JP2007280134A - Medical care support system - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To save the labor for preparing operation of order information to be used to prepare a recept and a prescription for medical action, to improve the efficiency of the preparation operation and to prevent ordering errors and order input omissions as well. <P>SOLUTION: This medical care support system 1 preliminarily stores medical treatment prearrangement information 22 and relevant information 23 in a storing part 20. An order information generating part 60 acquires from the relevant information 23 information of insurance items and insurance points corresponding to medical treatment execution information input when medical treatment action included in the medical treatment prearrangement information 22 is executed to generate order information. The generated order information is transmitted to an ordering system 3. When a medical treatment end key 2011 is clicked when medical treatment to a corresponding patient ends, the order information is transmitted to a recept system 7. <P>COPYRIGHT: (C)2008,JPO&INPIT

Description

  The present invention relates to a medical support system that generates an order for medical practice.

  In recent years, digitization of medical information is progressing in medical institutions such as hospitals. In the old days, there were receipt computers that computerized accounting and reception work, and medical diagnostic systems that computerized diagnosis, and computerization of medical records for the purpose of improving the efficiency of medical sites was tried from an early stage and has become widespread.

  As this electronic medical record system, an electronic medical record creation apparatus has been proposed that creates an electronic medical record in which an image is inserted in a medical record and the schema recording screen can be viewed on the electronic medical record screen (for example, Patent Document 1).

  In recent years, information processing systems of medical institutions have been advanced, and the spread of ordering systems is also desired as a medical office accounting system of medical institutions. The ordering system is an information transmission system related to examinations and prescriptions. For example, by inputting the order (examination contents and prescriptions) previously written on paper by a doctor into the computer, the operations of related departments are linked. Processes and operations related to medical accounting from subsequent medical treatments will be accelerated.

  For example, when a doctor inputs an instruction for X-ray examination from the terminal device in the examination room, the instruction is transmitted to the terminal device in the X-ray examination room, or when a prescription instruction is input for a medicine, the prescription instruction is transmitted to the terminal device in the dispensing room. An ordering system is also known (for example, Patent Document 2).

  In addition, as a system for integrated electronic medical record ordering control, a symptom keyword list related to symptom keywords on the electronic medical record entered by a doctor is extracted, and a corresponding keyword is selected from the symptom keyword list. (For example, Patent Document 3).

Japanese Patent Laid-Open No. 11-232364 JP 2002-189802 A JP 2005-38262 A

  However, according to Patent Documents 1 and 2, since the electronic medical record system and the ordering system are separate and independent systems, the doctor conducts medical treatment of the patient and inputs the electronic medical record (for example, examination results and examination findings). After inputting), the ordering system was activated and input items of various orders had to be entered manually against the information entered in the electronic medical record. For this reason, the order creation work becomes complicated, and there is a possibility that problems such as an order input error and an input leakage may occur.

  Further, according to Patent Document 3, since the contents of the findings described in the electronic medical record are used to determine the order information, the above problem may be partially solved, but the order In order to determine the information, it is necessary to individually select input items of various orders through selection of a keyword by a doctor, and the ordering work is still complicated, and there is a possibility of causing an order mistake.

  Further, depending on the contents of medical care / examination, there is an order that is uniquely generated depending on the action item such as medical care / examination. Therefore, regarding the order information that is uniquely determined by medical treatment / examination, etc., when the findings etc. are described in the electronic medical record, if the work of electronic medical record input and ordering is performed individually, the duplication of electronic medical record input and ordering for the same item There has been a waste of time and labor in performing the input work or selection work.

  In addition, in the relationship between the electronic medical record and the medical treatment schedule planned by the doctor, duplicate input work has been performed on the same content. After the doctor examines the patient (for example, after the first visit), based on the test results and the findings of the doctor, the medical plan for medical activities such as subsequent examination, medical treatment, hospitalization, surgery, drug administration, etc. However, the order information may be uniquely determined in advance depending on the contents of the examination and the like determined by this medical plan. In this case, there is a waste because it is divided into separate work such as filling out a medical plan, filling in findings by examination based on the plan, and ordering.

  The present invention has been made in view of the above problems, and by reflecting the contents input to the electronic medical chart system in the ordering system, it is possible to save labor and improve efficiency in the ordering work, An object is to provide a medical support system capable of preventing input leakage.

  In order to solve the above-mentioned problem, the invention described in claim 1 is characterized in that the medical treatment is performed in response to storage means for storing medical treatment content information indicating the content of the medical treatment in advance and medical practice information indicating the implementation of the medical treatment. It is a medical support system characterized by comprising information generation means for generating order information used for preparation of a receipt and / or a prescription based on medical treatment content information corresponding to a medical practice indicated in the information.

  The invention of claim 2 is a setting means for setting medical care content information indicating the content of a medical practice scheduled to be implemented in the future, a storage means for storing the set medical care content information, and a medical care indicating the implementation of the medical practice. Information generating means for receiving execution information and generating order information for preparation of a receipt and / or a prescription based on medical treatment content information corresponding to the medical practice indicated in the medical practice information. It is a medical support system that is characterized.

According to a third aspect of the present invention, when performing a medical practice other than the medical practice indicated in the set medical care content information, a medical care content identifying unit that identifies the content of the medical practice, and a medical treatment identified by the medical content identifying unit The medical support system according to claim 2, further comprising information generation means for generating order information based on medical practice information based on an action.

  The invention of claim 4 comprises a medical device for performing a medical practice, and an input means for inputting the medical practice information to the information generating means when the medical practice is performed. The medical support system according to any one of Items 1 to 3.

  The invention of claim 5 is characterized in that the receipt system and / or the prescription system for processing the order information is provided with a transmission means for transmitting the order information. It is a medical support system.

  According to a sixth aspect of the present invention, display means for displaying the medical treatment content information set by the setting means, and implemented information indicating that the medical practice indicated in the medical practice information has been performed in response to the medical practice information. The medical support system according to claim 2, further comprising a control unit that causes the display unit to display a message.

  A seventh aspect of the present invention is the medical support system according to any one of the first to sixth aspects, wherein the order information is a test content and a treatment drug associated with the practiced medical practice.

  In the medical support system according to claim 1 or claim 2 according to the present invention, the information generating means that receives the input of the medical practice information indicating that the medical practice has been performed is used as the medical practice indicated in the medical practice information. Order information is generated based on the corresponding medical treatment content information.

