JP2020156624A - Remote examination system using digital stethoscope - Google Patents

Abstract

To provide a remote examination system using a digital stethoscope that allows an examiner to execute medical treatment for a patient in a remote area.SOLUTION: A remote examination system includes a stethoscope 1 for acquiring sound information based on a biological sound of a patient X, and a transmission processing device 2 for transmitting the sound information to an external instrument. The stethoscope 1 includes transmission means 101 for transmitting the sound information to the transmission processing device 2. The transmission processing device 2 includes reception means 201 for receiving the sound information, and reproduction processing means 202 for executing reproduction processing for reproducing the sound information with the external instrument.SELECTED DRAWING: Figure 1

Description

The present invention relates to a remote medical care system using a digital stethoscope.

Traditionally, a stethoscope has been used by doctors and nurses as a device for listening to sounds generated from a patient's heart, lungs, blood vessels, and the like.

By the way, auscultation is a technique that requires skill, and in order to obtain accurate biometric information, it is necessary to accurately reproduce a predetermined auscultation condition.

For this reason, for example, when the doctor in charge is changed, or when a person other than the doctor in charge such as a family member handles the stethoscope in the situation of remote medical care or home medical care, it becomes difficult to reproduce the auscultation conditions. ..

In order to solve such a problem, Patent Document 1 describes an electronic stethoscope capable of accurately reproducing auscultation conditions regardless of the person who handles the stethoscope.

That is, the electronic stethoscope described in Patent Document 1 has a chest piece that comes into contact with the surface of a living body, a position acquisition unit that acquires position information indicating the position of the chest piece with respect to the surface of the living body, and a contact of the chest piece with respect to the surface of the living body. It includes a contact state acquisition unit that acquires contact state information indicating a contact state, and a recording unit that records the position information and the contact state information in association with each other.

By recording the position information and the contact state information for each patient in this way, anyone can accurately reproduce the auscultation conditions of the target patient based on the information.

JP-A-2017-000198

However, the above-mentioned electronic stethoscope is used only when a medical examiner who handles a stethoscope such as a doctor in charge provides face-to-face medical treatment with a patient in an environment where position information, contact state information, etc. can be referred to. is there.

Therefore, for example, when the patient is in a remote place and it is difficult to perform face-to-face medical treatment with the doctor in charge, it is still difficult for an alternative examiner to accurately reproduce the auscultation conditions.

The present invention has been made in view of the above circumstances, and provides a remote medical examination system using a digital stethoscope, which enables a medical examiner to perform medical treatment even for a patient in a remote place. That is the issue.

In order to solve the above problems, the present invention
A stethoscope for acquiring voice information based on the patient's biological sound and a transmission processing device for transmitting the voice information to an external device are provided.
The stethoscope has a transmission means for transmitting the voice information to the transmission processing device.
The transmission processing device is characterized by having a receiving means for receiving the voice information and a reproduction processing means for performing a reproduction process for reproducing the voice information with the external device.

According to the present invention, the examiner can listen to the voice information based on the patient's biological sound even when the patient is in a remote place by having the patient use the stethoscope. As a result, the examiner can perform medical treatment even when face-to-face medical treatment is difficult.

In a preferred embodiment of the present invention, the contact position display means worn on the patient's body is provided.
The surface of the contact position display means is provided with a contact mark indicating the contact position of the stethoscope with respect to the patient's body.

With such a configuration, the examiner can accurately convey to the patient the appropriate contact position of the stethoscope for acquiring the desired voice information, and the stethoscope is used for the patient. Even in the case of remote medical treatment, it is possible to proceed smoothly with medical treatment.

In a preferred embodiment of the present invention, the stethoscope is characterized by having a detachable means for detaching the chest piece.

With such a configuration, the examiner can perform medical treatment using a chest piece that he / she is familiar with and is familiar with.

A preferred embodiment of the present invention is characterized by comprising a recording means for recording the voice information.

With such a configuration, the examiner can utilize the voice information in the electronic medical record. That is, the examiner can share the findings with the patient and confirm the progress of the medical examination.

In a preferred embodiment of the present invention, the transmission processing device is characterized by including an analysis processing means for analyzing and processing the voice information.

With such a configuration, the examiner can utilize more detailed information on the voice information such as graph information that visualizes the voice information and heart murmur information in the electronic medical record.

