JP2003323496A - Coordinated diagnosis system - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a coordinated diagnosis system for allowing a plurality of doctors to cooperate to efficiently make diagnosis. <P>SOLUTION: The coordinated diagnosis system comprises a server with a database storing medical examination information; and requesting terminals and diagnostic terminals both of which are connected with the server. The system includes an examination number converting means for converting an examination number into a characteristic examination ID on the server for management upon diagnosis request data being registered into the server. <P>COPYRIGHT: (C)2004,JPO

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a cooperative diagnosis system in which a plurality of doctors cooperate with each other to make a diagnosis.

[0002]

2. Description of the Related Art Conventionally, when a doctor diagnoses a patient, in many cases, one doctor diagnoses one patient. Depending on the type of illness and the condition of the patient, it is often necessary to request a second opinion from another doctor or refer another hospital to outsource the diagnosis.

[0003] For example, when a diabetic patient visits a physician, it is desirable to have an ophthalmologic examination because of the possibility of diabetic retinopathy, but if there is no ophthalmology in the same hospital facility, refer to the ophthalmologist. Will be done. In that case, it was necessary to prepare a letter of introduction, an inspection data vote, and the like, and it was necessary to interact with the other party at the referral destination, which required a great deal of time and effort. In addition, it was troublesome for the patient to visit the physician and the ophthalmologist separately.

In order to solve this problem, some physicians use a non-mydriasis fundus camera to take a fundus photograph of a diabetic patient and mail the film taken to the ophthalmologist to read and diagnose retinopathy. Is outsourced. In addition, JP-A-2001-27
As described in 3365 (conventional example 1), a method of requesting a diagnosis from another doctor by using a computer terminal connected to a network is also used.

[0005]

If the method of sending the film by mail as described above takes time and effort for mailing the data, and the film and the report are lost during the mailing. There is a fear. Further, it is necessary to manage the images of the film and the like, the patient data and the inspection data, and the report created by the ophthalmologist, which requires a great deal of administrative work.

When using a network,
There is a problem that "the requesting doctor can browse all the registered information, and information about the patient's name, date of birth, address, etc. may be leaked." As a result, there are problems such as "I cannot request an external doctor to make a diagnosis in order to maintain confidentiality of information, and I cannot select an optimal diagnostician."

[0007]

In view of the above problems, in the present invention, when cooperative diagnosis is performed using a network, the ID of the inspection request source side and the ID of the inspection side are made different, and the two IDs are different. The feature is that the privacy can be protected by performing the conversion of.

A detailed description will be given below based on embodiments of the present invention.

[0009]

BEST MODE FOR CARRYING OUT THE INVENTION Embodiments of the present invention will be described.

FIG. 1 shows an example of the configuration of a cooperative diagnosis system according to the embodiment of the present invention. Reference numeral 10 denotes a requesting hospital, and a photographing device 11 such as a fundus camera for photographing a fundus image.
It also has a requesting medical terminal 12 for recording examination information, patient information and the like together with the photographed image and making a request to another doctor (diagnostic doctor). The patient information database 13 stores patient information registered at the time of patient reception.
1 is connected to the requesting medical terminal 12, it is possible to search the patient information database 13 for patient information input at the time of image capturing or when making a diagnosis request. The request terminal connects to the management server 20 through a network such as a LAN or the Internet, sends a diagnosis request voucher to the management server, and registers data to make a diagnosis request.

The management server 20 has a medical information database for diagnosis, an order management database for managing orders for diagnostic requests, a diagnostic doctor database for managing registered doctor data, and a charging database for managing billing and distribution.
The requesting hospital 10 and the diagnostician 30 who have the requesting hospital database and are registered through the network
Connections can be made from A, 30B, 30C, etc. The management server 20 may be located in the facility of the requesting hospital, but may be a facility located in a place different from the requesting hospital and accessible by a public network such as the Internet.

Each of the diagnostician 30A, 30B, 30C, etc. has a diagnostic terminal 31A, etc., accesses the management server 20 via the network, browses the diagnostic request imposed on him / her, and writes the diagnostic result. The data of the diagnosis result can be registered by transmitting to the management server.
The diagnostic terminal 31 can be used by a plurality of diagnostic doctors by sharing one terminal by confirming the person himself / herself with an electronic signature or a password. Also, if the application to be used for diagnosis is requested as a web base using a standard browser, and necessary operations such as browsing and diagnosis report can be performed, the request can be made from any PC regardless of the type of terminal and OS. It is convenient because it can handle different diagnoses.

