JP2023071818A - Clinical support system and clinical support device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To support a determination as to whether to request a support from a specialist.

SOLUTION: A clinical support system comprises an acquisition unit, an analysis unit, a determination unit, and a display control unit. The acquisition unit acquires patient information related to a patient, inquiry information indicating the details of the patient's answers to an inquiry, and conversation information in which the conversation with the patient is recorded. The analysis unit performs analysis processing using the patient information, the inquiry information, and the conversation information to generate patient characteristic information indicating a psychological profile and a social profile of the patient. The determination unit determines at least one supporter from whom the system requests a support based on the patient characteristic information, a medical care event for the patient, and a request condition for requesting a support in the medical care event. The display control unit displays a screen including information on the supporter determined by the determination unit.

SELECTED DRAWING: Figure 2

COPYRIGHT: (C)2023,JPO&INPIT

Description

The embodiments disclosed in this specification and drawings relate to a clinical support system and a clinical support device.

Conventionally, medical professionals such as doctors are required to provide medical care based not only on biological aspects such as test results, but also on the social and psychological aspects of patients. Therefore, medical professionals collect information on psychological and social aspects through communication with patients. Based on the collected information, medical professionals are required to provide medical care in collaboration with various specialists.

However, depending on the information collected, it was sometimes difficult for medical professionals to determine when to seek help from which specialist.

Japanese Patent Application Publication No. 2014-503894

One of the problems to be solved by the embodiments disclosed in the specification and drawings is to assist in determining whether to request assistance from a professional. However, the problems to be solved by the embodiments disclosed in this specification and drawings are not limited to the above problems. A problem corresponding to each effect of each configuration shown in the embodiments described later can be positioned as another problem.

A clinical support system according to an embodiment includes an acquisition unit, an analysis unit, a determination unit, and a display control unit. The acquisition unit acquires patient information related to a patient, inquiry information indicating the patient's answers to the inquiry, and conversation information in which the patient's conversation is recorded. The analysis unit generates patient characteristic information indicating a patient's psychological and social aspects through analysis processing using the patient information, the inquiry information, and the conversation information. The determination unit determines at least one supporter who requests support based on the patient characteristic information, the patient's medical event, and request conditions for requesting support in the medical event. The display control unit displays a screen including information about the supporters determined by the determination unit.

FIG. 1 is a block diagram showing an example of the configuration of a clinical support system according to this embodiment. FIG. 2 is a block diagram showing an example of the configuration of the clinical support device according to this embodiment. FIG. 3 is a diagram showing an example of the data configuration of analysis target information. FIG. 4 is a diagram showing an example of the data configuration of medical event information. FIG. 5 is a diagram showing an example of the data configuration of support request information. FIG. 6 is an explanatory diagram showing an example of a medical treatment schedule screen according to this embodiment. FIG. 7 is a flowchart showing an example of support request processing executed by the clinical support device according to this embodiment. FIG. 8 is a flowchart showing an example of supporter determination processing executed by the clinical support apparatus according to this embodiment. FIG. 9 is a diagram showing an example of a first classification screen showing classification items up to middle classification according to Modification 3. As shown in FIG. FIG. 10 is a diagram showing an example of a second classification screen according to Modification 3. As shown in FIG.

Hereinafter, a clinical support system and a clinical support device according to this embodiment will be described with reference to the drawings. In the following embodiments, it is assumed that parts denoted by the same reference numerals perform the same operations, and overlapping descriptions will be omitted as appropriate.

(this embodiment)
Medical professionals such as doctors are required to provide holistic medical care based not only on biological aspects but also on the psychological and social aspects of patients. More specifically, medical professionals are required to make decisions on medical care policies that take into consideration various aspects, rather than solely based on biological aspects such as the results of diagnostic imaging and laboratory test results. ing.

For example, patients with chronic diseases such as lifestyle-related diseases may not be cured by treatment from the biological aspect of drug administration alone. For example, in the case of low back pain, it is preferable that the medical staff not only prescribe poultices but also give advice according to the patient's lifestyle such as work content.

Medical professionals can expect further improvement through medical treatment that encourages improvement in lifestyle habits rather than administration of drugs alone. In addition, the patient's adherence during and after treatment (the patient's active involvement in treatment and taking medication, and the patient's adherence to the treatment and taking the medication) is enhanced by determining the treatment policy, including whether the patient has children and the status of his/her work. receive better care), live better lives and have better outcomes. Furthermore, the patient can concentrate on the treatment with peace of mind because the explanation and treatment are given according to the patient's own personality.

In this way, medical professionals can provide better medical care by determining treatment policies based on biological, psychological, and social aspects. In other words, medical professionals are required to provide so-called holistic medical care that includes not only biological aspects but also psychological and social aspects. Medical professionals collect information on psychological and social aspects through communication with patients.

However, medical professionals communicate with patients based on self-improvement and experience. And medical professionals may have difficulty gathering information on psychological and social aspects. In addition, the medical staff also has to decide which of the psychological aspects and the social aspects of the information to be recorded in the electronic medical record or the like. Furthermore, medical professionals are required to utilize this information while overlooking it.

In addition, in recent years, medical care is provided jointly with various specialists instead of being treated by doctors alone. Medical professionals such as doctors seek support according to the stage of medical care and the patient's condition. As a result, each professional works in accordance with his/her specialty. For example, a social worker provides consultation on the patient's lifestyle. In addition, oncology nurses provide care appropriate to cancer treatment.

Thus, medical professionals need to seek help according to the stage of care and the condition of the patient. However, it can be difficult for health care workers to determine when and from which professional to seek help. Therefore, there is a demand for a technique for assisting in determining whether or not to request assistance from a professional.

FIG. 1 is a block diagram showing an example of the configuration of a clinical support system 1 according to this embodiment. The clinical support system 1 includes a hospital information system (HIS) 10, a radiology information system (RIS) 20, a medical image management system (PACS: Picture Archiving and Communication Systems) 30, and a clinical examination information system. (LIS: Laboratory Information System) 40 , a patient terminal 50 , a patient measurement terminal 60 , a clinical support device 70 and a display device 80 . In addition, each system and each device are connected via a network 90 so as to be able to communicate with each other. Note that the configuration shown in FIG. 1 is an example, and the number of each system and each device may be changed arbitrarily. Devices not shown in FIG. 1 may also be connected to network 90 .

