JP2016218799A - Complex medical care supporting system, complex medical care supporting method, and complex medical care supporting program - Google Patents

Abstract

CONSTITUTION: A RIS server 14 sv in a RIS14 creates an inspection list including an inspection purpose and an accession number when it receives an inspection order from an HIS server 12 sv in an HIS12, and transfers the created inspection list to a modality console 16. The modality console 16 stores, into a PACS26, a DICOM file storing a medical image captured for the inspection purpose in the received inspection list and storing the accession number in the received inspection list. An image checking system 20 acquires, from the RIS server 14, an inspection list including a desired inspection purpose of the inspection lists created by the RIS server 14 sv, and acquires, from a PACS, a DICOM file storing an accession number corresponding to the accession number in the acquired inspection list.EFFECT: To enhance a medical care supporting system based on image checking.SELECTED DRAWING: Figure 1

Description

  The present invention relates to a composite medical support system, and more particularly to a composite medical support system including a radiology information system, a modality console, and an imaging system.

  The present invention also relates to a composite medical support method, and more particularly, a first medical support method executed by a radiology information system, a second medical support method executed by a modality console, and a third medical support executed by an imaging system. A combined medical support method.

  The present invention further relates to a combined medical support program, a first medical support program provided to the radiology information system, a second medical support program provided to the modality console, and a third medical support program provided to the imaging system; The present invention relates to a combined medical support program.

  When the hospital information system issues an examination order, the radiology information system creates an examination list in which patient information and examination information are described. Here, the examination information includes an examination purpose indicating either “examination” or “diagnosis” and a unique accession number (examination number).

  When imaging a patient using a modality, the radiologist adjusts imaging conditions with reference to an examination list created by the radiology information system. In particular, the radiation dose at the time of imaging is set to a different value depending on the inspection purpose indicated in the inspection list. For example, if the examination purpose is “examination”, the radiation dose is set to a preset value with a slight modification. If the examination purpose is “diagnosis”, the radiation dose is strictly determined based on the examination site and physique. Is set to the adjusted value.

  The imaging condition information is transmitted to the radiology information system after completion of imaging by the modality and described in the examination list. On the other hand, a medical image captured by a modality is stored in a DICOM (Digital Imaging and Communication in Medicine) file together with patient information, accession number, and imaging condition information, and stored in an image server in a file format. Thus, a common patient exam list and DICOM file are associated with each other by a common accession number.

“Guidelines for Confirmation of Image Information Version 2.1” (Japan Radiological Technology Society, August 18, 2014)

  However, when the DICOM file stored in the image server is imaged, the examination purpose is not referred to at present, and there is a limit to the medical support system based on the imaging. Note that the 11th page of the non-patent document describes the purpose of the inspection, but the specific method of using the inspection purpose is not specified.

  Therefore, a main object of the present invention is to provide a combined medical support system, a combined medical support method, and a combined medical support program capable of enhancing a medical support system based on imaging.

  A combined medical support system according to the present invention is a combined medical support system including a radiology information system (14: reference numerals corresponding to the embodiments; the same applies hereinafter), a modality console (16), and an imaging system (20) The radiology information system includes creation means (S113) for creating examination information including a pair of examination purposes and examination numbers, and transfer means (S137) for transferring examination information created by the creation means to the modality console. The modality console stores an image file containing a medical image taken along the examination purpose included in the examination information transferred by the transfer unit and an examination number included in the examination information transferred by the transfer unit. (222, 207) is provided with storage means (S189), and the imaging system includes a desired number of inspection numbers included in the inspection information created by the creation means. First acquisition means (S213 to S217) for obtaining an examination number paired with an examination purpose from the radiology information system, and an image file containing an examination number corresponding to the examination number obtained by the first obtaining means. Second acquisition means (S219 to S223) for acquiring from the apparatus is provided.

  Preferably, a hospital information system (12) for issuing a test order is further provided, and the creating means creates test information according to the test order issued by the hospital information system.

  Preferably, the image file stored by the storage unit further stores patient information, and the imaging system includes a grouping unit (S225 to S227) for grouping the image files acquired by the second acquisition unit based on the patient information. Further prepare.

  More preferably, the image file stored by the storage unit further stores a dose index of radiation transmitted through the patient at the time of imaging, and the imaging system visualizes the dose index stored in the image file belonging to a desired group ( S229 to S233).

  Preferably, the first acquisition means includes first request issuing means (S215) for issuing an examination information request including a desired examination purpose to the radiology information system, and the radiology information system is provided by the first request issuing means. It further comprises information return means (S161 to S165) for returning the inspection information that matches the issued inspection information request to the request source.

  Preferably, the main storage device is provided in the external server (22), the second acquisition means is a second request issuing means (S221) for issuing an image file request in which the target examination number is described to the external server, and 2 includes image file receiving means (S223) for receiving the image file returned from the external server in response to the image file request issued by the request issuing means.