  As a result, order information can be automatically generated, so that labor saving and efficiency improvement can be achieved. In addition, since order information is automatically generated, it is possible to prevent input errors and omissions and to ensure the accuracy of medical office work compared to the case where order information is entered by browsing and referring to electronic medical records. It becomes possible to do.

  An example of the best embodiment of the medical support system according to the present invention will be described in detail with reference to the drawings.

[System configuration]
FIG. 1 shows a configuration of a medical support system 1 according to the present embodiment. The medical support system 1 includes an electronic medical record system 2 and an ordering system 3. The electronic medical chart system 2 is connected to each of the medical data system 5 and the ordering system 3 so as to be able to communicate with each other.

  The medical data system 5 includes processing for inputting examination instructions and the like transmitted from the electronic medical chart system 2 to the ophthalmic apparatuses A to C and information such as examination results obtained by the ophthalmic apparatuses A to C to the electronic medical chart system 2. Perform input processing. Each of the ophthalmologic apparatuses A to C is an arbitrary ophthalmologic apparatus used for ophthalmic examination or ophthalmologic imaging, and is, for example, an apparatus such as a tonometer, an autorefractometer, an autokeratometer, a slit lamp, or a fundus camera. When a medical practice is performed by the ophthalmic apparatuses A to C, medical practice information indicating that the medical practice has been performed is transmitted from the ophthalmic apparatuses A to C to the medical data system 5. The medical care data system 5 transmits this medical care implementation information to the electronic medical chart system 2.

  The ordering system 3 is connected to a reception system 7. The receipt system 7 is a system that executes processing such as receipt and prescription creation including information such as examination name, treatment name, medical site, insurance score, prescription drug name, prescription eyeglass lens, and the like. In general, a system for creating a receipt and a system for creating a prescription are provided separately, but here, for the sake of simplification of illustration, it is assumed that the reception system 7 performs both processes. Further, the medical support system 1 shown in FIG. 1 is configured not to include the reception system 7, but the medical support system according to the present invention includes the reception system 7 together with the electronic medical record system 2 and the ordering system 3. It is good.

(Configuration of electronic medical record system)
The electronic medical chart system 2 includes a storage unit 20 that stores various data, a UI (User Interface) 30, a control unit 40 that controls each part of the system, a medical practice information input unit 50 that inputs medical practice information, And an order information generating means 60.

  The storage unit 20 stores information necessary for the operation of the medical support system according to the present embodiment. In particular, the storage unit 20 generates electronic medical record information 21 including data recorded in the electronic medical record for each patient, medical schedule information 22 including a medical schedule (medical service plan) for each patient, and generation of order information. And related information 23 to be stored. For example, a storage device such as a hard disk drive is used as the storage unit 20.

  The electronic medical record information 21 includes the patient ID for each patient, the patient's name, age, gender, date of birth, date of first visit, disease / injury name, visit history, surgery history, doctor in charge, main complaint data ( Main physical symptom data appearing due to such), examination information, finding data (including character finding information), schema (may include character finding information), special remarks, and other information. The user can read out the electronic medical chart information 21 as appropriate, and input or edit various information.

  The medical treatment schedule information 22 is information on a medical treatment schedule (plan) for each patient input by a doctor, and is used for order information generation processing and electronic medical record information input processing. The items of information included in the medical treatment schedule information 22 include a patient ID, a patient's name, a medical treatment date, medical treatment items (examination name, treatment name, part, treatment drug name, etc.), and a doctor name in charge.

  Here, as examination information in the ophthalmic field, visual acuity value information obtained by visual acuity examination (spherical power, astigmatism power, astigmatic axis angle, etc. of the eye to be examined), intraocular pressure value information obtained by intraocular pressure examination, and others There is test result information of any ophthalmic examination. In addition, the examination information includes images taken by an ophthalmologic photographing apparatus such as a slit lamp and a fundus camera.

  The related information 23 is information used for generating order information. FIG. 11 shows an example of the related information 23. In the figure, related information 23 related to the examination among various medical practices is described. The related information 23 associates the corresponding “insurance item” and “insurance score” for each examination described in the “examination name” column indicating the examination type. In addition to the information related to the examination shown in FIG. 11, the related information 23 stores information related to various medical treatments such as various treatments, prescriptions for drugs and spectacle lenses.

  The UI 30 includes a display unit 31 and an operation unit 32. The display unit 31 displays various screens such as a screen for inputting a medical schedule, a screen for inputting an electronic medical record, and a screen for selecting medical items. For example, an arbitrary display device such as an LCD (Liquid Crystal Display) or a CRT (Cathode Ray Tube) is used as the display unit 31. The operation unit 32 includes an arbitrary input device such as a keyboard, a mouse, and an electronic pen, and an operation device. Note that the display unit 31 and the operation unit 32 do not need to be provided separately, and for example, a UI in which they are integrated, such as a touch panel type LCD, can be used.

  The control unit 40 displays various screens to be described later on the display unit 31, controls each part of the device in response to an operation on the operation unit 32, controls to store information in the storage unit 20, and various types from the storage unit 20. Control to read out information. Further, the control unit 40 performs processing for transmitting information obtained from the storage unit 20 and the UI 30 to the order information generation unit 60.

  In addition, the control unit 40 controls the order information generation unit 60 to generate order information. When the medical treatment is completed, control is performed to receive medical input information from the operation unit 32 of the UI 30 and transmit the medical treatment end information to the ordering system 3. This medical treatment end information is information that is input to the ordering system 3 when all medical practices to be performed are performed. The ordering system 3 that has received the medical treatment end information transmits the order information to the reception system 7. The control unit 40 further performs various other controls related to the operation of the electronic medical chart system 2.

  The medical treatment information input unit 50 is connected to the medical data system 5 so as to be communicable. Various medical devices (for example, ophthalmic devices A to C) are communicably connected to the medical data system 5 shown in FIG. When examinations and imaging are performed by the ophthalmologic apparatuses A to C, the above-described medical care implementation information is transmitted to the electronic medical chart system 2 via the medical data system 5. The medical treatment implementation information input unit 50 performs a process of receiving the medical treatment implementation information and inputting it to the order generation unit 60. The medical practice information input unit 50 is not limited to such a configuration. For example, the medical practice information input unit 50 has a configuration for manually inputting medical practice information indicating implementation of a medical practice by the ophthalmologic apparatuses A to C. (It will be described later).

