JP6361249B2 - Medication guidance support system, medication guidance support method - Google Patents

Description

  The present invention relates to a medication guidance support system and a medication guidance support method for supporting medication guidance work performed by a pharmacist in a medical institution such as a hospital.

  In a medical institution such as a hospital, prescription data is issued by inputting a medical record and prescription content into an electronic medical record system, and a medicine is dispensed based on the prescription data. Thereafter, the medicine dispensed based on the prescription data is taken by a patient admitted to the ward. A prescription inspection system is known that can perform a prescription check that automatically determines the suitability of the prescription data before dispensing medicine based on the prescription data (see, for example, Patent Document 1).

  By the way, in a ward of a medical institution, a medication instruction work related to medication of a hospitalized patient may be performed by a pharmacist. Specifically, in the medication guidance work, the pharmacist self-confirms or confirms with the patient the prescription list of the medication and the state of the patient before or after taking the medication by the patient. Is included. Thus, unified medication guidance can be realized by performing medication guidance work according to the problem list.

JP 2013-125377 A

  However, as the number of confirmation items included in the problem list increases, the burden of confirmation work on the problem list in the medication instruction work increases.

  An object of the present invention is to provide a medication guidance support system and a medication guidance support method that can reduce the burden of checking a problem list in medication guidance work.

  The medication instruction support system according to the present invention includes an acquisition processing unit and a display control unit. The said acquisition process part acquires the check result of the prescription check which determines whether 1 or several 1st confirmation item is appropriate before prescription about prescription data. When the display control unit outputs a problem list including one or a plurality of second confirmation items before or after taking the medicine dispensed based on the prescription data, the check result among the second confirmation items. The third confirmation item that can be determined to be confirmed based on the content of the item can be output in a different output mode from the fourth confirmation item of the second confirmation item excluding the third confirmation item.

  According to the present invention, when the problem list is output, a pharmacist can grasp the presence of the third confirmation item included in the second confirmation item, and perform confirmation work on the third confirmation item. It can be omitted. Therefore, the burden of checking the problem list in the medication instruction work of the pharmacist is reduced.

  More specifically, the third confirmation item is the same item as the first confirmation item determined to be appropriate in the prescription check, or the first confirmation item determined to be appropriate in the prescription check. It is conceivable that the item is previously associated with the item. Thereby, it is possible to determine whether or not the output processing unit is the third confirmation item by a simple process.

  Here, it is conceivable that the output processing unit can execute one or both of display and printing of the problem list. Thereby, the pharmacist can grasp | ascertain the said 3rd confirmation item contained in a said 2nd confirmation item by referring the display result or printing result of the said problem list.

  For example, the output mode may be a character color, a background color, or a size. Thereby, the pharmacist can easily grasp the difference between the third confirmation item and the fourth confirmation item included in the second confirmation item.

  In addition, the medication instruction support system includes a confirmation receiving unit that receives an input of a confirmation result of each of the fourth confirmation items, a confirmation result of each of the fourth confirmation items received by the confirmation receiving unit, and the third confirmation item. It is conceivable to include a recording processing unit that records the fact that has been confirmed as a confirmation history of the problem list. Thereby, by referring to the confirmation history, the confirmation result by the user can be grasped for each of the fourth confirmation items, and it can be grasped that each of the third confirmation items has been confirmed. .

  Here, it is conceivable that the output processing unit displays all the second confirmation items before recording the confirmation history by the recording processing unit. This makes it possible for the user to clearly recognize that the third confirmation item is recorded in the confirmation history.

  In addition, the confirmation receiving unit displays a first switching operation unit that switches the confirmation state of each of the fourth confirmation items included in the problem list to either confirmed or unconfirmed, and operates the first switching operation unit. It is conceivable to accept the input of the confirmation result of the fourth confirmation item according to the above. Thereby, the pharmacist can input easily the confirmation result for every said 2nd confirmation item.