  The combined medical support method according to the present invention is executed by the first medical support method executed by the radiology information system (14) and the second medical support method executed by the modality console (16) and the imaging system (20). The first medical support method includes a creation step (S113) for creating examination information including a pair of examination purposes and an examination number, and a creation step (S113). The second medical support method includes a transfer step (S137) for transferring the created examination information to the modality console, and the second medical support method transfers the medical image taken along the examination purpose included in the examination information transferred in the transfer step and the transfer step A storage step (S189) for storing in the main storage device (222, 207) an image file containing the examination number included in the examination information transferred by the third medical The support method includes a first acquisition step (S213 to S217) for acquiring, from the radiology information system, an inspection number that is paired with a desired inspection purpose among the inspection numbers included in the inspection information created in the creation step, and the first A second obtaining step (S219 to S223) for obtaining an image file containing an examination number corresponding to the examination number obtained in the obtaining step from the main storage device;

  The combined medical support program according to the present invention is provided to the first medical support program provided to the radiology information system (14) and the second medical support program provided to the modality console (16) and the imaging system (20). The first medical support program includes a creation step (S113) for creating examination information including a pair of examination purposes and examination numbers, and a creation step. This is a program for causing the processor (14sv4) of the radiology information system to execute the transfer step (S137) for transferring the created examination information to the modality console, and the second medical support program uses the examination information transferred in the transfer step. Included in the medical image taken for the purpose of examination included in and the examination information transferred in the transfer step This is a program for causing the processor (162) of the modality console to execute the storing step (S189) for storing the image file containing the examination number in the main storage device (222, 207). The third medical support program is created A first acquisition step (S213 to S217) that acquires from the radiology information system an inspection number that is paired with a desired inspection purpose among the inspection numbers included in the inspection information created by the steps, and is acquired by the first acquisition step. This is a program for causing the processor (202) of the image inspection system to execute a second acquisition step (S219 to S223) for acquiring an image file containing an inspection number corresponding to the inspection number from the main storage device.

  The examination information and the image file are managed by the radiology information system and the external server, respectively, and are associated with each other by the examination number. Based on this, the imaging system acquires examination information including a desired examination purpose from the radiology information system, and obtains an image file related to the obtained examination information from an external server based on the examination number. As a result, it is possible to perform image inspection on a medical image created for a desired inspection purpose, and to enhance the medical support system based on the image inspection.

  The above object, other objects, features and advantages of the present invention will become more apparent from the following detailed description of embodiments with reference to the drawings.

It is a block diagram which shows the structure of the composite medical assistance system of this Example. It is a block diagram which shows an example of a structure of the HIS server, RIS server, or image storage communication system shown in FIG. It is a block diagram which shows an example of a structure of the HIS terminal, RIS terminal, modality console, or image detection system shown in FIG. It is an illustration figure which shows an example of the test | inspection list produced by a RIS server. It is an illustration figure which shows an example of the reservation list produced by a RIS server. It is an illustration figure which shows an example of the reception screen displayed on the RIS terminal for reception. It is an illustration figure which shows an example of the test | inspection room screen displayed on the RIS terminal for a test | inspection. It is an illustration figure which shows another example of the test | inspection room screen displayed on the RIS terminal for a test | inspection. It is an illustration figure which shows an example of the test | inspection list multiplexedly displayed by the RIS terminal for a test | inspection. It is an illustration figure which shows an example of the structure of the DICOM file produced by the modality console. (A) is an illustrative view showing an example of a configuration of a console register provided in the RIS server, and (B) is an illustrative view showing an example of a configuration of a RIS terminal register provided in the RIS server. It is an illustration figure which shows an example of the frequency distribution graph displayed on an imaging system. It is a flowchart which shows a part of operation | movement of CPU provided in the HIS terminal. It is a flowchart which shows a part of other operation | movement of CPU provided in the HIS terminal. It is a flowchart which shows a part of operation | movement of CPU provided in the HIS server. It is a flowchart which shows a part of operation | movement of CPU provided in the RIS terminal. It is a flowchart which shows a part of other operation | movement of CPU provided in the RIS terminal. It is a flowchart which shows a part of operation | movement of CPU provided in the RIS server. It is a flowchart which shows a part of other operation | movement of CPU provided in the RIS server. It is a flowchart which shows a part of other operation | movement of CPU provided in the RIS server. It is a flowchart which shows further another part of operation | movement of CPU provided in the RIS server. It is a flowchart which shows a part of operation | movement of CPU provided in the modality console. It is a flowchart which shows a part of operation | movement of CPU provided in the image preservation | save communication system. It is a flowchart which shows a part of operation | movement of CPU provided in the image detection system. It is a flowchart which shows a part of other operation | movement of CPU provided in the image detection system. It is a block diagram which shows the structure of the composite medical assistance system of this Example.

  Referring to FIG. 1, the combined medical support system of this embodiment includes a hospital information system (hereinafter referred to as “HIS”) 12, a radiology information system (hereinafter referred to as “ RIS ”) 14, a modality console 16, an image inspection system 20, and an image storage communication system (hereinafter referred to as“ PACS ”) 22 which is an external server.

  In this embodiment, the HIS 12 includes a single HIS server 12sv connected to the communication network 10 and a single HIS terminal 12tm connected to the HIS server 12sv. The RIS 14 includes a single RIS server 14sv connected to the communication network 10 and two RIS terminals 14tm and 14tm connected to the RIS server 14sv (one is “for acceptance” and the other is “for inspection”). Consists of. Further, the modality console 16 is connected to the modality 18 in order to operate the modality 18 such as CT or MRI.

  The HIS terminal 12tm is installed in the examination room where the attending physician waits, the reception RIS terminal 14tm is installed in the radiology department reception, the examination RIS terminal 14tm is installed in the radiology examination room, and the modality console 16 The modality 18 is installed in a radiology room.

  The HIS server 12sv, the RIS server 14sv, or the PACS 22 is configured as shown in FIG. Further, the HIS terminal 12tm, the RIS terminal 14tm, the modality console 16 or the imaging system 20 are configured as shown in FIG.