Next, a work flow in the case where a plurality of doctors cooperate with each other to make a diagnosis by using this cooperative diagnosis system will be described with reference to FIG. First, the requesting hospital makes a diagnosis request S10 to the diagnosis doctor A having the highest priority through the management server. The diagnostician A interprets the image to make a diagnosis,
The diagnosis report S20A is sent to the requesting hospital. The diagnosis confirmation S30 is performed at the requesting hospital, and this inspection is completed.

Further, when the diagnostician is requested to make a diagnosis and judges that the diagnosis cannot be made due to poor image quality of the diagnostic image or inadequate patient data, the re-examination request S22 can be sent to the requesting hospital. . When the re-inspection request is made, the diagnosis request is canceled and the requester is notified of that.
The request for re-examination will be re-taken at the requesting hospital after re-imaging of images and addition / correction of patient data.

The diagnosis request thus generated at the requesting hospital is completed by issuing a diagnosis report or canceling it as a reinspection request. In this way, by setting the priority order in consideration of the schedule of the diagnostician, the specialized field, etc., it is possible to surely request the diagnosis.

By setting a deadline for reporting the diagnostic result, for example,
If the diagnosis report is not made within one week after the diagnosis request is made, the server may automatically make a re-inspection request and cancel the diagnosis request. By doing so, it is possible to prevent the examination process from being delayed by the diagnostician.

A method for realizing the above work flow will be described in detail. FIG. 3 shows the steps performed by the requesting hospital and the diagnostician and the processing performed by the management server.

First, at the requesting hospital, the magnetic card reader or the like (not shown) connected to the fundus camera reads the magnetic card of the patient and inputs the patient ID. The patient data for the patient is entered using the data input device equipped on the fundus camera. Patient data is personal information consisting of name and address,
It consists of sex, date of birth, weight, blood pressure, diagnostic information such as medical history, and so on. These data are obtained from the patient information database network-connected to the fundus camera.
You may search by using as a key and input. Next, the fundus image of the patient is captured after adjusting the imaging conditions of the fundus camera. The fundus image captured by the fundus camera is sent to the requesting medical terminal and displayed on the diagnosis request form screen as shown in FIG.

The diagnostic request sheet includes image data sent from the fundus camera, patient data input by the fundus camera, and image-related data such as image number, photographing device, photographing date and time, left / right eye discrimination. It is also sent and displayed together. The examination number is automatically assigned for each diagnosis request so that it will not be duplicated in the hospital.

The requesting doctor is the examination date, hospital name, hospital code,
Enter the requested data such as the name of the doctor in charge, the purpose of the examination, and the deadline for the diagnostic report. As for patient data, it is possible to add / correct each data as needed. The patient data may not be input by the fundus camera, but may be performed on this screen after image transfer.

Diagnostic Request Voucher Screen When the diagnostic doctor selection button shown in FIG. 4 is clicked, a diagnostic doctor selection setting screen having a diagnostic doctor list is displayed as shown in FIG. The contents of the diagnostic doctor list include items such as the diagnostic doctor's priority, the diagnostic doctor's name, specialty, post, work schedule, etc., and are managed in the diagnostic doctor database of the management server.

The priority order of the diagnostician can be set in advance in the diagnostician database of the management server by the requesting hospital, but by using the priority order change button on the diagnostician selection setting screen, it can be set as necessary. For example, the priority order can be changed according to the case of the patient or in consideration of the displayed schedule of the diagnostician. It is also possible to add or delete a diagnostician to the diagnostician list by using the add / delete button of the diagnostician.

As described above, the management server sends a diagnosis request from the requesting hospital to the diagnosis doctor having the highest priority. When making a diagnosis request, the management server searches the diagnostic doctor database, checks the schedule of the highest diagnostic doctor's schedule, and when the schedule is not available for a certain period of time, selects whether to request the doctor with the next priority Is displayed. For example, “Mr. XX cannot make a diagnosis report until December 16th. Do you still ask the teacher for a diagnosis? Or do you want to change the request to XX teacher? ] Is displayed. The requesting hospital determines a doctor to diagnose by selecting either option.