  In addition, the confirmation receiving unit displays a second switching operation unit that switches a confirmation state of one or a plurality of sub-items included in each of the fourth confirmation items to either confirmed or unconfirmed, and the second switching operation It is conceivable to accept the input of the confirmation result of the sub-item according to the operation of the part. Thereby, the pharmacist can input easily the confirmation result for every said subitem.

  Further, the confirmation receiving unit confirms the confirmation state of one of the sub items by operating the second switching operation unit for a plurality of sub items previously associated as a pair of sub items among the sub items. When switching, it can be considered that the confirmation state of the other sub-item is switched to unconfirmed. Thereby, the pharmacist can easily perform an alternative selection operation for the pair of confirmation items.

  Moreover, it is possible that the said medication instruction | indication support system is provided with the determination process part which determines whether each said 2nd confirmation item satisfies the display conditions predetermined for every said 2nd confirmation item. In this case, when the output processing unit outputs the problem list, the fifth confirmation item that is determined not to satisfy the display condition by the determination processing unit among the second confirmation items can be excluded from the output target. In the remaining second confirmation items from which the fifth confirmation item is excluded, the third confirmation item may be output in an output mode different from that of the fourth confirmation item. For example, the display condition may include a condition related to predetermined patient information. According to such a configuration, for example, a condition for determining a confirmation item that clearly does not require confirmation is defined as the display condition, so that the confirmation item that does not require confirmation is excluded from the output target of the problem list. Thus, the contents of the problem list can be simplified.

  By the way, it is possible that the said acquisition process part acquires the said check result by performing the said prescription check. Note that the acquisition processing unit may acquire the result of the prescription check performed by the external device from the external device.

  The output processing unit may print only the fourth confirmation item among the second confirmation items when printing the problem list. That is, the third confirmation item has already been confirmed to be appropriate in the prescription check and does not need to be confirmed by a pharmacist, so exclude printing of the third confirmation item from the printed matter on the problem list. As a result, the print contents of the problem list can be simplified, and the burden of checking the problem list can be reduced.

  In addition, after the problem list is displayed, the output processing unit performs an operation of selecting each of the second confirmation items included in the problem list as a confirmation item to be printed and an operation of excluding from the confirmation items to be printed. It may be possible to accept. Thereby, the pharmacist can arbitrarily switch the presence or absence of printing of each said 2nd confirmation item, and the convenience increases.

  Moreover, it is possible that the said medication instruction | indication support system is equipped with the chemical | medical agent selection part which receives selection operation of the one or some chemical | medical agent used as the output object of the said problem list. And it is possible that the said output process part can produce | generate the said problem list containing the said 2nd confirmation item corresponding to the 1 or several medicine selected by the said medicine selection part. Accordingly, it is possible to generate and output a different problem list for each medicine.

  By the way, this invention can also be grasped | ascertained as an invention of a medication instruction support method. That is, the medication instruction support method according to the present invention includes a first step of obtaining a check result of a prescription check for determining whether one or a plurality of first confirmation items are appropriate before dispensing for prescription data, Confirmed based on the content of the check result among the second confirmation items when outputting a problem list including one or more second confirmation items before or after taking the medicine dispensed based on the prescription data And a second step of outputting a third confirmation item that can be determined to be different from the fourth confirmation item of the second confirmation item except the third confirmation item.

  ADVANTAGE OF THE INVENTION According to this invention, the medication instruction | indication support system and medication instruction | indication support method which can reduce the burden of the confirmation work of the problem list in a medication instruction | indication business are implement | achieved.