  In the HIS server 12sv, a communication I / F 12sv1, a main storage device 12sv2, a DRAM 12sv3, a CPU 12sv4, and a communication I / F 12sv5 are connected to the bus 12sv6. The communication I / F 12sv1 is a device for communicating with the HIS terminal 12tm, and the communication I / F 12sv5 is a device for communicating with the communication network 10.

  In the RIS server 14sv, a communication I / F 14sv1, a main storage device 14sv2, a DRAM 14sv3, a CPU 14sv4, and a communication I / F 14sv5 are connected to the bus 14sv6. The communication I / F 14sv1 is a device for communicating with the RIS terminals 14tm and 14tm, and the communication I / F 14sv5 is a device for communicating with the communication network 10.

  In the PACS 22, a main storage device 222, a DRAM 223, a CPU 224, and a communication I / F 225 are connected to the bus 226. The communication network 10 is connected to a communication I / F 225. Unlike the HIS server 12sv or the RIS server 14sv, the PACS 22 omits a device corresponding to the communication I / F 12sv1 or 14sv1.

  In the HIS terminal 12tm, a communication I / F 12tm1, a CPU 12tm2, a keyboard 12tm3, a mouse pointer 12tm4, a display device 12tm5, a DRAM 12tm6, and a main storage device 12tm7 are connected to the bus 12tm8. The communication network 10 is connected to the communication I / F 12tm1.

  In the RIS terminal 14tm, a communication I / F 14tm1, a CPU 14tm2, a keyboard 14tm3, a mouse pointer 14tm4, a display device 14tm5, a DRAM 14tm6, and a main storage device 14tm7 are connected to the bus 14tm8. The communication network 10 is connected to the communication I / F 14tm1.

  In the modality console 16, a communication I / F 161, a CPU 162, a keyboard 163, a mouse pointer 164, a display device 165, a DRAM 166, and a main storage device 167 are connected to the bus 168. The communication network 10 is connected to the communication I / F 161. The modality console 16 is additionally provided with a communication I / F (not shown) for connecting to the modality 18.

  In the image detection system 20, a communication I / F 201, a CPU 202, a keyboard 203, a mouse pointer 204, a display device 205, a DRAM 206, and a main storage device 207 are connected to the bus 208. The communication network 10 is connected to the communication I / F 201.

  The CPU 12tm2 provided in the HIS terminal 12tm executes processing according to the flowcharts shown in FIGS. 13 to 14, and the CPU 12sv4 provided in the HIS server 12sv executes processing according to the flowchart shown in FIG. The control program corresponding to the flowcharts shown in FIGS. 13 to 14 is stored in the main storage device 12tm7, and the control program corresponding to the flowchart shown in FIG. 15 is stored in the main storage device 12sv2.

  Further, the CPU 14tm2 provided in the RIS terminal 14tm executes processing according to the flowcharts shown in FIGS. 16 to 17, and the CPU 14sv4 provided in the RIS server 14sv executes processing according to the flowcharts shown in FIGS. The control program corresponding to the flowcharts shown in FIGS. 16 to 17 is stored in the main storage device 14tm7, and the control program corresponding to the flowcharts shown in FIGS. 18 to 21 is stored in the main storage device 14sv2.

  Further, the CPU 162 provided in the modality console 16 executes processing according to the flowchart shown in FIG. 22, and the CPU 224 provided in the PACS 22 executes processing according to the flowchart shown in FIG. The CPU 202 executes processing shown in the flowcharts shown in FIGS. The control program corresponding to the flowchart shown in FIG. 22 is stored in the main storage device 167, the control program corresponding to the flowchart shown in FIG. 23 is stored in the main storage device 222, and the flowcharts shown in FIGS. The corresponding control program is stored in the main storage device 207. Below, the process of each flowchart is demonstrated along the action of the patient who visited the hospital.

  The patient first meets with the attending physician who operates the HIS terminal 12tm in the examination room. The attending physician performs an electronic medical chart requesting operation with the keyboard 12tm3 or the mouse pointer 12tm4 in order to view the electronic medical chart of the patient. Then, the CPU 12tm2 determines YES in step S1 shown in FIG. 13, and issues an electronic medical record transfer request to the HIS server 12sv in step S7. The electronic medical chart transfer request is output from the communication I / F 12tm1 and is given to the CPU 12sv4 of the HIS server 12sv via the communication I / F 12sv1 provided in the HIS server 12sv.

  If the attending physician performs another operation, the CPU 12tm2 determines YES in step S3, and executes other processing in step S5. When the other processing is completed, the CPU 12tm2 returns to step S1.

  In FIG. 15, the CPU 12 sv 4 of the HIS server 12 sv responds to the electronic medical record transfer request received from the HIS terminal 12 tm, proceeds from step S 41 to step S 43, and acquires the electronic medical record that matches the request from the main storage device 12 sv 2. The acquired electronic medical chart is temporarily held in the DRAM 12sv3. In step S45, the CPU 12sv4 commands the communication I / F 12sv1 to transfer the acquired electronic medical record to the request source. The electronic medical chart held in the DRAM 12sv3 is output from the communication I / F 12sv1, and is taken into the DRAM 12tm6 of the HIS terminal 12tm via the communication I / F 12tm1 provided in the HIS terminal 12tm.