  The order information generation unit 60 is used to create order information (for example, a receipt or a prescription) based on the medical practice information input from the medical practice information input unit 50 and the related information 23 input by the control unit 40. Information). That is, the order information generation unit 60 collates information specifying the medical practice included in the medical practice information with information specifying the medical practice included in the related information 23, and associates the information associated with the medical practice with the related information. It is acquired from the information 23 and used as order information of the medical practice.

  For example, when medical practice information including information for specifying an intraocular pressure test is input, the order information generation unit 60 performs an intraocular pressure test from an examination item included in the “examination name” column of the related information 23 illustrated in FIG. 11. Search for an item. Information related to the searched intraocular pressure item “intraocular pressure”, that is, “precision tonometry” and “AAABBBCCCDD0.4%” in the “insurance item” column, and “insurance score” column “85” and “1” are acquired. The information “precision tonometry”, “AAABBBCCCDD0.4%”, “85”, “1” acquired in this way is handled as order information. “AAAABBBCCCDD0.4%” is the name of the drug used in the intraocular pressure test. At this time, a plurality of examination contents and treatment drugs thereof may be handled as order information for one medical practice.

  Further, the order information generation unit 60 acquires the description contents such as findings and schemas described at the time of performing the medical practice from the electronic medical record information 21, and identifies the medical practice based on the description contents. Then, the information associated with the specified medical practice is acquired from the related information 23 and used as the target order information.

  The order information generated as described above is input to the ordering system 3 together with the patient ID and the like.

(Configuration of ordering system)
The ordering system 3 performs processing on the order information input from the electronic medical chart system 2. For example, the ordering system 3 accumulates the order information input from the electronic medical record system 2 for each patient (combines the order information of each patient based on the patient ID), and the medical treatment end information is the electronic medical record system 2. In response to the input from, the stored order information is transmitted to the receipt system 7.

  In FIG. 1, one electronic medical record system is connected to the ordering system, but a plurality of electronic medical record systems may be connected (not shown). For example, an electronic medical chart system of a plurality of departments such as an electronic medical chart system for surgery, an electronic medical chart system for internal medicine, an electronic medical chart system for radiology, and an electronic medical chart system for ophthalmology are connected to the ordering system It is also possible to take

  Further, in the medical support system 1 according to the present embodiment, the electronic medical record system 2 and the ordering system 3 are configured as separate systems, but the medical support system according to the present invention is not limited to this. For example, the electronic medical record system and the ordering system can be formed by the same computer (not shown).

  Further, in the medical support system 1 according to the present embodiment, the order information is transmitted to the reception system 7 in response to the input of medical treatment end information from the electronic medical record system 2 to the ordering system 3. The medical support system according to the present invention is not limited to this. For example, the order information generated in the order information generation unit 60 of the electronic medical record system 2 is temporarily stored in the storage unit 20 to control the medical end information. The stored order information may be transmitted to the ordering system 3 and further transmitted to the reception system 7 in response to the input to the system. Such a configuration is suitable when a plurality of electronic medical record systems are connected to the ordering system 3 as described above.

  The medical treatment schedule information 22 of the present embodiment is included in the “medical treatment content information” in the present invention. The storage unit 20 corresponds to an example of “storage means”. The order information generation unit 60 corresponds to an example of “information generation means”. Further, the order information generating unit 60 functions as “medical care content specifying means”. The UI 30 corresponds to an example of “setting means”. The display unit 31 of the UI 30 includes “display means”. The control unit 40 includes “control means”. The ophthalmologic apparatuses A to C are included in the “medical apparatus”. The medical practice information input unit 50 corresponds to “input means”.

[Hardware configuration]
The hardware configuration of the electronic medical record system 2 and the ordering system 3 will be described with reference to FIG. In the figure, the configuration of a computer constituting the electronic medical record system 2 and the ordering system 3 is described.

  A computer 10 constituting the electronic medical chart system 2 includes a CPU 11 (microprocessor such as a RAM), a RAM 12, a ROM 13, a hard disk drive 14, a display 15, an electronic pen 16, a keyboard 17, a mouse 18, and a communication interface 19 (LAN card, etc.). Consists of including. These units are connected via a bus 100. Here, the electronic pen 16 is arbitrarily provided, and when it is provided, a touch panel type LCD (tablet) is used as the display 15.

  The ordering system 3 has the same hardware configuration as that of the electronic medical record system 2, but the display 15, the electronic pen 16, the keyboard 17, the mouse 18, etc. may not be provided. The communication interface 19 of the ordering system 3 is included in the “transmission means” of the present invention.

  The storage unit 20 of the electronic medical record system 2 includes a hard disk drive 14. The display unit 31 includes the display 15. The operation unit 32 includes the electronic pen 16, the keyboard 17, and the mouse 18. The control unit 40 includes a CPU 11, a RAM 12, and a communication interface 19. Here, a control program (not shown) is stored in advance in the hard disk drive 14, and the CPU 11 develops this control program on the RAM 12 to perform processing characteristic of the present embodiment.

  The medical practice information input unit 50 for receiving medical practice information from the medical information data system 5 includes a CPU 11, a RAM 12, a communication interface 19, and the like. When applying a configuration in which the user manually inputs medical practice information, the medical practice information input unit 50 includes, for example, a mouse 18 and the like. The order information generation unit 60 includes a CPU 11, a RAM 12, and the like. Also for the order information generation unit 60, the CPU 11 develops the above-described control program on the RAM 12 to perform processing characteristic to the present embodiment.

  In the ordering system 3, the CPU 11 develops a control program stored in advance in the hard disk drive 14 on the RAM 12, thereby performing processing characteristic to the present embodiment.

[Configuration of display screen]
Below, the display screen shown in FIGS. 3-10 is demonstrated. FIG. 3 shows a medical plan display screen 1000 for setting the medical plan information 22 for each patient. FIG. 4 shows a medical information display screen 2000 that presents the electronic medical record information 21 in a predetermined display format. FIG. 5 shows today's schedule screen 3000 that displays a list of medical practices included in the medical schedule information 22. FIG. 6 shows an order information display screen 4000 that displays order information. FIG. 7 shows a schema diagram creation screen 5000 for creating a schema diagram. FIG. 8 shows a state where a new medical treatment item (medical practice “slit”) is added to the schedule screen 3000 of today. FIG. 9 shows a medical item addition screen 6000 for adding a medical item to today's schedule screen. The process of displaying these screens on the display unit 31 is executed by the control unit 40.