The hospital information system 10, the radiology information system 20, the medical image management system 30, and the laboratory test information system 40 are implemented by computer equipment such as servers and workstations, for example.

A hospital information system 10 stores electronic medical record information 11 and medical interview information 12 . The electronic medical chart information 11 is information in which a patient's clinical progress is recorded. For example, the electronic medical record information 11 includes information for identifying a patient, personal information such as the patient's age, sex, and family structure, information such as the name of the disease the patient suffered from, the name of the prescribed drug, and the duration of treatment. have. The inquiry information 12 is information indicating the content of the patient's answers to the inquiry. For example, the inquiry information 12 includes answers to the patient's current symptoms, answers to the patient's living environment, and answers to the patient's character diagnosis.

The radiology information system 20 stores interpretation report information 21 . The interpretation report information 21 is information containing findings by a doctor or the like who has interpreted the image information 31 captured by the medical image diagnostic apparatus.

The medical image management system 30 stores image information 31 . The image information 31 has an image captured by a medical image diagnostic apparatus. The medical image diagnostic apparatus is, for example, an X-ray CT (Computed Tomography) apparatus, an MRI (Magnetic Resonance Imaging) apparatus, an X-ray diagnostic apparatus, an ultrasonic diagnostic apparatus, or the like. The image information 31 complies with the DICOM (Digital Imaging and Communications in Medicine) standard.

The clinical test information system 40 stores clinical test result information 41 and clinical test report information 42 . The clinical test result information 41 is information indicating the results of clinical tests. The clinical test report information 42 is information having findings on clinical test results.

A patient terminal 50 is a terminal used by a patient. The patient terminal 50 is implemented by, for example, a smart phone, tablet terminal, wearable terminal, or personal computer. The patient terminal 50 also stores conversation information 51 in which the patient's conversation is recorded. For example, the conversation information 51 is information on conversations between medical professionals such as doctors, nurses, counselors, and patients. Further, the conversation information 51 is not limited to the conversation about the contents of medical care, and may include chat. Specifically, the conversation information 51 includes voice information obtained by recording a conversation and information obtained by converting voice into text. Also, the conversation information 51 may include video information such as moving images and still images including conversation. When image information is included, the conversation information 51 has an image showing the patient's facial expression.

The patient measuring terminal 60 is a terminal for measuring patient's vital signs. The patient measurement terminal 60 is implemented by, for example, a wearable terminal. The patient measurement terminal 60 measures vital signs such as blood pressure, pulse, body temperature, and respiration. Also, the patient measurement terminal 60 may record the conversation. Then, the patient measurement terminal 60 stores personal health information 61 having the measurement results of vital signs.

The patient measurement terminal 60 is not limited to a wearable terminal, and may be a body fat meter, an activity meter, or other devices. In addition, the patient measurement terminal 60 may measure body fat, measure the amount of activity, or measure other items. Furthermore, the clinical support system 1 may have a plurality of patient measurement terminals 60 . Further, in the clinical support system 1, the measurement targets of the plurality of patient measurement terminals 60 may be different.

The clinical support device 70 is a device that supports a medical worker such as a doctor in clinical practice. The clinical support device 70 is realized by, for example, computer equipment such as a server or workstation. The clinical support device 70 analyzes the patient's biological, social, and psychological aspects based on the information acquired from each system and device of the clinical support system 1 . The clinical support device 70 also analyzes information that does not belong to the patient's biological, social, and psychological aspects as other aspects. In addition, the clinical support device 70 generates information indicating biological aspects, social aspects, psychological aspects, and other aspects of the patient. The clinical support device 70 may be installed in the facility, or may be a server on the Internet.

The display device 80 is a device capable of displaying various information. The display device 80 is realized by computer equipment such as a personal computer and a tablet terminal. The display device 80 displays various information generated by the clinical support device 70 . For example, the display device 80 displays a medical treatment schedule screen G1 (see FIG. 6). The display device 80 is an example of a display controller.

By viewing the information displayed on the display device 80, a medical worker such as a doctor can determine whether or not to request assistance from a professional.

Next, the clinical support device 70 will be described.

FIG. 2 is a block diagram showing an example of the configuration of the clinical support device 70 according to this embodiment. The clinical support device 70 has a NW (network) interface 710 , an input interface 720 , a display 730 , a memory circuit 740 and a processing circuit 750 .

The NW interface 710 is connected to the processing circuit 750 and controls transmission and communication of various data with each device connected via the network 90 . For example, the NW interface 710 is implemented by a network card, network adapter, NIC (Network Interface Controller), or the like.

The input interface 720 is connected to the processing circuit 750 , converts an input operation received from an operator (medical worker) into an electrical signal, and outputs the electrical signal to the processing circuit 750 . Specifically, the input interface 720 converts an input operation received from the operator into an electrical signal and outputs the electrical signal to the processing circuit 750 . For example, the input interface 720 includes a trackball, a switch button, a mouse, a keyboard, a touch pad that performs input operations by touching an operation surface, a touch screen that integrates a display screen and a touch pad, and a non-optical sensor. It is implemented by a contact input circuit, an audio input circuit, and the like. In this specification, the input interface 720 is not limited to having physical operation parts such as a mouse and a keyboard. For example, the input interface 720 also includes an electrical signal processing circuit that receives an electrical signal corresponding to an input operation from an external input device provided separately from the device and outputs the electrical signal to the control circuit.

The display 730 is connected to the processing circuit 750 and displays various information and various image data output from the processing circuit 750 . For example, the display 730 is implemented by a liquid crystal display, a CRT (Cathode Ray Tube) display, an organic EL display, a plasma display, a touch panel, or the like.

The storage circuit 740 is connected to the processing circuit 750 and stores various data. In addition, the storage circuit 740 stores various programs for realizing various functions by being read and executed by the processing circuit 750 . For example, the storage circuit 740 is implemented by a semiconductor memory device such as a RAM (Random Access Memory) or flash memory, a hard disk, an optical disk, or the like.