  Returning to FIG. 13, when the CPU 12tm2 of the HIS terminal 12tm receives the electronic medical chart that matches the request from the HIS server 12sv, the CPU 12tm2 proceeds from step S9 to step S11, and instructs the display device 12tm5 to display the received electronic medical chart. The electronic medical record stored in the DRAM 12tm6 is read by the display device 12tm5 and displayed on the monitor screen.

  The attending physician operates the keyboard 12tm3 or the mouse pointer 12tm4 to input findings into the electronic medical chart while interrogating the patient. The input findings may include a description requesting inspection. In the description for requesting the inspection, the part to be inspected is specified as the inspection name, and either “examination” or “diagnosis” is specified as the inspection purpose.

  When such an input operation such as a finding is performed, the CPU 12tm2 determines YES in step S13, and updates the description of the electronic medical record stored in the DRAM 12tm6 in step S15. The updated description is also reflected in the electronic medical record on the monitor screen.

  An electronic medical record may be associated with a medical image of a patient taken in the past. When the attending physician performs an image display operation using the keyboard 12tm3 or the mouse pointer 12tm4 to view this medical image, the CPU 12tm2 proceeds from step S17 to step S19, and issues a DICOM file transfer request to the HIS server 12sv. The DICOM file transfer request is also output from the communication I / F 12tm1 and given to the CPU 12sv4 of the HIS server 12sv via the communication I / F 12sv1 provided in the HIS server 12sv.

  Referring to FIG. 15, in response to the DICOM file transfer request received from HIS terminal 12tm, CPU 12sv4 proceeds from step S47 to step S49. In step S49, the received DICOM file transfer request is forwarded to the PACS 22. The DICOM file transfer request is output from the communication I / F 12sv5 and is given to the CPU 224 of the PACS 22 via the communication network 10 and the communication I / F 225 provided in the PACS 22.

  In FIG. 23, the CPU 224 proceeds from step S201 to step S203 in response to the DICOM file transfer request forwarded from the HIS server 12sv. In step S203, a DICOM file that matches the request is acquired from the main storage device 222. The acquired DICOM file is temporarily held in the DRAM 223.

  In step S205, the communication I / F 225 is instructed to transfer the DICOM file thus obtained to the request source. The DICOM file held in the DRAM 223 is output from the communication I / F 225 and taken into the DRAM 12sv3 of the HIS server 12sv via the communication network 10 and the communication I / F 12sv5 provided in the HIS server 12sv.

  Returning to FIG. 15, when the CPU 12 sv 4 receives the DICOM file from the PACS 22, the process proceeds from step S 51 to step S 53 and forwards the received DICOM file to the HIS terminal 12 tm. The DICOM file is output from the communication I / F 12sv1 and stored in the DRAM 12tm6 of the HIS terminal 12tm via the communication I / F 12tm1 provided in the HIS terminal 12tm.

  Returning to FIG. 14, the CPU 12tm2 of the HIS terminal 12tm proceeds from step S21 to step S23 when the DICOM file matching the request is taken into the DRAM 12tm6. In step S23, the display device 12tm5 is instructed to display the medical image stored in the DICOM file on the DRAM 12tm6. The display device 12tm5 reads the requested medical image from the DRAM 12tm6 and displays the read medical image on the monitor screen.

  When the inquiry to the patient is completed and the attending physician performs an end operation with the keyboard 12tm3 or the mouse pointer 12tm4, the CPU 12tm2 proceeds from step S25 to step S27, and hides the electronic medical record and medical image on the monitor screen. If there is a change in the description of the electronic medical record, the CPU 12tm2 proceeds from step S29 to step S31, and issues an electronic medical record storage request to the HIS server 12sv.

  The issued electronic medical record storage request is accompanied by the changed electronic medical record. The electronic medical chart storage request and the electronic medical chart are output from the communication I / F 12tm1, and are respectively provided to the CPU 12sv4 and the DRAM 12sv3 of the HIS server 12sv via the communication I / F 12sv1 provided in the HIS server 12sv.

  Referring to FIG. 15, in response to the electronic medical record storage request received from HIS terminal 12tm, CPU 12sv4 proceeds from step S55 to step S57, and stores the electronic medical record on DRAM 12sv3 in main memory 12sv2. If there is a description requesting the electronic medical chart on the DRAM 12sv3 to inspect, the CPU 12sv4 proceeds from step S59 to step S61, and notifies the RIS server 14sv of the inspection order.

  The examination order includes a unique accession number (examination number) in addition to patient information, examination name, and examination purpose described in the electronic medical record. In particular, the accession number is paired with the inspection purpose, and a pair of inspection purpose and accession number is included in the inspection order. The inspection order is output from the communication I / F 12sv5, and is given to the CPU 14sv4 of the RIS server 14sv via the communication network 10 and the communication I / F 14sv5 provided in the RIS server 14sv.

  When receiving another request, the CPU 14sv4 determines YES in step S63, and executes other processing in step S65.

  18, when the inspection order is notified from the HIS server 12sv, the CPU 14sv4 of the RIS server 14sv proceeds from step S111 to step S113, and displays an inspection list (inspection information) that matches the notified inspection order. Create it as shown in. In the created examination list, patient information, examination name, examination purpose, and accession number (displayed as an order number) included in the examination order are described. Imaging conditions such as tube voltage, tube current, exposure time, and distance are uniformly set to values corresponding to the inspection name and inspection purpose. Further, the status of the examination list is set to “unaccepted”.