(Medical schedule display screen)
The medical schedule display screen 1000 is a screen for setting a medical practice scheduled to be performed at the next visit, for example. The medical treatment schedule display screen 1000 is provided with a medical treatment content display unit 1001 and a date / time display unit 1002.

  The medical treatment content display unit 1001 displays a list of the content of medical treatments such as examination name, treatment name, prescription drug name, and spectacle lens prescription result ("medical treatment item" column). The medical treatment content display unit 1001 is provided with a column for displaying a medical site, a column for describing a creator of the medical plan, and a column for describing a comment of the creator.

  The clinical site is specified by a check mark that is alternatively input to the check boxes corresponding to “right” (right eye), “left” (left eye), “both” (both eyes), and “none”. Is done. This check mark is manually set by clicking an appropriate check box with the mouse 18 or the like.

  The medical site “none” is selected when a medical practice other than the medical practice performed directly on the eye to be examined is performed, for example, when an analgesic is administered.

  The medical plan display screen 1000 is provided with various soft keys, and a medical practice is input by operating these soft keys. Further, the creator name and the creator comment are input using the electronic pen 16 or the keyboard 17. The medical plan set on the medical plan display screen 1000 is stored in the storage unit 20 as the medical plan information 22.

(Medical information display screen)
The medical information display screen 2000 shown in FIG. 4 is a display screen that presents information included in the electronic medical record information 21 in a display format as shown in FIG.

  As described above, the electronic medical record information 21 includes the patient ID, the patient's name, age, injury and illness, visit history, main complaint information, examination information, findings information, schema (may include findings information), special notes, etc. It is included. The medical information display screen 2000 is provided with a display area for presenting such information. For example, wound name information is displayed on the wound name display section 2001, main complaint information is displayed on the main complaint display section 2002, and visual acuity value information and intraocular pressure value information, which are examination information, are displayed on the examination information display section 2003. The Detailed inspection information (examination name, inspection result details, etc.) of the inspection information is displayed in the inspection details display section 2004, a schema diagram is displayed in the schema diagram display section 2005, and the findings etc. are displayed in the character findings display section 2006. Is displayed.

  The medical information display screen 2000 is provided with today's schedule key 2007 for accepting today's schedule list display operation. When the today's schedule key 2007 is clicked with, for example, the mouse 18, the control unit 40 reads the patient's medical schedule information 22 set on the medical schedule display screen 1000 from the storage unit 20, and based on this medical schedule information 22, The schedule screen 3000 is displayed. The display mode of today's schedule screen 3000 will be described later.

  The medical care information display screen 2000 is provided with a photographing key 2008. When this photographing key 2008 is clicked, an item indicating the type of ophthalmic photographing is displayed by, for example, a pull-down menu. When the user selectively clicks on a desired item using the operation unit 32, the control unit 40 transmits a signal requesting execution of ophthalmic imaging corresponding to the item to the medical data system 5. The medical data system 5 transmits this signal to the target ophthalmologic apparatuses A to C. Then, the ophthalmologic apparatuses A to C that have received this signal perform target ophthalmologic imaging.

  The medical care information display screen 2000 is provided with an examination input key 2009. When the examination input key 2009 is clicked, items relating to the examination are displayed by a pull-down menu, and the examination item (for example, an intraocular pressure examination) is performed by the user selecting a desired item. Here, for example, it has a function of manually registering a color vision test, a tear test, and findings related thereto, in addition to a test result that is automatically measured and registered by intraocular pressure measurement or a refractometer.

  The medical care information display screen 2000 is provided with a schema diagram creation key 2010 for creating (including editing) a schema diagram. When the schema diagram creation key 2010 is clicked by the operation unit 32, the schema diagram creation screen 5000 of FIG. 7 is displayed on the display unit 31.

  The medical treatment information display screen 2000 is provided with a medical treatment end key 2011. The medical care end key 2011 is clicked by the operation unit 32 when the medical care for the patient is finished (that is, when the display of the medical care information display screen 2000 of the patient is finished). When this medical care end key 2011 is operated, the control unit 40 transmits a control signal to the ordering system 3. Upon receiving this control signal, the ordering system 3 transmits the order information accumulated so far to the reception system 7. Further, the control unit 40 switches the display screen of the display unit 31 to the order information display screen 4000 shown in FIG. 6 in response to the operation of the medical treatment end key 2011.

(Today's schedule display screen)
The today's schedule display screen 3000 shown in FIG. 5 is a display screen that presents the medical schedule information 22 set in the medical schedule display screen 1000 in a display format as shown in FIG.

  As described above, the medical schedule information 22 includes information such as the patient ID, the patient's name, the examination name and treatment name for each medical practice, the prescription drug name, the prescription result of the spectacle lens, the medical site, the creator of the schedule, and the like. It is included.

  In today's schedule display screen 3000, a patient name display field 3001 for displaying the patient's name and a patient ID display field for displaying the patient ID as display areas for presenting the information included in the medical schedule information 22 3002 and today's schedule display section 3003 for displaying the contents of today's medical treatment schedule are provided. The schedule display section 3003 of today is provided with a medical treatment item column 3003a for presenting the type of medical practice and a medical treatment region column 3003b for presenting the medical treatment region.

  In addition, today's schedule display section 3003 is provided with a check column 3003c in which a check box is provided for each medical treatment schedule. If a check mark is entered in this check box, it means that the corresponding medical treatment schedule has been implemented. The check mark may be input automatically or manually by the user.

  First, the former automatic input process will be described. For example, many ophthalmologic apparatuses such as an autorefractometer, a tonometer, and an ophthalmologic photographing apparatus can determine which of the left and right eye is being examined based on information such as an alignment position with respect to the eye. Therefore, by including this discrimination information in the medical practice information, the control unit 40 can automatically input a check mark in an appropriate check box.

  On the other hand, the latter manual input can be configured to input a check mark by a click operation of the mouse 18, for example.

  In addition, on the schedule display screen 3000 of today, a medical item addition key 3005 is provided. When this medical item addition key 3005 is selected (clicked or the like) by the operation unit 32 (mouse 18 or the like), a medical item addition screen 6000 shown in FIG. 9 is displayed. Similarly, when the treatment medicine addition key 3006 is selected by the operation unit 32, a treatment medicine addition screen or a treatment medicine addition menu (not shown) is displayed. This display screen switching process is executed by the control unit 40.