A preferred embodiment of the present invention is characterized by comprising a filter means for extracting a specific frequency component of the voice information.

With such a configuration, the examiner can listen to the voice information more clearly.

In a preferred embodiment of the present invention, the stethoscope is characterized by having a switching means for switching the filter characteristics of the filter means.

With such a configuration, the examiner can obtain a plurality of voice information by applying an appropriate filter characteristic to each part even if the parts for acquiring the plurality of voice information are different. It becomes possible to hear clearly.

In a preferred embodiment of the present invention, the stethoscope is characterized by having a volume adjusting means for adjusting the volume of the voice information.

With such a configuration, the examiner can listen to the voice information at an appropriate volume.

In a preferred embodiment of the present invention, the stethoscope is characterized by having a holding means for holding the contact state of the patient with the body.

With such a configuration, the examiner always acquires voice information based on the patient's biological sound even when it is difficult to move the body, for example, when the patient is bedridden. And it becomes possible to listen.

The present invention is a remote medical treatment method.
Obtain voice information based on the patient's biological sound with a stethoscope,
The voice information acquired by the stethoscope is transmitted to the transmission processing device, and the voice information is transmitted to the transmission processing device.
It is characterized in that a reproduction process for reproducing the voice information received by the transmission processing apparatus by an external device is performed.

According to the present invention, it is possible to provide a remote medical examination system using a digital stethoscope, which enables a medical examiner to perform medical treatment even for a patient in a remote place.

It is a figure which shows the outline of the remote medical care system which concerns on embodiment of this invention. It is a functional block diagram which shows the functional structure example of the remote medical care system which concerns on embodiment of this invention. It is a figure which shows the stethoscope in the remote medical care system which concerns on embodiment of this invention, is (a) schematic perspective view, (b) bottom view. It is a figure which shows the attachment / detachment means of the stethoscope in the remote medical care system which concerns on embodiment of this invention. It is a figure which shows the attachment / detachment means of the stethoscope in the remote medical care system which concerns on embodiment of this invention. It is a figure for demonstrating the embodiment of the remote medical care using the remote medical care system which concerns on embodiment of this invention. It is a figure for demonstrating the embodiment of the remote medical care using the remote medical care system which concerns on embodiment of this invention. It is a figure for demonstrating the embodiment of the remote medical care using the remote medical care system which concerns on embodiment of this invention. It is a figure for demonstrating the embodiment of the remote medical care using the remote medical care system which concerns on embodiment of this invention. It is a figure which shows the modification example of the stethoscope in the remote medical care system which concerns on embodiment of this invention, is (a) schematic perspective view, (b) side view. It is a figure which shows the wearing mode of the stethoscope in the remote medical care system which concerns on embodiment of this invention.

Hereinafter, the remote medical care system according to the embodiment of the present invention will be described with reference to FIGS. 1 to 11.
The embodiments shown below are examples of the present invention, and the present invention is not limited to the following embodiments.

For example, in the present embodiment, the configuration, operation, and the like of the remote medical care system will be described, but a method, an apparatus, a computer program, a recording medium, and the like having the same configuration can also exert the same effects. Further, the program may be stored in a recording medium. Using this recording medium, for example, the program can be installed on a computer. Here, the recording medium in which the program is stored may be a non-transient recording medium such as a CD-ROM.

FIG. 1 is a diagram showing an outline of a remote medical care system S when performing remote medical care.
As shown in FIG. 1, the remote medical examination system S includes a stethoscope 1 to which a chest piece C is attached and acquires voice information based on the patient's biological sound, a transmission processing device 2 that transmits voice information to an external device, and the like. It includes a patient terminal T1, a examiner terminal T2, and a listening means L.
The listening means L is a headphone in the present embodiment, but may be an earphone, a speaker, or the like.

The stethoscope 1 wirelessly communicates with the patient terminal T1.
The transmission processing device 2, the patient terminal T1, and the examiner terminal T2 are connected to each other so as to be able to communicate with each other via the network N.

