JP5426428B2 - Patient status information management system - Google Patents

Description

  The present invention relates to a patient state information management system, and more specifically, can grasp a patient's state and movement in real time at a hospital facility, a care facility, or a home medical care site, so that an accident such as a fall or a fall may occur in advance. The present invention relates to a patient status information management system that can be prevented.

  It is said that a large percentage of serious accidents that occur at hospital facilities, nursing homes, home medical care, home care, etc., are accidents such as patient falls and fractures due to falls. Especially when the patient is an elderly person, as a result of aging or past medical history, the degree of freedom of the limbs may be insufficient or the muscle strength to support themselves may be insufficient. There are times when it falls from the bed or falls. If a fracture occurs due to a fall or fall, the treatment takes extra time and money, and in the case of the elderly, there is a risk of causing a serious problem that it becomes difficult to resume walking on its own if the inability to walk is prolonged. There is sex.

  For this reason, conventionally, various management systems have been proposed that aim to grasp the patient's condition and movement in real time in order to prevent falls and fall accidents. For example, Patent Document 1 discloses a safety management system in which sensors such as a weight sensor are arranged on a bed, and these sensors detect that a patient is about to leave the bed. However, in this safety management system, the signal from the sensor placed on the bed is sent to the central control device via the nurse call terminal, and only a buzzer is sounded to alert the medical staff such as a nurse. Therefore, at that time, even though it can be known to which room the signal is, it disappears only at that time, and there is an insufficiency that nothing is recorded. In addition, because the sensor placed on the bed is always active, the patient can move on the bed even when a medical staff such as a nurse is dealing with it or someone is present. For example, there is a possibility that the buzzer of the central controller may sound, and it is difficult to determine whether or not the call from the safety management system is really urgent.

  Further, for example, Patent Document 2 discloses a care recipient monitoring system in which a signal from a sensor or the like indicating a patient's condition is recorded in a recording unit of a management apparatus. However, also in this monitoring system, the connection between various sensors and a management device and the association between various sensors and a patient are performed using an existing nurse call system. Therefore, for example, if the patient's room is changed and the correspondence between the nurse call slave unit and the patient in the nurse call system changes, the correspondence between signals from various sensors and the patient must be changed accordingly. However, there is a drawback that management of various sensor signals recorded in the management device is troublesome. Also in this monitoring system, since various sensors are always operating, signals from various sensors are transmitted to the management device and recorded even when medical staff are dealing with them. Has a disadvantage that it contains a lot of noise.

JP 2000-105885 A JP-A-2005-46320

  The present invention was made to eliminate the disadvantages and disadvantages of the conventional monitoring system as described above, and it is easy to associate a signal from a sensor for detecting the patient's condition with the patient, and to store it. It is an object of the present invention to provide a patient state information management system in which information to be generated is low in noise and a program for realizing such a system.

  As a result of intensive studies to solve the above problems, the present inventors installed a bedside terminal equipped with a means for recognizing a patient who is a user on the bedside of the patient, and used this bedside terminal as a client terminal. It has been found that if the signal from the sensor that detects the patient state is transmitted to the system, the signal from the sensor that detects the patient state can be easily associated with the patient. Furthermore, when the bedside terminal is not recognizing the patient who is the user, the present inventors provide a means for discarding the signal from the sensor as invalid, whereby noise stored in the information stored in the system. The present invention has been completed by finding that it is possible to greatly suppress the inclusion of.

That is, the present invention is connected to a state detection device including a sensor for detecting a patient state, and includes at least one client terminal having means for recognizing the ID number of a patient who is a user; A database server connected through a network; a management terminal connected to the database server through the network; patient information including at least a name of a patient to be managed, the patient information, and the ID number A patient information storage system for storing a correspondence relationship between
A) When the client terminal is in a state of recognizing the patient's ID number as a user, the database server determines that the patient state signal from the state detection device is valid information and the patient ID number together with the patient ID number. And a means for determining that the patient state signal from the state detection device is invalid information and discarding it when it is in a state where the ID number of the patient who is the user is not recognized;
A) The database server includes means for storing the patient status signal transmitted from the client terminal in a storage device in association with the received patient ID number and reception time;
C) The management terminal includes means for outputting the patient status signal stored in the database server to a monitor screen together with patient information stored in the patient information storage device;
By providing a patient state information management system, the above-described problems are solved.

  Moreover, this invention solves said subject by providing the program which described the procedure which makes a computer operate | move as the said client terminal in the patient status information management system of this invention, the said management server, or the said database server. Is.

  The state detection device including a sensor for detecting a patient state, the client terminal, or the database server includes a movement determination unit that analyzes an output signal of the sensor to determine movement of the patient. The patient status signal stored by the database server includes information related to the patient's movements determined by the movement determination unit. Examples of patient movement information include, for example, resting on the bed, active, getting on the bed, trying to get off the bed (predicting falling), getting off the bed, on the bed Information such as not being present or convulsions. If such patient movement information is included in the patient status signal, the patient status signal stored in the database server is sent via the management terminal to an appropriate monitor screen or the like, for example. By sequentially outputting to the output device, a medical staff such as a nurse can know in real time what the patient is currently on the bed.

  Moreover, the patient state information management system according to the present invention, in a preferred aspect thereof, the patient information stored in the patient information storage device is obtained by separately investigating a patient to be managed. It is desirable to include information about the risk of falling. The information about the risk of falls is, for example, information obtained by conducting a survey called fall and fall assessment on a patient-by-patient basis. It is. For example, if the information about the risk of falls is output together with the patient status signal on the monitor screen of the management terminal, the risk of falls and falls can be evaluated for each patient. Can be dealt with.