  Further, an order information display key 3004 is provided on the schedule display screen 3000 of today. When the order information display key 3004 is selected (clicked or the like) by the operation unit 32 (mouse 18 or the like), an order information display screen 4000 shown in FIG. 6 is displayed. This display screen switching process is executed by the control unit 40.

(Order information display screen)
The order information display screen 4000 shown in FIG. 6 is a display screen that presents the order information generated by the order information generation unit 60 in the display format as shown in FIG.

  The order information display screen 4000 is provided with an order information display unit 4001. This order information display section 4001 has an “inspection / treatment / treatment drug name” column for displaying the type of order, such as examination name, treatment name, prescription drug name, prescription for spectacle lenses, and the like in the medical practice corresponding to each order. A “part” column for displaying a medical site, a “number” column for displaying the number of times a medical practice has been performed, a “score” column for displaying insurance points, and the like are provided.

(Schema diagram creation screen)
A schema diagram creation screen 5000 shown in FIG. 7 is a screen displayed in response to an operation of the schema diagram creation key 2010 on the medical treatment information display screen 2000 shown in FIG.

  This schema diagram creation screen 5000 is provided with a schema diagram selection menu 5001. This schema diagram selection menu 5001 is formed to be scrollable, and displays various reduced schema diagrams (thumbnails). The display contents of the schema diagram selection menu 5001 can be scrolled up and down by operating the scroll bar at the right end. A scroll operation can also be performed using the up / down key of the keyboard 17.

  When a desired schema diagram is selected from the schema diagram selection menu 5001 (for example, clicked with the mouse 18), the selected schema diagram is displayed on the schema diagram display unit 5002. These display controls are performed by the control unit 40 (CPU 11).

  The schema creation diagram screen 5000 is provided with a medical site information selection tab 5004 and a wound name selection menu 5005. The medical site information selection tab 5004 has tabs for each medical site (cornea, anterior chamber, etc.). When one of the tabs is clicked, a wound name selection menu 5005 corresponding to the tab is presented. In this wound name selection menu 5005, keys indicating various wound names related to the medical site are arranged. When one of these keys is clicked, a character string indicating the name of the injury / illness of the key is entered in the schema diagram display unit 5002.

  The schema diagram creation result on the schema diagram creation screen 5000 is reflected on the medical treatment information display screen 2000 of FIG. That is, after the schema diagram is created, when the “OK” key at the lower right end of the schema diagram creation screen 5000 is clicked, the created schema diagram (the display contents of the schema diagram display unit 5002) is displayed on the medical information display screen 2000. It is displayed on the display unit 2005 (it may be added only to the electronic medical record shown on the medical treatment information display screen 2000). The display control described above is performed by the control unit 40 (CPU 11).

(Medical item addition screen)
A medical item addition screen 6000 shown in FIG. 9 is a screen used to add a new medical item or the like to today's schedule display unit 3003 of today's schedule display screen 3000 shown in FIG. It is displayed in response to operating 3005.

  This medical item addition screen 6000 is provided with a medical site information selection menu 6001 for setting a medical site of a new medical item. The medical site information selection menu 6001 is provided with medical site information keys 6001a, 6001b, 6001c, and 6001d for setting the right eye, left eye, both eyes, and other sites as medical sites.

  When any one of the medical site information keys 6001a to 6001d is selectively clicked, the selected key is highlighted. Only one of the medical site information keys 6001a to 6001d can be selected. When a certain key is selected and highlighted, and another key is selected, the previously selected key is selected. The reverse display is canceled, the key selected later is highlighted, and the medical site corresponding to the key selected later is set.

  The medical item addition screen 6000 includes a medical item selection menu 6002 for setting a medical item (medical practice). In the medical care item selection menu 6002, keys indicating various medical care items are arranged so that they can be alternatively selected as in the medical care site information selection menu 6001. These keys are selected using the operation unit 32 (such as the mouse 18).

  In addition, an area between the medical site information selection menu 6001 and the medical item selection menu 6002 is provided with a “display set” selection menu in which keys for collectively setting a medical practice such as a series of examinations are arranged. ing. This selection menu includes a key for collectively setting typical medical practices at the first visit, a key for collectively setting typical medical practices at the second visit, and a series of medical treatments for glaucoma patients. Keys etc. are provided for setting actions collectively.

  The user additionally sets a medical site using a medical site information menu 6001 and additionally sets a medical item using a medical item selection menu 6002. Then, by clicking the “add” key at the upper right end of the medical care item addition screen 6000, the content of the additional setting is confirmed. In response to the click of the “add” key, the control unit 40 adds the contents of the additional setting to the schedule display screen 3000 for today.

  For example, when the schedule display screen 3000 of FIG. 5 is changed to the medical item addition screen 6000, the “both” key 6001c is selected in the medical site information menu 6001, and the “slit” key is selected in the medical item selection menu 6002. As shown in FIG. 8, the new medical treatment item “slit” and the medical treatment site “both” are additionally displayed on today's schedule display screen 3000 (the creator is also displayed). Corresponding to the practice of the newly added medical treatment item, a check mark is entered in the check box. Further, the order information generation unit 60 generates order information corresponding to this medical practice. The screen display control described above is performed by the control unit 40.

[Operation]
The operation of the medical support system 1 of the present embodiment as described above will be described. FIG. 10 is a flowchart showing an example of use of the medical support system 1 for explaining an electronic medical record entry and order information generation work of a certain patient. An example of the operation of the medical support system 1 will be described based on this usage example.

  First, the user (doctor) inputs information for specifying a patient such as a patient ID (S1). This step S1 can be performed, for example, by reading a patient card in which a patient ID or the like is recorded with a reader (not shown), or by a user manually inputting a patient ID or the like.

  The control unit 40 searches the storage unit 20 for the electronic medical record information 21 of the patient based on the input patient ID and the like. And based on this electronic medical record information 21, the medical treatment information display screen 2000 of the said patient is displayed on the display part 31 (S2). When the user clicks today's schedule key 2007 on the medical information display screen 2000, the control unit 40 causes the display unit 31 to display today's schedule screen 3000 (S3). The user confirms the medical practice scheduled to be performed today that is listed on the today's schedule screen 3000.