The patient terminal T1 and the examiner terminal T2 are communication units that are interfaces for communicating with external devices, input units such as touch panels and physical keys, output units such as displays, and audio input / output, respectively. An information communication terminal such as a personal computer equipped with an audio input / output unit or the like, a smartphone equipped with a touch panel, a tablet terminal, a portable information terminal such as a PDA, or the like.
Further, the patient terminal T1 and the examiner terminal T2 store the remote medical care program or the web browser program used when performing the face-to-face remote medical care shown in FIGS. 6 to 8 in the auxiliary storage unit. ing.

As shown in FIG. 2, the stethoscope 1 includes a transmission means 101 for transmitting voice information to the transmission processing device 2, a filter means 102 for extracting a specific frequency component of the voice information, a switching means 103, and a volume adjusting means 104. And have.
Further, the transmission processing device 2 includes a receiving means 201 for receiving audio information, a reproduction processing means 202 for performing reproduction processing for reproducing the audio information by an external device, a recording means 203, and an analysis processing means 204. Have.

As shown in FIG. 3, the stethoscope 1 has a stethoscope main body 11 and a detachable means 12 provided on the upper part of the stethoscope main body 11.

The stethoscope main body 11 is provided with a switching means 103 configured as a switch and a dial-type volume adjusting means 104 on the outer surface thereof, and further, a power supply unit 11a for switching ON / OFF of the stethoscope 1 and an external device. A connection portion 11b for connecting to is provided.

The connection unit 11b is composed of a USB terminal 11b1 for connecting and charging with an external device such as a transmission processing device 2, and a phone terminal 11b2 for connecting with the listening means L.
In addition to this, the connection portion 11b may include an AV terminal such as a Lightning terminal, a VGA terminal, and the like.

The phone terminal 11b2 can be used with headphones or earphones when the patient listens to his / her own voice information in remote medical care, or when the examiner listens to the patient's voice information in general face-to-face medical care or home-visit nursing. It is used by being connected to a speaker or the like.

The stethoscope 1 is configured to be capable of wirelessly communicating with the patient terminal T1 and the listening means L by the transmission means 101. As the wireless communication standard, various wireless communication configurations such as a wireless communication standard such as Bluetooth (registered trademark) and Zigbee (registered trademark), a mesh network format, and a P2P (Peer to Peer) format can be adopted.
Further, the examiner or the patient may connect the stethoscope 1 and the patient terminal T1 by wire using the USB terminal 11b1 depending on the usage environment and the like.
Further, the examiner terminal T2 and the listening means L can also be configured to be capable of wireless communication in the same manner.

As shown in FIG. 4A, the attachment / detachment means 12 is composed of a pair of attachment / detachment means main bodies 12a, a substantially cylindrical chest piece accommodating portion 12b, and a plurality of ring-shaped bodies 12c.
The attachment / detachment means main body 12a is attached to the upper portion of the stethoscope main body 11 by a spring (not shown) provided inside the stethoscope main body 11 toward a substantially cylindrical sound collecting portion 11c provided on the upper surface of the stethoscope main body 11. It is being pushed.
A pair of fitting grooves 12b1 into which the upper protrusions 12a1 (see FIG. 5) of the attachment / detachment means main body 12a are fitted are provided on the outer surface of the chest piece accommodating portion 12b.
The ring-shaped body 12c has elasticity, and its outer shape is formed to be slightly larger than the inner diameter of the chest piece accommodating portion 12b.
Further, as shown in FIG. 4B, the chest piece C has a stepped lower portion.

When attaching the chest piece C to the attachment / detachment means 12, the patient or the examiner first attaches the ring-shaped body 12c to each step of the lower part of the chest piece C as shown in FIG. 5A, and then attaches the lower part to the chest. It is inserted into the piece accommodating portion 12b.
Next, the patient or the examiner changes the pair of attachment / detachment means main bodies 12a from the state shown in FIG. 5 (b-1) to the state shown in FIG. 5 (b-2). That is, the patient or the examiner presses the lower part of the pair of attachment / detachment means main body 12a toward the stethoscope main body 11 side, and separates the pair of upper protrusions 12a1.
Next, the patient or the examiner brings the lower surface of the chest piece accommodating portion 12b into contact with the upper surface of the stethoscope main body 11 and accommodates the sound collecting portion 11c inside the chest piece accommodating portion 12b.
Next, the patient or the examiner urges the pair of upper protrusions 12a1 again toward the sound collecting portion 11c by removing the pressing force of the pair of attachment / detachment means main bodies 12a on the stethoscope main body 11.
By doing so, as shown in FIG. 5C, the pair of upper protrusions 12a1 are fitted into the pair of fitting grooves 12b1, and the chest piece C is attached to the stethoscope 1.

