JP2009230304A - Medical report creation support system, program, and method - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To obtain the thinking process of a report creator who inputs each of a plurality of opinions included in a medical report in more detail than a conventional manner. <P>SOLUTION: The report creation support system records an opinion input history 51 of opinions to be input to each input column in a compilation screen and an image display history 52 of a check image displayed on an image display screen. The opinion input history 51 includes an input start time and an input end time of each opinion. The display history of the check image to be browsed by the report creator is recorded by opinion units in the image display history 52. The opinion input history 51 and the image display history 52 are associated with a created report 24. <P>COPYRIGHT: (C)2010,JPO&INPIT

Description

  The present invention relates to a medical report creation support system that supports creation of a medical report, a medical report creation support program, and a medical report creation support method.

  A medical report (hereinafter, simply referred to as a medical report) that interprets inspection images taken with medical inspection equipment (modalities) such as CR (Computed Radiography), CT (Computed Tomography), and MRI (Magnetic Resonance Imaging). 2. Description of the Related Art A medical report creation support system (hereinafter simply referred to as a report system) that creates a report) is known. The report is created by, for example, an image interpretation doctor specializing in image diagnosis.

  The report system includes a report creation terminal that creates a report and a report server that stores data of the created report. The report creation terminal has a function of inputting a finding and editing the report. The findings include the diagnostic results such as the state of the lesion recognized by observing the examination image and the name of the diagnosis disease made based on the recognition. The examination image is displayed on a terminal having an image display function for displaying the examination image, such as a report creation terminal or a dedicated image display terminal, and is observed by an interpretation doctor.

  In the report system described in Patent Document 1, an input box for inputting a finding is inserted into a display screen for displaying an examination image so that the finding can be input on the examination image. A plurality of input boxes can be inserted into one inspection image. The data of a plurality of findings input on the inspection image are collected into one report and displayed as a list on the report display screen. When observing the examination image and inputting the findings in parallel, the interpretation doctor must alternately view the examination image display screen and the editing screen for inputting the findings. As in the report system of Patent Document 1, it is possible to reduce the movement of the viewpoint between the display screen and the editing screen by allowing the findings to be input on the inspection image.

  In addition, the medical report creation support system of Patent Document 1 records the link information between the findings and the examination image in which the findings input box is inserted, and also displays the display size, display magnification, and display of the examination image at the time when the findings are entered. It also has a function to record the display state such as the position. According to this, it is possible to reproduce which image interpretation doctor has input a finding while observing which examination image is in what display state.

The report systems described in Patent Documents 2 and 3 also have a function of recording display histories of a plurality of examination images observed by an interpretation doctor when creating a report. The display history includes a display state for each inspection image. In the report system of Patent Literature 2, when observing an inspection image prior to the input of findings, a display history of a plurality of inspection images at the time of observation is recorded, so that the inspections observed at the time of inputting the findings The image and its display state can be reproduced. In the report system described in Patent Document 3, the display time is recorded in units of a plurality of inspection images, and based on the display time, it is determined whether there is an inspection image with insufficient observation or insufficient observation.
JP 2005-025669 A JP-A-9-198453 JP 2007-260064 A

  In the medical field, for the purpose of improving diagnosis accuracy and educating a resident, there is a tendency for a plurality of people to interpret the same patient examination image. In that case, multiple findings will be input for each interpreting doctor, but if each finding is different, the validity of each finding will be examined, or the findings that are clearly incorrect Therefore, detailed examination work for each finding is required, such as grasping the circumstances that led to the finding. When reviewing these findings, each interpreting doctor's thought process, such as what examination images each patient observes, what kind of recognition, and what kind of diagnosis he made, is as detailed as possible. It is important to grasp.

  The report systems of Patent Documents 1 to 3 have a function of recording a display state and a display history of an examination image observed by a radiogram interpretation doctor at the time of creating a report. None of them were sufficient to understand the thinking process of the doctor.

  In the report system of Patent Document 1, the link information between the observation and the inspection image and the display state of the inspection image are recorded. However, the link information is only one-to-one correspondence between the observation and the inspection image. The radiologist interprets various thoughts while observing a plurality of examination images, and summarizes the results into findings. In the report system of Patent Document 1, since one inspection image associated with the findings is only an inspection image that simply represents the result, it is not sufficient for grasping the thinking process of the interpreting doctor.

  In the report systems of Patent Documents 2 and 3, the display history including the display state of the inspection image is recorded, but the display history is recorded in units of reports. For this reason, when a plurality of findings are input in the report, the correspondence between the findings and the display history of the examination image is not known, and therefore the thought process of each interpretation doctor cannot be grasped for each finding.

  The present invention has been made in view of the above background, and its purpose is to provide a more detailed description of the thinking process of the creator of a medical report that inputs findings when multiple findings are entered in the medical report. It is to be able to grasp.

  In order to solve the above-described problems, a medical report creation support system according to the present invention is a medical report creation support system that supports creation of a medical report. The medical report creation support system supports at least the first and second findings. Editing processing means for editing, and browsing data display control means for performing display control for displaying a plurality of browsing data browsed by a creator of the medical report that inputs each finding when inputting each finding. A finding input history recording means for recording a finding input history including each input time of each finding, and a browsing data display including a display time of the browsing data displayed on the browsing screen during the input of each finding Browsing data display history recording means for recording history in units of the findings, the finding input history and the browsing data display history, Characterized in that a associating means for associating the use reports.

  The browsing data display history recording means preferably records, as the display time, a start time at which display of the browsing data is started on the browsing screen and an end time at which the display is ended in the browsing data unit. .