  The user usually conducts medical care according to the list of medical treatments displayed on the schedule screen 3000 of today, and inputs findings, schemas, etc. to the electronic medical record (S4).

  When the medical treatment is performed by the ophthalmologic apparatuses A to C, the ophthalmologic apparatuses A to C transmit medical practice information including information for specifying the medical practice to the medical care data system 5 in response to the end of the medical practice. The medical care data system 5 transmits this medical care implementation information to the electronic medical chart system 2. The medical practice information input unit 50 (here, the CPU 11, the communication interface 19 and the like shown in FIG. 2) of the electronic medical record system 2 receives this medical practice information and inputs it to the order information generation unit 60 (S5).

  Based on this medical practice information, the control unit 40 discriminates the performed medical practice, and a check mark is added to a check box corresponding to the identified medical practice among the medical actions listed on the schedule screen 3000 of the current day. Enter.

  In addition, the control unit 40 uses a timer (not shown) (a timekeeping function of the CPU 11) to start the medical practice start time (click time of the imaging key 2008 or the examination input key 2009, or examination from the ophthalmologic apparatuses A to C). Time information input time, etc.) and enter it in the “start time” field of the medical practice on the schedule screen 3000 of today, and also acquire the end time of the medical practice (input time of medical practice information, etc.) And enter it in the “End time” field.

  Note that when a medical practice is performed without using the ophthalmologic apparatuses A to C, for example, when a drug is administered, the user may manually input a check mark. The control unit 40 inputs information (medical practice information) that identifies the medical practice for which the check mark has been input to the order information generation unit 60 (S5). In this case, the operation unit 32 (for example, the mouse 18) functions as the medical practice information input unit 50.

  Further, the control unit 40 reads the related information 23 from the storage unit 20 and sends it to the order information generation unit 60 in response to the medical practice information input to the electronic medical record system 2.

  When the medical practice information is input from the ophthalmologic apparatuses A to C, the control unit 40 determines whether the medical practice performed in step S4 is included in the list of the current schedule screen 3000 (S6). This process is executed by collating the medical practice (information for specifying) shown in the medical practice information with each medical practice displayed in the list.

  When it is determined that the implemented medical practice is included in the list (S6; Y), the order information generating unit 60 orders information corresponding to the medical practice shown in this medical practice information (insurance items, insurance points, etc.) Is obtained from the related information 23, and order information of the medical practice is generated (S7). For example, when the medical practice indicated in the medical practice information is “eye test”, the order information generation unit 60 searches for “eye test” from the test name column of the related information 23 shown in FIG. The insurance item “corrected visual acuity test (glasses prescription delivery)” and the insurance score “74” associated with the “visual acuity test” are acquired and used as order information corresponding to the medical practice “visual acuity test”.

  Note that the control unit 40 corresponds to the practice of the medical treatment included in the list (that is, corresponds to the input of the medical practice information of the medical practice), and the contents of the medical practice (examination name, A medical site) is added to the electronic medical record information 21. In addition, when a medical treatment result is included in the medical treatment implementation information, this medical treatment result is also added to the electronic medical record information 21. As a result, this additional information is displayed in a predetermined display area of the medical care information display screen 2000. For example, when an intraocular pressure test is included in the list and medical treatment execution information for this tonometry is input, the fact that the intraocular pressure test has been performed and the test result are added to the electronic medical record information 21. The information is displayed on the examination information display section 2003 and the like of the medical information display screen 2000.

  On the other hand, when it is determined that the performed medical treatment is not included in the list (S6; N), the order information generation unit 60 can generate order information based on the information input to the electronic medical record and the related information 23. Whether or not (S8). This process is performed by determining whether or not the performed medical practice can be specified based on the description content of the electronic medical record (if the medical practice can be specified, order information can be generated based on the related information 23).

  Here, an example of the determination process in step S8 will be described. The user operates the examination input key 2009 on the medical information display screen 2000 to display an examination menu (not shown), selects an objective test, performs the objective test, and inputs the test result to the electronic medical record. The case will be described. In this case, the order information generating unit 60 can specify that the performed medical practice is “an objective test” based on information indicating that the objective test is selected from the test menu. Therefore, since the insurance item corresponding to “Lefkera (an objective test)” can be acquired from the related information 23, it is determined that the order information can be generated.

  A case will be described in which the user operates the photographing key 2008 on the medical care information display screen 2000 to display a photographing menu (not shown) and selects examination (photographing) using a slit lamp. The order information generation unit 60 can specify that the performed medical practice is “examination using slit lamp” based on the information indicating that “slit lamp” is selected from the examination menu. However, it is not possible to specify the medical site by itself, and thus the performed medical practice cannot be specified.

  Therefore, the order information generation unit 60 refers to the schema diagram used when creating the electronic medical chart. The schema diagram is specified by being selected from the schema diagram selection menu 5001 on the schema diagram creation screen 5000. It is assumed that information (schema diagram specifying information) for specifying the schema diagram is given to the specified schema diagram.

  For example, when the schema diagram of “anterior chamber” shown in FIG. 7 is used, the order information generation unit 60 determines that the schema diagram uses the anterior chamber as a diagnostic part based on the schema diagram specifying information. recognize. Thereby, it can be specified that the practiced practice is “anterior chamber examination using slit lamp”. Therefore, since the insurance item corresponding to this inspection can be acquired from the related information 23, it is determined that order information can be generated.

  On the other hand, for example, as shown in FIG. 13, when the schematic diagram of the anterior eye part and the posterior eye part is selected on the schema diagram creation screen 5000, the examination is for “anterior eye part and posterior eye part”. Whether there is only an "anterior eye part" and only the "rear eye part" is displayed for the sake of convenience, or an examination of only the "rear eye part" and the "anterior eye part" is also for convenience It is not possible to specify whether it is only displayed. In other words, in this case, it is determined that the diagnosis site cannot be uniquely specified, and therefore generation of order information is impossible.

  In addition, a character string indicating the state of a lesion site or a treatment site may be entered in the schema diagram. The order information generating unit 60 searches for a specific character string in the schema diagram in the electronic medical record. This specific character string includes information representing a medical site, for example, information such as the name of a site in the eye or a lesion that occurs only in a specific site. When such a specific character string is searched, the order information generation unit 60 can determine the medical site by the character string, and therefore determines that the order information of the performed medical practice can be generated. In addition, when a character string indicating an examination name (for example, a slit lamp), a medicine name, or a treatment name is included in the schema diagram, the examination name, the medicine name, or the treatment name is specified by the character string. Also good. Further, not only the character string in the schema but also a character string displayed in an arbitrary display area in the electronic medical record, for example, a specific character string is searched from the character finding display unit 2006 to determine whether order information can be generated. It can also be configured to.