The storage circuit 740 stores analysis target information 741 , medical event information 742 , and support request information 743 .

FIG. 3 is a diagram showing an example of the data configuration of the analysis target information 741. As shown in FIG. The analysis target information 741 is information specifying targets to be analyzed as biological, social, psychological and other aspects of the patient among the information acquired by each system and device of the clinical support system 1. be.

The analysis target information 741 associates a classification, an analysis item, and an analysis target item. Classifications are divisions such as biological aspects, psychological aspects, social aspects, and others. A biology is a classification that indicates a biological aspect of a patient. For example, the biological aspect is associated with biological analysis items such as various test results, disease, and physical condition of the patient. In addition, the biological aspects are not limited to biological aspects, and may be associated with analysis items related to physical aspects, medical aspects, and pathological aspects. The psychological aspect is a classification that indicates the psychological aspect of the patient. For example, the psychological aspect is associated with psychological aspect analysis items such as the patient's intention and character. Psychological aspects may also include the patient's emotional state. The emotional state is an emotion such as depressed or angry. Psychological aspects include life expectancy declarations that indicate whether or not a patient wants to know how long they live, treatment preferences that indicate how the patient chooses options regarding treatment, the patient's thoughts and values, and what kind of personality the patient has. may be included. The social aspect is a classification that indicates the patient's social aspect. For example, social aspects are associated with analysis items of social aspects such as work, human relationships, hobbies, and educational background. Others are associated with analysis items that do not belong to any of the biological, psychological, and social aspects. An analysis item is an item for analyzing a patient. The analysis target item is information in which whether or not to analyze the analysis item is set. That is, the clinical support device 70 analyzes the analysis item set as the analysis target in the analysis target item. Further, the association between the classification of the analysis target information 741 and the analysis items shown in FIG. 3 is an example and may be changed arbitrarily.

FIG. 4 is a diagram showing an example of the data configuration of the medical event information 742. As shown in FIG. The medical event information 742 is information in which a medical event is associated with the importance of the medical event. A medical event is an event in medical care. The degree of importance is information indicating the degree of priority given to a medical event among medical events. The medical event shown in FIG. 4 is an example, and any event may be used as the medical event. That is, the medical events may include additional medical events that are not included in the medical event information 742 shown in FIG. 4, or may not include medical events included in the medical event information 742 shown in FIG. Also, the importance shown in FIG. 4 is an example and may be changed arbitrarily. Note that the medical event information 742 does not have to have a degree of importance.

FIG. 5 is a diagram showing an example of the data configuration of the support request information 743. As shown in FIG. The support request information 743 is information having a list of specialists to support when the request conditions are met in the medical event. Also, FIG. 5 shows part of the support request information 743 . That is, the support request information 743 includes information about other medical events, not limited to the medical event "under treatment". Further, the support request information 743 shown in FIG. 5 indicates that, when the request condition “changed condition exists” is satisfied in the medical event “under treatment”, the specialist associated with the request condition “changed condition” is the supporter. This indicates that it is a candidate for In addition, the information indicating each profession is associated with a priority. Priority indicates the degree to which the associated professional should be requested for assistance. Also, the clinical support device 70 displays a list of specialists based on the priority. This makes it easier for the clinical support device 70 to request support from more important specialists. Also, the request conditions, professions, and priorities shown in FIG. 5 are examples and may be changed arbitrarily. Note that the support request information 743 does not have to have a priority.

The processing circuit 750 controls the overall operation of the clinical support device 70 . The processing circuit 750 includes, for example, a patient designation function 751, an information acquisition function 752, an analysis target designation function 753, a feature analysis function 754, a medical event determination function 755, a support determination function 756, a supporter identification function 757, an information generation function 758, It has an operation input function 759 , a support request function 760 and a setting function 761 . In the embodiment, a patient designation function 751, an information acquisition function 752, an analysis target designation function 753, a feature analysis function 754, a medical event determination function 755, a support determination function 756, a supporter identification function 757, and an information generation function 758 are components. , the operation input function 759, the support request function 760, and the setting function 761 are stored in the storage circuit 740 in the form of programs executable by the computer. The processing circuit 750 is a processor that reads a program from the storage circuit 740 and executes it to implement a function corresponding to each program. In other words, the processing circuit 750 with each program read has each function shown in the processing circuit 750 of FIG.

In FIG. 2, a single processor includes a patient designation function 751, an information acquisition function 752, an analysis target designation function 753, a feature analysis function 754, a medical event determination function 755, a support determination function 756, and a supporter identification function 757. , information generation function 758, operation input function 759, support request function 760, and setting function 761 have been described. The function may be realized by doing so. Also, in FIG. 2, a single memory circuit such as the memory circuit 740 has been described as storing a program corresponding to each processing function. , the corresponding programs may be read from individual storage circuits.

The term "processor" used in the above description includes, for example, a CPU (Central Processing Unit), a GPU (Graphical Processing Unit), an application specific integrated circuit (ASIC), a programmable logic device (for example, a simple Circuits such as a simple programmable logic device (SPLD), a complex programmable logic device (CPLD), and a field programmable gate array (FPGA). The processor implements its functions by reading and executing programs stored in the storage circuit 740 . Note that instead of storing the program in the memory circuit 740, the program may be configured to be directly embedded in the circuit of the processor. In this case, the processor realizes its function by reading and executing the program embedded in the circuit.

The patient specification function 751 accepts specification of a patient for whom a treatment policy is to be created. In other words, the patient designation function 751 accepts designation of a patient whose biological, social, and psychological aspects are to be analyzed. The patient specification function 751 receives patient specification from the display device 80, for example. For example, the patient designation function 751 accepts information that can identify a patient, such as a patient's name and a patient code for identifying the patient. Alternatively, the patient designation function 751 accepts designation of a patient by selecting from a list of patients.