  Further, in a preferable aspect of the patient state information management system of the present invention, when the client terminal transmits a patient state signal from the state detection device as valid information to the database server, the monitor screen is displayed. And a means for displaying that the status information management for the patient is in the on state and displaying on the monitor screen that the status information management for the patient is in the off state when not being transmitted. . As a result, not only the patient but also medical staff such as caregivers and nurses can know whether the patient state information management system of the present invention is operating for the patient at the patient's bedside. For example, to prevent mistakes such as forgetting to operate the system or caring for the patient while the system is operating, so that a patient status signal that is originally noise is transmitted to the database server Can do.

  In addition, in a preferable aspect of the client terminal, the patient himself / herself, an attendant, a nurse and other medical staff appropriately turn on the operation of the patient state information management system as necessary at the patient's bedside. For example, an on / off button is provided on the screen in addition to on / off depending on whether or not the patient ID number is recognized.

  Furthermore, in a preferable aspect of the patient state information management system of the present invention, the database server turns on the state information management for the patient based on whether or not the patient state signal is transmitted from the client terminal. On / off state determination means for determining whether the patient is in an off state or not, and the patient state signal stored in the database server includes state information about the patient determined by the on / off state determination means Contains information about management on / off status. As a result, it is possible to confirm whether the patient status information management system of the present invention is operating for each patient even in a nurse station, for example, where a management terminal is installed. Mistakes can be prevented.

  Further, in a preferred aspect of the present invention, the database server includes means for determining whether or not an emergency response is necessary for each patient's motion determined by the motion determination means, and the database server stores the information. The patient status signal includes information regarding the necessity of emergency response for each of the patient's movements. The necessity of emergency response can be determined based on the determined movement. For example, if the determined motion is “going to get off the bed (falling fall prediction)”, the database server determines that this is motion that requires an emergency response. In addition, the movement of "getting out of bed" does not predict the risk of falling or falling in a healthy person, but the patient is an elderly person, the degree of freedom of the limbs is not enough, When there is a lack of muscle strength to support itself, it often falls from the bed or falls when trying to get off the bed, so the motion determination means is referred to as “falling fall prediction”. It is preferable to judge.

  If the determined movement is “convulsions”, the database server determines that this is movement that requires an emergency response. The information related to the necessity of emergency response includes information about the time at which the motion that is determined to require emergency response has occurred. It should be noted that what kind of movement is determined to be emergency movement needs to be set in the database server in advance, and it goes without saying that the setting can be changed as appropriate.

  When such information regarding necessity of emergency response is included in the patient status signal, the patient status signal stored in the database server is displayed on the monitor screen of the management terminal, for example, via the management terminal. By outputting sequentially, medical staff such as nurses can know in real time that the patient is in a state that requires emergency response, such as the patient is likely to fall or fall or is convulsed. By rushing to the patient's bed, it is possible to prevent falls or falls and to take necessary measures.

  Furthermore, the patient state information management system of the present invention is, in a preferred aspect thereof, the client terminal, a confirmation button, and means for transmitting a confirmed signal to the database server when the confirmation button is pressed. When the database server receives the confirmed signal, the database server stores at least the immediately confirmed mark requiring emergency response stored in the database server for the patient who is the user of the client terminal. It has means to attach. When the client terminal is equipped with such means, if a nurse rushes to the patient bed and performs the necessary treatment, the patient's emergency response from the client terminal on the patient's bedside Since it is possible to notify the database server that the movement requiring movement has already been handled, it is possible to prevent double correspondence.

  In addition, when the database server receives the confirmed signal, the database server not only needs the immediate response stored in the database server but also requires the emergency response for the patient issued in the past. You may make it attach | subject a confirmed mark to all.

  The patient state information management system of the present invention, in a preferred embodiment thereof, has at least one portable terminal for medical staff, and the patient information storage device includes a patient to be managed, a medical staff in charge, When the database server determines that the patient's movement determined by the movement determination unit requires urgent response, the database server stores it in the patient information storage device. Based on the correspondence relationship between the patient and the medical staff in charge, there is provided means for notifying the portable terminal of the medical staff in charge of the patient of the patient name and the movement that requires emergency response. This notification may be mail via a wireless LAN. As a result, even if the medical staff is away from the management terminal, the medical staff can immediately know that there has been a movement that requires emergency response for the patient he / she is in charge of, and rush to the patient's bedside to take the necessary action. Can be performed.

  Moreover, the patient state information management system of this invention has the portable terminal for at least 1 medical staff in the suitable one aspect | mode, The said patient information storage device and the patient in charge and the medical treatment in charge The correspondence relationship with the staff is memorize | stored, The said portable terminal is provided with the means to confirm regularly the presence or absence of the patient movement which requires emergency response with respect to the said database server, The said database server is the said portable terminal When the confirmation request is received from the patient, the correspondence between the patient and the medical staff in charge stored in the patient information storage device and the patient status signal stored in the database server are used. The mobile terminal is provided with means for notifying the mobile terminal of the presence or absence of movement requiring emergency response for the patient in charge of the medical staff who is the user. As a result, medical staff can update information on their mobile devices in real time regarding the presence or absence of movement that requires emergency response without waiting for notification from the database server. Can be detected without delay.

  The patient status information management system of the present invention is effective for a large number of patients who have beds in one or a plurality of hospitals or nursing care facilities, as well as home medical care in which beds are distributed in a certain area. Or it is effective also for the patient of home care.

  Since the patient state information management system of the present invention is configured as described above, the patient state signal detected by the sensor can be easily and reliably associated with the patient, and the patient state information can be easily managed. There is an advantage. In addition, when the patient state signal detected by the sensor is not associated with the patient, the signal from the sensor is discarded as invalid, so the patient state stored in the database server There is an advantage that noise can be prevented from being included in the signal, and only truly useful information can be stored as the patient state signal. In addition, by analyzing the signal from the sensor, it is possible to obtain information about the patient's movements in chronological order and determine the necessity of emergency response. There is an excellent advantage that necessary treatment can be performed.