  In step S115, some of the items described in the examination list are extracted, and the extracted items are described in the empty columns of the reservation list shown in FIG. At this time, the status of the description destination column is set to “unaccepted”, and an “not yet” icon is displayed in the description destination column.

  The reception RIS terminal 14tm is provided at the reception of the radiology department and is operated by an office staff. When the patient who has completed the inquiry by the attending physician visits the reception of the radiology department, the office staff performs a reception screen display operation with the keyboard 14tm3 or the mouse pointer 14tm4. The CPU 14tm2 provided in the RIS terminal 14tm proceeds from step S71 shown in FIG. 16 to step S73, and issues a reservation list transfer request to the RIS server 14sv. The reservation list transfer request is output from the communication I / F 14tm1 and is given to the CPU 14sv4 of the RIS server 14sv via the communication I / F 14sv1 provided in the RIS server 14sv.

  18, the CPU 14sv4 proceeds from step S117 to step S119 when receiving the reservation list transfer request from the RIS terminal 14tm. In step S119, a reservation list that matches the request is acquired from the main storage device 14sv2, and the communication I / F 14sv1 is instructed to transfer the acquired reservation list to the RIS terminal 14tm. The acquired reservation list is output from the communication I / F 14sv1, and stored in the DRAM 14tm6 of the RIS terminal 14tm via the communication I / F 14tm1 provided in the RIS terminal 14tm.

  Returning to FIG. 16, when the CPU 14tm2 of the RIS terminal 14tm receives the reservation list from the RIS server 14sv, the process proceeds from step S75 to step S77. In step S77, a reception screen on which the received reservation list is drawn is created on the DRAM 14tm6, and the display device 14tm5 is instructed to display the created reception screen. The display device 14tm5 reads the reception screen from the DRAM 14tm6, and displays the read reception screen as shown in FIG.

  When a radiology staff member performs a reservation reception operation with the keyboard 14tm3 or the mouse pointer 14tm4, the CPU 14tm2 proceeds from step S79 to step S83, and the column (= radiation) designated by the reservation reception operation among the columns on the reservation list. The status of the column of the patient who visited the department reception is updated to “accepted”. The “not yet” icon display on the reception screen is updated to “reception” by the process of step S83.

  When the update is completed, the CPU 14tm2 transmits a reservation acceptance notification to the RIS server 14sv in step S85. The reservation acceptance notification is output from the communication I / F 14tm1 and given to the CPU 14sv4 of the RIS server 14sv via the communication I / F 14sv1 provided in the RIS server 14sv.

  When the radiology reception staff performs an end operation using the keyboard 14tm3 or the mouse pointer 14tm4, the CPU 14tm2 determines YES in step S81, and instructs the display device 14tm5 to hide the reception screen in step S87. As a result, the reception screen disappears from the display device 14tm5.

  Referring to FIG. 18, when the CPU 14 sv 4 of the RIS server 14 sv receives a reservation acceptance notification from the RIS terminal 14 tm, the CPU 14 sv 4 proceeds from step S 121 to step S 123, and among the columns on the reservation list, the column specified by the reservation acceptance operation ( = The column of the patient who visited the department of radiology) is updated to “accepted”. Specifically, the “unreceived” icon on the reservation list is updated to “accepted”, and the description of “unaccepted” on the examination list is updated to “accepted”. The description of the reservation list is synchronized between the RIS terminal 14tm and the RIS server 14sv by updating the icon.

  The inspection RIS terminal 14tm is operated by a radiologist. When the radiologist performs an examination room screen display operation using the keyboard 14tm3 or the mouse pointer 14tm4, the CPU 14tm2 proceeds from step S89 shown in FIG. 16 to step S91, and issues an examination / reservation list transfer request to the RIS server 14sv. The inspection / reservation list transfer request is output from the communication I / F 14tm1 and is given to the CPU 14sv4 of the RIS server 14sv via the communication I / F 14sv1 provided in the RIS server 14sv.

  18, the CPU 14sv4 proceeds from Step S125 to Step S127 when receiving the inspection / reservation list transfer request from the RIS terminal 14tm. In step S127, the examination list and reservation list that match the request are acquired from the main storage device 14sv2, and the communication I / F 14sv1 is instructed to transfer the acquired examination list and reservation list to the RIS terminal 14tm. The acquired examination list and reservation list are output from the communication I / F 14sv1, and stored in the DRAM 14tm6 of the RIS terminal 14tm via the communication I / F 14tm1 provided in the RIS terminal 14tm.

  Returning to FIG. 17, when the CPU 14tm2 of the RIS terminal 14tm receives the examination list and the reservation list from the RIS server 14sv, the process proceeds from step S93 to step S95. In step S95, an inspection room screen on which only the column indicating the status “accepted” among the columns on the received reservation list is created on the DRAM 14tm6, and the display device 14tm5 is instructed to display the generated inspection room screen. To do. The examination room screen is read by the display device 14tm5 and displayed as shown in FIG.

  The radiologist operates the keyboard 14tm3 or the mouse pointer 14tm4, clicks the column of the patient who has visited the examination room from the “accepted” columns on the examination room screen, and designates the modality 18. These operations are called “reservation execution operations”. When the reservation execution operation is performed, the CPU 14tm2 proceeds from step S97 to step S101, and updates the status of the clicked column from “accepted” to “under examination”. The displayed examination room screen is updated from FIG. 7 to FIG. That is, the icon display of “Receive” on the examination room screen is updated to “Test”.

  In step S103, the examination list corresponding to the column clicked from the examination list received from the RIS terminal 14tm (= the examination list of the patient who visited the examination room) is specified, and the display of the specified examination list is displayed on the display device 14tm5. To order. The display device 14tm5 reads the inspection list according to the command from the DRAM 14tm6, and displays the read inspection list in a multiplexed manner on the monitor screen in the manner shown in FIG. When the display is completed, the CPU 14tm2 transmits an inspection execution notification to the RIS server 14sv in step S105. The inspection execution notification is output from the communication I / F 14tm1 and is given to the CPU 14sv4 of the RIS server 14sv via the communication I / F 14sv1 provided in the RIS server 14sv.

  In FIG. 19, when the CPU 14sv4 receives the examination execution notification from the RIS terminal 14tm, the CPU 14sv4 proceeds from step S129 to step S131, and among the columns on the reservation list, the status of the column clicked by the radiologist is “accepted”. To “inspection”. Specifically, the “received” icon on the reservation list is updated to “inspection”, and the description of “accepted” on the inspection list is updated to “under inspection”.

  In step S171 shown in FIG. 22, the CPU 162 of the modality console 16 issues an examination list transfer request to the RIS server 14sv by the MWM (Modality Worklist Management) method. The inspection list transfer request is output from the communication I / F 161 and is given to the CPU 14sv4 of the RIS server 14sv via the communication network 10 and the communication I / F 14sv5 provided in the RIS server 14sv. The inspection list transfer request is repeatedly issued until the inspection list is received from the RIS server 14sv.

  Returning to FIG. 19, if the examination list transfer request is received from the modality console 16 and the request source is the modality console 16 associated with the modality 18 designated by the reservation execution operation, the CPU 14sv4 determines YES in steps S133 and S135. And the process proceeds to step S137. In step S137, the communication I / F 14sv5 is commanded to transfer the same examination list as the examination list being displayed. The inspection list according to the command is output from the communication I / F 14sv5 and is stored in the DRAM 166 of the modality console 16 via the communication network 10 and the communication I / F 161 provided in the modality console 16.

  22, when the CPU 162 of the modality console 16 receives the examination list from the RIS server 14sv, the CPU 162 proceeds from step S173 to step S175, and instructs the display device 165 to display the examination list. The display device 165 reads the inspection list stored in the DRAM 166 and displays the read inspection list on the monitor screen. As a result, the common examination list is displayed on the display device 14tm5 of the RIS terminal 14tm and the display device 165 of the modality console 16.

  The radiologist moves from the examination room to the imaging room and brings the patient into the imaging room. When the patient is placed in the modality 18, the radiologist performs an imaging condition adjustment operation, an imaging execution operation, and an examination end operation while checking the examination list displayed on the display device 165. These operations are performed by the keyboard 163 or the mouse pointer 164.

  The imaging condition adjustment operation is performed with reference to imaging conditions (tube voltage, tube current, exposure time, distance) described in the examination list. Then, the CPU 162 proceeds from step S177 to step S179, and adjusts the shooting condition, that is, the setting of the modality 18. Specifically, the modality 18 is accessed through a communication I / F (not shown) to adjust tube voltage, tube current, distance, exposure time, and the like.

  When the photographing execution operation is performed, the CPU 162 proceeds from step S181 to step S183, and instructs the modality 18 to perform photographing through the communication I / F. The patient is photographed according to the photographing conditions set in the modality 18, and thereby a medical image representing the affected part is obtained. In step S185, a DICOM file containing the taken medical image is created.

  In addition to medical images, the DICOM file contains imaging condition information indicating imaging conditions set in the modality 18 and an EI value indicating a dose index of radiation transmitted through the patient at the time of imaging, and is further described in the examination list. Patient information and accession number. The created DICOM file has the file structure shown in FIG. 10, and is temporarily held in the DRAM 166 of the modality console 16 via the communication I / F.

  When the inspection end operation is performed, the CPU 162 proceeds from step S187 to step S189, and issues a DICOM file save request to the PACS 22 in order to save the DICOM file held in the DRAM 166 in the PACS 22. The issued DICOM file save request is accompanied by a DICOM file to be saved.

  The DICOM file storage request and the DICOM file are output from the communication I / F 161 and are provided to the CPU 224 and the DRAM 223 of the PACS 22 via the communication I / F 225 provided in the PACS 22, respectively.

  In FIG. 23, when the CPU 224 receives a DICOM file save request from the modality console 16, the process proceeds from step S207 to step S209. In step S209, the DICOM file stored in the DRAM 223 is saved in the main storage device 167.

  Returning to FIG. 22, in step S191, an examination end notification describing the accession number and the imaging conditions is transmitted to the RIS server 14sv by the MPPS (Modality Performed Procedure Step) method. The inspection end notification is output from the communication I / F 161 and is given to the CPU 14sv4 of the RIS server 14sv via the communication network 10 and the communication I / F 14sv5 provided in the RIS server 14sv.

  After the examination end operation, the radiologist releases the patient from the modality 18 and returns from the imaging room to the examination room. When the radiologist performs an end operation using the keyboard 14tm3 or the mouse pointer 14tm4 provided in the RIS terminal 14tm of the examination room, the CPU 14tm2 proceeds from step S99 shown in FIG. 17 to step S107, and the examination end in which the accession number is described is completed. A notification is transmitted to the RIS server 14sv.