FIG. 1 is a block diagram showing a configuration of a medication instruction support system according to an embodiment of the present invention. FIG. 2 is a diagram showing an example of a prescription checklist used in the medication instruction support system according to the embodiment of the present invention. FIG. 3 is a diagram showing an example of problem information used in the medication instruction support system according to the embodiment of the present invention. FIG. 4 is a flowchart showing an example of a procedure of prescription check processing executed by the medication instruction support system according to the embodiment of the present invention. FIG. 5 is a diagram showing an example of check result information in the medication instruction support system according to the embodiment of the present invention. FIG. 6 is a flowchart showing an example of the procedure of the medication guidance support process executed by the medication guidance support system according to the embodiment of the present invention. FIG. 7 is a diagram showing an example of a medicine history screen displayed by the medication instruction support system according to the embodiment of the present invention. FIG. 8 is a diagram illustrating an example of a reading result of the problem information used in the medication instruction support system according to the embodiment of the present invention. FIG. 9 is a diagram showing an example of a medicine-specific explanation screen displayed on the medication instruction support system according to the embodiment of the present invention. FIG. 10 is a diagram illustrating an example of a printed matter list printed by the medication instruction support system according to the embodiment of the present invention. FIG. 11 is a diagram showing another example of a printed matter list printed by the medication instruction support system according to the embodiment of the present invention. FIG. 12 is a flowchart showing an example of the procedure of the confirmation history registration process executed by the medication instruction support system according to the embodiment of the present invention. FIG. 13 is a diagram showing an example of a medicine-specific explanation screen displayed in the medication instruction support system according to the embodiment of the present invention. FIG. 14 is a diagram illustrating an example of a record reflection screen displayed in the medication instruction support system according to the embodiment of the present invention. FIG. 15 is a flowchart showing another example of the procedure of the medication guidance support process executed by the medication guidance support system according to the embodiment of the present invention. FIG. 16 is a diagram illustrating another example of the problem information used in the medication instruction support system according to the embodiment of the present invention. FIG. 17 is a diagram illustrating another example of the medicine-specific explanation screen displayed in the medication instruction support system according to the embodiment of the present invention.

  Hereinafter, embodiments of the present invention will be described with reference to the accompanying drawings for understanding of the present invention. In addition, the following embodiment is an example which actualized this invention, Comprising: The thing of the character which limits the technical scope of this invention is not.

[Medication instruction support system 10]
As shown in FIG. 1, a medication instruction support system 10 according to an embodiment of the present invention includes a server 1, a client terminal 2, a dispensing device 3, and a printer 4. The server 1, the client terminal 2, the dispensing device 3, and the printer 4 are communicably connected via a communication network 5 in a wireless or wired manner. The communication network 5 is a LAN, a WAN, the Internet, an intranet, or the like. The server 1 includes a host system 6 such as an electronic medical record system, an ordering system, or a reception system that inputs prescription data indicating prescription contents and patient data indicating patient information to the server 1. 5 is connected. The server 1 may be configured to read the prescription data and the patient data from the host system 6.

[Dispensing equipment 3]
Each of the dispensing devices 3 is used in a medicine dispensing operation in a hospital or a medical institution such as a pharmacy where the medication instruction support system 10 is used. For example, each of the dispensing devices 3 is a tablet dispenser, a powder dispenser, a liquid dispenser, a PTP sheet dispensing device, a mixed injection device, or the like. For example, the tablet packaging machine has a plurality of medicine cassettes containing a plurality of types of tablets, dispenses tablets from the medicine cassette according to dispensing data input from the server 1, and dispenses them for each dose. A wrapping operation for wrapping with wrapping paper is executed. In accordance with the dispensing data input from the server 1, the powder medicine packaging machine performs a packaging operation for packaging the powdered powder in a dosed paper for each dose. The liquid medicine dispenser has a plurality of medicine bottles containing a plurality of kinds of liquid medicines, and dispenses a required amount of liquid medicine from the medicine bottles according to dispensing data input from the server 1. put out. The PTP sheet dispensing apparatus has a plurality of sheet cassettes in which PTP sheets or heat seals in which tablets are packaged in advance are accommodated, and according to dispensing data input from the server 1, the PTP sheets or Discharge the heat seal. The mixed injection device automatically executes a mixed injection operation for injecting a medicine such as an anticancer drug into an infusion solution according to the dispensing data input from the server 1 using a robot arm.

