. program.

(Appendix 3) The information providing program according to Appendix 1, wherein the output process outputs payment items to which the insurance can be applied together with information indicating whether or not the insurance money has been paid. ..

(Appendix 4) The computer is further executed to create a list of treatment method candidates that can be selected by the user based on the medical information.
The information provision described in Appendix 1 is characterized in that the output process compares the list of candidates with the insurance information, and outputs the payment items corresponding to the list of candidates together with the applicability of insurance. program.

(Appendix 5) A computer is further executed to calculate a score indicating the risk of the user for each specific disease specified in advance based on the medical information.
The output process is characterized in that a list of the specific diseases whose score is equal to or higher than the threshold value is further output together with the information indicating whether or not the insurance for each disease is applicable, which is obtained from the insurance information. The information providing program described in any of Appendix 1 to 4.

(Appendix 6) When the input of the user identification information is accepted, the first server that manages the insurance information contracted by the user corresponding to the user identification information is requested to transmit the insurance information, and the user's Request the second server that manages medical information based on medical examinations at a medical institution to send the medical information.
The insurance information is received from the first server, and the medical information is received from the second server.
The received insurance information is compared with the medical information, and payment items included in the medical information to which insurance can be applied are output.
An information providing method characterized in that a computer executes processing.

(Appendix 7) Based on the medical information, the computer further executes a process of creating a list of medical services received by the user at the medical institution.
The information provision described in Appendix 6 is characterized in that the output process compares the history list with the insurance information and outputs the payment items corresponding to the history list together with the applicability of insurance. Method.

(Appendix 8) The information providing method according to Appendix 6, wherein the output process outputs payment items to which the insurance can be applied together with information indicating whether or not the insurance money has been paid. ..

(Appendix 9) The computer further executes a process of creating a list of treatment method candidates that can be selected by the user based on the medical information.
The information provision described in Appendix 6 is characterized in that the output process compares the list of candidates with the insurance information and outputs the payment items corresponding to the list of candidates together with the applicability of insurance. Method.

(Appendix 10) The computer further executes a process of calculating a score indicating the risk of the user for each specific illness determined in advance based on the medical information.
The output process is characterized in that a list of the specific diseases whose score is equal to or higher than the threshold value is further output together with the information indicating whether or not the insurance for each disease is applicable, which is obtained from the insurance information. The information providing method according to any one of Supplementary notes 6 to 9.

(Appendix 11) When the input of the user identification information is accepted, the first server that manages the insurance information contracted by the user corresponding to the user identification information is requested to transmit the insurance information, and the user's A requesting department that requests the transmission of the medical information to a second server that manages medical information based on medical examinations at a medical institution.
A receiving unit that receives the insurance information from the first server and receives the medical information from the second server.
An output unit that compares the received insurance information with the medical information and outputs a payment item to which insurance can be applied included in the medical information.
An information providing device characterized by having.

(Appendix 12) Further having a creation unit for creating a list of the history of medical services received by the user at the medical institution based on the medical information.
The information providing device according to Appendix 11, wherein the output unit compares the list of histories with the insurance information, and outputs the payment items corresponding to the list of histories together with the applicability of insurance. ..

(Appendix 13) The information provision according to the appendix 11 or 12, wherein the output unit outputs the payment items to which the insurance can be applied together with the information indicating whether or not the insurance money has been paid. Device.

(Appendix 14) Further having a creation unit that creates a list of treatment method candidates that can be selected by the user based on the medical information.
The information providing device according to Appendix 11, wherein the output unit compares the list of candidates with the insurance information, and outputs the payment items corresponding to the list of candidates together with the applicability of insurance. ..

(Appendix 15) Further having a calculation unit for calculating a score indicating the risk of the user for each specific disease determined in advance based on the medical information.
The output unit is characterized in that a list of the specific diseases whose score is equal to or higher than the threshold value is further output together with the information indicating whether or not the insurance for each disease is applicable, which is obtained from the insurance information. The information providing device according to any one of Appendix 11 to 14.

1 ... Information providing system 10a, 10b ... User terminal 11 ... Input unit 12 ... Display unit 13, 21 ... Communication unit 14, 22 ... Storage unit 15, 23 ... Control unit 20 ... Information providing device 30 ... Insurance information management system 40 ... Medical information management system 151 ... Request unit 221 ... Authentication information 222 ... Insurance information 223 ... Medical information 224 ... Injury and illness information 225 ... Surgery information 231 ... Authentication unit 232 ... Request unit 233 ... Reception unit 234 ... Creation unit 235 ... Calculation unit 236 ... Output section

Claims (6)

When the input of the user identification information is accepted, the first server that manages the insurance information contracted by the user corresponding to the user identification information is requested to transmit the insurance information, and the user's medical institution requests the transmission of the insurance information. Request the second server that manages medical information based on medical examination to send the medical information,
The insurance information is received from the first server, and the medical information is received from the second server.
Based on the medical information, a list of medical services received by the user at the medical institution is created.
The received insurance information is compared with the medical information, payment items to which insurance can be applied included in the medical information are output , and the list of the history is compared with the insurance information to obtain the history. Output the payment items corresponding to the list together with the applicability of insurance,
An information providing program characterized by having a computer execute processing. The information providing program according to claim 1, wherein the output process outputs payment items to which the insurance can be applied together with information indicating whether or not the insurance money has been paid. Based on the medical information, the computer is further subjected to a process of creating a list of treatment method candidates that can be selected by the user.
The information according to claim 1, wherein the output process compares the list of candidates with the insurance information, and outputs the payment items corresponding to the list of candidates together with the applicability of insurance. Offer program. A computer is further subjected to a process of calculating a score indicating the risk of the user for each specific predetermined illness based on the medical information.
The output process is characterized in that a list of the specific diseases whose score is equal to or higher than the threshold value is further output together with the information indicating whether or not the insurance for each disease is applicable, which is obtained from the insurance information. The information providing program according to any one of claims 1 to 3. When the input of the user identification information is accepted, the first server that manages the insurance information contracted by the user corresponding to the user identification information is requested to transmit the insurance information, and the user's medical institution requests the transmission of the insurance information. Request the second server that manages medical information based on medical examination to send the medical information,
The insurance information is received from the first server, and the medical information is received from the second server.
Based on the medical information, a list of medical services received by the user at the medical institution is created.
The received insurance information is compared with the medical information, payment items to which insurance can be applied included in the medical information are output , and the list of the history is compared with the insurance information to obtain the history. Output the payment items corresponding to the list together with the applicability of insurance,
An information providing method characterized in that a computer executes processing. When the input of the user identification information is accepted, the first server that manages the insurance information contracted by the user corresponding to the user identification information is requested to transmit the insurance information, and the user's medical institution requests the transmission of the insurance information. A requesting department that requests the transmission of the medical information to a second server that manages medical information based on medical examinations.
A receiving unit that receives the insurance information from the first server and receives the medical information from the second server.
A creation unit that creates a list of the history of medical services that the user received at the medical institution based on the medical information.
The received insurance information is compared with the medical information, payment items to which insurance can be applied included in the medical information are output , and the list of the history is compared with the insurance information to obtain the history. An output unit that outputs the payment items corresponding to the list together with the applicability of insurance,
An information providing device characterized by having.

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