  The observation input history recording means preferably records, as the input time, a start time at which the input of the observation is started and an end time at which the input is ended in the observation unit.

  The finding input history recording means preferably records the creator's ID in the finding unit.

  It is preferable that the browsing data display history recording unit records the display state of the browsing data displayed on the browsing screen together with the display time.

  It is preferable to provide a history display screen generating means for generating a history display screen for displaying the contents based on the browsing data display history.

  It is preferable that the input time included in the finding input history is displayed on the history display screen.

  The history display screen preferably includes a plurality of browsing data lists. The browsing data list is arranged in either order of a start time when display of the browsing data is started on the browsing screen or a display time while the browsing data is displayed on the browsing screen. It is preferable.

  It is preferable that the history display screen includes a reproduction image that reproduces the display state of the browsing screen.

  The history display screen has display format selection means for selecting a display format in which the browsing data display history is displayed. The selectable display format includes a reproduced image that reproduces the display state of the browsing screen. It is preferable that at least two display formats are included: a first format for displaying in time series and a second format for displaying a list of the plurality of browsing data.

  The browsing data preferably includes test data that is a test result of a medical test, and the test data preferably includes a test image.

  The medical report creation support program according to the present invention is a medical report creation support program that allows a computer to realize a function for supporting the creation of a medical report. The medical report creation support program edits a medical report to which at least a plurality of first and second findings are input. A processing function, and a browsing data display control function for performing display control for displaying a plurality of browsing data viewed by a creator of the medical report that inputs each finding on a browsing screen when inputting each finding, and A finding input history recording function for recording a finding input history including each input time of each finding, and a browsing data display history including a display time of the browsing data displayed on the browsing screen during the input of each finding, The browsing data display history recording function for recording in the findings unit, the finding input history and the browsing data display history, And associating the ability to associate a serial medical report, characterized in that to realize the computer.

  The medical report creation support method of the present invention is a medical report creation support method for supporting the creation of a medical report, the editing processing step of editing a medical report to which at least the first and second plurality of findings are input, When inputting findings, a browsing data display control step for performing display control for displaying a plurality of browsing data viewed by a creator of the medical report that inputs each finding on a browsing screen, and each input of each finding A finding input history recording step for recording a finding input history including time, and a browsing data display history including a display time of the browsing data displayed on the browsing screen during the input of each finding are recorded in units of the findings. Browsing data display history recording step, associating the finding input history and the browsing data display history with the medical report Characterized by comprising the steps associated.

  According to the present invention, when inputting a plurality of findings, the observation input history including each input time of each finding is recorded, and a plurality of browsing data browsed by a creator who inputs each finding is displayed on the browsing screen. The displayed display history is recorded in units of findings, and is associated with the medical report in which the findings are entered. Therefore, for each finding included in the medical report, the thought process of the creator of the medical report is more detailed than before. I can grasp.

  The medical information system shown in FIG. 1 is constructed in a medical facility such as a hospital, for example. The medical information system includes a medical record system 11 installed in the medical department 10 and a report system 13 installed in a radiation examination department (hereinafter simply referred to as an examination department) 12. These are communicably connected through the network 14. The network 14 is, for example, a LAN (Local Area Network) laid in the hospital.

  The medical record system 11 includes a medical record server 16 and a medical department terminal 17 arranged in each medical department 10 such as internal medicine and surgery. In the medical record server 16, a medical record DB (Data Base) 18 in which medical record data for each patient is stored so as to be searchable is constructed. The clinical department terminal 17 is operated by the staff of the clinical department 10 such as doctors and nurses of the clinical department 10 and is used for issuing an order for requesting the examination to the examination department 12 in addition to reading and inputting the medical chart. Is done. The medical department terminal 17 is also used for browsing examination results such as examination images and reports provided from the examination department 12.

  The report system 13 includes a report creation terminal 21, a report server 22, and an image server 23, and constitutes a medical report creation support system that supports report creation by an interpreting doctor. The interpretation doctor confirms the order of interpretation from the clinical department terminal 17 on the report creation terminal 21, reads the examination image to be interpreted from the image server 23 according to the order, and reports the interpretation result of the examination image. 24. The data of the created report 24 is stored in the report server 22. The report server 22 has a report DB 26 for storing reports so as to be searchable.

  When the creation of the report 24 is completed, a completion notice is transmitted to the requesting medical department terminal 17. The completion notification includes addresses in the image server 23 and the report server 22 where the inspection image and the report 24 are stored. The doctor of the medical department 10 accesses the address through the medical department terminal 17 and browses the examination image and the report 24.

  The image server 23 is a so-called PACS server that configures a PACS (Picture Archiving and Communication Systems) together with a modality 27 such as a CR apparatus, a CT apparatus, and an MRI apparatus, and receives and stores data acquired by the modality 27 through the network 14. is there. In the image server 23, an image DB 28 for storing inspection images is constructed. The inspection image is given an image ID for identifying each inspection image. The examination image is stored in a file format compliant with, for example, DICOM (Digital Imaging and Communication in Medicine), and a DICOM tag that records incidental information including items such as patient ID, examination date, examination type is added to the file. Is done. The inspection image stored in the image DB 28 can be searched using items included in the DICOM tag as search keys.

  Each of these servers 16, 22, 23, and terminals 17, 21 is based on a computer such as a server computer, a personal computer, or a workstation, and a control program such as an operating system or an application program such as a client program or a server program. Installed and configured.