It is a conceptual diagram which shows the whole structure of the patient state information management system of this invention. It is a figure which shows an example of the monitor screen which a client terminal outputs. It is a figure which shows another example of the monitor screen which a client terminal outputs. It is a figure which shows an example of the monitor screen which a management terminal outputs. It is a figure which shows the other example of the monitor screen which a management terminal outputs. It is a figure which shows the further another example of the monitor screen which a management terminal outputs.

  EXAMPLES Hereinafter, although this invention is explained in full detail based on an Example, it cannot be overemphasized that this invention is not restricted to the thing of an Example.

<System configuration>
FIG. 1 is a conceptual diagram showing the overall configuration of the patient state information management system of the present invention. In FIG. 1, 1 shows the patient status information management system of the present invention, M ₁ and M ₂ are patients, 2 ₁ and 2 ₂ are beds of patients M ₁ and M ₂ , respectively. In patients status information management system 1 of the present invention, the configuration of the equipment installed on the bed and bedside are basically the same for each bed, below, are placed around the bed 2 ₁ patient M ₁ will be described equipment (bed 2 ₂ peripherals patient M _2, are denoted by the same reference numerals as the bed 2 ₁ peripheral patient M _1). In FIG. 1, only two patients and two beds are shown, but the number of patients may be one or three or more. Of course, it may be more than a table.

1, 3 is a client terminal installed in bedside bed 2 _1, the client terminal 3, the state detection unit 4 is connected. The state detection device 4 is generally composed of sensors 5 and 5 that detect the state of the patient M ₁ and a controller 6 connected to the sensors 5 and 5. In patients status information management system 1 of the present invention, sensors 5, 5 constituting the state detection unit 4, as far as possible the detection state of the patient M _1, it may be of any type. For example, a strain sensor attached to a bed frame disclosed in Japanese Patent Application Laid-Open No. 2009-118935 may be used, or a weight sensor or a piezoelectric sensor installed in a bed as described in Patent Documents 1 and 2 Alternatively, it may be a photoelectric sensor, a biosensor for measuring the patient's body temperature, heart rate, respiration rate, blood pressure, etc., a CCD camera for photographing the patient's condition, or a combination of two or more of these. . As a matter of course, the number of sensors 5 and 5 is not limited to two as shown in FIG. 1, and may be one or three or more.

Further, the controller 6 may be anything as long as it can transmit signals from the sensors 5 and 5 to the client terminal 3. For example, it comprises means for analyzing the signals from the sensors 5 and 5 and discriminating the movement of the patient M ₁ , and transmits the discrimination information to the client terminal 3 together with the signals from the sensors 5 and 5. Alternatively, only the information related to the determined movement and movement may be transmitted to the client terminal 3, and further, the signal from the sensors 5 and 5 may be removed by, for example, removing noise or amplifying the movement and movement. The sensor signal may be transmitted only to the client terminal 3 as a sensor signal having a quality improved to the extent possible.

7 is a non-contact IC card reader / writer, and 8 is an IC card. IC card 8 is usually because it has a unique number for each card, using a card-specific ID of the IC card 8 as the ID number of the patient M _1. Instead of the card-specific ID of the IC card 8, as such the ID number of the patient M ₁ existing patient number or newly assigned patient number, may be stored in the IC card 8.

Reference numeral 9 denotes a database server, 10 denotes a management terminal, and 11 denotes a network. The client terminal 3, the database server 9, and the management terminal 10 are always or occasionally connected via the network 11. The network 11 is an in-hospital or in-facility network when the beds 2 ₁ , 2 ₂ etc. are in the same hospital or the same care facility, but may be a general-purpose network such as the Internet.

  A hospital information system server 12 is also connected to the network 11, and a portable terminal 13 is connected to the network 11 via a wireless LAN. Although the mobile terminal 13 is always carried by a medical staff and only one is shown in the figure, it goes without saying that there are two or more mobile terminals 13 corresponding to the number of medical staff. Absent.

  The hospital information system server 12 usually has patient information such as patient number, name, date of birth, age, gender, address, emergency contact, insurance number, department, disease name, doctor in charge, nurse in charge, The person in charge, password, biometric information, and the like are stored, and when a medical staff such as a doctor or a nurse possesses a mobile terminal, the mobile terminal number and mail address are also stored. When the unique number of the IC card 8 distributed to the patient is used as the patient ID number, the hospital information system server 12 also has a correspondence between the unique number of the IC card 8 distributed to the patient and the patient information. It will be remembered. In this case, the hospital information system server 12 functions alone as a patient information storage device in the patient state information management system 1 of the present invention.

  Note that the correspondence between the unique number of the IC card 8 distributed to the patient and the patient information does not necessarily have to be stored in the hospital information system server 12, but the database server 9 or the management terminal 10, Or you may memorize | store in the server provided separately. In this case, the hospital information system server 12 that stores patient information, the database server 9 that stores the correspondence between the patient ID number and the patient information, the management terminal 10, or a separately provided server It functions as a patient information storage device in the patient status information management system 1 of the invention. Further, the hospital information system server 12 may exist not in the hospital facility but in a data center or the like.

  In the patient state information management system 1 of the present invention, the hospital information system server 12 is not necessarily essential. That is, when there is a server or the like that stores patient information other than the hospital information system server 12, the server or the like may be used as a storage source for patient information, and the patient state information management system 1 of the present invention. A server for storing patient information may be provided. However, since it is very labor intensive to newly input patient information into a server or the like, there is already a server that stores patient information, such as the existing hospital information system server 12. In this case, it is desirable to use the server as a patient information storage source, as a patient information storage device in the patient state information management system 1 of the present invention, or as a part thereof.