  When it is determined in step S8 that the order information can be generated, the order information generation unit 60 generates the order information based on the information input to the electronic medical record and the related information 23 (S7).

  On the other hand, when it is determined in step S8 that order information cannot be generated, the user clicks the medical item addition key 3005 on the schedule display screen 3000 of today to display the medical item addition screen 6000 (S9). The display process of this medical item addition screen 6000 is executed by the control unit 40.

  The user uses the medical item addition screen 6000 to input a medical item and a medical site corresponding to the performed medical practice (S10). The order information generating unit 60 acquires insurance items and insurance points associated with the input medical items and medical sites from the related information 23 and generates order information (S7).

  The order information generated in step S7 is transmitted to the ordering system 3 through the network 200 (S11).

  The user determines whether to continue the medical care for the patient (S12). In general, if an unscheduled medical plan remains on today's schedule screen 3000, the medical procedure is continued unless there are special circumstances such as deterioration of the patient's condition (S12; Y). In this case, the process returns to step S4, and this unsettled medical practice is performed. Since this medical practice is displayed on today's schedule screen 3000 (S6; Y), order information is generated based on the medical practice information (S7) and transmitted to the ordering system 3 (S11).

  In addition, it may be necessary to perform a new medical practice as a result of performing medical care based on a medical schedule. For example, it may be necessary to perform observation with a slit lamp from the result of fundus observation with a fundus camera. In such a case, the medical care is continued regardless of whether or not an unimplemented medical care plan remains on the schedule screen 3000 of today (S12; Y). In this case, it returns to step S4 and implements this new medical practice. Since this medical practice is not displayed on today's schedule screen 3000 (S6; N), order information is generated and transmitted to the ordering system 3 by the processes of steps S8 to S10 and S7 described above (S11).

  Further, when all the medical treatment schedules listed on the schedule screen 3000 of today are implemented, the medical care is terminated unless there is a need for a new medical practice as described above (S12; N). The user clicks the medical care end key 2011 on the medical care display screen 2000 in order to end the medical care for the patient. When the medical care end key 2011 is clicked, the control unit 40 transmits medical care end information to the ordering system 3. (S13).

  Upon receiving this medical treatment end information, the ordering system transmits the stored order information about the patient to the reception system 7 (S14).

[Action / Effect]
The operation and effect of the medical support system 1 according to the present embodiment as described above will be described.

  The electronic medical record system 2 in the medical support system 1 stores in advance related information 23 that associates various medical practices and order information (insurance items and insurance points) corresponding to the medical practices. When the medical practice information is input to the electronic medical record system 2, the order information generation unit 60 acquires the insurance items associated with the contents of the medical practice specified (identified) by the medical practice information from the related information 23. In this way, order information is generated.

  Therefore, when a medical practice is performed and information indicating that the medical practice has been performed (medical practice information) is input, order information used for creating a receipt and / or a prescription can be automatically generated. Therefore, it is not necessary to duplicate the work of inputting medical practice information in the electronic medical record and the work of inputting order information by referring to the information in the electronic medical record, and the conventional redundant work is omitted. Therefore, work efficiency and labor saving can be achieved. In addition, it is possible to eliminate the possibility of occurrence of a situation such as an order error or omission of input of order information.

  In addition, the medical support system 1 according to the present embodiment describes the description content (electronic medical record information 21) of the patient's electronic medical record, for example, characters input to the schema diagram display unit 2005 on the medical information display screen 2000 shown in FIG. It acts to identify the performed medical practice based on the observation information displayed on the columns and the character observation display unit 2006, and to automatically generate order information corresponding to the identified medical practice.

  According to the medical support system 1 having such a configuration, even when a medical practice not scheduled in the medical schedule information 22 is performed, order information can be generated based on the electronic medical record information 21 and the related information 23. , It is not necessary to duplicate the work of inputting medical practice information into the electronic medical record and the work of inputting order information by referring to the information of the electronic medical record, and it is possible to omit the duplicate work and create the order information Work efficiency can be improved and order mistakes and input leakage can be prevented.

  Further, the medical support system 1 according to the present embodiment can set a medical practice, a medical site, and the like as a medical schedule on the medical schedule display screen 1000 shown in FIG. The set medical schedule is stored as medical schedule information 22. On the day of medical treatment, the medical treatment schedule is displayed in a list on today's schedule screen 3000. When a medical practice is performed based on this medical schedule, information indicating the medical contents of the medical practice is added to the electronic medical chart information. As a result, the medical practice information is automatically input to the electronic medical record without inputting the same content again.

  Therefore, if a medical treatment schedule is set, the content of the medical practice is automatically reflected in the electronic medical record and order information is automatically generated in response to the implementation of the medical practice. This makes it possible to save work and improve efficiency.

[Modification]
The configuration described above is merely one configuration example for suitably carrying out the present invention. Therefore, arbitrary modifications within the scope of the gist of the present invention can be made as appropriate.

  Further, in the medical support system 1 according to the present embodiment, the order information generating unit 60 that generates the order information is provided in the electronic medical record system 2, but the present invention is not limited to this embodiment, and for example, in the ordering system 3 An order information generation unit 60 may be provided. At this time, it is desirable to store the related information 23 in the ordering system 3 as well. In this modified example, the electronic medical chart system 2 operates to transmit the received medical practice information to the ordering system 3. The ordering system 3 generates order information based on the medical practice information received from the electronic medical chart system 2 and the related information 23.

  As another example of the related information 23, as shown in FIG. 12 (A), when the insurance item and the description mode of the insurance score are determined according to the difference in the medical treatment part, or as shown in FIG. 12 (B) In some cases, insurance items and insurance points are determined according to the number of medical treatments.