Setting screen for selecting a diagnostician When the application button is clicked after changing the setting in FIG. 5, the screen returns to the diagnostic request form screen, and at the same time, the changed setting is registered in the diagnostician database of the management server and occurs thereafter. The diagnosis request is processed according to this condition. This step can be omitted when the setting relating to the diagnostician is not changed.

The requesting doctor, after changing the setting relating to the diagnostician or changing the setting of the disclosure range, returns to the diagnosis request screen of FIG. 4, confirms the requested data, etc., and then clicks the diagnosis request button. The contents of the diagnosis request form are sent to the management server, and the work of the diagnosis request is completed.

The data of the transmitted diagnostic request form is registered in the medical care information database after it is confirmed by the management server that there is no defect in each data item. When registering, combine the hospital code, which is a number representing the facility of the requesting hospital, and the examination number issued at the requesting hospital,
After creating a unique number on the management server and confirming that this does not overlap with the already registered inspection, a new unique number is issued as the inspection request number.

The management server further registers the inspection number and inspection request number of this inspection in association with the order management database, and records them together with data such as the date and time of the diagnosis request and the current status (waiting for diagnosis).

Next, the diagnosis doctor having the highest priority set in the diagnosis doctor selection list for this examination is searched from the diagnosis doctor database, and a diagnosis request is issued to the diagnosis doctor (diagnosis doctor A). Will be contacted by means such as email transmission, and at the same time, the access level setting for the medical care database will be changed to "viewable / reportable".

When the diagnostician A is notified that a diagnostic request has been issued, the diagnostician A accesses the management server from the diagnostic medical terminal. After the management server confirms that the person is the person himself / herself with the ID, password, and electronic signature, the management server displays a list of diagnosis request items as shown in FIG. 6 on the diagnostic doctor terminal. It should be noted that if the identification of the person is performed by using a fingerprint, an iris, etc., it is possible to perform a strict check so that another person does not impersonate the diagnostician A and browse the medical care data or make a diagnostic report.

When the diagnostician selects and displays the requested examination from the list, the diagnostic report screen as shown in FIG. 7 is displayed. Necessary data such as request data for diagnosis, patient's personal information, and image data are displayed on this screen, and the diagnostician can enter the results of interpretation and diagnosis of these display data in the diagnostic result entry field. Has become.

The data displayed to the diagnostician is limited to only the items required by the requesting hospital for diagnosis in order to protect the privacy of the patient, and personal information such as the patient's address and telephone number is provided by the diagnostician. It is not possible to browse. As for the examination number, only the examination request number issued by the management server is displayed, and the examination number at the requesting hospital is not displayed to the diagnostician, so privacy such as personal information of the patient is not lost.

As described above, the requesting hospital can keep the confidentiality of privacy such as the personal information of the patient, while disclosing only the information necessary for the diagnosis to the diagnostician.

Using the information displayed on this screen, the diagnostician A can select either reimaging request or report registration to make the selection.

The diagnostician interprets the quality of the displayed image
If you judge that the diagnosis is not enough, or if you have doubts about the patient data such as blood pressure or blood sugar level, you can cancel the diagnosis request by clicking the re-imaging request button and re-acquire it at the requesting hospital. You can ask them to take a picture.

When the diagnostician enters the result of diagnosis in the result entry field and clicks the report registration button, the data of the diagnostic report is transmitted to the management server and the step of diagnostic report is completed.

Next, the procedure when the diagnostician registers a report will be described. For diagnosis, image data, patient data, and the like are browsed on a diagnostic report screen as shown in FIG. 7, and diagnosis is performed based on this, and the diagnostic results such as the disease name and findings are entered in the diagnostic result entry field. When the report registration button is clicked, the entered diagnostic result data is sent to the management server.

The management server, after confirming that there is no defect in the transmitted data, registers the diagnosis result in the medical information database and changes the status on the order management database to "diagnosed / waiting for confirmation". Report the diagnosis report to the requesting hospital by e-mail. At this time, the inspection request number is converted back to the original inspection number used when the diagnosis request was made.

The requesting hospital that received the diagnostic report mail,
When the management server is accessed, a diagnostic report confirmation screen as shown in FIG. 8 is displayed, and after confirming the content of the diagnostic result, clicking the request source confirmation button transmits the information to the management server. In this diagnostic report screen, it is not necessary to keep the information private for confidentiality, and the examination number of the requesting hospital and the personal information of the patient are displayed as in the diagnostic request form screen.