The information acquisition function 752 acquires patient information related to the patient, inquiry information 12 indicating the content of the patient's answer to the inquiry, and conversation information 51 in which the patient's conversation is recorded. The information acquisition function 752 is an example of an acquisition unit. Here, the patient information is information obtained by monitoring the patient, such as electronic chart information 11, interpretation report information 21, image information 31, clinical test result information 41, clinical test report information 42, and personal health information 61. . For example, when a patient is designated by the patient designation function 751, the information acquisition function 752 acquires patient information, interview information 12, and conversation information 51 of the designated patient.

The analysis target designation function 753 designates an analysis target item to be analyzed by the feature analysis function 754 among the analysis items of the patient's biological, psychological, and social aspects. That is, the analysis target specification function 753 specifies the analysis target item of the analysis target information 741 .

More specifically, the analysis target specification function 753 accepts specification of an analysis target to be analyzed using the patient information acquired by the information acquisition function 752, the inquiry information 12, and the conversation information 51. FIG. For example, the analysis target designation function 753 receives designation of the analysis target based on information received by the NW interface 710 or an operation received by the input interface 720 . For example, the analysis target specification function 753 receives specification of the analysis target from the display device 80 via the NW interface 710 . Then, the analysis target specifying function 753 specifies the analysis target item of the specified analysis target information 741 as the analysis target.

A feature analysis function 754 analyzes the patient information, the interview information 12, and the conversation information 51 to analyze the patient's biological, psychological, social, and other aspects of the patient's characteristics. Generate information. Feature analysis function 754 is an example of an analysis unit. The analysis process is a process of extracting information from the patient information, the interview information 12, and the conversation information 51, judging, analyzing, and generating new information. Patient characteristic information is information that indicates characteristics of a patient in biological, psychological, social, or other aspects. Further, the patient characteristic information is the analysis result for each analysis item of the patient's biological aspect, psychological aspect, social aspect, or other aspect.

More specifically, the feature analysis function 754 generates patient feature information for items to be analyzed for each of the patient's biological, psychological, and social aspects. The feature analysis function 754 generates patient feature information corresponding to the analysis target item of the biological aspect specified by the analysis target information 741 among the information included in the patient information. Specifically, the feature analysis function 754 generates patient feature information indicating co-morbidities and physical conditions included in the patient information.

In addition, the feature analysis function 754 analyzes patient features of psychological and social analysis target items specified by the analysis target information 741 among the information included in the patient information, the interview information 12, and the conversation information 51. Generate information. For example, the feature analysis function 754 generates patient feature information corresponding to the psychological and social analysis target items specified by the analysis target information 741 from the medical interview information 12 . Specifically, the feature analysis function 754 extracts answers to questions such as character judgment, work, and human relations included in the medical interview information 12 .

Also, the feature analysis function 754 analyzes the conversation information 51 to generate patient feature information including conversation content information and emotion information of the conversation. The conversation content information is information indicating the content of the conversation. The emotion information is information indicating the patient's emotion when each sentence in the conversation is uttered.

More specifically, the feature analysis function 754 generates patient feature information including conversation content information and emotional information corresponding to psychological and social analysis target items specified by the analysis target information 741 . For example, the feature analysis function 754 generates conversation content information indicating the content of the conversation by executing natural language processing on the conversation information 51 . For example, if the conversation information 51 includes an utterance "My back hurts", the feature analysis function 754 generates a sentence "My back hurts".

Also, the feature analysis function 754 generates emotion information indicating the emotion of the patient who made the utterance. Here, when the symptoms are aggravated, the patient often speaks with negative emotions. On the other hand, when symptoms are improving, patients often speak with positive emotions. For example, the feature analysis function 754 generates emotion information that indicates the patient's emotion expressed by tone of voice, hesitation, nuances, etc. in the utterance "My back hurts." In this manner, the feature analysis function 754 generates patient feature information in which emotion information is associated with conversation content information.

For example, the feature analysis function 754 may utilize artificial intelligence such as AI (Artificial Intelligence). For example, the feature analysis function 754 generates emotion information indicating the emotion of the speaker of the conversation included in the conversation information 51 using a learned model generated by machine learning. The trained model is generated by supervised learning in which conversation information 51 is input as teacher data on the input side, and emotion information indicating the emotion of the speaker is input as teacher data on the output side. Note that the learned model may be generated by other methods, not limited to such machine learning.

Also, the feature analysis function 754 may generate information indicating the patient's emotional information and sense of values by comparing the conversation information 51 with other information such as the patient information and the interview information 12 . For example, the feature analysis function 754 recognizes that 6 hours is medium intensity when the answer is medium intensity standing work in the inquiry information 12 and 6 hours of standing work is answered in the conversation information 51. Information indicative of the patient's values can be generated.

In addition, the patient's social and psychological conditions change over time. Therefore, the characteristic analysis function 754 may generate patient characteristic information for each fixed period, or may generate patient characteristic information for each clinical event such as an examination or notification.

Note that the feature analysis function 754 generates patient feature information indicating not only the patient's biological aspects, psychological aspects, social aspects, and other aspects, but also psychological aspects and social aspects. may be

The medical event determination function 755 is based on the patient information monitored by the patient, such as the electronic medical record information 11, the interpretation report information 21, the image information 31, the clinical test result information 41, the clinical test report information 42, and the personal health information 61. It is determined which medical event in the medical event information 742 corresponds. Medical events include, for example, "first visit", "preparation", "notice", "start of treatment", "under treatment", "drug change", "end of treatment", "discontinuation of treatment", "end of life", and the like.

“First visit” is a medical event indicating the first medical examination. The medical event determination function 755 determines that the medical examination record of the clinical department registered in the electronic medical record information 11 falls within the set period from the current time, and corresponds to the "first medical examination". For example, the medical event determination function 755 determines that the patient corresponds to the “first visit” if there is no medical examination record within a set period from the date of the last medical examination, even if the same department has been examined in the past. Also, the medical event determination function 755 determines that the first medical record corresponds to the “first visit”.

A “precision examination” is a medical event indicating that a detailed examination such as an image diagnosis or a clinical examination is being performed. The medical event determination function 755 determines that a "precise examination" is applicable when there is examination order information.