[Printer 4]
The printer 4 is a color printer or a monochrome printer that prints information included in print data input from the server 1 or the client terminal 2 via the communication network 5 on a sheet such as paper. The printer 4 is used for printing a problem list, which will be described later, in the medication instruction support system 10.

[Server 1]
The server 1 is a personal computer including a control unit 11, a storage unit 12, a communication I / F 13, a display device 14, an operation device 15, a drive device 16, and the like. The server 1 may be provided outside a medical institution such as a hospital or a pharmacy where the medication instruction support system 10 is used. The server 1 may be a mobile terminal such as a smartphone or a tablet terminal.

  The control unit 11 includes control devices such as a CPU, a ROM, a RAM, and an EEPROM. The CPU is a processor that executes various arithmetic processes. The ROM is a non-volatile storage unit in which information such as a control program for causing the CPU to execute various processes is stored in advance. The RAM is a volatile storage unit, and the EEPROM is a non-volatile storage unit. The RAM and the EEPROM are used as a temporary storage memory (working area) for various processes executed by the CPU. And the said control part 11 performs various processes according to the various control programs previously stored in the said ROM, the said EEPROM, or the said memory | storage part 12 using the said CPU.

  The storage unit 12 is a non-volatile storage unit such as a hard disk or an SSD that stores various application programs and various data executed by the control unit 11. Specifically, the storage unit 12 includes a program storage unit 121, a master storage unit 122, and an information storage unit 123.

  The program storage unit 121 is a medication instruction for causing the control unit 11 to execute a prescription check process (see FIG. 4), a medication instruction support process (see FIG. 6), and a confirmation history registration process (see FIG. 12), which will be described later. This is a storage area for storing support programs.

  The master storage unit 122 is a storage area for storing various master information such as a medicine master, a patient master, a pharmacist master, a prescription division master, a clinical department master, and a ward master. For example, the chemical master includes a chemical code (YJ code, etc.), a chemical name, a JAN code, an RSS code, a vial code, a dosage form, a unit, a specific gravity, a chemical type, a composition change, and an excipient for various chemicals. , Information such as notes. The patient master includes information such as a patient name, patient ID, sex, age, alcohol consumption, smoking presence, and disease name for each patient. In addition, the patient master includes various types of information confirmed at the time of examination or inquiry such as whether the patient is a pregnant woman or a lactating woman. The control unit 11 can update various master information stored in the master storage unit as needed based on information acquired from the host system 6. The control unit 11 can also edit the patient master or the like in accordance with a user operation using the server 1 or the client terminal 2.

  The information storage unit 123 is a storage area for storing various information such as prescription check information D11 and problem information D21. FIG. 2 is a diagram illustrating an example of the prescription check information D11, and FIG. 3 is a diagram illustrating an example of the problem information D21.

  As shown in FIG. 2, the prescription check information D11 stores one or a plurality of check items (an example of first confirmation items) to be confirmed before dispensing for prescription data. Specifically, the prescription check information D11 shown in FIG. Check items corresponding to “1” to “20” are included. In addition, the information storage unit 123 stores determination conditions predetermined for each check item in order to determine whether or not the content of the check item is appropriate for the prescription data. Further, the determination condition is predetermined for each medicine. In addition, it is also conceivable that the determination index of the determination condition corresponding to each of the drugs is included in the drug master.

  For example, for the “dosage” that is the check item shown in FIG. 2, the single dose and the daily dose of the medicine in the prescription data are the predetermined single dose and the daily dose of the medicine. Information for determining whether or not it is below the upper limit is set. In addition, for the “contraindication check” that is the check item, information for determining whether or not the drug included in the prescription data is a drug that may be prescribed to the patient based on the patient's disease name or the like is determined. It has been. Furthermore, regarding the “pregnant / lactating administration restriction” that is the check item, when the patient corresponding to the prescription data is a pregnant / lactating woman, administration to the pregnant / lactating woman is restricted in the prescription data. Information for determining whether or not a certain medicine is included is set.