In FIG. 5, the attachment / detachment means main body 12a, the chest piece accommodating portion 12b, the ring-shaped body 12c, and the sound collecting portion 11c are shown in cross section.
Further, in FIGS. 5 (b-1), (b-2) and (c), the stethoscope main body 11 is omitted except for the upper surface thereof and the sound collecting portion 11c.

The sound acquired by the chest piece C is input to the inside of the stethoscope main body 11 via the sound collecting unit 11c.
A microphone element, an amplifier, and the like are built in the stethoscope main body 11, and the voice input inside the stethoscope main body 11 is converted as voice information that can be transmitted to the outside.

Hereinafter, a case where remote medical care is performed using the remote medical care system S will be described with reference to FIGS. 6 to 8.

First, as shown in FIG. 6, the patient X and the examiner Y face each other via the patient terminal T1 and the examiner terminal T2, respectively, so that they can communicate with each other.

Then, the patient X holds the stethoscope 1 to which the chest piece C is attached by his / her own hand.
Further, the examiner Y wears the listening means L in his / her ear in order to listen to the voice information based on the biological sound of the patient X.

Further, as shown in FIG. 7, the patient X is equipped with the contact position display means W.
The contact position display means W is a T-shirt in the present embodiment, and a plurality of contact marks W1 on which the contact position of the stethoscope 1 with respect to the body of the patient X is displayed are provided on the surface thereof. ing.
Each of the plurality of contact marks W1 is configured by writing different numbers in a round frame.

The contact position display means W is preferably clothing for ease of wearing, but is not particularly limited as long as it can be worn on the body.
Further, the contact mark W1 does not necessarily have to have the above-described configuration, and any configuration may be adopted as long as the patient X and the examiner Y can recognize the contact position. ..
Further, the number of contact marks W1 is not particularly limited, and may be any number, and may be provided on the back surface.

Next, as shown in FIG. 8, the patient X moves the stethoscope 1 held by his / her hand to bring the chest piece C into contact with the contact mark W1.
At this time, the examiner Y sends the chest piece C to the patient X by transmitting the number of the desired contact mark W1 corresponding to the portion for which voice information is to be acquired among the plurality of contact marks W1. , The desired contact mark W1 is contacted.
Note that FIG. 7 shows a case where the examiner Y instructs the patient X to bring the chest piece C into contact with the contact mark W1 on which the number 1 is written.

The voice information acquired by the stethoscope 1 is transmitted by the transmission means 101 to the transmission processing device 2 via the network N.
The transmission processing device 2 receives the transmitted voice information by the receiving means 201, and performs the reproduction processing by the reproduction processing means 202.

The voice information reproduced and processed by the transmission processing device 2 is transmitted to the examiner terminal T2 via the network N and then reproduced via the listening means L to be heard by the examiner Y.

The switching means 103 switches the filter characteristics of the filter means 102.
The volume adjusting means 104 adjusts the volume of the voice information acquired by the stethoscope 1.

In the present embodiment, the switching means 103 and the volume adjusting means 104 can be appropriately used in order to enable the examiner Y to hear the voice information reproduced via the listening means L in a clearer state.

More specifically, for example, when the filter characteristics of the filter means 102 clarify the lung sound and the chest piece C is in contact with the contact mark W1 corresponding to the part where the heart sound is heard. The examiner Y instructs the patient X to switch the filter characteristics of the filter means 102 by the switching means 103 to make the heart sounds clear.
The filter means 102 may have a so-called pass-through filter that can listen to the sound acquired from the chest piece C as it is, a so-called noise reduction filter that reduces ambient environmental sounds, and the like. Further, the filter means 102 can obtain the filter characteristics required by each specialist, for example, for internal medicine, pediatrics, cardiology, respiratory department, etc. by causing the stethoscope main body 11 to read a program for updating as appropriate. The configuration may be such that it is added.

Further, for example, when the volume of the voice information is low and it is difficult to hear the voice information, the examiner Y instructs the patient X to increase the volume of the voice information by the volume adjusting means 104.