  The patient information stored in the patient information storage device of the patient state information management system 1 of the present invention preferably includes information on the risk of falls and falls for individual patients obtained by the fall / fall assessment. . The fall and fall assessment refers to which items each patient falls into regarding multiple items related to the degree of health impairment, the ability to move, whether there are changes in the environment, the type of drugs used, the state of excretion, life experience, etc. The numerical value obtained by summing up the numerical values assigned to the corresponding items is used as an index of the degree of risk. The greater the total number, the higher the degree of danger. For example, 0 to 10 are classified into rank A, 11 to 20 are classified into rank B, 21 and above are classified into rank C, and rank C has the highest degree of danger. Information on the degree of risk obtained by such a fall / fall assessment may be stored in the hospital information system server 12, or stored in the database server 9, the management terminal 10, or a separately provided server. Also good.

<System operation>
For patients M ₁ bed 2 _1, the patient status information management system 1 of the present invention starts the operation as follows. That is, when the patient M ₁ or a nurse or the like at the bedside places the IC card 8 of the patient M ₁ on the non-contact IC card reader / writer 7, the non-contact IC card reader / writer 7 is stored in the IC card 8. It reads the card-specific number and a patient ID numbers M _1, the client terminal 3 connected to the non-contact IC card reader-writer 7, recognizes that the user of the client terminal 3 is a patient M _1. ID number of the patient M ₁ stored in the IC card 8 is not a unique number of the IC card 8, even existing patient number for a patient M _1, newly assigned patient number on the patient M ₁ It may be as described above.

On the other hand, the sensor 5 and 5, and detects the state and movement of the patient M ₁ that are on the bed 2 _1, and sends a detection signal to the controller 5. The sensors 5 and 5 and the controller 6 constitute the state detection device 4 as described above. Controller 6, if based on the signal from the sensor 5, 5 comprises a movements discriminating means for discriminating movements of the patient M ₁ that are on the bed 2 _1, i.e., the signal from the sensor 5, 5 to the controller 6 If the basis to program describing an algorithm to determine the movements of the patient M ₁ that are on the bed 2 ₁ is installed, the controller 6 in accordance with the program analyzes the signals from the sensors 5,5, the patient The movement of M ₁ is, for example, “rest” (resting on the bed), “activity” (acting on the bed), “getting on” (boarding), “leaving” (Exit from bed), “absence” (not on bed), “convulsions” (convulsions), “falling fall prediction” (approaching from bed), etc.

For example, when the sensor 5 and 5 is the strain sensor mounted on the bed frame of the bed 2 _1, the sensor 5,5, only body movement according to the heartbeat of the patient M ₁ is detected, a large body movement to other Is not detected, “activity” when posture change or movement of the upper or lower limbs is detected, “getting on” or “getting off”, “getting off” when a specific waveform is detected "to continue when not detected body motion according to the heartbeat" absent ", when vibration due to spasm is detected" spasm ", the weight of the patient M ₁ is gradually moved or is moving to the edge of the bed Is detected by the controller 6 as “falling fall prediction”.

  However, the type of movement and the determination method thereof described above are merely examples, and may be changed as appropriate depending on the type of sensor to be used, its arrangement, combination, and the like. In the patient state information management system 1 according to the present invention, it is only necessary to determine whether the patient is moving or not based on a signal from a sensor that detects the patient's state or movement. In addition, the type of movement to be determined is not limited to a specific one. For example, when using the above-described biological sensor that measures the patient's body temperature, heart rate, respiration rate, blood pressure, etc., the body temperature, heart rate, respiration rate, or blood pressure detected by the sensor exceeds a certain value. When it rises or falls, the movement determination unit may determine the movement of the patient as “abnormal body temperature”, “abnormal heart rate”, “abnormal respiration rate”, or “abnormal blood pressure”. When the sensor is a photographing device such as a CCD camera that photographs the patient's condition, the captured image is analyzed, and the motion determination means determines whether the patient is moving or not. It is also possible to determine that “they are”), “convulsions”, “rest”, “absence”, and the like.

The determination as described above by the movement determination unit is executed at intervals of, for example, once every 5 seconds, preferably once every 3 seconds, and more preferably once every 1 second. Thus, movements of the patient M ₁ is determined substantially in real time by the controller 6, as the information about the movements are sent to the client terminal 3. At this time, the controller 6 improves the quality by removing or amplifying noise from the raw sensor signals from the sensors 5 and 5 or the raw sensor signals as the basis of the determination of movement in addition to the information about movement. The sensor signal may also be sent to the client terminal 3 together.

The client terminal 3 that has received the information about the movement of the patient M ₁ from the controller 6 constituting the state detection device 4 together with the sensors 5 and 5 is in a state of recognizing the ID number of the patient M ₁ at that time. , information about the received dynamic and stationary, if there is a sensor signal which is also in conjunction, it is determined that the valid information, as the patient condition signals, together with the ID number of the patient M _1, is sent to the database server 9.

Database server 9 receives the ID number of the patient condition signals and patient M ₁ from the client terminal 3 via the network 11, the received patient condition signals, in association with the ID number and the reception time of the patient M ₁ received Store in the storage device. Further, the database server 9 includes means for determining whether or not the movement requires urgent action based on the information related to the movement of the patient included in the received patient status signal. The determination result is included in the patient status signal and stored in the storage device as information on the necessity of emergency response regarding the movement. The determination as to whether or not individual movements included in the received patient status signal require emergency response is to determine what of the movements determined by the movement determination means determines that emergency response is required. For example, the data can be specified in advance in the storage device of the database server 9, and the database server 9 can refer to the specified contents as needed. Examples of movements that require urgent action include “falling fall prediction” and “convulsions”, but are not limited thereto.