  The inspection end notification is output from the communication I / F 14tm1 and is given to the CPU 14sv4 of the RIS server 14sv via the communication I / F 14sv1 provided in the RIS server 14sv. When the transmission is completed, the process proceeds to step S109 to instruct the display device 14tm5 to hide the examination room screen. As a result, the examination room screen disappears from the display device 14tm5.

  Referring to FIG. 20, when the CPU 14 sv 4 of the RIS server 14 sv receives the examination end notification from the modality console 16, the process proceeds from step S 139 to step S 141. In step S141, the inspection end notification is stored in the console register formed in the manner shown in FIG. 11A on the DRAM 14sv3. When the CPU 14sv4 receives the inspection end notification from the RIS terminal 14tm, the process proceeds from step S143 to step S145. In step S145, the inspection end notification is stored in the RIS terminal register formed in the manner shown in FIG. 11B on the DRAM 14sv3.

  In step S147, a test end notification having a common accession number is searched from the console register and the RIS terminal register. When the desired inspection end notification is found, the process proceeds from step S149 to step S151, and the inspection list having the same accession number as the accession number described in the found inspection end notification is specified from the DRAM 14tm6.

  In step S153, the imaging conditions included in the examination end notification found from the console register are read, and the read imaging conditions are described in the examination list identified in step S151. The imaging conditions described in the examination list when receiving the examination order are overwritten by the imaging conditions included in the examination end notification. In step S153, the description of “inspection” on the inspection list is updated to “performed”.

  When the process of step S153 is completed, the CPU 14sv4 proceeds to step S155, and stores this examination list in the main storage device 14sv2. In step S157, the detected examination end notification is deleted from the console register and the RIS terminal register. In step S159, the column corresponding to the examination list stored in the main storage device 14sv2 is deleted from the columns on the reservation list.

  The DICOM file stored in the PACS 22 is an object of image detection work by the image detection system 20. The imaging system 20 is operated by a radiologist. First, the CPU 202 of the imaging system 20 expands the search screen in the DRAM 206 in step S211 shown in FIG. 24, and instructs the display device 205 to display the expanded search screen. As a result, a search screen is displayed on the display device 205.

  When the radiologist operates the keyboard 203 or the mouse pointer 204 and designates the examination purpose, the CPU 202 proceeds from step S213 to step S215, and directs the examination list transfer request describing the designated examination purpose to the RIS server 14sv. Issue. The inspection list transfer request is output from the communication I / F 201 and given to the CPU 14sv4 of the RIS server 14sv via the communication network 10 and the communication I / F 14sv5 provided in the RIS server 14sv.

  Referring to FIG. 21, when receiving the inspection list transfer request from the image inspection system 20, the CPU 14sv4 proceeds from step S161 to step S163, and acquires one or more inspection lists that match the request from the main storage device 14sv2. To do. The acquired inspection list is temporarily stored in the DRAM 14sv3. In step S165, the communication I / F 14sv1 is instructed to transfer the acquired examination list to the request source. The inspection list on the DRAM 14 sv 3 is output from the communication I / F 14 sv 5 and is taken into the DRAM 206 of the image detection system 20 via the communication network 10 and the communication I / F 201 provided in the image detection system 20.

  If another request or notification is received, the CPU 14sv4 determines YES in step S167, and executes another process in step S169.

  Returning to FIG. 24, when the CPU 202 of the imaging system 20 receives the examination list from the RIS server 14sv, the process proceeds from step S217 to step S219. In step S219, an accession number is extracted from the received examination list. In step S221, a DICOM file transfer request in which the extracted accession number is described is issued to the PACS 22. The DICOM file transfer request is output from the communication I / F 201 and is given to the CPU 224 of the PACS 22 via the communication I / F 225 provided in the PACS 22.

  In FIG. 23, when the CPU 224 receives a DICOM file transfer request from the image inspection system 20, the process proceeds from step S201 to step S203. In step S203, one or more DICOM files having the same accession number as the accession number described in the DISCOM file transfer request are acquired from the main storage device 222. The acquired DICOM file is temporarily held in the DRAM 223.

  In step S205, the communication I / F 225 is instructed to transfer the DICOM file thus obtained to the request source. The DICOM file held in the DRAM 223 is output from the communication I / F 225 and taken into the DRAM 206 of the image detection system 20 through the communication network 10 and the communication I / F 201 provided in the image detection system 20.

  Returning to FIG. 24, when the CPU 202 of the imaging system 20 receives the DICOM file from the PACS 22, the process proceeds from step S223 to step S225. In step S225, patient information is detected from the received DICOM file. In step S227, the received DICOM files are grouped based on the detected patient information. Grouping is performed based on age and sex, for example.

  When the radiologist operates the keyboard 203 or the mouse pointer 204 to specify a desired group, the CPU 202 proceeds from step S229 to step S231, and detects an EI value from one or more DICOM files belonging to the specified group. . In step S233, the frequency distribution graph of the detected EI value is drawn on the DRAM 206, and the display device 205 is instructed to display the drawn frequency distribution graph. The frequency distribution graph is read by the display device 205 for visualization and displayed on the monitor screen in the manner shown in FIG.

  When the radiologist performs an end operation using the keyboard 203 or the mouse pointer 204, the CPU 202 proceeds from step S235 to step S237, and instructs the display device 205 to hide the frequency distribution graph. As a result, the frequency distribution graph disappears from the monitor screen.

  As can be seen from the above description, the composite medical line-of-sight system according to this embodiment includes the HIS 12, the RIS 14, the modality console 16, and the imaging system 20.

  When the RIS server 14sv provided in the RIS 14 receives the inspection order from the HIS server 12sv provided in the HIS 12, the RIS server 14sv creates an inspection list including a pair of inspection purposes and an accession number (S113). Is transferred to the modality console 16 (S137).

  The modality console 16 stores in the PACS 26 a DICOM file in which the received examination list contains the medical images taken along the examination purpose and the accession numbers included in the received examination list (S189).

  The imaging system 20 acquires from the RIS server 14sv an examination list including a desired examination purpose among the examination lists created by the RIS server 14sv (S213 to S217), and sets the accession number included in the obtained examination list. A DICOM file containing the corresponding accession number is acquired from the PACS (S219 to S223).

  In this way, the examination list and the DICOM file are managed by the RIS 14 and the PACS 22, respectively, and are associated with each other by the accession number. Based on this, the image inspection system 20 acquires an inspection list including a desired inspection purpose from the RIS 14, and acquires a DICOM file related to the acquired inspection list from the PACS 22 based on the accession number. As a result, it is possible to perform image inspection on a medical image created for a desired inspection purpose, and to enhance the medical support system based on the image inspection.

  In this embodiment, a PACS 22 is provided separately from the imaging system 20, and a DICOM file created by the modality console 16 is stored in the main storage device 222 of the PACS 22. However, as shown in FIG. 26, the PACS 22 may be integrated with the imaging system 20 and the DICOM file created by the modality console 16 may be stored in the main storage device 207 of the imaging system 20. In this case, the processing corresponding to the flowchart shown in FIG. 23 is executed by the CPU 202 of the imaging system 20.

10 ... Communication network 12 ... HIS
12sv ... HIS server 12tm ... HIS terminal 14 ... RIS
14 sv ... RIS server 14 tm ... RIS terminal 16 ... modality console 18 ... modality 20 ... imaging system 22 ... PACS

Claims (8)

A combined medical support system comprising a radiology information system, a modality console, and an imaging system,
The radiology information system includes:
Creating means for creating inspection information including a pair of examination purposes and examination numbers; and transfer means for transferring the examination information created by the creating means to the modality console,
The modality console is
An image file containing a medical image taken along the examination purpose included in the examination information transferred by the transfer unit and an examination number included in the examination information transferred by the transfer unit is stored in the main storage device. With storage means,
The imaging system includes:
First acquisition means for acquiring from the radiology information system an examination number that is paired with a desired examination purpose among examination numbers included in the examination information created by the creation means, and obtained by the first acquisition means A combined medical support system comprising second acquisition means for acquiring an image file containing an examination number corresponding to an examination number from the main storage device. A hospital information system for issuing inspection orders;
The combined medical support system according to claim 1, wherein the creating unit creates the examination information according to an examination order issued by the hospital information system. The image file stored by the storage means further stores patient information,
The composite medical support system according to claim 1, wherein the imaging system further includes a grouping unit that groups the image files acquired by the second acquisition unit based on the patient information. The image file stored by the storage means further contains a dose index of radiation transmitted through the patient at the time of imaging,
The composite medical support system according to claim 3, wherein the imaging system further includes a visualization unit that visualizes a dose index stored in an image file belonging to a desired group. The first acquisition means includes first request issuing means for issuing an inspection information request including the desired inspection purpose to the radiology information system,
5. The composite according to claim 1, wherein the radiology information system further includes information return means for returning examination information that matches the examination information request issued by the first request issuing means to the request source. Medical support system. The main storage device is provided in an external server,
The second acquisition means is a second request issuing means for issuing an image file request in which a target examination number is described to the external server, and the external request for the image file request issued by the second request issuing means. 6. The combined medical support system according to claim 1, further comprising image file receiving means for receiving an image file returned from the server. A combined medical support method comprising a first medical support method executed by a radiology information system, a second medical support method executed by a modality console, and a third medical support method executed by an imaging system,
The first medical support method includes:
A creation step for creating examination information including a pair of examination purposes and an examination number, and a transfer step for transferring the examination information created by the creation step to the modality console,
The second medical support method includes:
An image file containing a medical image taken along the examination purpose included in the examination information transferred in the transfer step and an examination number included in the examination information transferred in the transfer step is stored in the main storage device. With a save step,
The third medical support method includes:
A first acquisition step of acquiring from the radiology information system an inspection number that is paired with a desired inspection purpose among the inspection numbers included in the inspection information generated by the generation step; and acquired by the first acquisition step A combined medical support method comprising a second acquisition step of acquiring an image file containing an examination number corresponding to an examination number from the main storage device. A combined medical support program comprising a first medical support program provided to the radiology information system, a second medical support program provided to the modality console, and a third medical support program provided to the imaging system,
The first medical support program includes
In order to cause the processor of the radiology information system to execute a creation step of creating examination information including a pair of examination purposes and an examination number, and a transfer step of transferring the examination information created by the creation step to the modality console Is a program of
The second medical support program is
An image file containing a medical image taken along the examination purpose included in the examination information transferred in the transfer step and an examination number included in the examination information transferred in the transfer step is stored in the main storage device. A program for causing the processor of the modality console to execute a storing step,
The third medical support program is
A first acquisition step of acquiring from the radiology information system an inspection number that is paired with a desired inspection purpose among the inspection numbers included in the inspection information generated by the generation step; and acquired by the first acquisition step A combined medical support program, which is a program for causing a processor of the imaging system to execute a second acquisition step of acquiring an image file containing an examination number corresponding to an examination number from the main storage device.

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