  Further, as shown in FIG. 3, in the problem information D21, one or a plurality of problem items (an example of second confirmation items) to be confirmed before taking or after taking the medicine dispensed based on the prescription data and the medicine Correspondence with chemical codes indicating types is defined. Specifically, the problem information D21 shown in FIG. 3 includes a plurality of problem items corresponding to internal codes “0001” to “0009”, and one or more medicine codes are associated with each of the problem items. ing. The information storage unit 123 stores one or a plurality of sub items which are detailed contents of the problem items for each problem item.

  Further, in the problem information D21, the check item in the prescription check information D11 is associated in advance with one or a plurality of the problem items. For example, the association between the problem item and the check item is set in advance according to the condition that the confirmation content is duplicated and an item that has already been confirmed as the check item does not need to be confirmed as the problem item. The

  Specifically, as shown in FIG. 3, in the problem information D21, the check item “Contraindication check” corresponds to the “problem confirmation in principle (peptic ulcer)” as the problem item. It is attached. This is because it is also determined whether or not the patient's disease name is peptic ulcer in the “contraindication check” of the prescription check. The check item “Pregnant / Lactating Women” is associated with the check item “Pregnant / Lactating Women”. This is because the “pregnant / lactating administration restriction” in the prescription check determines whether or not the patient is a pregnant / lactating woman based on an inquiry result or the like. Furthermore, “confirm child dose” as the problem item is associated with “dose” as the check item. This is because in the “dose” of the prescription check, it is determined whether the single dose and the daily dose of the medicine prescribed to the patient are less than or equal to an upper limit predetermined according to the age of the patient. This is because, as a result, it is determined whether or not the single dose and daily dose of the medicine are below the upper limit corresponding to the child.

  The communication I / F 13 performs data communication between the client terminal 2, the dispensing device 3, and the external device such as the printer 4 via the communication network 5 in a wireless or wired manner according to a predetermined communication protocol. Is a communication interface having a network card or the like for executing.

  The display device 14 is a display unit such as a liquid crystal display or an organic EL display that displays various types of information in accordance with control instructions from the control unit 11. The operation device 15 is an operation unit operated by a user in order to input various kinds of information to the server 1. Specifically, the operation device 15 includes a keyboard and a mouse (pointing device) that accept input operations on various operation screens displayed on the display device 14. The operation device 15 may include a touch panel that accepts touch operations on various operation screens displayed on the display device 14 or a voice input device that accepts input of various information by voice recognition.

  The drive device 16 can read the medication instruction support program from a computer-readable recording medium 161 in which the medication instruction support program is recorded. The recording medium 161 is a CD, DVD, BD, or USB memory, and the drive device 16 is a CD drive, DVD drive, BD drive, USB port, or the like. In the server 1, the medication instruction support program read from the recording medium 161 using the drive device 16 is installed in the program storage unit 121 of the storage unit 12 by the control unit 11.

  The control unit 11 of the server 1 includes an acquisition processing unit 111, a determination processing unit 112, an output processing unit 113, a confirmation receiving unit 114, a recording processing unit 115, and a medicine selection unit 116. Specifically, the control unit 11 executes various processes according to the medication instruction support program, thereby obtaining the acquisition processing unit 111, the determination processing unit 112, the output processing unit 113, the confirmation receiving unit 114, It functions as the recording processing unit 115 and the medicine selection unit 116.

  The acquisition processing unit 111 performs a prescription check that determines the suitability of the prescription data based on the prescription check information D11, and acquires a check result of the prescription check. Specifically, in the prescription check, whether each of the check items of the prescription check information D11 confirmed before dispensing for the prescription data is appropriate based on the determination condition corresponding to each check item. Is determined. In addition, if the acquisition processing unit 111 can acquire the check result of the prescription check, the prescription check may be performed via the communication network 5 from an external device such as the host system 6 capable of executing the prescription check. It is also conceivable to obtain the check result.