  As shown in FIG. 2, the computers constituting the server and the terminal have substantially the same basic configuration, and each includes a CPU 31, a memory 32, a storage device 33, a LAN port 34, and a console 36. . These are connected via a data bus 37. The console 36 includes a display 38 and an input device 39 such as a keyboard and a mouse.

  The storage device 33 is, for example, an HDD (Hard Disk Drive), and stores a control program and an application program (AP) 40. In addition to the HDD storing the program, the server in which the DB is constructed is provided with, for example, a disk array in which a plurality of HDDs are connected as the DB storage device 33. The disk array may be built in the server main body, or may be provided separately from the server main body and connected to the server main body through a cable or a network.

  The memory 32 includes a RAM, which is a work memory for the CPU 31 to execute processing, and a video memory (VRAM) for drawing data to be output to the display 38. The CPU 31 centrally controls each unit of the computer by loading a control program stored in the storage device 33 to the RAM and executing processing according to the program. The LAN port 34 is a network interface that performs transmission control with the network 14.

  In the medical department terminal 17, client programs such as medical chart software for browsing and editing medical charts and a browser for browsing reports 24 and examination images are installed as AP 40. When the client program is activated, an operation screen based on a GUI (Graphical User Interface) is displayed on the display of the medical department terminal 17. On the operation screen, patient chart data selected by the input device and read from the chart DB 18 is displayed.

  The medical department terminal 17 receives operation instructions such as a chart input / edit instruction and an order input / issue instruction through the console. The input chart and order data are stored in the chart DB 18. Further, the medical department terminal 17 accesses the report server 22 and the image server 23 through medical chart software and a browser, reads the report 24 and the examination image, and displays them on the display.

  When a doctor of the medical department 10 requests an examination, the contents of the examination request, specifically, patient ID, patient name, examination type (CT, MRI, etc.), imaging region, interpretation, are read at the medical department terminal 17. Enter information such as the necessity of request and issue an order issue instruction. The order issued by the clinical department terminal 17 is transmitted to the order reception terminal (not shown) of the examination department 12 and accepted. The staff of the examination department 12 performs imaging using the modality 27 according to the received order. The interpreting physician creates a report 24 using the report creation terminal 21 based on the examination image obtained by imaging.

  In the report server 22 and the image server 23, a server program is installed as the AP 40, which executes processing in response to a request from a client and responds with a processing result. The server programs of the report server 22 and the image server 23 execute storage processing in the DBs 26 and 28 in response to a storage request for data (report 24, inspection image) from clients such as the report creation terminal 21 and the modality 27. In addition, the report server 22 and the image server 23 respond to the report 24 and the inspection image distribution request from the medical department terminal 17 and the report creation terminal 21, and send the requested report 24 and the inspection image from the respective DBs 26 and 28. Search and distribute the searched data to the request source.

  A report editing client program for supporting report creation is installed in the report creation terminal 21 as the AP 40. The report creation terminal 21 performs inspection image display processing in addition to report editing processing by a report editing client program.

  As shown in FIG. 3, when the CPU of the report creation terminal 21 starts a report editing client program, the console control unit 21a, the image acquisition unit 21b, the editing processing unit 21c, the history recording unit 21d, and the history display screen generation unit 21e functions.

  As the report creation terminal 21, for example, a multi-display in which two displays 38 are connected to the terminal body is adopted. One display 38 is used for displaying an inspection image and displays an image display screen 46. The other display 38 is used for report editing and displays a report editing screen 47.

  The image display screen 46 and the report edit screen 47 constitute an operation screen based on GUI (Graphical User Interface). The console control unit 21a outputs these operation screens to each display 38, and receives an operation instruction input from the input device 39 through the operation screens.

  The image display screen 46 and the report edit screen 47 are activated in conjunction with each other. For example, when an examination ID including an examination image to be interpreted is input from the report editing screen 47, the image acquisition unit 21b accesses the image server 23 and obtains an examination image corresponding to the examination ID. The console control unit 21 a activates the image display screen 46 when outputting the acquired inspection image to the display 38.

  Further, the console control unit 21a controls the display state such as the display size of the inspection image in the image display screen 46, the display position in the screen, and the display magnification of enlargement or reduction in units of inspection images in accordance with the input of the operation instruction. To do. The operation screen and inspection image data are drawn in the VRAM and output to the display 38. For example, the console control unit 21a grasps the display state based on the address information of the inspection image drawn in the VRAM.

  On the image display screen 46, an inspection image such as a fluoroscopic image captured by a CR apparatus, a tomographic image captured by a CT apparatus or an MRI apparatus, and a three-dimensional image generated based on the tomographic image is displayed. On the image display screen 46, for example, a plurality of inspection images can be displayed simultaneously, such as displaying six frames of tomographic images arranged on one screen. The image display screen 46 is provided with various operation tools constituting the GUI such as operation buttons, list boxes, and icons. Various operation instructions are input from the input device 39 through such an operation tool.

  The operation instructions include an image selection instruction and a display state change instruction for the displayed image. The display state change instruction includes, for example, an instruction for enlarging or reducing the display size of the entire image for one frame of the six-frame tomographic images displayed in an array, and a partial display magnification in the one-frame tomographic image. There are an instruction for raising and enlarging the display, and an instruction for moving each frame within the image display screen 46 to change the display position. The image interpretation doctor changes the display state of the examination image while inputting such an instruction from the input device 39, and observes the examination image.

  The image acquisition unit 21b transmits an inspection image distribution request to the image server 23 based on an image selection instruction input through the image display screen 46, and acquires the requested inspection image. Upon receiving the inspection image distributed from the image server 23, the image acquisition unit 21b delivers the received image to the console control unit 21a.

  The report editing screen 47 is provided with a plurality of input fields 47a and 47b for inputting the findings of the interpretation doctor. In each of the input fields 47a and 47b, for example, findings of a plurality of interpreting doctors such as an interpreting doctor who is undergoing training and an interpreting doctor in a leadership position, or an interpreting doctor who is in charge of primary interpretation and an interpreting doctor who is in charge of secondary interpretation. Is entered.

  In addition to the input fields 47a and 47b, the report editing screen 47 is provided with various operation tools constituting the GUI, such as operation buttons, list boxes, and icons, like the image display screen 46. Various operation instructions are input from the input device 39 through such an operation tool.

  For the operation instruction, any one of the file reading instruction for reading the file of the report 24 to be edited from the report DB 26, the instruction for saving the file, and the input fields 47a and 47b is selected to be active (a state in which text can be input). Instructions, instructions to save the input findings, etc. are included.

  The input fields 47a and 47b are activated by, for example, designating one of them with the mouse pointer 48 and performing a click operation. A caret that is a pointer indicating a text input position blinks in an activated input field among the input fields 47a and 47b. The interpretation doctor activates the input field and inputs the finding text from the input device 39.

  There are two types of instructions for saving input findings data: a temporary save instruction for saving data being edited, and a fixed save instruction for confirming the input contents. The operation buttons for instructing these savings are provided for each of the input fields 47a and 47b, for example, and it is possible to temporarily save or confirm save the data of the respective findings at different timings.

  The edit processing unit 21c receives an instruction related to editing of the report 24 and findings input to the input fields 47a and 47b through the console control unit 21a. The edit processing unit 21c distinguishes and blocks the findings data input from the input fields 47a and 47b, and “findings 1” and “findings 2” for the blocked data (see FIG. 4). Thus, the observation ID is given. The edit processing unit 21c stores the data of each finding in the data file of the report 24 so that it can be handled in units of findings.

  The edit processing unit 21c assigns a doctor ID (see FIG. 4) for identifying the interpretation doctor who inputs each finding to the data of each finding given the finding ID. The doctor ID is input by the interpretation doctor at the time of user authentication, such as when the report creation terminal 21 is activated. The edit processing unit 21 c assigns an observation ID and a doctor ID to the data of each finding, and stores them in the data file of the report 24. Each data file is given an examination ID for each report 24.

  The history recording unit 21d includes an input history (findings input history) 51 of observations input from the input fields 47a and 47b of the report editing screen 47, and a display history (image display history) of inspection images displayed on the image display screen 46. ) 52 is recorded in units of 24 reports. The history recording unit 21d sequentially acquires the operation instruction from the input device 39, the image ID of the inspection image being displayed on the image display screen 46, and information on the display state of each inspection image through the console control unit 21a. The observation input history 51 and the image display history 52 are recorded.

  The history recording unit 21d outputs and saves the data files of the finding input history 51 and the image display history 52 to the report DB 26. The history recording unit 21d assigns the same examination ID as the examination ID assigned to the report 24 to the data files of the observation input history 51 and the image display history 52, respectively. Thereby, the three data files of the report 24, the finding input history 51, and the image display history 52 are associated with each other.

  The history display screen generation unit 21e reads the observation input history 51 and the image display history 52 from the report DB 26, and generates a history display screen 66 (see FIG. 5) described later based on them. The data of the history display screen 66 generated by the history display screen generation unit 21e is output to the display 38 via the console control unit 21a.

  As shown in FIG. 4, the finding input history 51 records the input histories 51a and 51b of the input fields 47a and 47b. In the input histories 51a and 51b, the doctor ID of the interpretation doctor who inputs each finding and the input time of the findings including at least the input start time and the input end time are recorded. The input start time is, for example, the time when the respective input fields 47a and 47b are first activated after an instruction to create a new report 24 is given. The input end time is, for example, a time at which confirmation and storage of the input finding data is instructed. The input start time and the input end time are recorded for each of the input fields 47a and 47b. Thereby, the approximate time of the time when the interpretation doctor started the input operation of the finding and the time when the input operation of the finding was completed is estimated.

  Note that temporary storage may be instructed between the input start time and the input end time, or automatic data storage may be executed at preset time intervals. These storage times may be recorded in the finding input history 51 in addition to the input start time and the input end time. Furthermore, findings data in the middle of input at each storage time may be recorded in the findings input history 51. As a result, it is possible to grasp the input progress of findings such as how far and what content has been input.

  The image display history 52 is inspection image display histories 52a and 52b displayed on the image display screen 46 during input of each finding ("findings 1" and "findings 2"), and is recorded in units of findings. Each display history 52a, 52b is provided with a field for recording each item of the operation history and the display state. The operation history is a history of operation instructions (input from the input device 39) relating to display that changes the contents of the image display screen 46, such as display start, display end, enlargement, reduction, and movement of the inspection image. The console control unit 21a executes display processing corresponding to each operation instruction. In the operation history item, the contents of the display processing corresponding to each operation instruction are recorded together with the processing time.

  In the operation history item, for example, as shown in the display history 52a of “finding 1”, the start and end of the display of the six frames of inspection images with the image IDs “CT01 to CT06” and the image ID of “CT01” are displayed. The contents of display processing such as the start and end of enlargement and the start of display of the inspection image with the image ID “CR11” are recorded. Here, the examination images “CT01 to CT06” are tomographic images taken by the CT apparatus, and the examination image “CR11” is a simple chest image taken by the CR apparatus.

  As described above, the content of the display state is represented by the display size of each inspection image in the image display screen 46, the display position in the screen, and the display magnification of enlargement or reduction. In the display state item, display state data in which these pieces of information are recorded is recorded every time display processing corresponding to one operation instruction is executed. The display state data is used to reproduce the display content of the image display screen 46 at the time when each display process is executed.

  The history recording unit 21d acquires information related to the operation history and the display state from the console control unit 21a. When an operation instruction is input from the input device 39, the console control unit 21a sends the operation instruction to the history recording unit 21d. The history recording unit 21d records the contents of the display process in the operation history field based on the operation instruction.

  When the image display screen 46 is output to the display 38, the screen data is drawn on the VRAM. The console control unit 21a sends the address of the screen data drawn on the VRAM to the history recording unit 21d for each inspection image. Based on the address, the history recording unit 21d records the display position and display size for each inspection image in the image display screen 46 in the display state field. When a part of the inspection image is enlarged, the history recording unit 21d acquires the coordinates in the inspection image representing the part to be enlarged from the console control unit 21a, and uses the acquired coordinates as the display position and the display position. In addition to the display size, it is recorded in the display state field.

  Instead of recording the display state data based on the address on the VRAM, the screen data representing the entire image display screen 46 drawn in the VRAM is captured, and the captured screen data is recorded as the display state data. Also good.

  The history recording unit 21d records the image display history 52 when either of the input fields 47a and 47b is active. Conversely, if both are not active, The display history 52 is not recorded. Accordingly, the history recording unit 21d executes a warning process that prompts the user to activate the input field for inputting findings when both the input fields 47a and 47b are not active.

  As described above, when the report editing screen 47 is activated, the image display screen 46 is activated in conjunction therewith. The warning timing is preferably the timing when the image display screen 46 is activated or when the first operation instruction is input from the input device 39 through the image display screen 46 after the image display screen 46 is activated.

  As a warning method, there are a method of outputting a warning message on the display 38, a method of outputting by voice, and the like, and any method may be used. When outputting to the display 38, either the image display screen 46 or the report editing screen 47 may be used, but the purpose of the warning is that the report editing screen 47 is used for an interpreting doctor who is gazing at the image display screen 46. Therefore, it is preferable to output to the image display screen 46. By giving such a warning, it is possible to prevent a history record from being missed.

  Further, in addition to or instead of the warning, when any of the input fields 47a and 47b is not active, the reception of an operation instruction related to the display of the image display screen 46 may be prohibited. In addition to or instead of the warning, when one of the input fields 47a and 47b is not active, for example, one of the input fields may be automatically activated. As the input field to be activated, for example, a specific input field such as an input field 47a at the top of the report editing screen 47 or an input field that was active when the report editing screen 47 was previously terminated is set in advance. . As described above, if the acceptance of the operation instruction is prohibited or the input field is automatically activated, it is possible to more reliably prevent the history record from being missed.

  When automatically activating one input field, it is preferable to insert a message informing the radiology doctor which input field has been activated in the content of the warning. By notifying these messages, if the input field intended by the interpreting physician (the input field for the person trying to input) differs from the automatically activated input field, the input intended by the interpreting doctor Can prompt changes to the column.

  By recording the display histories 52a and 52b of the input fields 47a and 47b by the history recording unit 21d, for example, as shown in the screens 56a to 56c, the transition of the display content of the image display screen 46 is recorded. Can do. The transition of the display content is information indicating what inspection image is observed in what display state while the interpretation doctor inputs findings in either of the input fields 47a and 47b. This is an important clue in understanding the thought process of the doctor.

  A history display screen 66 shown in FIG. 5 is an example of a screen generated by the history display screen generation unit 21 e based on the finding image display history 51 and the image display history 52. On the report editing screen 47, a history button 67 is provided beside the input fields 47a and 47b. The history button 67 is an operation tool for displaying history contents corresponding to each finding on the history display screen 66. When the mouse pointer 48 is clicked with the history button 67 being clicked, a history display screen 66 is opened and the history content of each finding is displayed.

  The history display screen 66 is displayed on, for example, the display 38 of the image display screen 46 different from the display 38 of the report edit screen 47 so as to be contrasted with the report edit screen 47. The history display screen 66 may be displayed on the same display as the report editing screen 47. In that case, it is preferable to display the report editing screen 47 side by side in a single display screen. Of course, the image display screen 46 and the report edit screen 47 may be configured as one screen, and an image display area and a report edit area corresponding to each may be provided in the screen.

  On the history display screen 66, the examination ID, the finding ID, the doctor ID, and the input time (start and end) of the findings recorded in the finding input history 51 are displayed on the upper side. Below that, the history content generated based on the image display history 52 is displayed. In the history contents, the operation history recorded in the image display history 52 and images 69a to 69c are displayed in correspondence with the operation history. The images 69a to 69c are images representing the display contents of the image display screen 46 at the time when the display process corresponding to the operation instruction is executed. The images 69a to 69c correspond to the screens 56a to 56c shown in FIG. 4, and are images that reproduce the images of the respective screens.

  The procedure for the history display screen generation unit 21e to generate the images 69a to 69c is as follows. First, the history display screen generation unit 21e reads an image ID (such as “CT01”) from the operation history item in the image display history 52, and sends an inspection image corresponding to the image ID via the image acquisition unit 21b. Obtained from the image server 23. Next, the acquired inspection images are arranged based on the display state data recorded in the image display history 52, thereby generating the images 69a to 69c. As described above, the method of recording the captured screen data as the display state data has a demerit that the data amount of the image display history 52 is large, but such generation processing is not necessary.

  The history display screen 66 shown in FIG. 5 displays the operation history related to the display and the images 69a to 69c reproducing the screen image. The history display screen 66 allows the details of the history contents to be confirmed. . In addition to the “detailed display” shown in FIG. 5, “image list (time series)” and “image list (in order of display time)” can be selected as the history content display format. The menu box 71 is an example of an operation tool (corresponding to display format selection means) for selecting a history content display format. The menu box 71 is displayed by pointing the history button 67 with the pointer 48 and performing, for example, a right click operation of the mouse.

  As shown in FIG. 6, when “image list (time series)” is selected, the history display screen 66 displays a list of thumbnail images of all the inspection images displayed on the image display screen 46 arranged in a matrix format. Is displayed. The arrangement order of the inspection images is the order in which the display start time is early. Around each inspection image, each image ID, display start time and end time are displayed. When “detailed display” shown in FIG. 5 is selected as the display format, the display content of the image display screen 46 corresponding to the operation history is reproduced, so that the same inspection image is displayed a plurality of times. The same inspection image is repeatedly displayed. In the “image list (time series)” display format, the same inspection image is not repeatedly displayed. Therefore, the display format of the “image list (time series)” can be used as an index of the inspection image displayed on the image display screen 46.

  The display format (not shown) of the “image list (in order of display time)” is a display for displaying a list of inspection images displayed on the image display screen 46 in the same manner as the display format of “image list (time series)”. Format. The display order of inspection images is different from the display format of “image list (time series)”. In the display format of “image list (order of display time)”, the display order is the display time order of each inspection image. .

  Here, the display time is the time during which the inspection image is displayed on the image display screen 46. As the display time, for example, the accumulated time during which each inspection image is displayed on the image display screen 46 is used from the input start time to the end time of the findings. Therefore, for example, when the first display of the inspection image is finished and the display is restarted, the first and second display times are added up. Note that one display time may be used as the display time.

  The history display screen generation unit 21e calculates the display time of each inspection image based on the display start and end times of the inspection image included in the image display history 52, and in order from the longer calculated display time, Arrange inspection images. The calculated display time is displayed around each inspection image.

  The longer the display time is, the longer the interpretation doctor's observation time for the examination image is. Therefore, the examination image with a long display time is considered to be the examination image that is particularly focused when the interpretation doctor inputs findings. It is done. As shown in FIG. 5 and FIG. 6, if the display start time and end time are displayed, the display time can be calculated from the display and an inspection image with a long display time can be found, but the display time is automatically calculated. Then, by arranging the examination images in the order of display time, the examination image focused on by the interpretation doctor can be easily found.

  In addition, in the display format of the image list of this example, the example is described in which the thumbnail image of the inspection image is displayed. However, only the identification information for identifying the inspection image such as the image ID and the file name is displayed without displaying the thumbnail image. May be displayed in a list.

  In this way, by enabling the selection of the display format of the history contents on the history display screen 66, which inspection image is read in what display state in what order and how much time is taken. It is possible to grasp the progress of interpretation work, such as whether it has been performed. Further, by changing the display format of the history content, it is possible to easily perform a multifaceted analysis regarding the progress of the interpretation work. This makes it easy to grasp the thought process when inputting the findings of the interpreting physician.

  Hereinafter, the operation of the above configuration will be described with reference to the flowchart shown in FIG. When the interpretation doctor creates the report 24, the report editing screen 47 is activated on the report creation terminal 21 (step (S) 101). When an examination ID of a patient to be interpreted is input from the report editing screen 47, the image acquisition unit 21b acquires an examination image corresponding to the examination ID from the image server 23. In S102, the console control unit 21a activates the image display screen 46 and displays the inspection image acquired by the image acquisition unit 21b on the image display screen 46.

  In S103, the history recording unit 21d determines whether any of the input fields 47a and 47b of the report editing screen 47 is active when the image display screen 46 is activated (S103). If either of the input fields 47a and 47b is active, recording of the history of the observation input history 51 and the image display history 52 corresponding to the input field that is active is started (S104). . If it is not active, a warning process to activate it is performed (S105). This prevents a history record from being missed.

  The image interpretation doctor creates a report 24 by observing an examination image on the image display screen 46 and inputting findings in any of the input fields 47 a and 47 b of the report editing screen 47. The editing processing unit 21c executes editing processing of the report 24 in response to the input of findings (S106). When the confirmation button provided for each of the input fields 47a and 47b is clicked and the input of findings is completed, the edit processing unit 21c saves the input findings data in the data file of the report 24 and performs the edit processing. The process ends (S107).

  The history recording unit 21d uses the time when the input field becomes active as the input start time and the time when the finding data input to the input field is confirmed and stored as the input end time. , 47b and recorded in the finding input history 51. In addition, the history recording unit 21 d records the image display history 52 based on an operation instruction input through the image display screen 46. When the finding data is confirmed and stored, the history recording unit 21d finishes recording the finding input history 51 and the image display history 52 (S108).

  When the record recording unit 21d finishes recording the observation input history 51 and the image display history 52, the history recording unit 21d assigns an observation ID, a doctor ID, and an examination ID to each data file, and assigns an examination ID to the data file of the report 24. Assign and associate (S109). The associated finding input history 51, image display history 52, and report 24 data files are stored in the report DB 26. When a finding is input to an input field different from the input field that has already been input, the finding input history 51 and the image display history 52 corresponding to the input field are recorded by the above procedure.

  In S110, when the history button 67 on the report edit screen 47 is clicked to display a history, the history display screen generation unit 21e displays the history contents of the input field 47a corresponding to the clicked history button 67. A display screen 66 is generated. The history display screen 66 is output to the display 38 by the console control unit 21a (S111).

  On the history display screen 66, the display time of the inspection image is displayed together with the input time and end time of the findings. For this reason, the correspondence between the two becomes clear, and it is possible to understand what inspection image the observation image was observed in and in what order while inputting the findings. Thereby, compared with the past, it is possible to grasp in detail the thinking process of the interpreting doctor who inputs the findings.

  In addition, by displaying the display start time and display end time of the inspection image, it is possible to confirm how much time has been taken to observe each inspection image. Further, if an image list in which examination images are arranged in order of display time is displayed, the examination image particularly focused on by the interpretation doctor can be easily confirmed.

  Further, by displaying the images 69a to 69c, it is possible to confirm the image of the screen observed by the image interpretation doctor. Furthermore, by displaying the images 69a to 69c in chronological order and with the display time, what kind of inspection image the observation image doctor has observed in what display state and over what time, etc. It is possible to easily trace the interpretation work. This makes it possible to grasp the thinking process of interpretation easily and clearly. In addition, since the display format of the history display screen 66 can be selected, it is possible to easily perform a multifaceted analysis of interpretation work for grasping the thinking process of the interpretation doctor.

  Since the history display screen 66 is displayed in units of a plurality of findings included in one report 24, for example, the thinking process of the resident doctor and his / her instructor, or the primary interpretation doctor and the secondary interpretation doctor is contrasted. be able to. Such a contrast greatly contributes to improving the education and diagnostic accuracy of residents.

  In the above embodiment, the findings are input on the report editing screen different from the image display screen. However, as described in Patent Document 1, the input box for inputting the findings on the image display screen. May be displayed to input the findings.

  In the above-described embodiment, an example in which the history button 67 is provided on the report editing screen 47 is described. However, as illustrated in FIG. 8, the history button 67 is provided on the report display screen 73 for viewing the report 24. The history display screen 66 may be displayed from the report display screen 73.

  The report display screen 73 is provided with display fields 73a and 73b for displaying the findings input in the input fields 47a and 47b of the report editing screen 47, and a plurality of history buttons 67 corresponding to the respective fields. By enabling the history to be displayed on the report display screen 73, for example, when the doctor of the medical department 10 who is the interpretation request source views the report 24 on the medical department terminal 17, the history display screen 66 is viewed. It is also possible.

  In this case, the CPU of the report server 22 is caused to execute the process executed by the history display screen generation unit 21e. When the report server 22 receives the distribution request for the history display screen 66 from the medical department terminal 17 after distributing the report 24 to the medical department terminal 17, the report server 22 executes the same processing as the history display screen generation unit 21e, A history display screen 66 is generated. The history display screen 66 is processed into a Web page format created in a markup language such as XML (Extensible Markup Language) and distributed to the medical department terminal 17 via the network 14. Thereby, the medical department terminal 17 can display on the display using the browser for browsing the report 24 without using dedicated display software.

  In the above embodiment, the description input history and image display history data files are stored in the report DB. However, the history input history is stored in the report DB and the image display history is stored in the image DB. You may store in a storage means. Even in this way, since each history and report are associated with each other by the examination ID, it is possible to search from one to the other. Although the association is performed by the examination ID, the association may be performed by other data such as a report ID instead of the examination ID.

  In the above embodiment, an example has been described in which the input field is activated as a trigger for starting the recording of the observation input history and the image display history. However, the present invention is not limited to this example. An operation tool may be provided. Even when the recording start button is provided, when the display operation is started on the image display screen, it is determined whether or not the recording is started, and if the recording is not started, the warning process is performed. It is recommended to execute.

  In the above-described embodiment, an example in which two input fields for findings are provided in the report has been described. Of course, two or more input fields may be provided. In addition, an example has been described in which different interpretation doctors input their findings in each entry field, and a report is created by multiple people. However, when there is only one creator of the report, there are multiple creators. Findings may be entered in the entry field. For example, if there is a need to distinguish multiple findings such as finding findings for each lesion, finding findings for each type of examination, or finding findings for each purpose of examination, , Each finding to be distinguished is entered in each entry field.

  Further, although the keyboard and mouse have been described as examples of the input device, a microphone may be used as the input device, and the input of findings and operation instructions may be received by voice.

  In the above-described embodiment, the inspection image has been described using the inspection image obtained by the CT inspection and the CR inspection as an example, but of course, the inspection type is not limited to these, and MRI inspection, PET (positron emission tomography) Inspection images obtained by other inspections such as inspection, ultrasonic inspection, and endoscopic inspection may also be used. Further, the examination data may not be an image, and may be numerical data obtained by a specimen examination such as a pathological examination or a physiological examination, or a waveform diagram such as an electrocardiogram.

  Further, the inspection data may be a report summarizing past inspection results, a report created by another inspection, or the like. Further, when creating a report for follow-up observation, since past inspection data is often browsed, past inspection data may be used as the inspection data.

  In addition, the browsing data of the present invention may be other than examination data, for example, data such as a patient's medical record, a rehabilitation instruction record by a physical therapist, and any data that the report creator browses when inputting findings. Good. As shown in the above embodiment, various data such as inspection data of different inspection types can be combined with the browsing data.

  Further, the medical report of the present invention has been described by taking the interpretation report that summarizes the interpretation results as an example. However, the medical report is not limited to the interpretation report, but may be any medical report that summarizes the findings regarding the medical treatment of the patient. Therefore, the creator of the medical report is not limited to the interpretation doctor. Further, for example, the present invention can be applied to the creation of a medical report created by a person other than a doctor, such as a medical report created by a physical therapist engaged in rehabilitation guidance.

  In the above embodiment, the report system has been described as an example in which the report system is configured by one report creation terminal and one report server. However, the report creation terminal and the report server may be configured by a plurality of units. Further, the function of the report creation terminal and the function of the report server may be integrated into one computer. In this case, a program that integrates the client program and the server program installed in the report creation terminal constitutes a report creation support program. Further, instead of constructing the image DB and report DB on separate servers, both DBs may be integrated into one server. In addition, as a storage device for constructing the DB, a storage device connected via a network such as NAS (Network Attached Storage) or SAN (Storage Area Network) may be used. Thus, the physical configuration of the computer system can be changed as appropriate.

  In the above embodiment, the LAN is described as an example of the network. However, when the clinical department and the examination department are distributed at a plurality of bases, a combination of the LAN and the WAN (Wide Area Network) is used as the network. May be used.

  As shown in the above embodiment, the present invention naturally extends to a program form and further to a storage medium for storing the program.

It is a block diagram of a medical information system. It is a block diagram which shows the outline of the computer which comprises each server and each terminal. It is a block diagram which shows the outline of a report system. It is explanatory drawing of a finding input log | history and an image display log | history. It is explanatory drawing of a log | history display screen. It is explanatory drawing of another display format of a log | history display screen. It is a flowchart which shows a report preparation procedure. It is explanatory drawing of a report display screen.

Explanation of symbols

10 clinical departments 11 medical record system 12 radiology department (examination department)
13 Report system 21 Report creation terminal 21a Console control unit (display control means)
21b Image acquisition unit 21c Editing processing unit 21d History recording unit (finding input history recording unit, image display history recording unit)
21e History display screen generation unit 22 Report server 23 Image server 24 Report DB
26 Image DB
38 Display 39 Input device 46 Image display screen (viewing screen)
47 Report Edit Screen 47a Input Field 51 Finding Input History 52 Image Display History 66 History Display Screen 67 History Buttons 69a to 69c Images (Reproduced Images)

Claims (15)

In the medical report creation support system that supports the creation of medical reports,
Editing processing means for editing the medical report into which at least first and second plurality of findings are input;
Upon inputting each finding, browsing data display control means for performing display control for displaying a plurality of browsing data browsed by the creator of the medical report that inputs each finding on a browsing screen;
A finding input history recording means for recording a finding input history including each input time of each finding;
Browsing data display history recording means for recording browsing data display history including the display time of the browsing data displayed on the browsing screen during the input of each finding, in units of the findings;
A medical report creation support system comprising association means for associating the finding input history and the browsing data display history with the medical report.   The browsing data history recording means records, as the display time, a start time at which display of the browsing data is started on the browsing screen and an end time at which the display is ended in the browsing data unit. The medical report creation support system according to claim 1.   3. The finding input history recording unit records, as the input time, a start time at which the input of the finding is started and an end time at which the input is ended in the finding unit. The medical report creation support system described.   The medical report creation support system according to any one of claims 1 to 3, wherein the finding input history recording unit records an ID of the creator in units of the findings.   The medical report creation support system according to claim 1, wherein the browsing data display history recording unit records a display state of the browsing data displayed on the browsing screen together with the display time.   6. The medical report creation support system according to claim 1, further comprising history display screen generation means for generating a history display screen for displaying the contents based on the browsing data display history.   The medical report creation support system according to claim 6, wherein the input time included in the finding input history is displayed on the history display screen.   The medical report creation support system according to claim 6 or 7, wherein the history display screen includes a list of a plurality of the browsing data.   The browsing data list is arranged in either order of a start time when display of the browsing data is started on the browsing screen or a display time while the browsing data is displayed on the browsing screen. The medical report creation support system according to claim 8, wherein:   The medical report creation support system according to any one of claims 6 to 8, wherein the history display screen includes a reproduced image reproducing the display state of the browsing screen. The history display screen has a display format selection means for selecting a display format for displaying the browsing data display history,
The display formats that can be selected include at least two display formats: a first format that displays a reproduction image reproducing the display state of the browsing screen in time series, and a second format that displays a list of a plurality of browsing data. The medical report creation support system according to claim 6, wherein the medical report creation support system is included.   The medical report creation support system according to any one of claims 1 to 11, wherein the browsing data includes test data that is a test result of a medical test.   The medical report creation support system according to claim 12, wherein the examination data includes an examination image. In a medical report creation support program that allows a computer to implement functions that support the creation of medical reports,
An editing processing function for editing a medical report into which at least a plurality of first and second findings are input;
A browsing data display control function for performing display control for displaying a plurality of browsing data viewed by a creator of the medical report that inputs each finding on the browsing screen when inputting each finding,
A finding input history recording function for recording a finding input history including each input time of each finding;
A browsing data display history recording function that records a browsing data display history including a display time of the browsing data displayed on the browsing screen during the input of each finding, in units of the findings;
A medical report creation support program for causing the computer to realize an association function for associating the finding input history and the browsing data display history with the medical report. In a medical report creation support method that supports the creation of a medical report,
An editing process step for editing a medical report into which at least a first and second plurality of findings are input;
A browsing data display control step for performing display control for displaying a plurality of browsing data viewed by a creator of the medical report that inputs each finding on the browsing screen when inputting each finding,
A finding input history recording step of recording a finding input history including each input time of each finding;
A browsing data display history recording step for recording a browsing data display history including a display time of the browsing data displayed on the browsing screen during the input of each finding, in units of the findings;
A medical report creation support method comprising the step of associating the finding input history and the browsing data display history with the medical report.

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