  Part pattern 1 in the related information in FIG. 12A shows an example of examination for both eyes, and part pattern 2 shows an example of examination for one eye. Each examination relates to the same examination performed by the same apparatus or instrument, although there are differences in the medical site of both eyes and one eye. The insurance score corresponding to the inspection for both eyes is double the insurance score for the inspection for one eye. However, when written on the receipt, the insurance score corresponding to the examination for both eyes is not calculated by simply doubling the score for the examination for one eye, but for the description mode for the examination for both eyes and the examination for one eye. There is an actual situation that each description mode is determined. In the present invention, related information corresponding to the examination for both eyes and related information corresponding to the examination for one eye are separately provided. Thereby, based on the information on the medical site included in the medical practice information and the medical schedule information 22, order information according to each description mode can be automatically generated.

  Further, the related information shown in FIG. 12B relates to a medical practice in which a description mode of insurance items and insurance points is determined according to the number of times the eyelashes are extracted (the number of extracted eyelashes). Therefore, as in the case of FIG. 12A, by providing each related information according to the number of times of eyelash removal (number of times of medical care), based on information included in the medical practice information and medical schedule information 22, Order information corresponding to each description mode can be automatically generated.

  In an ophthalmic examination, for example, a mydriatic agent may be used when performing a precise fundus examination using a mydriatic fundus camera. In that case, the user clicks the mydriatic start key 2012 on the medical care information display screen 2000 with the mouse 18 or the like to display a mydriatic selection menu (not shown) and designates the mydriatic to be used. Thereby, a timer (mydriatic timer) that measures a typical time until the action of the mydriatic agent appears starts timing. Even in this case, the order information generating unit 60 can acquire the insurance item and the insurance score corresponding to the designated mydriatic agent from the related information 23 and generate the order information.

  The embodiment described above is described for facilitating the understanding of the present invention, and is not described for limiting the present invention. Each element disclosed in the above embodiment is intended to include any design change or equivalent belonging to the technical scope of the present invention.

It is the schematic showing an example of the whole structure and functional structure of suitable embodiment of the medical assistance system which concerns on this invention. It is a schematic block diagram showing an example of the hardware constitutions of suitable embodiment of the medical assistance system which concerns on this invention. It is the schematic showing an example of the screen structure of the medical treatment schedule display screen which suitable embodiment of the medical assistance system which concerns on this invention displays. It is the schematic showing an example of the screen structure of the medical treatment information display screen which suitable embodiment of the medical assistance system which concerns on this invention displays. It is an example of the screen structure of today's schedule screen which suitable embodiment of the medical assistance system which concerns on this invention displays. The order information display screen which a suitable embodiment of a medical support system concerning the present invention displays is shown. It is the schematic showing an example of the screen structure of the schema creation screen which suitable embodiment of the medical assistance system which concerns on this invention displays. The state (medical practice) to which the new medical treatment item was added is displayed on today's schedule screen which the suitable embodiment of the medical assistance system concerning the present invention displays. The medical care item addition screen which suitable embodiment of the medical assistance system which concerns on this invention displays is shown. It is a flowchart showing an example of the usage pattern of suitable embodiment of the medical assistance system which concerns on this invention. The related information in the memory | storage part of the electronic medical chart system of suitable embodiment of the medical assistance system which concerns on this invention is shown. The modification of the relevant information in the memory | storage part of the electronic medical record system of the medical assistance system which concerns on this invention is shown. It is the schematic showing an example of the screen structure of the schema creation screen which suitable embodiment of the medical assistance system which concerns on this invention displays.

Explanation of symbols

1 Medical Support System 2 Electronic Medical Record System 3 Ordering System 5 Medical Data System 7 Receipt System 10 Computer 11 CPU
12 RAM
13 ROM
14 Hard Disk Drive 15 Display 16 Electronic Pen 17 Keyboard 18 Mouse 19 Communication Interface 20 Storage Unit 21 Electronic Medical Record Information 22 Medical Record Information 23 Related Information 30 UI
31 display unit 32 operation unit 40 control unit 50 medical treatment execution information input unit 60 order information generation unit 100 bus 200 network 1000 medical treatment schedule display screen 1001 medical treatment content display unit 1002 date display unit 2000 medical treatment information display screen 2001 wound name display unit 2002 chief complaint Display unit 2003 Examination information display unit 2004 Examination detail display unit 2005 Schematic diagram display unit 2006 Character observation display unit 2007 Today's schedule key 2008 Imaging key 2009 Examination input key 2010 Schema diagram creation key 2011 Medical treatment end key 3000 Today's schedule screen 3001 Patient Name display column 3002 Patient ID display column 3003 Today's schedule display section 3003a Medical item column 3003b Medical region column 3003c Check column 3004 Order information display key 3005 Medical item addition key 4000 Order information display Surface 4001 Order information display section 5000 Schema diagram creation screen 5001 Schema diagram selection menu 5002 Schema diagram display section 5004 Medical site information selection tab 5005 Sickness name selection menu 6000 Medical item addition screen 6001 Medical site information selection menu 6001a Medical site information key 6002 Item selection menu A Ophthalmic device

Claims (7)

Storage means for preliminarily storing medical treatment content information indicating the content of medical practice;
Information generating means for receiving medical practice information indicating implementation of a medical practice, and generating order information for preparation of a receipt and / or a prescription based on medical treatment content information corresponding to the medical practice indicated in the medical practice information; ,
A medical support system characterized by comprising: A setting means for setting medical treatment content information indicating the content of a medical practice scheduled to be implemented in the future;
Storage means for storing the set medical treatment information,
Information generating means for receiving medical practice information indicating the implementation of medical practice and generating order information for preparation of a receipt and / or prescription based on the medical treatment content information corresponding to the medical practice indicated in the medical practice information When,
A medical support system characterized by comprising: The storage means stores electronic medical record information for recording the results of medical practice,
The information generating means, when a new medical practice other than the medical practice shown in the medical practice information is performed, specifies the content of the new medical practice based on electronic medical record information related to the new medical practice Including content specifying means, and generating order information based on the content of the specified medical practice,
The medical support system according to claim 1 or claim 2, characterized by that. A medical device for performing a medical practice;
Input means for inputting the medical practice information to the information generating means when the medical practice is performed;
The medical support system according to claim 1, further comprising: A reception system and / or a prescription system for processing the order information, comprising transmission means for transmitting the order information;
The medical support system according to any one of claims 1 to 4. Display means for displaying medical treatment content information set by the setting means;
Control means for receiving the medical practice information and displaying on the display means implemented information indicating that the medical practice indicated in the medical practice information has been implemented;
The medical support system according to claim 2, further comprising: The order information is a test content and a treatment drug associated with a medical practice performed;
The medical support system according to claim 1, wherein: