JP2019174879A - Medical information management server, and medical information management system - Google Patents

Abstract

To enable a management of medical information on a plurality of patients prepared in a plurality of medical facilities regardless of whether a patient ID is provided to each patient between the medical facilities.SOLUTION: A selection of a patient is received due to a combination of a facility ID indicative of a medical facility and a patient ID in the facility, and a determination is made whether a common patient ID is associated with the combination of the facility ID and the patient ID in the facility (in a step S13). When the common ID is associated (in a step S13; YES), all patients associated with the same common patient ID are extracted (in a step S14), and medical information associated with the extracted all patients (in a step S15). When the common patient ID is not associated (in a step S13; NO), medical information associated with a patient to be identified by the combination of the facility ID and the patient ID in the facility is acquired (in a step S16).SELECTED DRAWING: Figure 7

Description

  The present invention relates to a medical information management server and a medical information management system.

  In recent years, with the diversification of medical technology, sharing of medical information is progressing between a plurality of medical facilities such as hospitals belonging to the same group. The patient ID for identifying the patient is usually managed separately for each medical facility, and when referring to the medical information related to each patient, the facility ID for identifying the medical facility is used in the facility. It is necessary to specify the patient ID.

  As a method for integrating information managed by different identification systems by a plurality of medical facilities, a common patient ID is set for a set of facility IDs and in-facility patient IDs, and information related to the same patient is set by this common patient ID. A management technique has been proposed (see Patent Document 1).

  In some group hospitals, a common numbering rule is set in advance in a group, and a common patient ID is used between medical facilities.

JP 2006-157189 A

However, as hospital grouping expands, situations may arise where existing independent hospitals later join the group. In this case, since it takes a lot of labor to re-assign a common patient ID to a patient at a medical facility that has joined the group later, it is difficult to always manage information with a common patient ID within the group.
For this reason, in a medical facility newly added to a group, a method is adopted in which only a new patient is given a common patient ID to share information. On the other hand, since there is a possibility that the existing in-facility patient ID may overlap with the common patient ID for existing patients, the patient's medical history, past examination images, etc. are mutually referred between the facilities in the group. There was a problem that I could not.

  The present invention has been made in view of the above-described problems in the prior art, and for each piece of medical information generated in a plurality of medical facilities, a common patient ID is provided between the medical facilities. Regardless of whether or not it is, it is an issue to be manageable.

  In order to solve the above-mentioned problem, the invention according to claim 1, medical information generated in each of a plurality of medical facilities includes facility information indicating the medical facility in which the medical information is generated and the medical information in the medical facility. The facility information is included in at least a part of the combination of the first storage means stored in association with the combination of the in-facility patient ID indicating the patient related to the medical information and the facility information and the in-facility patient ID. And the second storage means in which common information indicating that the patients specified by the combination of the patient ID and the in-facility patient ID are the same patient is stored in association with each other via a communication network. A receiving unit that receives selection of a combination of the facility information and the in-facility patient ID from the reference terminal, and the second storage unit; All the combinations that are the same patient as the patient specified by the selected combination are extracted from the second storage means based on the common information when the common information is associated with the combination. Medical information associated with all of the extracted combinations is acquired from the first storage unit, the acquired medical information is provided to the reference terminal, and the selected combination is stored in the second storage unit. Control in which only the medical information associated with the selected combination is acquired from the first storage unit and the acquired medical information is provided to the reference terminal when the common information is not associated with the selected combination And a medical information management server.

  The invention according to claim 2 is the medical information management server according to claim 1, wherein the common information is a common patient ID common to the plurality of medical facilities, and the second storage means has the same information. The same common patient ID is associated with the combination of the facility information of the patient and the in-facility patient ID, and the control unit is configured to share the selected combination with the selected combination in the second storage unit. When patient ID is matched, all the combinations by which the same common patient ID as the said common patient ID is matched are extracted from the said 2nd memory | storage means.

  According to a third aspect of the present invention, in the medical information management server according to the first aspect, the in-facility patient ID included in the combination in which the common information is associated is the plurality of medical facilities. Information that indicates that it also serves as a common patient ID, and the control means, in the second storage means, when the combination information is associated with the selected combination, All combinations that include the same in-facility patient ID as the in-facility patient ID included in the selected combination and are associated with the combination information are extracted from the second storage unit.

  According to a fourth aspect of the present invention, in the medical information management server according to any one of the first to third aspects, the medical information management server is connected to be able to perform data communication via a communication network, and is used in each of the plurality of medical facilities. Receiving means for receiving medical information from the in-facility terminal, identifying means for identifying the medical facility corresponding to the in-facility terminal that has transmitted the received medical information, and in-facility attached to the received medical information In-facility patient ID acquisition means for acquiring a patient ID, and the received medical information is associated with a combination of facility information indicating the identified medical facility and the acquired in-facility patient ID. When there is the first storage control unit to be stored in the storage unit and the common information corresponding to the received medical information, the common information is applied to the identified medical facility. Comprises a second storage control unit in association information and the combination of the acquired facilities within the patient ID is stored in the second storage means.

  According to a fifth aspect of the present invention, in the medical information management server according to the fourth aspect, the identification means includes a facility ID of a medical facility where the in-facility terminal is used, and a medical facility where the in-facility terminal is used The medical facility corresponding to the in-facility terminal is identified based on at least one of the facility name, the AE title of the in-facility terminal, and the IP address of the in-facility terminal.

  The invention according to claim 6 is the medical information management server according to claim 4 or 5, wherein the first storage control means includes facility information indicating the identified medical facility and the acquired in-facility patient ID. The combination is already registered in the first storage means, and if the combination is already registered in the first storage means, the received medical information is associated with the combination. In addition, it is stored in the first storage means.

  The invention according to claim 7 is a medical information management system in which a medical information management server and a reference terminal are connected via a communication network so that data communication is possible, and the medical information management server includes a plurality of medical facilities. The medical information generated in each is stored in association with the combination of the facility information indicating the medical facility in which the medical information is generated and the in-facility patient ID indicating the patient related to the medical information in the medical facility. The patients identified by the combination of the facility information and the in-facility patient ID are at least part of the combination of the first storage means and the facility information and the in-facility patient ID. A combination of the facility information and the in-facility patient ID from the second storage means in which the common information to be stored is stored in association with the reference terminal When the common information is associated with the selected combination in the accepting means for accepting selection of the image and in the second storage means, it is specified by the selected combination based on the common information All combinations that are the same patient as the patient are extracted from the second storage unit, medical information associated with all the extracted combinations is acquired from the first storage unit, and the acquired medical information is When the common information is not associated with the selected combination in the second storage means provided to the reference terminal, only the medical information associated with the selected combination is stored in the first storage. Control means for obtaining from the means and providing the obtained medical information to the reference terminal.

  According to the present invention, it is possible to manage medical information relating to a plurality of patients generated at a plurality of medical facilities regardless of whether or not each patient is provided with a common patient ID among the medical facilities.

It is a system configuration figure of the medical information management system in a 1st embodiment. It is a block diagram which shows the functional structure of a medical information management server. It is a structural example of each table memorize | stored in the medical information management server. It is a block diagram which shows the functional structure of a client terminal. It is a flowchart which shows a 1st medical information registration process. It is an example of a patient information correction screen. It is a flowchart which shows a 1st medical information provision process. It is a figure for demonstrating the specific example of the usage method of common patient ID. It is a structural example of each table memorize | stored in the medical information management server of 2nd Embodiment. It is a flowchart which shows a 2nd medical information registration process. It is a flowchart which shows a 2nd medical information provision process. It is a figure for demonstrating the specific example of the usage method of a common flag.

[First Embodiment]
First, a first embodiment of a medical information management system according to the present invention will be described with reference to FIGS. The present invention is not limited to the illustrated example.

FIG. 1 shows a system configuration of a medical information management system 100 according to the first embodiment.
As shown in FIG. 1, the medical information management system 100 includes a medical information management server 10, a client terminal 20A used in the medical facility A, a client terminal 20B used in the medical facility B, and so on. Configured. The medical information management server 10 and the client terminals 20A, 20B,... Are connected via a communication network N so that data communication is possible. Each device constituting the medical information management system 100 conforms to the DICOM (Digital Image and Communications in Medicine) standard, and communication between the devices is performed in accordance with DICOM.
In addition, the number of medical facilities and the number of client terminals 20A, 20B,... Installed in each medical facility are not particularly limited.

  The medical information management server 10 is a device that accumulates and manages medical information such as medical images generated in each medical facility, and provides medical information in response to a request from an external device.

  In the medical facility A, a client terminal 20A, a modality 30A, a PACS (Picture Archiving and Communication System) 40A, and the like are connected to each other via a facility network 50A such as a LAN (Local Area Network) so as to be able to communicate with each other.

  The client terminal 20A is a computer device used by a doctor in the medical facility A. The client terminal 20A accesses the medical information management server 10 via the communication network N, registers medical information in the medical information management server 10, browses medical information stored in the medical information management server 10, etc. Used for.

  The modality 30A captures a human body and generates digital data of the captured image (medical image). For example, CR (Computed Radiography), FPD (Flat Panel Detector), CT (Computed Tomography), MRI (Magnetic) Resonance Imaging), cassette-dedicated readers, film digitizers, etc. are applicable.

  The PACS 40A is a computer device including a control unit, a RAM (Random Access Memory), a communication unit, a storage unit, and the like. The medical image generated by the modality 30A in the medical facility A is stored in the storage unit, and the medical image It is an in-facility server that manages

In the medical facility B, the client terminal 20B, the modality 30B, the PACS 40B, and the like are connected to each other via a facility network 50B such as a LAN so as to be able to perform data communication with each other.
The devices provided in the medical facilities other than the client terminal 20B, the modalities 30B and the PACS 40B, and the medical facilities A and B provided in the medical facility B are the same as the devices provided in the medical facility A. Therefore, the description is omitted.
In the following, when the medical facilities are not particularly distinguished, the client terminals 20A, 20B,..., PACS 40A, 40B,. It is described as an in-facility network 50.

FIG. 2 shows a functional configuration of the medical information management server 10.
As illustrated in FIG. 2, the medical information management server 10 includes a control unit 11, a RAM 12, a communication unit 13, a storage unit 14, and the like, and each unit is connected by a bus 15.

  The control unit 11 is configured by a CPU (Central Processing Unit) or the like, and comprehensively controls the processing operation of each unit of the medical information management server 10. The control unit 11 reads out various programs stored in the storage unit 14, develops them in the RAM 12, and executes various processes in cooperation with the programs.

  The RAM 12 forms a work area that temporarily stores various programs, input or output data, parameters, and the like read from the storage unit 14 in various processes that are executed and controlled by the control unit 11.

  The communication unit 13 is a communication circuit that is configured by a network interface or the like and that transmits and receives data to and from an external device such as the client terminal 20 connected via the communication network N.

  The storage unit 14 is a storage device configured by a hard disk, a nonvolatile semiconductor memory, or the like. The storage unit 14 stores various programs executed by the control unit 11 and stores parameters and data necessary for executing the various programs. The storage unit 14 also includes a facility information table T1, a patient information table T2, an examination information table T3, a series information table T4, an image information table T5, a transmission source terminal information table T6, medical images generated at each medical facility, and the like. Medical information is stored.

FIG. 3 shows a configuration example of each table.
The facility information table T1 is a table for managing information related to medical facilities. In the facility information table T1, a facility LID, a facility ID, a facility name, a facility address, a facility telephone number, and the like are stored in association with each medical facility.
The facility LID is an internal management number assigned to each record (medical facility) in the facility information table T1. Each LID (facility LID, patient LID, examination LID, series LID, image LID, transmission source terminal LID) is an internal management number for associating records in each table.
The facility ID is identification information indicating a medical facility.
The facility name, facility address, and facility telephone number are the name, address, and telephone number of the medical facility, respectively.

The patient information table T2 is a table for managing information related to patients. In the patient information table T2, a patient LID, a facility LID, an in-facility patient ID, a common patient ID, a patient name, a sex, a date of birth, an address, and the like are stored in association with each patient.
The patient LID is an internal management number assigned to each record (patient) in the patient information table T2.
The facility LID is information corresponding to the medical facility where the medical information of the patient is generated.
The in-facility patient ID is patient identification information in the medical facility where the medical information of the patient is generated. That is, the patient LID (patient) is specified by the combination of the facility LID and the in-facility patient ID. In the facility information table T1, the facility LID and the facility ID are associated one-to-one, and therefore the patient LID (patient) is specified by the combination of the facility ID and the in-facility patient ID. .
The common patient ID is patient identification information common to a plurality of medical facilities, and is determined so as not to overlap within the medical information management system 100. When a common patient ID is defined for a patient, the “common patient ID” field has a value (common patient ID), and when a common patient ID is not defined for a patient, “common patient ID”. The field remains “NULL”.
The patient name, sex, date of birth, and address are the name, sex, date of birth, and address of the patient, respectively.
The “patient ID” field, “patient name” field, “sex” field, “birth date” field, and “address” field of the patient information table T2 are included in the patient information attached to the medical information. Each piece of information is stored.

The inspection information table T3 is a table for managing information related to inspection. In the examination information table T3, examination LID, patient LID, examination instance ID, examination ID, reception number, examination date, examination comment, requesting doctor, interpretation doctor, and the like are stored in association with each examination.
The inspection LID is an internal management number assigned to each record (inspection) in the inspection information table T3.
The patient LID is information corresponding to the patient to be examined.
In the “examination instance ID” field, “examination ID” field, “reception number” field, “examination date” field, “examination comment” field, “requesting physician” field, and “interpretation physician” field of the examination information table T3, Information included in the examination information attached to the medical information is stored.

The series information table T4 is a table for managing information related to the series. In the series information table T4, for each series, a series LID, examination LID, series instance ID, series number, modality, series date and time, left and right, part, series comment, and the like are stored in association with each other.
The series LID is an internal management number assigned to each record (series) in the series information table T4.
The examination LID is information corresponding to the examination to which the series belongs.
In the “Series Instance ID” field, “Series Number” field, “Modality” field, “Series Date / Time” field, “Left / Right” field, “Part” field, and “Series Comment” field of the series information table T4, medical information is included. Information included in the accompanying series information is stored.

The image information table T5 is a table for managing information related to medical images. In the image information table T5, for each medical image, an image LID, a series LID, an SOP instance ID, an image number, a patient direction, a collection date and time, an image type, an image comment, and the like are stored in association with each other.
The image LID is an internal management number assigned to each record (medical image) in the image information table T5.
The series LID is information corresponding to the series to which the medical image belongs.
The SOP instance ID is identification information given to each medical image. A medical image can be specified by the SOP instance ID.
The “SOP instance ID” field, “image number” field, “patient direction” field, “collection date / time” field, “image type” field, and “image comment” field of the image information table T5 are attached to the medical information. Each of the information included in the image information is stored.

The transmission source terminal information table T6 is a table for managing information related to the client terminal 20 that can transmit medical information (medical images and the like) to the medical information management server 10. In the transmission source terminal information table T6, for each client terminal 20, a transmission source terminal LID, a facility LID, an AE title, an IP address, a port number, and the like are stored in association with each other.
The transmission source terminal LID is an internal management number assigned to each record (client terminal 20) in the transmission source terminal information table T6.
The facility LID is information corresponding to a medical facility where the client terminal 20 is used.
The AE title, IP address, and port number are information corresponding to the client terminal 20.

  In the patient information table T2, in association with the patient (patient LID) specified by the combination of the facility LID (corresponding to the facility ID in the facility information table T1) and the in-facility patient ID, the examination information table T3, Medical information is managed by the series information table T4 and the image information table T5. That is, in the storage unit 14, medical information generated in each of a plurality of medical facilities includes a facility ID (facility information) indicating the medical facility in which the medical information is generated and a patient related to the medical information in the medical facility. Is stored in association with a combination with the in-facility patient ID (first storage means).

  Further, in the patient information table T2, the case where the common patient ID is associated with the combination of the facility LID (associated with the facility ID in the facility information table T1) and the in-facility patient ID is associated with There is a case where it is not (NULL). That is, in the storage unit 14, patients identified by a combination of the facility ID and the in-facility patient ID are at least part of the combination of the facility ID (facility information) and the in-facility patient ID are the same patient. Are stored in association with each other (second storage means). Specifically, in the storage unit 14, the same common patient ID is associated with the combination of the facility ID and the in-facility patient ID of the same patient.

  When the communication unit 13 receives medical information generated at the medical facility from the client terminal 20 of each medical facility, the control unit 11 stores the medical information in the storage unit 14 and relates to the medical information. Patient information, examination information, series information, and image information are stored in each table.

  The control unit 11 receives medical information from the client terminal 20 as an in-facility terminal used in each of a plurality of medical facilities via the communication unit 13.

The control unit 11 identifies a medical facility corresponding to the client terminal 20 that has transmitted the received medical information. That is, the control unit 11 functions as an identification unit. For example, the control unit 11 includes at least one of a facility ID of a medical facility where the client terminal 20 is used, a facility name of the medical facility where the client terminal 20 is used, an AE title of the client terminal 20, and an IP address of the client terminal 20. Based on the above, the medical facility corresponding to the client terminal 20 is identified.
The control unit 11 acquires the in-facility patient ID attached to the received medical information. That is, the control unit 11 functions as an in-facility patient ID acquisition unit.

The control unit 11 associates the received medical information with the combination of the facility ID (facility information) indicating the identified medical facility and the acquired in-facility patient ID in the storage unit 14 (first storage unit). Remember. That is, the control unit 11 functions as a first storage control unit.
The control unit 11 determines whether a combination of the facility ID indicating the identified medical facility and the acquired in-facility patient ID is already registered in the storage unit 14, and the combination is already registered in the storage unit 14. If it is, the received medical information is stored in the storage unit 14 in association with the combination.

  When there is a common patient ID (common information) corresponding to the received medical information, the control unit 11 sets the common patient ID between the facility ID indicating the identified medical facility and the acquired in-facility patient ID. The information is stored in the storage unit 14 (second storage unit) in association with the combination. That is, the control unit 11 functions as a second storage control unit.

  When the medical information reference request including the designation of the patient is received from the client terminal 20, the control unit 11 acquires medical information corresponding to the patient, and the acquired medical information is transmitted to the client via the communication unit 13. It transmits to the terminal 20.

  The control unit 11 receives a selection of a combination of a facility ID and an in-facility patient ID from a client terminal 20 serving as a reference terminal connected to be able to perform data communication via the communication network N. That is, the control unit 11 functions as a reception unit.

  When the common patient ID is associated with the combination of the selected facility ID (the facility LID corresponding to the facility ID) and the in-facility patient ID in the storage unit 14 (patient information table T2), the control unit 11 Based on the common patient ID, all combinations that are the same patient as the patient specified by the selected combination are extracted from the patient information table T2, and medical information associated with all the extracted combinations is stored in the storage unit. 14, and provides the acquired medical information to the client terminal 20. Specifically, when the common patient ID is associated with the selected combination in the storage unit 14 (patient information table T2), the control unit 11 corresponds to the same common patient ID as the common patient ID. All attached combinations are extracted from the patient information table T2.

  When the common patient ID is not associated with the combination of the selected facility ID and the in-facility patient ID in the storage unit 14 (patient information table T2), the control unit 11 is associated with the selected combination. Only the medical information obtained from the storage unit 14 is obtained, and the obtained medical information is provided to the client terminal 20.

FIG. 4 shows a functional configuration of the client terminal 20.
As shown in FIG. 4, the client terminal 20 includes a control unit 21, a RAM 22, a communication unit 23, an operation unit 24, a display unit 25, a storage unit 26, and the like, and each unit is connected by a bus 27 and the like. .

  The control unit 21 is configured by a CPU or the like, and comprehensively controls processing operations of each unit of the client terminal 20. The control unit 21 reads out various programs stored in the storage unit 26, develops them in the RAM 22, and executes various processes in cooperation with the programs.

  The RAM 22 forms a work area that temporarily stores various programs, input or output data, parameters, and the like read from the storage unit 26 in various processes executed and controlled by the control unit 21.

  The communication unit 23 is a communication circuit that is configured by a network interface or the like, and that transmits and receives data to and from external devices connected via the communication network N or the in-facility network 50.

  The operation unit 24 is an operation device configured to include a keyboard having cursor keys, character input keys, various function keys, and the like, and a pointing device such as a mouse, and an operation signal input by key operation or mouse operation on the keyboard. Is output to the control unit 21. For example, the operation unit 24 is used when selecting a facility ID and an in-facility patient ID in order to designate a patient whose medical information is to be displayed.

  The display unit 25 is a display device configured to include a monitor such as an LCD (Liquid Crystal Display), and displays various screens according to instructions of a display signal input from the control unit 21.

  The storage unit 26 is a storage device configured by a hard disk, a nonvolatile semiconductor memory, or the like. The storage unit 26 stores various programs executed by the control unit 21 and also stores parameters and data necessary for executing the various programs.

  When registering medical information in the medical information management server 10, the control unit 21 acquires the medical information selected by the operation unit 24 from the PACS 40 or the like, and stores the medical information in the medical information management server 10 via the communication unit 23. Send.

  When referring to the medical information managed by the medical information management server 10, the control unit 21 displays information indicating the combination of the facility ID selected in the operation unit 24 and the in-facility patient ID via the communication unit 23. To the medical information management server 10. In addition, it can replace with the combination of facility ID and in-facility patient ID, and can also specify a patient by common patient ID.

Next, the operation in the first embodiment will be described.
FIG. 5 is a flowchart showing a first medical information registration process performed in the medical information management server 10. The first medical information registration process is realized by cooperation between the control unit 11 and a program stored in the storage unit 14.

  First, the control unit 11 receives medical information from the client terminal 20 of a certain medical facility via the communication unit 13 (step S1).

  Next, the control unit 11 acquires the facility ID of the medical facility specified from the medical information transmission source terminal (client terminal 20) (step S2). Specifically, the control unit 11 refers to the transmission source terminal information table T6 in the storage unit 14 and is associated with the AE title, IP address, or port number in DICOM communication when medical information is received. Get the LID. Then, the control unit 11 refers to the facility information table T1 in the storage unit 14 and acquires the facility ID associated with the acquired facility LID.

  The facility ID of the medical facility that is the source of the medical information is acquired by receiving the medical information from the client terminal 20 in a state where the facility ID is included in the private information attached to the medical information. It is good. Further, by receiving the medical information from the client terminal 20 in a state where the facility name is included in the private information attached to the medical information, the facility name of the medical facility that is the source of the medical information is acquired, The facility ID associated with the acquired facility name may be acquired with reference to the facility information table T1.

  Next, the control part 11 acquires in-facility patient ID from the patient information incidental to medical information (step S3).

  Next, the control unit 11 determines whether or not the combination of the facility ID acquired in step S2 and the in-facility patient ID acquired in step S3 has been registered (step S4). Specifically, the control unit 11 determines whether or not a record including the facility LID corresponding to the facility ID and the in-facility patient ID is registered in the patient information table T2 of the storage unit 14.

  If the combination of the facility ID and the in-facility patient ID has not been registered (step S4; NO), the control unit 11 registers patient information in association with the facility ID (step S5). Specifically, the control unit 11 creates a new record in the patient information table T2 by assigning a new patient LID, and the patient information (facility) attached to the facility LID corresponding to the facility ID and medical information. Internal patient ID, patient name, sex, date of birth, address, etc.).

  In step S4, when the combination of the facility ID and the in-facility patient ID has already been registered (step S4; YES), or after step S5, the control unit 11 has received the common patient ID together with the medical information. Is determined (step S6). For example, the control unit 11 determines whether or not a common patient ID is included in patient information attached to medical information or private information.

  For patients whose common patient ID is determined, a correspondence table in which the combination of the facility ID and the in-facility patient ID is associated with the common patient ID is prepared in advance. The presence of the common patient ID may be confirmed by referring to the correspondence table and acquiring the common patient ID associated with the combination of the facility ID and the in-facility patient ID.

  When the common patient ID is received together with the medical information (step S6; YES), the control unit 11 adds the common patient ID and updates the patient information table T2 (step S7). Specifically, the control unit 11 stores the common patient ID in the “common patient ID” field of the record including the facility LID corresponding to the facility ID of the patient information table T2 and the in-facility patient ID.

In step S6, when the common patient ID is not received together with the medical information (step S6; NO), or after step S7, the control unit 11 corresponds the medical information to the combination of the facility ID and the in-facility patient ID. Attach and register (step S8). Specifically, the control unit 11 stores medical information in the storage unit 14, and also includes examination information, series information, and image information attached to the medical information (medical image), the examination information table T 3, and the series information table. Register in T4, image information table T5. The association between the tables is performed by each LID.
This completes the first medical information registration process.

In addition, not only at the time of receiving medical information, a common patient ID can be added to a patient for whom no common patient ID is registered.
For example, the control unit 11 of the medical information management server 10 receives selection of a patient to register a common patient ID from the client terminal 20. Specifically, the control unit 11 specifies a patient by receiving selection of a facility name and an in-facility patient ID from the operation unit 24 of the client terminal 20.

The control unit 11 acquires the facility LID corresponding to the facility name selected in the client terminal 20 from the facility information table T1 in the storage unit 14, and the combination of the facility LID and the in-facility patient ID selected in the client terminal 20 Is acquired from the patient information table T2 of the storage unit 14. Then, the control unit 11 generates display data for displaying the patient information correction screen on the display unit 25 of the client terminal 20 based on the acquired record and the selected facility name.
The control unit 11 transmits the generated display data for the patient information correction screen to the client terminal 20 via the communication unit 13.

  In FIG. 6, the example of the patient information correction screen 251 displayed on the display part 25 of the client terminal 20 is shown. The patient information correction screen 251 includes a pre-change information display area 61, a post-change information display area 62, a change button B1, and a cancel button B2.

In the pre-change information display area 61, the contents of each item (facility name, in-facility patient ID, common patient ID, patient name, gender, date of birth) registered in the medical information management server 10 are displayed. When the common patient ID is not registered, the common patient ID is blank in the pre-change information display area 61.
In the post-change information display area 62, the same contents as the pre-change information display area 61 are initially displayed. The content of each item can be corrected by the user inputting the content to be corrected in the corresponding area of the post-change information display area 62 and pressing the change button B1 by the operation from the operation unit 24. For example, when the user inputs “0300123456” in the common patient ID input field 63 of the post-change information display area 62 and presses the change button B1 by the operation from the operation unit 24, the control unit 21 of the client terminal 20 The input common patient ID is transmitted to the medical information management server 10 via the communication unit 23.

  In the medical information management server 10, the control unit 11 uses the common patient ID received from the client terminal 20 via the communication unit 13 as the target record (the facility LID corresponding to the facility name and the in-facility patient ID) of the patient information table T2. (Including records) and overwrite registration.

  FIG. 7 is a flowchart showing a first medical information provision process performed in the medical information management server 10. The first medical information provision process is realized by cooperation between the control unit 11 and a program stored in the storage unit 14.

  First, the control part 11 receives selection of a patient from the client terminal 20 of a certain medical facility via the communication part 13 (step S11). In the first embodiment, a patient is specified by a combination of a facility ID and an in-facility patient ID or a common patient ID.

  Next, the control unit 11 determines whether the patient selection received from the client terminal 20 is a combination of the facility ID and the in-facility patient ID or a common patient ID (step S12). .

  When the selection of the patient is based on a combination of the facility ID and the in-facility patient ID (step S12; facility ID / in-facility patient ID), the control unit 11 sets the facility ID in the patient information table T2 in the storage unit It is determined whether or not there is a value (common patient ID) in the “common patient ID” field of the record including the facility LID and the in-facility patient ID (step S13). That is, the control unit 11 determines whether or not the common patient ID is associated with the combination of the facility ID and the in-facility patient ID.

  When there is a value in the “common patient ID” field (step S13; YES), or when the patient is selected by the common patient ID in step S12 (step S12; common patient ID), the control unit 11 Extracts all the patients (combination of facility ID and in-facility patient ID) associated with the same common patient ID from the patient information table T2 (step S14). Specifically, the control unit 11 stores the common patient ID stored in the “common patient ID” field of the record including the facility LID corresponding to the facility ID and the in-facility patient ID from the patient information table T2, or All patient LIDs associated with the common patient ID designated by the patient selection are extracted.

  Next, the control part 11 acquires the medical information matched with all the extracted patients (step S15). Specifically, the control unit 11 acquires the examination LID associated with all the extracted patient LIDs from the examination information table T3, and obtains the series LID associated with the examination LID from the series information table T4. The SOP instance ID associated with the series LID is acquired from the image information table T5, and the medical information (medical image) specified by each SOP instance ID is acquired from the storage unit 14.

  In step S13, when there is no value in the “common patient ID” field (step S13; NO), that is, when the “common patient ID” field is “NULL”, the combination of the facility ID and the in-facility patient ID is used. Medical information associated with the identified patient is acquired (step S16). Specifically, the control unit 11 extracts the patient LID associated with the combination of the facility LID corresponding to the facility ID and the in-facility patient ID from the patient information table T2, and is associated with the extracted patient LID. The examination LID is acquired from the examination information table T3, the series LID associated with the examination LID is obtained from the series information table T4, and the SOP instance ID associated with the series LID is obtained from the image information table T5. The medical information (medical image) specified by each SOP instance ID is acquired from the storage unit 14.

After step S15 or step S16, the control unit 11 provides the acquired medical information to the client terminal 20 via the communication unit 13 (step S17). Here, the control unit 11 first provides a medical information list to be displayed on the display unit 25 of the client terminal 20, and then displays the medical information selected from the client terminal 20 on the display unit 25 of the client terminal 20. It is good also as providing it to do.
This completes the first medical information provision process.

Next, a specific example of a method for using the common patient ID will be described with reference to FIG.
In FIG. 8, a set of “patient LID”, “facility LID”, “in-facility patient ID”, and “common patient ID” is extracted from the patient information table T2, and the “facility LID” is extracted in the facility information table T1. The table is replaced with “facility ID” associated with “facility LID”.
The patients whose “patient LID” is “1”, “2”, and “4” are the same patient because the “common patient ID” is “20001”. When any one of “1”, “2”, and “4” is selected for “Patient LID”, all patients whose “Patient LID” is “1”, “2”, and “4” are selected. The associated medical information is provided to the client terminal 20.

  On the other hand, patients with “patient LID” “3” and “5” have “common patient ID” “NULL” and do not have a common patient ID. Treated as a separate patient. When a patient whose “patient LID” is “3” is selected, medical information associated with a patient whose “patient LID” is “3” is provided to the client terminal 20. Similarly, when a patient whose “patient LID” is “5” is selected, medical information associated with a patient whose “patient LID” is “5” is provided to the client terminal 20.

As described above, according to the first embodiment, when the common patient ID is associated with the combination of the facility ID selected as the reference target and the in-facility patient ID, the common patient ID is assigned to the common patient ID. Based on this, all combinations that are the same patient as the patient specified by the selected combination are extracted, and medical information associated with all the extracted combinations is provided to the client terminal 20.
On the other hand, when the common patient ID is not associated with the combination of the facility ID selected as the reference target and the in-facility patient ID, only the medical information associated with the selected combination is provided to the client terminal 20. .
Therefore, regardless of whether each patient has a common patient ID (common patient ID) between medical facilities, it is possible to manage medical information relating to a plurality of patients generated at a plurality of medical facilities. . Therefore, even if a patient with a common patient ID and a patient with no common patient ID are mixed, medical information can be shared among a plurality of medical facilities. Can easily cope with the case of joining the group of the medical information management system 100.

  Specifically, when the common patient ID is associated with the combination of the facility ID selected as the reference object and the in-facility patient ID, the same common patient ID is associated with the common patient ID. Since all combinations are extracted from the patient information table T2, medical information of the same patient can be acquired from medical information generated at a plurality of medical facilities.

  In addition, when the medical information management server 10 receives the medical information, and there is a common patient ID corresponding to the medical information, the common patient ID, the facility ID indicating the medical facility that transmitted the medical information, and the medical information Can be associated with a combination with the patient ID of the patient in the facility.

  In addition, when the combination of the facility ID indicating the medical facility that transmitted the medical information and the patient ID in the patient related to the medical information is already registered when the medical information is received, the combination is already registered. Medical information can be stored in association with a combination (patient).

[Second Embodiment]
Next, a second embodiment to which the present invention is applied will be described.
Since the medical information management system in the second embodiment has the same configuration as the medical information management system 100 shown in the first embodiment, FIG. 1, FIG. 2 and FIG. The illustration and description are omitted. Hereinafter, a configuration and processing characteristic of the second embodiment will be described.

In the second embodiment, a patient information table T12 is stored in the storage unit 14 of the medical information management server 10 instead of the patient information table T2 shown in the first embodiment.
FIG. 9 shows examples of the facility information table T1, the patient information table T12, the examination information table T3, the series information table T4, the image information table T5, and the transmission source terminal information table T6 according to the second embodiment.

The patient information table T12 is a table for managing information related to patients. In the patient information table T12, a patient LID, a facility LID, a patient ID, a common flag, a patient name, a sex, a date of birth, an address, and the like are stored in association with each patient.
The patient ID is patient identification information (in-facility patient ID) in a medical facility where the patient's medical information is generated. In the second embodiment, the patient ID may also serve as common patient identification information (common patient ID) among a plurality of medical facilities.
The common flag is information indicating whether or not the patient ID also serves as the common patient ID. When the patient ID also serves as the common patient ID, the common flag is “TRUE”, and when the patient ID does not serve as the common patient ID, the common flag is “FALSE”. That is, the common flag “TRUE” has a common patient ID among a plurality of medical facilities in a combination (combination of facility LID (facility ID) and patient ID) associated with the common flag “TRUE”. This is combined information indicating that it also serves as a common patient ID. The initial value of the common flag is “FALSE”.

  In the patient information table T12, the examination information table T3, series information is associated with the patient (patient LID) specified by the combination of the facility LID (associated with the facility ID in the facility information table T1) and the patient ID. Medical information is managed by the table T4 and the image information table T5. That is, in the storage unit 14, medical information generated in each of a plurality of medical facilities includes a facility ID indicating the medical facility where the medical information is generated and a patient ID indicating a patient related to the medical information in the medical facility. Is stored in association with the combination (first storage means).

  Further, in the patient information table T12, when common information is associated with a combination of a facility LID (associated with a facility ID in the facility information table T1) and a patient ID (common flag “TRUE”). And a case where they are not associated (common flag “FALSE”). That is, the storage unit 14 includes at least a part of the combination of the facility ID and the patient ID, common information indicating that the patients specified by the combination of the facility ID and the patient ID are the same patient (the common flag “ TRUE ”) is stored in association (second storage means).

  The control unit 11 receives medical information from the client terminal 20 as an in-facility terminal used in each of a plurality of medical facilities via the communication unit 13.

The control unit 11 identifies a medical facility corresponding to the client terminal 20 that has transmitted the received medical information.
The control unit 11 acquires a patient ID attached to the received medical information.

The control unit 11 stores the received medical information in the storage unit 14 (first storage unit) in association with the combination of the facility ID indicating the identified medical facility and the acquired patient ID.
The control unit 11 determines whether or not a combination of the facility ID indicating the identified medical facility and the acquired patient ID is already registered in the storage unit 14, and the combination is already registered in the storage unit 14. If it is, the received medical information is stored in the storage unit 14 in association with the combination.

  When there is dual-purpose information corresponding to the received medical information (information indicating that the patient ID also serves as the common patient ID), the control unit 11 identifies the dual-purpose information (common flag “TRUE”). The information is stored in the storage unit 14 (second storage unit) in association with the combination of the facility ID indicating the medical facility and the acquired patient ID.

  The control unit 11 receives selection of a combination of a facility ID and a patient ID from a client terminal 20 serving as a reference terminal connected to be able to perform data communication via a communication network N.

  In the storage unit 14 (patient information table T12), the control unit 11 associates a common flag “TRUE” (combined information) with the combination of the selected facility ID (corresponding facility LID) and the patient ID. In this case, based on the common flag “TRUE”, all combinations that are the same patient as the patient specified by the selected combination are extracted from the patient information table T12 and associated with all the extracted combinations. The obtained medical information is acquired from the storage unit 14, and the acquired medical information is provided to the client terminal 20. Specifically, when the common flag “TRUE” is associated with the selected combination in the storage unit 14 (patient information table T12), the control unit 11 includes the patient ID included in the selected combination. All combinations that include the same patient ID and are associated with the common flag “TRUE” are extracted from the patient information table T12.

  The control unit 11 selects the combination selected in the storage unit 14 (patient information table T12) when the combined information is not associated with the combination of the selected facility ID and patient ID (common flag “FALSE”). Only the medical information associated with is acquired from the storage unit 14, and the acquired medical information is provided to the client terminal 20.

Next, the operation in the second embodiment will be described.
FIG. 10 is a flowchart showing a second medical information registration process performed in the medical information management server 10. The second medical information registration process is realized by cooperation between the control unit 11 and the program stored in the storage unit 14.

  Since the process of step S21 and step S22 is the same as the process of step S1 and step S2 of the first medical information registration process (see FIG. 5), description thereof is omitted.

  Next, the control part 11 acquires patient ID from the patient information incidental to medical information (step S23).

  Next, the control unit 11 determines whether or not the combination of the facility ID acquired in step S22 and the patient ID acquired in step S23 has been registered (step S24). Specifically, the control unit 11 determines whether or not a record including the facility LID corresponding to the facility ID and the patient ID is registered in the patient information table T12 of the storage unit 14.

  When the combination of the facility ID and the patient ID has not been registered (step S24; NO), the control unit 11 registers patient information in association with the facility ID (step S25). Specifically, the control unit 11 assigns a new patient LID, creates a new record in the patient information table T12, and adds patient LID corresponding to the facility ID and patient information attached to the medical information (patient ID, patient name, gender, date of birth, address, etc.).

  In step S24, when the combination of the facility ID and the patient ID has already been registered (step S24; YES), or after step S25, the control unit 11 determines whether or not the patient ID also serves as the common patient ID. Judgment is made (step S26). For example, the control unit 11 refers to information indicating whether or not the patient ID also serves as the common patient ID, which is included in the private information attached to the medical information.

  In addition, when a common patient ID is introduced for all patients in a medical facility unit, a medical facility in which the common patient ID is introduced is registered in advance, and the registered medical facility is used. For the transmitted medical information, it may be determined that the patient ID also serves as the common patient ID.

  When the patient ID also serves as the common patient ID (step S26; YES), the control unit 11 sets the “common flag” of the corresponding record in the patient information table T12 to “TRUE” (step S27). Specifically, the control unit 11 stores “TRUE” in the “common flag” field of the record including the facility LID corresponding to the facility ID of the patient information table T12 and the patient ID.

In step S26, when the patient ID does not serve as the common patient ID (step S26; NO), or after step S27, the control unit 11 registers the medical information in association with the combination of the facility ID and the patient ID. (Step S28). Specifically, the control unit 11 stores medical information in the storage unit 14, and also includes examination information, series information, and image information attached to the medical information (medical image), the examination information table T 3, and the series information table. Register in T4, image information table T5. The association between the tables is performed by each LID.
This completes the second medical information registration process.

  FIG. 11 is a flowchart showing a second medical information provision process performed in the medical information management server 10. The second medical information provision process is realized by cooperation between the control unit 11 and the program stored in the storage unit 14.

  First, the control part 11 receives selection of the combination of facility ID and patient ID from the client terminal 20 of a certain medical facility via the communication part 13 (step S31).

  Next, the control unit 11 determines whether the “common flag” of the record including the facility LID corresponding to the facility ID of the patient information table T12 in the storage unit 14 and the patient ID is “TRUE” or “FALSE”. Is determined (step S32).

  When the “common flag” is “TRUE” (step S32; TRUE), the control unit 11 determines that “patient ID” is the same as the selected patient ID from the patient information table T12, and “ All patients whose common flag is “TRUE” are extracted (step S33). Specifically, the control unit 11 extracts, from the patient information table T12, the patient LID of the record that includes the “patient ID” included in the combination received in step S31 and whose “common flag” is “TRUE”. To do.

  Next, the control unit 11 acquires medical information associated with all the extracted patients (step S34). Specifically, the control unit 11 acquires the examination LID associated with all the extracted patient LIDs from the examination information table T3, and obtains the series LID associated with the examination LID from the series information table T4. The SOP instance ID associated with the series LID is acquired from the image information table T5, and the medical information (medical image) specified by each SOP instance ID is acquired from the storage unit 14.

  In step S32, when the “common flag” is “FALSE” (step S32; FALSE), medical information associated with the patient specified by the combination of the facility ID and the patient ID is acquired (step S35). ). Specifically, the control unit 11 extracts the patient LID associated with the combination of the facility LID corresponding to the facility ID and the patient ID from the patient information table T12, and the examination associated with the extracted patient LID. The LID is acquired from the examination information table T3, the series LID associated with the examination LID is obtained from the series information table T4, the SOP instance ID associated with the series LID is obtained from the image information table T5, and each Medical information (medical image) specified by the SOP instance ID is acquired from the storage unit 14.

After step S34 or step S35, the control unit 11 provides the acquired medical information to the client terminal 20 via the communication unit 13 (step S36).
This completes the second medical information provision process.

Next, a specific example of a method for using the common flag will be described with reference to FIG.
In FIG. 12, a set of “patient LID”, “facility LID”, “patient ID”, and “common flag” is extracted from the patient information table T12, and “facility LID” is extracted from the “facility LID” in the facility information table T1. The table is replaced with the “facility ID” associated with “.
The patients whose “patient LID” is “3” and “4” are the same patient because the “patient ID” is “10003” and the “common flag” is “TRUE”. When any one of “3” and “4” is selected as the “patient LID”, the medical information associated with all the patients whose “patient LID” is “3” and “4” It will be provided to the client terminal 20.

  On the other hand, patients whose “patient LID” is “1”, “2”, and “5” are treated as patients different from other “patient LID” patients because the “common flag” is “FALSE”. For example, patients with “Patient LID” “1” and “2” have the same “Patient ID” “10001”, but are treated as the same patient because the “Common Flag” is “FALSE”. Absent. In addition, a patient whose “patient LID” is “5” has a “patient ID” of “10003” and is common to patients whose “patient LID” is “3” and “4”. Is “FALSE”, the “patient ID” of the patient whose “patient LID” is “5” merely represents the in-facility patient ID.

As described above, according to the second embodiment, when the common flag “TRUE” (shared information) is associated with the combination of the facility ID selected as the reference target and the patient ID, Based on the common flag “TRUE”, all combinations that are the same patient as the patient specified by the selected combination are extracted, and medical information associated with all the extracted combinations is provided to the client terminal 20 To do.
On the other hand, when the common flag “TRUE” is not associated with the combination of the facility ID selected as the reference target and the patient ID, only the medical information associated with the selected combination is provided to the client terminal 20. .
Therefore, regardless of whether each patient is provided with a common patient ID between medical facilities, it is possible to manage medical information relating to a plurality of patients generated at a plurality of medical facilities. Therefore, even if the patient specified by the common patient ID and the patient specified by the patient ID in the medical facility are mixed, medical information can be shared among a plurality of medical facilities.