"Announcement" is the state of notifying the patient of something bad. The medical event determination function 755 determines whether or not there is examination order information, there is a history indicating that examinations have been performed, and there is clinical examination report information 42 or interpretation report information 21 . Then, the medical event determination function 755 determines whether or not it corresponds to the “notification” by analyzing the clinical test report information 42 or the interpretation report information 21 . For example, clinical event determination function 755 performs natural language processing on clinical laboratory report information 42 . Then, the medical event determination function 755 determines that a term corresponding to "announcement" corresponds to "announcement" when there is a term indicating cancer or a term such as malignancy or suspected malignancy that requires special attention. In addition, the medical event determination function 755 determines that when the interpretation report information 21 includes information indicating a metastatic lesion, it corresponds to "announcement". For example, in the case of a breast cancer patient, the medical event determination function 755 can detect the presence of a shadow thought to be cancer in the breast opposite to the breast with cancer or in organs other than the breast. notification”.

“Start of treatment” is a medical event indicating that the treatment is the first treatment for an injury or disease. Also, "under treatment" is a medical event indicating that the treatment for the injury or disease is the second or subsequent time. For example, the clinical event determination function 755 determines whether "treatment is started" or "treatment is in progress" based on the number of drug therapy orders and the number of consultation appointments with the radiotherapy department.

"Drug change" is a clinical event indicating that the drug administered to the patient has been changed. "Treatment discontinued" is a clinical event that indicates that treatment has been discontinued for a patient. For example, the clinical event determination function 755 is based on CTCAE (Common Terminology Criteria for Adverse Events) grade information, patient outcome report information, blood test result information, etc. described in electronic medical record information 11 and nursing reports. to determine if it corresponds to “drug change” or “treatment discontinuation”. In addition, the clinical event determination function 755 determines "drug change" or Determine whether it corresponds to “discontinuation of treatment”.

"Treatment end" is a clinical event indicating that the patient's treatment has ended. For example, the medical event determination function 755 determines whether “end of treatment” is met based on the standard number of times of treatment included in the electronic medical record information 11 . For example, the clinical event determination function 755 determines whether or not "treatment is completed" based on the drug therapy instruction count. In addition, 25 times of radiotherapy after conservative therapy for breast cancer is the standard number of times of treatment. Therefore, the medical event determination function 755 may determine whether or not "treatment is completed" based on the number of appointments made to the radiotherapy department.

“Terminal stage” is a medical event indicating that the injury or disease is unlikely to be cured and treatment is stopped or transitioned to palliative care only. For example, the medical event determination function 755 detects a metastatic lesion from the electronic medical record information 11, and when the treatment is discontinued, or when the treatment is switched to analgesic treatment only, it corresponds to the ``terminal stage''. determine whether to

The support determination function 756 determines whether the request conditions set for the clinical event have been met based on the patient characteristic information. Here, a supporter is a professional who supports a medical worker in response to a request for support. Note that the supporter is typically a professional, but does not have to be a professional.

For example, assume that the support request information 743 includes the request condition “depressed state” for the medical event “under treatment”. The support determination function 756 determines that the request condition has been satisfied when the medical event determination function 755 determines that the medical event is "under treatment" and the patient's characteristic information determines that the patient is in a "depressed state."

For example, assume that the request condition “retirement” is set in the support request information 743 for the medical event “precision examination”. The support determination function 756 determines that the request condition is satisfied when the medical event determination function 755 determines that the medical event is "precision examination" and the patient's characteristic information determines that the patient is "retired". The request condition "retirement" is not limited to the medical event "detailed examination", and may be set for other medical events.

For example, it is assumed that the support request information 743 is set with the request condition “introverted” for the medical event “announcement”. The support determination function 756 determines that the request condition is satisfied when the clinical event determination function 755 determines that the medical event is "announcement" and the patient characteristic information determines that the patient is "introverted".

The clinical event determination function 755 may determine that multiple clinical events apply. For example, the clinical event determination function 755 may determine "on treatment" and "drug change". More specifically, the support determination function 756 determines which medical event should be prioritized based on the importance of the medical event included in the medical event information 742 . For example, the support determination function 756 selects one medical event based on the importance of the medical event information 742 . Then, the support determination function 756 determines whether or not the request condition set for the prioritized medical event is satisfied based on the patient characteristic information. Note that the support determination function 756 determines whether or not the request conditions set for each medical event are satisfied when the medical event information 742 does not have a degree of importance.

The supporter identification function 757 determines at least one supporter requesting support based on the patient characteristic information, the patient's medical event, and the request conditions for requesting support in the medical event. The supporter identification function 757 is an example of a determination unit. More specifically, the supporter identification function 757 identifies, based on the support request information 743, the specialist associated with the request condition determined to be satisfied by the support determination function 756 as at least one person requesting support. Judged as a supporter.

In addition, when the medical event determination function 755 determines which medical event should be prioritized based on the importance of the medical event, the supporter identification function 757 determines the patient characteristic information, the medical event, and the medical event. At least one supporter who requests support is determined based on the degree of importance and request conditions. That is, the supporter identification function 757 determines that the professional associated with the request condition is the supporter.

The information generation function 758 generates information to be displayed on the display device 80 . The display device 80 displays various information generated by the information generation function 758 . For example, the information generation function 758 generates a medical care schedule screen G1 showing the patient's medical care schedule. Then, the display device 80 displays the medical treatment schedule screen G1 generated by the information generating function 758. FIG.

FIG. 6 is an explanatory diagram showing an example of the medical treatment schedule screen G1 according to this embodiment. The medical treatment schedule screen G1 has patient summary information G11, schedule information G12, and vital signs information G13. The patient summary information G11 is information indicating a patient summary. For example, the patient summary information G11 is information indicating the patient's name, patient's date of birth, patient's blood type, patient's height, patient's weight, and the like. The vital signs information G13 is information indicating vital signs for each day indicated in the schedule information G12.

