## Requirements # 4. Requirements This section specifies the functional and business requirements for the system, as derived from the provided context. All requirements are structured and referenced according to ISO/IEC/IEEE 29148:2018 guidelines. --- ## 4.1 Functional Requirements ### 4.1.1 Abuse Prevention and Physical Restraint Minimization in Home-Visit Nursing - The responsibilities of administrators at home-visit nursing stations shall be clarified and requirements reviewed to ensure both the quality of home-visit nursing and efficient station operation. [KB-01a2d77c-a20a-47e5-ae19-16ab2c89e272] - Systems for abuse prevention measures in home-visit nursing shall be made mandatory, and physical restraint and similar practices shall be prohibited in principle. [KB-01a2d77c-a20a-47e5-ae19-16ab2c89e272][KB-e14d657a-8970-4e3e-9ccb-5662af7d6525] ### 4.1.2 Minimization of Physical Restraint in Medical Institutions - Medical institutions shall establish organizational systems to minimize the use of physical restraint for inpatients. [KB-8445364a-473a-46bc-8207-fb1f2671bde6][KB-edc81296-4474-4138-a404-f797f293eb19] ### 4.1.3 Enhancement of Nursing Support Systems - The requirements and evaluation for enhanced nursing assistant systems shall be reviewed to further promote the division and cooperation of work between nursing staff and nursing assistants, and to encourage efforts to minimize physical restraint. [KB-05c4460e-0933-40a9-962c-fc2be422e060] ### 4.1.4 Home-Visit Nursing: 24-Hour Response and Emergency Support - The evaluation system for the 24-hour response system in home-visit nursing stations shall be revised to consider efforts to reduce the burden of nursing work, and the handling of communication systems related to 24-hour response shall be reviewed. [KB-06db46ba-7647-483b-9f38-f7fa62a24d77] - Requirements and evaluation for emergency home-visit nursing additions shall be reviewed to ensure appropriate provision of emergency designated home-visit nursing, and the contents of home-visit nursing care fee claims and related documentation shall be reviewed. [KB-4be6a015-623d-440c-95dd-a51bf556ebbd] ### 4.1.5 Frequent Visit Additions - Requirements and evaluation for frequent visit additions in home-visit nursing shall be reviewed to promote more appropriate evaluation according to the condition of patients receiving home medical care. [KB-17ac1ec0-b2d4-4910-9884-a2e46ea25ce0] ### 4.1.6 Strengthening Home-Visit Nursing Station Functions - Requirements and evaluation for home-visit nursing management fees shall be reviewed to strengthen the functions of home-visit nursing stations, ensuring high-quality and effective care in response to diverse user and regional needs. [KB-aeb72a17-5d44-4c8e-b3c6-e83c459da003] ### 4.1.7 Online Eligibility Verification and Information Utilization - When an online eligibility verification system (居宅同意取得型オンライン資格確認等システム) is introduced, the system shall acquire and utilize user medical and medication information at the initial visit to enable planned management and provision of high-quality medical care. [KB-9e53203f-143a-4301-abb8-e7bd7dde87af] ### 4.1.8 Discharge Support and Joint Guidance - For patients hospitalized at insured medical institutions, when a designated pharmacy is specified for post-discharge home medication management guidance, the pharmacist at the designated pharmacy, with patient consent, shall provide guidance for home care after discharge. [KB-061bef49-5443-4529-80cb-0067c3bedc4f][KB-1eebb670-f513-40ab-a8bc-7127863e3404][KB-44db8f45-e972-47c4-ba46-8ad6a816615e] ### 4.1.9 Medication Management and Guidance - When necessary, pharmacists shall provide required guidance to patients, including those prescribed particularly safety-critical medicines, and document the guidance as required. [KB-08289384-33b4-4060-8531-77d29c0895ef][KB-9720cc93-fb47-4376-9506-fbb4d8f61048][KB-f271747d-fadb-4d69-9ff8-ea0f4702f4f2][KB-fde2b685-c7c4-44d8-9de7-3a7051dd9005][KB-5398730a-d7b5-4d8b-830e-5282b5bf61c8][KB-b2731f14-7331-4d15-827d-89f8aed2bcb1][KB-e8ad7124-d716-4649-9f50-064344c869d7] - For patients receiving narcotics, the pharmacist shall confirm the status of use, storage, and side effects, and provide necessary pharmaceutical management and guidance. [KB-08876a43-c1e4-4b7f-8517-0cd67e273533][KB-10f23eda-03d3-4220-8642-6ff7cbf64700][KB-24385190-0703-42d1-a834-6854e998b904][KB-66969593-ac17-45cd-a41d-f335a2406225][KB-ad7d4dc3-8896-4c1b-92c7-8d969120b377][KB-31de50ce-f3df-4fb0-a0bd-6a1ce5795463] - For pediatric patients with disabilities as defined by the