In the case where the sensors 5 and 5 are biological sensors that measure the body temperature, heart rate, respiratory rate, blood pressure, etc. of the patient M ₁ , “abnormal body temperature”, “abnormal heart rate”, Movements such as “abnormal respiratory rate” or “abnormal blood pressure” may be stored in advance in the storage device of the database server 9 as movements requiring emergency response, and the sensors 5 and 5 are in the state of the patient M ₁ . In the case of a photographing apparatus such as a CCD camera for photographing the movement of “falling fall prediction” or “convulsions” of “going to get off the bed” determined by the operation determining means based on the captured image. Alternatively, it may be stored in the storage device of the database server 9 as a motion requiring emergency response.

Meanwhile, when receiving information from the controller 6 constituting the state detection device 4 regarding movements of the patient M _1, if a state in which the client terminal 3 does not know the ID number of the patient M _1, the client terminal 3 If the sensor signal is received, the received information related to movement is judged as invalid information and discarded, and is not transmitted to the database server 9. The state where the client terminal 3 does not recognize the ID number of the patient M ₁ is, for example, a state where the IC card 8 is not placed on the non-contact IC card reader / writer 7.

In the above example, by either not loaded or put the IC card 8 on the non-contact IC card reader-writer 7, the client terminal 3, or in a state that recognizes the ID number of the patient M _1, I do not know While it switched or condition is, separately, the client terminal 3, the recognition of the ID numbers patient M _1-on, may be provided with means for turning off. For example, by providing an on / off button on the monitor screen of the client terminal 3 and touching either the on / off button with the IC card 8 placed on the non-contact IC card reader / writer 7, the client on recognition of patient M ₁ ID number by the terminal 3, to be off. In such a case, even when carrying the IC card 8 on the non-contact IC card reader-writer 7, touching off button on the monitor screen, the client terminal recognizes the ID number of the patient M ₁ The information regarding the movement of the patient M ₁ from the state detection device 6 is determined as invalid information by the client terminal 3 and discarded.

In addition the above-described example, the case where the controller 6 constituting the state detection device 4 is provided with a movements discriminating means for discriminating movements of the patient M ₁ based on the signal from the sensor 5, 5 are on the bed 2 ₁ As described above, the movement determination unit may be included in the client terminal 3, or may be included in the database server 9 or other server connected via the network 11. When the controller 6 does not have a means for determining the movements of the patient M _1, the controller 6, the signal from the sensor 5, 5, for example, noise or to remove, or by amplification, the determination of the movements As described above, the sensor signal is transmitted to the client terminal 3 as a sensor signal whose quality is improved to the extent possible.

  Hereinafter, based on the monitor screen of the client terminal 3 and the management terminal 10, operation | movement of the patient state information management system 1 of this invention is demonstrated in detail.

<Client terminal>
FIG. 2 is an example of a top menu displayed on the monitor screen of the client terminal 3. The client terminal 3 is used as a bedside terminal to provide medical information such as medicine and medical records to a patient, and to provide entertainment and information tools such as a television and the Internet. In the invention, it is used as a client terminal.

As shown in FIG. 2, an area α for the patient state information management system of the present invention is provided in the lower part of the top menu screen of the client terminal 3, and the current time β is displayed in the upper left. At the far left of the region α, “absent” is displayed as “current state”, and below that, “13:52:10” when “absent” is displayed. In other words, the patient M ₁ is a user of the client terminal 3, will be absent from the bed to 13 at 52 minutes and 10 seconds, the current still, will not stay in on the bed. It goes without saying that the determination of movement as “absence” is performed by the movement determination unit described above.

In addition, when the controller 6 is provided with a means for determining whether the controller 6 is moving or not, the client terminal 3 is directly displayed on the screen of the client terminal 3 on the screen of the client terminal 3 based on the information related to moving and moving, such as “absence”. information may also be displayed about, but usually, information about the current movements contained in patient condition signals for the patient M ₁ stored in the database server 9, from the database server 9, the client terminal 3 is displayed on the screen of the client terminal 3.

  There is a display of “monitoring OFF” to the right of “absence”, and the client terminal 3 currently determines that the patient status signal from the status detection device 4 is invalid and discards it, and the database server 9 or This indicates that the management terminal 10 is not transmitting. “Monitoring OFF” means that the IC card 8 is not placed on the non-contact IC card reader / writer 7 and the client terminal 3 does not recognize the ID number of the patient who is the user. Because there is.

Further, on the right side, “fall / fall prediction” as the “necessary action event” and the date and time “2009/11/3 10:12:28” when the prediction was made are displayed. When the database server 9 determines that the movement / stabilization included in the received patient condition signal is movement / requisition requiring emergency response, the display of the “action required” column and the reception time Is transmitted to the client terminal 3. Since the current time β is “11/11/2009 PM 03:15” as displayed in the upper left corner of FIG. 2, the latest time transmitted from the database server 9 to the client terminal 3 for the patient M ₁ It can be seen that “fall prediction” is more than a week ago.

There is a “confirm” button next to the date of “fall / fall prediction”. When this “confirm” button is pressed, the client terminal 3 transmits a confirmed signal to the database server 9. When the database server 9 receives the confirmed signal from the client terminal 3, for the patient M ₁ who is the user of the client terminal 3, a mark that has been confirmed in the “prediction of fall and fall” immediately before the database server 9 stores To change from an unconfirmed state to a confirmed state. At the same time, the database server 9 changes the “fall / fall prediction” sent to the client terminal 3 from unconfirmed to confirmed. As a result of this change, the client terminal 3 initially stops the blinking of the “falling fall prediction” display, which has been flashing red, for example, and has changed the color from red to green. Indicates a past event that has already been confirmed and does not require urgency.

When the database server 9 receives the confirmed signal, it is considered that the database server 9 was confirmed or treated at the same time by the confirmation work as well as the “falling / falling prediction” immediately before stored in the database server 9. You may make it attach | subject a confirmed mark to all the movements which require emergency responses, such as the past unconfirmed "fall fall prediction" and "convulsions". Alternatively, patients who have been issued within a certain period of time, for example, within 30 minutes or within one hour from the receipt of the above confirmed signal, instead of attaching a confirmed mark to all the unconfirmed urgent actions requiring past emergency response for unconfirmed movements that require emergency response for M ₁ may be denoted by a verified mark. The same applies to the case where the “required action event” displayed on the monitor screen of the client terminal 3 is “convulsions” or other movements that require emergency response.