The schedule information G12 is information indicating a medical treatment schedule. The schedule information G12 indicates medical appointments indicating medical appointments and daily medical events. The information generation function 758 provides a supporter request button G14 for the medical event when the support determination function 756 determines that the request condition is satisfied. The supporter request button G14 is a button for displaying the supporter request information G15 indicating the supporter whose support is to be requested. The information generating function 758 may automatically present the supporter request information G15 even if the supporter request button G14 is not pressed. For example, when presenting the medical treatment schedule screen G1, the information generation function 758 may present the supporter request information G15 on condition that the support determination function 756 determines that the request condition is satisfied. In other words, the information generating function 758 generates the supporter request information G15 including the information regarding the supporter determined by the supporter specifying function 757 . Information generation function 758 is an example of an information generation unit. That is, the information generating function 758 generates the supporter request information G15 indicating the supporter whose support is to be requested.

Further, the supporter request button G14 is associated with the timing when it is determined that the request condition is satisfied in the medical event. That is, the information generating function 758 generates the supporter request information G15 including the information on the supporter in association with the timing when it is determined that the request condition is satisfied. This allows healthcare professionals to know when to request help.

The information generation function 758 generates supporter request information G15 when the supporter request button G14 is pressed. The supporter request information G15 is information for requesting support from a supporter. The supporter request information G15 includes message information G151, supporter list information G152, and a support request button G153.

The message information G151 is information indicating the medical event determined to satisfy the request condition and the timing of the medical event. The information generation function 758 generates the message information G151 based on the medical event determined by the support determination function 756 to satisfy the request condition and the timing of the medical event.

The supporter list information G152 is information for selecting a supporter requesting support. The information generation function 758 generates supporter list information G152, which is a list of supporters identified by the supporter identification function 757. FIG. Here, based on the support request information 743, the supporter identification function 757 identifies a supporter from a list of supporters registered for the request condition. That is, the information generation function 758 generates the supporter list information G152 for selecting a supporter requesting support from among the supporters registered for the request condition. The supporter list information G152 has a check box for each supporter. The support request button G153 is a button for requesting support from the supporter selected by the check box of the supporter list information G152.

The information generating function 758 also generates supporter list information G152 indicating a list of supporters requesting support based on the priority of the supporters included in the support request information 743 . For example, the information generating function 758 generates supporter list information G152 in which supporters are arranged in order according to the priority of the supporters. Thereby, the medical staff can grasp which supporter is the more important supporter. Note that the information generation function 758 may generate supporter list information G152 indicating a list of related supporters when the support request information 743 does not have a priority. That is, the information generation function 758 may generate the supporter list information G152 that is not arranged in order according to the priority.

The operation input function 759 accepts various operations. For example, the operation input function 759 receives an operation to select a supporter in the supporter request information G15. The operation input function 759 is an example of an input unit. Further, the operation input function 759 receives an operation of pressing the support request button G153 in the supporter request information G15. That is, the operation input function 759 receives an operation of pressing the support request button G153 from the display device 80, for example.

The support request function 760 notifies a support request to the support person selected by the operation input function 759 in the support person request information G15. The help request function 760 is an example of a notification unit. For example, the support request function 760 notifies the support request by sending an e-mail requesting support to the terminal of the supporter. Alternatively, the support request function 760 notifies the support request by registering the support request schedule in the supporter's calendar. It should be noted that these support request methods are merely examples, and the support request function 760 may request support by any method.

The setting function 761 sets various information for the medical event information 742 and the support request information 743 . For example, the setting function 761 sets the importance of the medical event in the medical event information 742 . The setting function 761 is an example of a first setting section. Also, the setting function 761 sets the priority of the specialist who will be the supporter in the support request information 743 . The setting function 761 is an example of a second setting section. In addition, the setting function 761 may set request conditions and specialists for medical care events in the support request information 743, in addition to the importance and priority. The setting function 761 also adds or deletes medical events to the medical event information 742 and the support request information 743 . Thereby, the setting function 761 can arbitrarily set the importance and priority for each facility such as a hospital.

The assistance determination function 756 may estimate when the request conditions may be met based on the patient characteristic information. For example, when the patient wishes to have children, the support determination function 756 grasps the ovulation cycle based on the patient characteristic information. Then, the support determination function 756 estimates the time when the request condition is satisfied by the cycle of ovulation. This allows the support determination function 756 to determine appropriate request timing.

Also, the setting function 761 may set the request condition “feeling more negative than the threshold” for all medical events. As a result, the support determination function 756 determines that the request condition "feelings negative than the threshold" is satisfied when the emotional value obtained by quantifying the negative emotion of the patient is lower than the threshold based on the patient characteristic information. and determine that the request conditions have been met. As a result, the information generation function 758 generates supporter request information G15 indicating a supporter who is a specialist other than the attending physician and to whom support is to be requested. For example, the information generating function 758 generates supporter request information G15 indicating supporters such as psycho-oncology psychiatrists, clinical psychologists, cancer counselors, and cancer specialist nurses. Therefore, medical staff can request support from specialists other than the attending physician.

Next, various processes executed by the clinical support system 1 will be described.

FIG. 7 is a flowchart showing an example of support request processing executed by the clinical support device 70 according to this embodiment. The support request process is a process of requesting support from a supporter.

The patient designation function 751 accepts designation of a patient to be the subject of the medical care schedule screen G1 (step S1).

The information acquisition function 752 acquires patient information such as electronic chart information 11, interpretation report information 21, image information 31, clinical test result information 41, clinical test report information 42, and personal health information 61 (step S2).

The information acquisition function 752 acquires the inquiry information 12 (step S3).

The information acquisition function 752 acquires the conversation information 51 (step S4).

The feature analysis function 754 performs analysis processing using the patient information, the interview information 12, and the conversation information 51 to obtain patient feature information indicating the patient's biological, psychological, social, and other aspects. is generated (step S5).

The clinical support device 70 executes supporter determination processing, which will be described later (step S6).

The information generation function 758 generates the medical treatment schedule screen G1 (step S7). The information generation function 758 then transmits the generated medical treatment schedule screen G1 to the display device 80 (step S8). As a result, the display device 80 displays the medical treatment schedule screen G1.

The support request function 760 determines whether or not an operation requesting support from the supporter has been received on the medical treatment schedule screen G1 displayed on the display device 80 (step S9). If there is no support request (step S9; No), the support request function 760 terminates the support request process.

If there is a support request (step S9; Yes), the support request function 760 requests support from the supporter (step S10).

With the above, the clinical support device 70 ends the support request process.

FIG. 8 is a flowchart showing an example of supporter determination processing executed by the clinical support device 70 according to this embodiment. The supporter determination process is a process of determining whether or not to request support from the supporter. Note that the supporter determination process shown in FIG. 8 is a process of determining whether or not the event corresponds to the medical event “announcement” based on the clinical test report information 42 and the interpretation report information 21 .

The medical event determination function 755 determines whether or not there is an examination order such as a clinical examination order or an imaging diagnosis order (step S21). If there is no examination order (step S21; No), the clinical support device 70 terminates the support determination process.

If there is an examination order (step S21; Yes), the medical event determination function 755 determines whether or not the examination requested by the examination order has been performed (step S22). If the examination has not been performed (step S22; No), the clinical support device 70 terminates the support determination process.

If the examination has been performed (step S22; Yes), the medical event determination function 755 determines whether or not there is an examination report such as the clinical examination report information 42 or the interpretation report information 21 (step S23). If there is no test report (step S23; No), the clinical support device 70 terminates the support determination process.

If there is a test report (step S23; Yes), the medical event determination function 755 analyzes the test report (step S24).

The medical event determination function 755 determines a medical event based on the analysis result of the examination report (step S25). In the supporter determination process shown in FIG. 8, it is determined whether or not the event corresponds to the medical event "announcement".

The support determination function 756 determines whether or not a supporter is required based on the patient characteristic information and the patient's medical event (step S26). In other words, the support determination function 756 determines whether the requirements set for the clinical event have been met based on the patient characteristic information. If it is determined that the supporter is unnecessary (step S26; No), the clinical support device 70 terminates the support determination process.

If the supporter is determined to be necessary (step S26; Yes), the supporter identification function 757, based on the support request information 743, determines whether the specialist identified by the request conditions set for the medical event It is determined whether there are more than one (step S27).

If there are not a plurality of specialists (step S27; No), the clinical support device 70 proceeds to step S29.

If there are multiple specialists (step S27; Yes), the information generation function 758 identifies the priority of each specialist based on the support request information 743 (step S28). As a result, for example, the information generation function 758 generates the supporter request information G15 for selecting a specialist who requests support in the order of priority indicated by the priority.

Based on the support request information 743, the supporter identification function 757 determines the specialist identified by the request conditions set for the medical event as the supporter to whom support is to be requested (step S29).

With the above, the clinical support device 70 ends the support determination process.

As described above, the clinical support system 1 according to the present embodiment acquires the patient information, the interview information 12, and the conversation information 51 related to the patient. In addition, the clinical support system 1 generates patient characteristic information indicating the patient's psychological and social aspects through analysis processing using the patient information, the inquiry information 12, and the conversation information 51. FIG. In addition, the clinical support system 1, based on the patient characteristic information, the patient's clinical event determined by the clinical event determination function 755, and the request conditions set in the support request information 743, identifies the support person to whom support is requested. judge. When the clinical support system 1 determines that the request condition is satisfied, the clinical support system 1 displays a medical treatment schedule screen G1 for requesting support. This allows medical professionals to consider whether to request support from each professional. Therefore, the clinical support system 1 can assist in determining whether or not to request support from a specialist.

Furthermore, the clinical support system 1 enables medical staff to request support from specialists suitable for individual patients at a time suitable for the patient. Therefore, medical staff can reduce their own burden and provide patients with comprehensive and high-quality medical care by supporters.

(Modification 1)
In this embodiment, it was explained that the information acquisition function 752 acquires patient information, interview information 12 and conversation information 51 . Furthermore, the information acquisition function 752 may acquire position information from the patient terminal 50, may acquire electroencephalogram information from the patient measurement terminal 60, or may acquire both of these information.

The location information is information indicating the location of the patient terminal 50 . In other words, the positional information is information indicating the patient's position. The feature analysis function 754 can extract the commute time by, for example, measuring the travel time from the patient's home to the workplace based on the location information and map information at each time. In a similar manner, feature analysis function 754 can extract hospital visit times. Further, the feature analysis function 754 can extract whether the patient is an active patient, a homebound patient, etc., based on the location information.

The electroencephalogram information is information indicating the electroencephalogram of the patient. For example, the information acquisition function 752 acquires electroencephalogram information indicative of the patient's electroencephalogram during a conversation with a healthcare professional. This allows the feature analysis function 754 to acquire the patient's state of mind during the conversation with the medical staff. For example, the feature analysis function 754 can extract whether the patient is relaxed, stressed, and the like.

This allows the feature analysis function 754 to analyze the patient in more detail. Therefore, the clinical support device 70 can determine in more detail whether or not to request support.

(Modification 2)
In this embodiment, the information generation function 758 generates the medical treatment schedule screen G1. Further, it has been explained that the display device 80 displays the medical treatment schedule screen G1. The information generation function 758 may display the medical treatment schedule screen G1 on the display 730 of the clinical support device 70, or may display it on another device.

(Modification 3)
When requesting support from a supporter, medical professionals must provide the supporter with the necessary information to proceed with treatment and care based not only on biological aspects, but also on the psychological and social aspects of the patient. to explain. By receiving the explanation, the supporter can provide support according to the patient's psychological and social aspects. Therefore, the information generation function 758 can generate not only the medical care schedule screen G1 but also a screen in which the patient's psychological and social aspects are classified into the patient's intention, peripheral matters, QOL (Quality of Life), etc. good. The display device 80 may display the screen generated by the information generation function 758 .

Here, the feature analysis function 754 shows the patient's biological, psychological, social, and other aspects through analysis processing using the patient information, interview information 12, and conversation information 51. Generate patient characteristic information. Furthermore, the feature analysis function 754 may classify information on biological aspects, psychological aspects, social aspects, and other aspects included in the patient feature information into predetermined items. In addition, the feature analysis function 754 may classify the biological, psychological, and social information included in the patient feature information into, for example, the patient's intentions, peripheral matters, QOL, and the like. In other words, the feature analysis function 754 may generate patient feature information classified according to predetermined classification items regarding the patient's psychological and social aspects. Furthermore, the feature analysis function 754 may classify classification items such as patient's intentions, peripheral matters, and QOL in stages, such as large classification, middle classification, and small classification.