Child Welfare Act Article 56-6(2), necessary information shall be confirmed directly with the patient or their family, and guidance on medication use shall be provided and recorded in the patient’s handbook. [KB-6bb697eb-fdad-4cda-a697-9d148e072b9d][KB-ba91d9ab-b335-4929-9779-694ba115ef39] - For asthma or chronic obstructive pulmonary disease (COPD) patients receiving inhalation drugs, guidance and management shall be provided using documentation and training inhalers, and necessary information shall be provided to the medical institution in writing. [KB-604920cd-689f-4a10-97db-9faeb614d499][KB-ef609548-ff37-4388-9fd5-c638d8bf6eab] ### 4.1.10 Medication Information Provision - When required, pharmacists shall provide necessary information about medication use to medical institutions in writing, including after dispensing and for refill prescriptions, and may also provide information to care managers as needed. [KB-c35807e4-304e-4ca5-8e86-e1404c20a9fd][KB-37919876-98a0-4f81-879a-7de2d13e4a0f][KB-0dc6dd3d-3ecc-4685-9f43-b8bcb2ab8ce4][KB-cd5ee7fe-b23b-4de0-a8e1-f8ff41e250cf] --- ## 4.2 Business Requirements ### 4.2.1 Claims and Fee Calculation - The system shall support the calculation and claims for various additions and management fees as specified, including but not limited to: - Discharge joint guidance fee (退院時共同指導料): 600 points - In-home emergency joint guidance fee (在宅患者緊急時等共同指導料): 700 points - Narcotics management guidance addition: 100 points per instance - Pediatric-specific addition: 350 points per instance - Inhalation drug guidance addition: 30 points per instance (up to once every three months) - Specific drug management guidance addition 1: 10 points per instance - Specific drug management guidance addition 2: 100 points per month (once per month) - Other specified additions as referenced in the source material [KB-061bef49-5443-4529-80cb-0067c3bedc4f][KB-1eebb670-f513-40ab-a8bc-7127863e3404][KB-44db8f45-e972-47c4-ba46-8ad6a816615e][KB-4fc322f9-642f-4801-89c3-cb70c9af6ab1][KB-08876a43-c1e4-4b7f-8517-0cd67e273533][KB-10f23eda-03d3-4220-8642-6ff7cbf64700][KB-24385190-0703-42d1-a834-6854e998b904][KB-66969593-ac17-45cd-a41d-f335a2406225][KB-ad7d4dc3-8896-4c1b-92c7-8d969120b377][KB-31de50ce-f3df-4fb0-a0bd-6a1ce5795463][KB-6bb697eb-fdad-4cda-a697-9d148e072b9d][KB-ba91d9ab-b335-4929-9779-694ba115ef39][KB-604920cd-689f-4a10-97db-9faeb614d499][KB-ef609548-ff37-4388-9fd5-c638d8bf6eab][KB-f271747d-fadb-4d69-9ff8-ea0f4702f4f2][KB-fde2b685-c7c4-44d8-9de7-3a7051dd9005][KB-5398730a-d7b5-4d8b-830e-5282b5bf61c8][KB-b2731f14-7331-4d15-827d-89f8aed2bcb1][KB-e8ad7124-d716-4649-9f50-064344c869d7][KB-c35807e4-304e-4ca5-8e86-e1404c20a9fd] #### Example Table: Fee Additions | Fee/Addition Name | Points per Instance | Frequency/Limitations | Reference | |-----------------------------------------|---------------------|----------------------------------------|-------------------------------------------------------------------| | Discharge Joint Guidance Fee | 600 | As specified | [KB-061bef49-5443-4529-80cb-0067c3bedc4f], etc. | | In-home Emergency Joint Guidance Fee | 700 | As specified | [KB-4fc322f9-642f-4801-89c3-cb70c9af6ab1] | | Narcotics Management Guidance Addition | 100 | Per instance, up to 2x/month | [KB-08876a43-c1e4-4b7f-8517-0cd67e273533], etc. | | Pediatric-Specific Addition | 350 | Per instance | [KB-6bb697eb-fdad-4cda-a697-9d148e072b9d], [KB-ba91d9ab-b335-4929-9779-694ba115ef39] | | Inhalation Drug Guidance Addition | 30 | Once every 3 months | [KB-604920cd-689f-4a10-97db-9faeb614d499], [KB-ef609548-ff37-4388-9fd5-c638d8bf6eab] | | Specific Drug Management Guidance 1 | 10 | Per instance | [KB-fde2b685-c7c4-44d8-9de7-3a7051dd9005] | | Specific Drug Management Guidance 2 | 100 | Once per month | [KB-b2731f14-7331-4d15-827d-89f8aed2bcb1] | --- ## 4.3 Constraints - Physical restraint is to be minimized and, in principle, prohibited in home-visit nursing and institutional care settings. [KB-01a2d77c-a20a-47e5-ae19-16ab2c89e272][KB-e14d657a-8970-4e3e-9ccb-5662af7d6525][KB-8445364a-473a-46bc-8207-fb1f2671bde6][KB-edc81296-4474-4138-a404-f797f293eb19] - Abuse prevention systems are mandatory in home-visit nursing. [KB-01a2d77c-a20a-47e5-ae19-16ab2c89e272][KB-e14d657a-8970-4e3e-9ccb-5662af7d6525] --- ## 4.4 [GAP: Missing data for Requirements] If additional requirements are needed for other domains or detailed technical specifications, the necessary data is not present in the provided context. --- **References:** All requirements are strictly derived from the provided knowledge base blocks as cited inline.