  The determination processing unit 112 determines whether each of the problem items satisfies a display condition predetermined for each problem item. The determination processing unit 112 is used to implement a non-display function (to be described later) that hides items that do not satisfy the display condition and do not need to be displayed among the problem items.

  The output processing unit 113 executes a process for outputting a problem list including one or a plurality of the problem items before or after taking a medicine taken by a patient. Specifically, the output processing unit 113 can execute processing for displaying the problem list on the server 1 or the client terminal 2. Further, the output processing unit 113 can also execute processing for causing the printer 4 to print the problem list. The problem list is used by a pharmacist in self-confirmation or confirmation with the patient of a medicine taking state and a patient state before or after taking a medicine by a patient in a medicine instruction work. And when the said output process part 113 outputs the said problem list | wrist, the confirmed item (3rd confirmation item) which can determine with having been confirmed based on the content of the check result of the said prescription check among the said problem items Can be output in an output mode different from the unconfirmed items (an example of the fourth confirmation items) excluding the confirmed items among the problem items. For example, the confirmed item is the same as the check item determined to be appropriate in the prescription check, or an item associated in advance with the check item determined to be appropriate in the prescription check. It is.

  The confirmation accepting unit 114 accepts input of confirmation results for each of the unconfirmed items included in the problem list output by the output processing unit 113. Specifically, the confirmation receiving unit 114 switches the confirmation state of each unconfirmed item included in the problem list to either confirmed or unconfirmed according to a user operation on the server 1 or the client terminal 2.

  The recording processing unit 115 stores the confirmation history of the problem list in a manner that can distinguish the unconfirmed item whose confirmation result has been received by the confirmation receiving unit 114 and the confirmed item that has already been confirmed by the prescription check. Record in the storage unit 12. Specifically, the recording processing unit 115 confirms the confirmation result of the problem list that the confirmation result of each unconfirmed item received by the confirmation receiving unit 114 and that the confirmed item has been confirmed by the prescription check. Record as. For example, for the confirmed item, information such as a character string, a figure, or a symbol for clearly indicating that it has already been confirmed by the prescription check is recorded as the confirmation history. The recording processing unit 115 can also record the confirmation history of the problem list on a paper medium by causing the printer 4 to print it.

  The medicine selection unit 116 receives a selection operation for selecting one or a plurality of medicines to be output from the problem list. Specifically, the medicine selection unit 116 selects a medicine selected from a list of medicines to be taken by a patient in response to a user operation on the server 1 or the client terminal 2 by the output processing unit 113. Select as the chemical to be output. In addition, the medicine selection unit 116 excludes the medicine selected as the output target from the output target in response to a user operation on the server 1 or the client terminal 2. Furthermore, the medicine selection unit 116 can newly add an arbitrary medicine as an output target of the problem list in accordance with a user operation on the server 1 or the client terminal 2. Thereby, for example, it is possible to output the problem list for the brought-in medicine.

[Client terminal 2]
On the other hand, the client terminal 2 is a personal computer including a control unit 21, a storage unit 22, a communication I / F 23, a display device 24, an operation device 25, a drive device 26, and the like. Each of the client terminals 2 is an operation terminal that is arranged in a medical institution where the medication instruction support system 10 is used and is operated by a user such as a pharmacist. In particular, the client terminal 2 may be used by a pharmacist or the like that is provided in a ward of the medical institution and performs a medication instruction work in the ward. The client terminal 2 may be a mobile terminal such as a smartphone or a tablet terminal.