The information generation function 758 generates a screen that displays patient characteristic information in stages of major, middle and minor categories in terms of patient's intentions, peripheral matters, and QOL. FIG. 9 is a diagram showing an example of a first classification screen G2 showing classification items up to middle classification according to Modification 3. As shown in FIG. The first classification screen G2 has a display area for displaying each classification item of medical indication, patient's intention, peripheral matter, and middle classification in QOL. The display area may display all of the classification items of the middle classification, or may display those of the classification items of the middle classification that are associated with the information included in the patient characteristic information. good too.

The first classification screen G2 also has a medical indication button G21, a patient's intention button G22, a peripheral matter button G23, and a QOL button G24. The medical adaptation button G21, patient's intention button G22, peripheral matter button G23, and QOL button G24 display the second classification screen G3 (see FIG. 10) showing classification items up to minor classifications included in the relevant large classification. It is a button that accepts an operation to

The information generation function 758 generates the second classification screen G3 of the corresponding major classification when any one of the medical indication button G21, patient's intention button G22, peripheral matter button G23, and QOL button G24 is selected. . FIG. 10 is a diagram showing an example of the second classification screen G3 according to Modification 3. As shown in FIG. The second classification screen G3 has small classification items outside the middle classification classification items. The classification items of the middle classification and the classification items of the small classification are connected by a lead line. As a result, the second classification screen G3 clearly indicates the relationship between the middle classification and the small classification and to which middle classification classification item the classification item of the small classification belongs. Further, the information generating function 758 may display the detailed information of the selected minor classification item when the minor classification item is selected on the second classification screen G3. Based on the patient characteristic information, the display device 80 generates screens such as the first classification screen G2 and the second classification screen G3 that show the patient's psychological and social aspects for each classification item.

In this way, the information generation function 758 classifies the patient characteristic information including the patient's psychological and social aspects into medical indications, patient intentions, peripheral matters, QOL, etc., as a first classification screen G2, and a second classification screen G3. Then, the display device 80 displays the first classification screen G2 and the second classification screen G3. Therefore, the supporter can provide support suitable for the patient based on not only the biological aspects but also the psychological and social aspects of the patient. Therefore, the information generating function 758 can support medical care in consideration of not only biological aspects but also psychological and social aspects.

According to at least one embodiment and the like described above, it is possible to assist in determining whether to request support from a professional.

While several embodiments have been described, these embodiments are provided by way of example and are not intended to limit the scope of the invention. These embodiments can be implemented in various other forms, and various omissions, replacements, changes, and combinations of embodiments can be made without departing from the scope of the invention. These embodiments and their modifications are included in the scope and spirit of the invention, as well as the scope of the invention described in the claims and equivalents thereof.

1 Clinical Support System 10 Hospital Information System (HIS)
11 Electronic chart information 12 Interview information 20 Radiology information system (RIS: Radiology Information Systems)
21 Interpretation report information 30 Medical image management system (PACS: Picture Archiving and Communication Systems)
31 image information 40 laboratory information system (LIS: Laboratory Information System)
41 Clinical test result information 42 Clinical test report information 50 Patient terminal 51 Conversation information 60 Patient measurement terminal 61 Personal health information 70 Clinical support device 80 Display device 741 Analysis target information 742 Medical event information 743 Support request information 751 Patient designation function 752 Information acquisition Function 753 Analysis target designation function 754 Feature analysis function 755 Medical event determination function 756 Support determination function 757 Supporter identification function 758 Information generation function 759 Operation input function 760 Support request function 761 Setting function G1 Medical treatment schedule screen G11 Patient summary information G12 Schedule information G13 Vital sign information G14 Supporter request button G15 Supporter request information G151 Message information G152 Supporter list information G153 Support request button G2 First classification screen G3 Second classification screen

Claims (11)

an acquisition unit that acquires patient information related to a patient, inquiry information that indicates the content of the patient's answers to the inquiry, and conversation information that records the conversation of the patient;
an analysis unit that generates patient characteristic information indicating psychological and social aspects of a patient by analysis processing using the patient information, the interview information, and the conversation information;
a determination unit that determines at least one support person who requests support based on the patient characteristic information, the patient's medical event, and request conditions for requesting support in the medical event;
a display control unit that displays a screen containing information about the supporter determined by the determination unit;
clinical support system. The display control unit displays information requesting support from a supporter,
The clinical support system according to claim 1. The display control unit displays information including information about the supporter in association with the time when it is determined that the request condition is satisfied.
The clinical support system according to claim 1. The display control unit displays information for selecting a supporter to request support from among the supporters registered for the request condition.
The clinical support system according to claim 1. The analysis unit generates the patient characteristic information classified according to predetermined classification items regarding the patient's psychological and social aspects,
The display control unit displays the patient's psychological and social aspects for each of the classification items based on the patient characteristic information.
The clinical support system according to claim 1. The determination unit determines at least one supporter who requests support based on the patient characteristic information, the medical event, the importance of the medical event, and the request condition.
The clinical support system according to claim 1. The display control unit displays a list of supporters whose support should be requested, based on the priority of the supporters.
The clinical support system according to claim 1. an input unit that receives an input for selecting a supporter who requests support;
A notification unit that notifies the supporter selected by the input unit of the support request,
The clinical support system according to claim 1. further comprising a first setting unit that sets the importance of the medical event;
The clinical support system according to claim 6. Further comprising a second setting unit that sets the priority of the supporter,
The clinical support system according to claim 7. an acquisition unit that acquires patient information related to a patient, inquiry information that indicates the content of the patient's answers to the inquiry, and conversation information that records the conversation of the patient;
an analysis unit that generates patient characteristic information indicating the patient's psychological and social aspects by analysis processing using the patient information, the interview information, and the conversation information;
a determination unit that determines at least one support person who requests support based on the patient characteristic information, the patient's medical event, and request conditions for requesting support in the medical event;
an information generation unit that generates a screen containing information about the supporter determined by the determination unit;
A clinical support device comprising

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