In order to identify the examination when it is necessary to contact the diagnostic physician directly by telephone, such as in an emergency, on the diagnostic report confirmation screen on the requesting medical terminal side, the diagnostic physician can display the examination number together with the examination number. The diagnosis request number used is also displayed.

The management server updates the status in the order management database to the end of examination, registers the record of the diagnostic report in the diagnostic physician database, and registers the charging / distributing data in the charging database. Finally, an email is sent to the requesting hospital and the diagnostician who made the diagnosis informing that all the processing for this examination has been completed, and the examination is completed.

(Second Embodiment) As shown in FIG. 9, viewers A, B, and C other than the diagnostician can also access the management server, view medical data about registered cases, and view the number of views. Alternatively, the access time or the like is managed by a billing server, and the viewer is billed according to the usage amount.

In such a system, a viewer can view a diagnostic report or the like, but personal information is not disclosed, and the inspection number is converted into a viewing ID number and displayed. Thereby, the inspection number, the inspection request number, etc. are not known to the viewer, and the medical data such as the image data and the diagnosis result can be presented to the viewer while keeping the confidentiality of the personal information.

(Third Embodiment) Next, a third embodiment will be described.

In the first embodiment, the examination is specified by using the examination number and hospital code issued at the requesting hospital, but this is the unique number of the image used for the diagnosis request, For example, when using a DICOM image, it is possible to perform recognition at the time of registration by using the study UID that is its property. Since the study UID is defined by the DICOM standard so that it is always made a unique value, it can be used as a unique number on the management server without combining it with the hospital code. It can also be used by converting it to the unique inspection request number above.

[0045]

EFFECT OF THE INVENTION By using the cooperative diagnosis system described above, a plurality of doctors can cooperate with each other to make a diagnosis efficiently and reliably. In particular, the requesting hospital can request a diagnosis without disclosing the examination number used in the hospital to an external diagnostician, which ensures the confidentiality of private data such as patient personal information and diagnosis results. To be done.

[Brief description of drawings]

FIG. 1 is a system configuration diagram of an embodiment of the present invention.

FIG. 2 is an explanatory diagram showing the flow of a diagnosis request.

FIG. 3 is an explanatory diagram showing a work flow of a diagnosis request.

[Fig. 4] Explanatory drawing of the diagnosis request form screen

FIG. 5 is an explanatory diagram of a setting screen for selecting a diagnostician.

FIG. 6 is an explanatory diagram of a diagnosis request list screen.

[Figure 7] Explanatory drawing of the diagnostic report screen

[Figure 8] Explanatory drawing of the screen of the diagnostic report confirmation

FIG. 9 is an explanatory diagram of the second embodiment.

[Explanation of symbols]

10 requesting hospital 11 fundus camera 12 Request terminal 13 patient information DB 20 Management server 30A, B, C diagnostician 31A, B, C Diagnostic medical terminal

Claims (4)

[Claims] 1. An inspection request unit for requesting inspection of inspection request data, a management unit for managing the inspection request data requested by the inspection request unit, and inspection request data managed by the management unit. In a test request system connected by a network having a browsing means for browsing, the test request system specifies a first test I.
The inspection means includes an inspection ID giving means for giving D to the inspection request data, the management means has an inspection ID conversion means for converting the inspection ID received from the inspection request means into a second inspection ID, and A first transmission procedure for transmitting to the browsing means using the converted second inspection ID, and the inspection by converting the second inspection ID transmitted from the browsing means back into the first inspection ID. An inspection request system having a management means characterized by transmitting to an ordering means. 2. The apparatus according to claim 1, wherein the first examination ID includes a patient ID identifying a patient. 3. The management means includes facility ID assigning means for assigning a predetermined facility ID to the inspection requesting means, and the inspection requesting means includes storage means for storing the assigned facility ID. The inspection requesting means has a transmission procedure of transmitting the facility ID when communicating with the managing means, and the inspection ID converting means is based on the received facility ID and the first inspection ID. The second inspection I unique to the management means
The inspection request system according to claim 1, wherein the inspection request system converts the inspection data into D. 4. The facility managing unit assigns a facility ID to the inspection requesting unit, a unique device ID assigned to a device generating inspection data of the inspection requesting unit, and the facility ID. The inspection request system has a transmission procedure for transmitting the device ID when communicating with the inspection center, and the inspection ID conversion unit has the received device ID and the inspection. ID
The system according to claim 1, wherein the inspection center converts the inspection ID into a unique inspection ID.