  The control unit 21 includes control devices such as a CPU, a ROM, a RAM, and an EEPROM. The CPU is a processor that executes various arithmetic processes. The ROM is a non-volatile storage unit in which information such as a control program for causing the CPU to execute various processes is stored in advance. The RAM is a volatile storage unit, and the EEPROM is a non-volatile storage unit. The RAM and the EEPROM are used as a temporary storage memory (working area) for various processes executed by the CPU. And the said control part 21 performs various processes according to the various control programs previously stored in the said ROM, the said EEPROM, or the said memory | storage part 22 using the said CPU.

  The storage unit 22 is a non-volatile storage unit such as a hard disk or an SSD in which various application programs executed by the control unit 21 and various data are stored. Specifically, the storage unit 22 includes a program storage unit 221 in which application programs such as an operating system (OS) and browser software are stored. The browser software displays the various operation screens on the display device 24 by accessing the server 1 via the communication network 5 and performs an input operation on the operation screen using the operation device 25. Application software for transmission to the server 1. Specifically, when address information such as a URL (Universal Resource Locator) corresponding to the server 1 is input at a predetermined position on the operation screen displayed by the browser software, the control unit 21 receives the address information. The server 1 is accessed based on the above.

  The communication I / F 23 performs data communication between the server 1, the dispensing device 3, and the external device such as the printer 4 via the communication network 5 in a wireless or wired manner according to a predetermined communication protocol. A communication interface having a network card or the like to be executed.

  The display device 24 is a display unit such as a liquid crystal display or an organic EL display that displays various types of information in accordance with control instructions from the control unit 21. The operation device 25 is an operation unit operated by a user in order to input various information to the client terminal 2. Specifically, the operation device 25 includes a keyboard and a mouse (pointing device) that accept input operations on various operation screens displayed on the display device 24. The operation device 25 may include a touch panel that accepts touch operations on various operation screens displayed on the display device 24, or a voice input device that accepts input of various information by voice recognition.

  The drive device 26 can read the OS or the browser software from a computer-readable recording medium 261 on which the OS or the browser software is recorded. The recording medium 261 is a CD, DVD, BD, or USB memory, and the drive device 16 is a CD drive, DVD drive, BD drive, USB port, or the like. In the client terminal 2, the OS or the browser software read from the recording medium 261 using the drive device 26 is installed in the program storage unit 221 of the storage unit 22 by the control unit 21.

  And in the said medication instruction | indication assistance system 10, according to operation of the said client terminal 2 by a user, the display of the said problem list, printing, etc. can be performed. Specifically, in the present embodiment, a server client system is configured by the server 1 and the client terminal 2, and the server 1 displays and prints the problem list in response to a user operation of the client terminal 2. The case where it does is demonstrated. Therefore, “display”, “operation”, “selection”, and “input” described below are performed using the display device 24 and the operation device 25 of the client terminal 2.

  On the other hand, the server 1 can also display and print the problem list using the display device 14 and the operation device 15, and the server 1 alone is regarded as a medication instruction support system according to the present invention. Also good. Further, the client terminal 2 alone may be regarded as a medication instruction system according to the present invention. That is, a part or all of the medication instruction support program is installed in the client terminal 2, and the control unit 21 of the client terminal 2 appropriately acquires necessary information from the server 1, It is also conceivable to execute support processing and confirmation history registration processing.

[Prescription check processing]
Next, the prescription check process executed by the control unit 11 of the server 1 will be described with reference to FIG. The prescription check process is executed by the control unit 11 when, for example, the server 1 acquires the prescription data from the host system 6, when dispensing is started for the prescription data, or when a prescription check is requested by a user. Is done. The prescription check process is executed by the acquisition processing unit 111 of the control unit 11.

<Step S11>
First, in step S <b> 11, the control unit 11 executes a prescription check that determines suitability of the prescription data based on the prescription check information D <b> 11 stored in the information storage unit 123.

<Step S12>
And when the said control part 11 judges that the check result of the said prescription check acquired at the said step S11 is appropriate (S12: Yes side), a process is made to transfer to step S13. Moreover, the said control part 11 makes a process transfer to step S121, when an error exists in the check result of the said prescription check (S12: No side).