The recording means 203 records the voice information acquired by the stethoscope 1.
In the present embodiment, the recording means 203 is configured to be possessed by the transmission processing device 2, but may be possessed by the stethoscope 1.

The analysis processing means 204 analyzes the voice information acquired by the stethoscope 1.
More specifically, the analysis processing means 204 performs graphing processing, heart murmur information acquisition processing, and the like by frequency-analyzing a plurality of acquired voice information.
The heart murmur information is information such as the frequency of the heart murmur in specific voice information, the timing at which the heart murmur occurs, and the duration of the heart murmur.

In the present embodiment, the acquired voice information can be useful for medical treatment by being recorded by the recording means 203 or analyzed and processed by the analysis processing means 204.

More specifically, the acquired plurality of voice information is stored by the recording means 203 in a storage unit (not shown) included in the transmission processing device 2.
Then, the examiner Y calls the desired voice information from the transmission processing device 2 at a desired timing such as when sharing the findings with the patient X after the medical examination or when confirming the progress of the medical examination, and the examiner terminal T2 Above, this audio information can be reproduced.

Further, the examiner Y can also call the graph information and the heart murmur information that visualize the voice information from the transmission processing device 2 and display the information on the examiner terminal T2.

That is, the voice information recorded by the recording means 203 and the voice information analyzed and processed by the analysis processing means 204 can be used for medical treatment as a part of the electronic medical record.

In addition to this, the stethoscope 1 can be utilized like an IC recorder by the recording means 203. As a result, the examiner Y uses the stethoscope 1 to record not only the voice information based on the biological sound of the patient X but also the contents of the conversation at the time of medical examination, and this is part of the electronic medical record by converting it into a text. Can be.

Further, the analysis processing means 204 can be configured to detect an abnormal waveform from the voice information and warn the patient X and the examiner Y of the abnormality. As a result, the patient X conducts auscultation with the stethoscope 1 by himself / herself even when he / she is not receiving the remote medical examination by the examiner Y, and when an abnormality is warned, the patient X transmits voice information to the examiner Y and the like. By doing so, the findings can be obtained from the examiner Y.

FIG. 9 shows an example of displaying the electronic medical record K on the examiner terminal T2.
FIG. 9A is a display example of the entire electronic medical record K, and FIG. 9B is an enlarged display example of the voice information display unit K3.

As shown in FIG. 9, a schematic view K1 of the human body is displayed on the electronic medical record K, and a plurality of voice information selection units K2 capable of being pressed are displayed at positions corresponding to the contact marks W1.

When the examiner Y presses and operates the specific voice information selection unit K2, the voice information display unit K3 that displays the information related to the specific voice information is displayed.

In the voice information display unit K3, for example, graph information K3a that visualizes specific voice information, heart murmur information K3b, comment K3c by the examiner Y, and a play button K3d are displayed.
The examiner Y can reproduce specific voice information by pressing the play button K3d.

It should be noted that such a display on the examiner terminal T2 can naturally be displayed on the patient terminal T1 as well.

According to the present embodiment, the examiner Y causes the patient X to use the stethoscope 1 to listen to the voice information based on the biological sound of the patient X even when the patient X is in a remote place. Can be done. As a result, the examiner Y can perform medical treatment even when face-to-face medical treatment is difficult.

Further, the contact position display means W allows the examiner Y to accurately convey to the patient the appropriate contact position of the stethoscope 1 for acquiring desired voice information, and to the patient X. Even in the case of remote medical treatment using the stethoscope 1, it is possible to smoothly proceed with the medical treatment.

Further, since the stethoscope 1 has the attachment / detachment means 12, the examiner Y can perform medical treatment using the chest piece C that he / she is familiar with.

Further, since the transmission processing device 2 has the recording means 203, the examiner Y can utilize the voice information for the electronic medical record K. That is, the examiner Y can share the findings with the patient X, confirm the progress of the medical examination, and the like.

Further, since the transmission processing device 2 has the analysis processing means 204, the examiner Y can utilize more detailed information on the voice information such as graph information and heart murmur information that visualize the voice information in the electronic medical record K. Is possible.

Further, since the stethoscope 1 has the filter means 102, the examiner Y can listen to the voice information more clearly.

Further, since the stethoscope 1 has the switching means 103, the examiner Y can apply an appropriate filter characteristic to each part even if the parts for acquiring a plurality of voice information are different. It becomes possible to listen to a plurality of voice information more clearly.

Further, since the stethoscope 1 has the volume adjusting means 104, the examiner Y can listen to the voice information with an appropriate volume feeling.

The various shapes, dimensions, and the like of each component shown in the above-described embodiment are examples, and can be variously changed based on design requirements and the like.

For example, in the present embodiment, the case of performing remote medical care is shown, but this system can be naturally applied even in the case of carrying out general face-to-face medical care and home-visit nursing care.
When performing face-to-face medical care or home-visit nursing, the patient terminal T1 is not always required, and the examiner Y can operate the switching means 103, the volume adjusting means 104, and the like.

Further, as shown in FIG. 10, the stethoscope 1 may have a holding means H for holding the contact state of the patient X with the body.

The holding means H is, for example, a band-shaped body configured to be able to form a ring of a predetermined size by providing connecting means (not shown) such as a hook-and-loop fastener and an insertion buckle at both ends. It is partially fixed to one side.

In the stethoscope 1 configured in this way, as shown in FIG. 11, by wrapping the holding means H around the chest and waist of the patient X, the chest piece C is brought into contact with the portion for which voice information is to be acquired. In this state, it is attached to patient X.

As a result, even when it is difficult to move the body, for example, when the patient X is bedridden, the examiner Y always acquires and listens to the voice information based on the biological sound of the patient X. It becomes possible to do.

A plurality of stethoscopes 1 may be attached to the holding means H, and by making the chest piece C of each stethoscope 1 abut on different parts, it is acquired from different parts such as heart sounds and lung sounds. It is also possible to configure the structure so that the voice information can be acquired at the same time.

S Remote medical examination system 1 Stethoscope 11 Stethoscope body 11a Power supply 11b Connection part 11b1 USB terminal 11b2 Phone terminal 11c Sound collecting part 12 Detachable means 12a Detachable means body 12a1 Upper protrusion 12b Chest piece accommodating part 12b1 Fitting groove 12c Ring-shaped body 101 Transmission means 102 Filter means 103 Switching means 104 Volume adjusting means 2 Transmission processing device 201 Reception means 202 Playback processing means 203 Recording means 204 Analysis processing means W Contact position display means W1 Contact mark C Chest piece L Stethoscope T1 For patients Terminal T2 Stethoscope terminal N Network K Electronic chart K1 Schematic diagram of human body K2 Voice information selection unit K3 Voice information display unit K3a Graph information K3b Heart murmur information K3c Comment K3d Play button H Holding means X Patient Y Stethoscope

Claims (10)

A stethoscope for acquiring voice information based on the patient's biological sound and a transmission processing device for transmitting the voice information to an external device are provided.
The stethoscope has a transmission means for transmitting the voice information to the transmission processing device.
The transmission processing device is a remote medical care system including a receiving means for receiving the voice information and a reproduction processing means for performing a reproduction process for reproducing the voice information on the external device. The contact position display means to be attached to the patient's body is provided.
The remote medical care system according to claim 1, wherein a contact mark indicating the contact position of the stethoscope with respect to the body of the patient is provided on the surface of the contact position display means. .. The remote medical care system according to claim 1 or 2, wherein the stethoscope has a detachable means for attaching and detaching the chest piece. The remote medical care system according to any one of claims 1 to 3, further comprising a recording means for recording the voice information. The remote medical care system according to any one of claims 1 to 4, wherein the transmission processing device includes an analysis processing means for analyzing and processing the voice information. The remote medical care system according to any one of claims 1 to 5, further comprising a filter means for extracting a specific frequency component of the voice information. The remote medical care system according to claim 6, wherein the stethoscope has a switching means for switching the filter characteristics of the filter means. The remote medical care system according to any one of claims 1 to 7, wherein the stethoscope has a volume adjusting means for adjusting the volume of the voice information. The remote medical care system according to any one of claims 1 to 8, wherein the stethoscope has a holding means for holding the contact state of the patient with the body. Obtain voice information based on the patient's biological sound with a stethoscope,
The voice information acquired by the stethoscope is transmitted to the transmission processing device, and the voice information is transmitted to the transmission processing device.
A remote medical treatment method comprising performing a reproduction process for reproducing the voice information received by the transmission processing device on an external device.