On the right side of the “Confirm” button, there is a display of “Danger Level C27” as “Fall and Fall Assessment”. This display is stored, for example, in the hospital information system server 12 when the client terminal 3 first recognizes the ID number of the patient M ₁ and transmits the patient state signal from the state detection device 4 to the database server 9. The database server 9 reads out the degree of risk of the patient M ₁ that has been read and transmits it to the client terminal 3 to be displayed. Display of the degree of risk, or the client terminal 3 recognizes the ID numbers of other patients without the patient M _1, until risk of patient M ₁ stored in the hospital information system server 12 is changed, the client terminal 3 is in a state that recognizes the ID number of the patient M _1, regardless or not, it is displayed as is.

  FIG. 3 shows a top menu screen of the client terminal 3 after two minutes have elapsed from the state of FIG. As shown in FIG. 3, the “current state” is changed from “absent” to “rest”, and “rest” is “15:17:30”, that is, 3:17 pm It turns out that it is 30 seconds. Needless to say, the determination of “rest” is also made by the above-described movement determination unit.

There is a display of the right of "rest", "monitoring ON", the patient M ₁ was back on the _bed, or, the medical staff of nurses, such as it is confirmed that the patient M ₁ is returned to the bed, the patient M by carrying the _first IC card 8 on the non-contact IC card reader-writer 7, it indicates that in the state in which the client terminal 3 recognizes the ID number of the patient M _1. In this state, the client terminal 3 transmits the patient state signal from the state detection device 4 to the database server 9 as valid information.

<Management terminal>
FIG. 4 shows an example of a “target patient list” monitor screen output by the management terminal 10. As shown in the figure, the current time β is displayed in the upper right corner of the screen, and below it is “patient room”, “bed”, “patient number”, “patient name”, “current status”, “latest unconfirmed event ( Prediction) ”,“ monitoring ”, and“ risk ”items are provided, and these pieces of information about individual patients are displayed for each patient.

  Information about “hospital room” and “bed” can be obtained from information regarding the installation location of the client terminal that transmits a patient status signal for each patient. Information regarding the installation location of the client terminal may be stored in, for example, the hospital information system server 12, or stored in the client terminal 3, the database server 9, the management terminal 10, or another server on the network 11. May be. The “patient number”, “patient name”, and “risk level” can be read from, for example, patient information stored in the hospital information system server 12 based on the patient ID number recognized by the client terminal 3. .

  In addition, information regarding “current status” and “latest unconfirmed event (prediction)” can be obtained from a patient information signal stored in the database server 9. The information displayed in the column of “latest unconfirmed event (prediction)” is information about what is an emergency response such as “falling fall prediction” or “convulsions”, and this information includes , Information on how many seconds (or minutes) before the time when these movements occurred can be included.

  For example, when the patient information signal is constantly transmitted from the client terminal 3, the database server 9 determines that “monitoring is on” and the information about “monitoring” is on / off. As described above, when the patient information signal is not transmitted from the client terminal 3, it can be obtained by the database server 9 determining “monitoring off”. The information “monitoring on” or “monitoring off” determined by the database server 9 is included in the patient status signal together with the time of the determination and stored in the database server 9.

  Since the patient information management system 1 of the present invention has a list of all patients targeted by the system in the patient information storage device as patient information, the “target patient” shown in FIG. A screen like "List" can be output. By outputting such a “target patient list” screen, it is possible to look down on the status of all the patients to be managed, and to check whether there is any omission of monitoring. For example, since the patient in the bed 101 is “absent” and the “monitoring” may be “OFF”, the patient in the bed 305 is still displayed as “rest” and “monitoring” is performed. Since it is “OFF” and the IC card 8 has fallen from the non-contact IC card reader / writer 7 or forgotten to be loaded for some reason, a medical staff such as a nurse goes to the patient's bedside. It is clear that the situation needs to be confirmed.

  In addition, the patient of bed 102 is “current” is “getting out of bed”, that is, is in the state of getting out of bed, and “prediction of falling” has appeared 30 seconds ago, so rushed to confirm the current situation I know you need to do that. In particular, the patient in the bed 102 has a high “risk” of “C27”, and the risk of falling and falling is extremely high. The patient in the bed 501 has "convulsions" 60 seconds ago, and it is necessary to rush to this patient and confirm the current situation. In FIG. 4, only information for 10 patients is shown, but the monitor screen can be scrolled up and down, and it is a matter of course that the same display can be performed for all patients to be managed.

  The “target patient list” as shown in FIG. 4 can be outputted by variously arranging the displayed items as keys. For example, it is possible to display in order of degree of risk or patient name, to extract and output only target patients whose monitoring is turned off, or to display in various forms as necessary. Further, for example, age, sex, and past history that are not displayed in the example of FIG. 4 can be displayed together, or these items can be rearranged in various ways and output. The output destination may be a monitor screen as shown in FIG. 4, a printer, or another server connected via the network 11.

  FIG. 5 is another output example of the management terminal 10 and is a screen on which patient status signals for a specific patient are displayed in time series. The screen as shown in FIG. 5 is switched and displayed by, for example, clicking the name of the desired patient on the screen shown in FIG.

  The example of FIG. 5 displays the patient status signal stored in the database server 9 for the patient in the bed 101 in FIG. 4. In the area indicated by γ at the top of the screen, “reference date and time”, “ "Display width" and "Unit" are displayed. As is clear from the display in these sections, the screen of FIG. 5 is included in the patient status signal every 10 minutes in a 2-hour width with reference to midnight on November 11, 2009. The movement of the patient is displayed in time series. It should be noted that the numbers displayed in each movement column such as “absence” and “boarding” indicate the number of times such a determination has been made. For example, looking at the column from 0:00 am to 10 minutes, the patient is judged to be “boarding”, that is, to get on the bed, and then to be “active” twice. That is, it can be seen that a fall / fall prediction has been made. Needless to say, the reference date and time, display width, and display unit can be changed as appropriate.

  FIG. 6 is a diagram showing still another example of the monitor screen output by the management terminal 10, which is an “unconfirmed fall / fall prediction list”. That is, it is determined by the motion determination means that it is “falling fall prediction”, and even though the database server 9 determines that an emergency response is necessary, the medical staff such as a nurse is still confirming the site. Those that are not displayed are displayed in order from the oldest predicted time. Regarding the patients displayed in this “Unconfirmed Falling Fall Prediction List”, it is necessary to immediately rush to the patient's bedside to check the current situation, but nurses and other medical staff display in the “Unconfirmed Falling Fall Prediction List” The priority order can be determined in consideration of the information on how many minutes before the predicted prediction has been made and the “risk level” displayed in the same manner. In addition, the “unconfirmed fall / fall prediction list” as shown in FIG. 6 is displayed on the same screen as the “target patient list” shown in FIG. You may do it.

  For “convulsions” instead of “fall / fall prediction”, “unconfirmed list of convulsions” may be displayed in the same way, and “emergency response” is combined with “fall / fall prediction” and “convulsions”. It may be displayed as a “necessary unconfirmed movement list”. Furthermore, in addition to or in place of "fall fall prediction" and "convulsions", movements such as "abnormal body temperature", "abnormal heart rate", "abnormal respiratory rate", or "abnormal blood pressure" If these are movements and actions requiring urgent action and unconfirmed, they may be displayed as an “unconfirmed action and movement list requiring urgent action”.

<Bedside support>
The medical staff who rushed to the patient's bedside by looking at the “unconfirmed fall prediction list” as shown in FIG. 6 displayed on the monitor screen of the management terminal 10 first confirms the current situation and checks the patient's safety. When the IC card 8 is removed from the contactless IC card reader / writer 7 or the client terminal 3 is provided with a button for turning on / off the recognition of the patient ID number, etc. Turn off monitoring, for example by pressing a button. Thus, for example, even if the patient is lowered from the bed, placed on the bed, or moved on the bed with the assistance of a medical staff, the sensors 5 and 5 corresponding to such an operation are used. Signals and information about patient movement based on these signals are not transmitted to the database server 9. Since the patient status signal obtained when the patient is moved, for example, by medical staff assistance, can be said to be noise rather than the original patient status signal, such patient status signal is sent to the database server 9. Not being stored has the advantage of preventing the patient status signal stored in the database server 9 from containing noise and allowing only truly useful information to be stored as the patient status signal. Is.

  When the patient can be returned to a safe state, a medical staff such as a nurse presses the “confirm” button displayed in the region α in FIG. 2 to confirm that the fall / fall prediction has been confirmed. The server 9 is notified. The database server 9 that has received the notification that it has been confirmed adds a mark of “confirmed” to the fall prediction as described above, and changes from the unconfirmed state to the confirmed state. As a result, the fall / fall prediction is deleted from the “unconfirmed fall / fall prediction list” shown in FIG. 6. Also, the “target patient list” shown in FIG. 4 disappears from the “latest unconfirmed event (prediction)” column.

<Notification to mobile device>
In the above description, a medical staff such as a nurse looks at the monitor screen of the management terminal 10 to know the presence or absence of a patient requiring emergency response. However, the present invention has a function of notifying a mobile terminal. According to the patient state information management system 1, even when the medical staff is away from the management terminal 10, it is possible to know the presence or absence of movement requiring emergency response for the patient in charge.

  That is, when the received patient state signal includes information related to movement and movement that are determined to be emergency, the database server 9 wirelessly transmits to the portable terminal 13 of the medical staff in charge of the patient. Notification of the occurrence of movement requiring emergency response is sent by e-mail or the like via a network such as a LAN or the Internet. The notified information includes the type of movement requiring emergency response, the time of occurrence thereof, and the corresponding patient name. In some cases, the patient's room number and bed number may be notified together. The correspondence relationship between the patient, the medical staff in charge, and the e-mail address and unique number of the mobile terminal of the medical staff in charge is stored in, for example, the hospital information system server 12 constituting the patient information storage device, and the database server 9 Reads out this information from the hospital information system server 12 and automatically notifies the mobile terminal 13 of the medical staff in charge of the occurrence of movement requiring emergency response. Thereby, even when the medical staff is away from the management terminal 10, the medical staff can know the occurrence of movement that requires urgent action for the patient in charge, and rush to the patient's bedside to take necessary measures. Can be applied.

  However, since there may be a time lag of several seconds to several tens of seconds in the notification by e-mail from the database server 9, the mobile terminal 13 determines whether or not the patient is in need of emergency response to the database server 9. You may make it check regularly. That is, the portable terminal 13 transmits a signal requesting confirmation of the presence or absence of patient movement requiring emergency response to the database server 9 at an interval of once every several seconds, for example. This signal naturally includes information about the mail address or unique number of the mobile terminal 13. Upon receiving such a confirmation request signal, the database server 9 searches the patient status signal stored in the database server 9 for the patient in charge of the user of the mobile terminal 13 and is in a state where an emergency response is required. If there is an unconfirmed item, the type of movement, occurrence time, and patient name are transmitted to the portable terminal 13. At this time, of course, the patient's hospital room number and bed number may be notified together.

  Note that information on who the medical staff who is the user of the mobile terminal 13 is in charge is stored in patient information such as the hospital information system server 12 based on the mail address or unique number of the mobile terminal 13. Can be obtained from the device.

  In this way, when not periodically waiting for notification from the database server 9 but periodically checking the database server 9 from the mobile terminal 13 for the presence or absence of movement requiring emergency response, the mail from the database server 9 Since there is no time lag from when the notification is sent to the mobile terminal 13, even if a medical staff such as a nurse is away from the management terminal 10, It is possible to know the presence / absence in real time and to obtain an excellent advantage that quick response is possible.

  The operations of the client terminal 3, the database server 9, and the management terminal 10 described above are realized by a computer program that is programmed to cause the computer to operate as the client terminal 3, the database server 9, or the management terminal 10, respectively. Needless to say.

  The above description is based on the assumption that a plurality of patients are present in a single hospital. However, the patient status information management system of the present invention is not limited to a plurality of patients or care recipients present in a single hospital or care facility. It is not intended only for the person. The patient targeted by the patient status information management system of the present invention may be a plurality of patients or care recipients present in two or more separate hospitals or care facilities, and may be separated depending on home medical care or home care. It may be a plurality of patients or care recipients individually existing in the house.

  As described above, according to the patient state information management system of the present invention, since it is easy to grasp and manage the movements of a plurality of patients in real time, it is possible to prevent accidents such as falls and falls, It is extremely useful for responding to emergency situations such as "abnormal body temperature" and "abnormal heart rate", contributing to the improvement of safety in home medical care and home care as well as hospital facilities and nursing homes. There is a great deal of availability.

DESCRIPTION OF SYMBOLS 1 Patient state information management system 2 ₁ , 2 ₂ beds 3 Client terminal 4 State detection device 5 Sensor 6 Controller 7 Non-contact IC card reader / writer 8 IC card 9 Database server 10 Management terminal 11 Network 12 Hospital information system server 13 Portable terminal M ₁ , M ₂ patient α Area for patient condition information management system β Current time γ “Reference date / time” “Display width” “Unit” area

Claims (10)

At least one client terminal connected to a state detection device having a sensor for detecting the patient's state and having means for recognizing the ID number of a patient who is a user; connected to the client terminal via a network A database server; a management terminal connected to the database server via a network; and patient information including at least a name of a patient to be managed, and a correspondence between the patient information and the ID number A patient status information management system comprising: a patient information storage device;
A) When the client terminal is in a state of recognizing the patient's ID number as a user, the database server determines that the patient state signal from the state detection device is valid information and the patient ID number together with the patient ID number. And a means for determining that the patient state signal from the state detection device is invalid information and discarding it when it is in a state where the ID number of the patient who is the user is not recognized;
A) The database server includes means for storing the patient status signal transmitted from the client terminal in a storage device in association with the received patient ID number and reception time;
C) the management terminal, the patient condition signals stored in the database server, with the patient information stored in the patient information storage device, comprising means for outputting to the monitor screen; Furthermore,
D) The state detection device, the client terminal, or the database server includes a movement determination unit that analyzes the output signal of the sensor to determine movement of the patient on the bed, and the database server stores the movement detection unit. The patient status signal includes information related to the patient's movement determined by the movement determination means;
Patient status information management system. The patient status information according to claim 1, wherein the patient information stored in the patient information storage device includes information on a risk of falling and falling obtained by separately investigating a patient to be managed. Management system. When the client terminal is transmitting a patient status signal from the status detection device to the database server as valid information, the status information management for the patient is on in the monitor screen. The patient status information management system according to claim 1 or 2, further comprising means for displaying on the monitor screen that status information management for the patient is in an off state when the message is not transmitted. The patient state information management system according to any one of claims 1 to 3 , wherein the client terminal includes means for turning on / off recognition of a patient ID number. The database server includes on / off state determination means for determining whether state information management for the patient is in an on state or an off state based on whether or not a patient state signal is transmitted from the client terminal. provided, the patient condition signals the database server stores the any of claims 1 to 4, which contains information about the on-off state of the status management on the patient, wherein the on-off state determination means has determined The patient status information management system described in Crab. The database server includes means for determining whether or not an emergency response is necessary for each patient movement determined by the movement determination means, and the patient status signal stored in the database server includes the patient movement The patient state information management system according to any one of claims 1 to 5 , wherein information on whether or not an emergency response is required is included. The client terminal includes a confirmation button and means for transmitting a confirmed signal to the database server when the confirmation button is pressed. When the database server receives the confirmed signal, the client terminal The patient state information management system according to claim 6 , further comprising means for attaching a confirmed mark to a movement requiring at least the immediately preceding emergency response stored in the database server for a patient who is a user of the terminal. The patient status information management system further includes at least one portable terminal for medical staff, and the patient information storage device stores a correspondence relationship between a patient to be managed and a medical staff in charge. When the database server determines that the patient's movement determined by the movement determination unit requires emergency response, the database server stores the patient stored in the patient information storage device and the medical staff in charge. 8. The patient state information management system according to claim 6 or 7, further comprising means for notifying the portable terminal of the medical staff in charge of the patient of the patient name and the movement requiring emergency response based on the correspondence relationship. The patient status information management system further includes at least one portable terminal for medical staff, and the patient information storage device stores a correspondence relationship between a patient to be managed and a medical staff in charge. The portable terminal includes means for periodically transmitting a confirmation request signal requesting the database server for confirmation of the presence or absence of patient movement requiring urgent action; When the confirmation request signal is received , the correspondence between the patient and the medical staff in charge stored in the patient information storage device and the patient status signal stored in the database server are used. A request provided with a means for notifying the mobile terminal of the presence or absence of movement requiring emergency response for the patient in charge of the medical staff who is the user. Claim 6 or 7 patient state information managing system according. The program which described the procedure which operates a computer as the said client terminal in the patient status information management system in any one of Claims 1-9 , the said management terminal , or the said database server.

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