  Specifically, when the common flag “TRUE” (combined information) is associated with the combination of the facility ID selected as the reference target and the patient ID, it is the same as the patient ID included in the selected combination. Since all combinations that include the patient ID and are associated with the common flag “TRUE” (combined information) are extracted from the patient information table T12, the medical information generated in a plurality of medical facilities Medical information of the same patient can be acquired from the inside.

  Further, when the medical information management server 10 receives the medical information, if there is dual-purpose information corresponding to the medical information (information indicating that the patient ID also serves as the common patient ID), the dual-purpose information (common The flag “TRUE”) can be associated with a combination of the facility ID indicating the medical facility that transmitted the medical information and the patient ID of the patient related to the medical information.

  In addition, when the combination of the facility ID indicating the medical facility that transmitted the medical information and the patient ID of the patient related to the medical information is already registered when the medical information is received, the combination already registered Medical information can be stored in association with (patient).

  In addition, the description in each said embodiment is an example of the medical information management system which concerns on this invention, and is not limited to this. The detailed configuration and detailed operation of each device constituting the system can be changed as appropriate without departing from the spirit of the present invention.

  For example, in each of the above embodiments, the medical information is mainly described as medical information managed by the medical information management server 10, but the same applies to other medical information such as examination results and medical records.

  FIG. 1 illustrates the case where the medical information management server 10 is placed outside the medical facility, but the medical information management server 10 is placed in the medical facility A, the medical facility B, or another medical facility. It may be.

  In the above description, an example in which a hard disk or a non-volatile semiconductor memory is used as a computer-readable medium storing a program for executing each process has been disclosed. However, the present invention is not limited to this example. As another computer-readable medium, a portable recording medium such as a CD-ROM can be applied. A carrier wave may be applied as a medium for providing program data via a communication line.

DESCRIPTION OF SYMBOLS 10 Medical information management server 11 Control part 13 Communication part 14 Storage part 20A, 20B Client terminal 20 Client terminal 21 Control part 23 Communication part 24 Operation part 25 Display part 26 Storage part 100 Medical information management system N Communication network T1 Facility information table T2 Patient information table T3 Examination information table T4 Series information table T5 Image information table T6 Source terminal information table T12 Patient information table

Claims (7)

Medical information generated in each of a plurality of medical facilities is associated with a combination of facility information indicating the medical facility where the medical information is generated and an in-facility patient ID indicating a patient related to the medical information in the medical facility First storage means stored and stored;
Common information indicating that the patients specified by the combination of the facility information and the in-facility patient ID are the same patient is associated with at least a part of the combination of the facility information and the in-facility patient ID. Second storage means stored in memory,
Accepting means for accepting selection of a combination of the facility information and the in-facility patient ID from a reference terminal that is connected to enable data communication via a communication network;
In the second storage means, when the common information is associated with the selected combination, all combinations that are the same patient as the patient specified by the selected combination based on the common information Is extracted from the second storage means, medical information associated with all the extracted combinations is acquired from the first storage means, and the acquired medical information is provided to the reference terminal,
In the second storage means, when the common information is not associated with the selected combination, only the medical information associated with the selected combination is obtained from the first storage means, and the acquisition is performed. Control means for providing the medical information to the reference terminal;
Medical information management server with The common information is a common patient ID common to the plurality of medical facilities,
In the second storage means, the same common patient ID is associated with the combination of the facility information and the in-facility patient ID of the same patient,
The control means, in the second storage means, when the common patient ID is associated with the selected combination, all combinations in which the same common patient ID is associated with the common patient ID. The medical information management server according to claim 1, wherein the information is extracted from the second storage means. The common information is combined information indicating that the in-facility patient ID included in the combination associated with the common information also serves as a common patient ID common to the plurality of medical facilities,
In the second storage unit, the control unit includes the in-facility patient ID identical to the in-facility patient ID included in the selected combination when the combined information is associated with the selected combination. 2. The medical information management server according to claim 1, wherein all the combinations including the combination information and the combination information are extracted from the second storage unit. Receiving means for receiving medical information from an in-facility terminal connected in a data communication manner via a communication network and used in each of the plurality of medical facilities;
Identification means for identifying a medical facility corresponding to the in-facility terminal that has transmitted the received medical information;
An in-facility patient ID acquisition means for acquiring an in-facility patient ID attached to the received medical information;
First storage control means for storing the received medical information in the first storage means in association with a combination of facility information indicating the identified medical facility and the acquired in-facility patient ID;
When there is the common information corresponding to the received medical information, the common information is associated with a combination of facility information indicating the identified medical facility and the acquired in-facility patient ID. Second storage control means for storing in the two storage means;
The medical information management server according to any one of claims 1 to 3.   The identification means includes at least a facility ID of a medical facility where the in-facility terminal is used, a facility name of the medical facility where the in-facility terminal is used, an AE title of the in-facility terminal, and an IP address of the in-facility terminal. The medical information management server according to claim 4, wherein a medical facility corresponding to the in-facility terminal is identified based on one.   The first storage control unit determines whether a combination of facility information indicating the identified medical facility and the acquired in-facility patient ID has already been registered in the first storage unit, and the combination The medical information management server according to claim 4 or 5, wherein the received medical information is stored in the first storage means in association with the combination when the information is already registered in the first storage means. A medical information management system in which a medical information management server and a reference terminal are connected so that data communication is possible via a communication network,
The medical information management server is
Medical information generated in each of a plurality of medical facilities is associated with a combination of facility information indicating the medical facility where the medical information is generated and an in-facility patient ID indicating a patient related to the medical information in the medical facility First storage means stored and stored;
Common information indicating that the patients specified by the combination of the facility information and the in-facility patient ID are the same patient is associated with at least a part of the combination of the facility information and the in-facility patient ID. Second storage means stored in memory,
Receiving means for receiving selection of a combination of the facility information and the in-facility patient ID from the reference terminal;
In the second storage means, when the common information is associated with the selected combination, all combinations that are the same patient as the patient specified by the selected combination based on the common information Is extracted from the second storage means, medical information associated with all the extracted combinations is acquired from the first storage means, and the acquired medical information is provided to the reference terminal,
In the second storage means, when the common information is not associated with the selected combination, only the medical information associated with the selected combination is obtained from the first storage means, and the acquisition is performed. Control means for providing the medical information to the reference terminal;
A medical information management system comprising:

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