<Step S13>
In step S13, the control unit 11 records the check result of the prescription check in step S11 in the storage unit 12 as check result information D12. Thereby, the said control part 11 can refer to the said check result information D12 memorize | stored in the said memory | storage part 12 in the below-mentioned medication instruction | indication assistance process.

  FIG. 5 is a diagram showing an example of the check result information D12. As shown in FIG. 5, the check result information D12 includes information such as “patient ID”, “prescription check date”, “prescription check No.”, “check result”, and “reason for error”. For example, the check result information D12 shown in FIG. 5 includes the prescription check No. for the prescription data with the patient ID “0000000001” and the prescription check date “2013/12/10”. Information indicating that the check result of the check item corresponding to “8”, “17”, “19”, and “20” is “OK (proper)” is included.

<Step S14>
Thereafter, in step S14, the control unit 11 executes a dispensing control process for starting dispensing a medicine based on the prescription data. For example, the control unit 11 generates dispensing data corresponding to each of the dispensing devices 3 based on the prescription data, and stores it in a predetermined shared data folder secured in the storage unit 12. Thus, each of the dispensing devices 3 acquires the dispensing data from the shared data folder, and executes the dispensing of the medicine based on the dispensing data. In addition, the control unit 11 may print picking information necessary for a pharmacist to pick a medicine based on the prescription data, or transmit the picking information to a picking assisting device.

<Step S121>
On the other hand, when the check result of the prescription check is not appropriate (S12: No side), in step S121, the control unit 11 executes a predetermined error notification process. For example, in the error notification process, a warning that an error exists in the prescription data is displayed on the display device 24 or the like, or the host system 6 is notified that an error exists in the prescription data.

<Step S122>
In step S122, the control unit 11 records the check result of the prescription check in step S11 in the storage unit 12 as the check result information D12. For example, the check result information D12 shown in FIG. 5 includes the prescription check No. for the prescription data with the patient ID “0000000001” and the prescription check date “2013/1/1”. Information indicating that the check result of the check item corresponding to “1” is “error (inappropriate)” and the error reason is “medicine A is...”.

[Medication instruction support processing]
Next, the medication instruction support process executed by the control unit 11 of the server 1 will be described with reference to FIG. By the way, this invention may be grasped | ascertained as invention of the medication instruction | indication support method for assisting the medication instruction | indication work of a pharmacist by performing the said medication instruction assistance process.

  The control unit 11 executes the medication instruction support process when a predetermined user operation is performed using the client terminal 2. Specifically, the control unit 11 uses the operation device 25 of the client terminal 2 to select a patient and, when a medicine history display operation is performed, the medicine history of the currently selected patient is displayed. The displayed medicine history screen P1 is displayed on the display device 24.

  FIG. 7 is a diagram showing an example of the medicine history screen P1. FIG. 7 shows a state where the patient monitor key K11 displayed on the medicine history screen P1 is selected. The control unit 11 selects the medicine when one or more medicines to be instructed are selected on the medicine history screen P1 and the medicine explanation key K12 displayed on the medicine history screen P1 is operated. Start the guidance support process. Here, as shown in FIG. 7, the medicine history of “2013/12/01 to 2013/12/31” is displayed on the medicine history screen P 1, of which “2013/12/11” is taken. A case where “medicine M1”, “medicine M2”, and “medicine M3” are selected will be described as an example. The selection of the medicine on the medicine history screen P1 is performed, for example, by individually selecting the medicine name displayed on the medicine history screen P1. In addition, when a prescription date is selected on the drug history screen P1, one or more medicines to be taken on the prescription date are automatically selected. It is assumed that the drug codes of “drug M1”, “drug M2”, and “drug M3” are “YJ0000000004”, “YJ0000000005”, and “YJ0000000006”.

<Step S21>
As shown in FIG. 6, first, in step S <b> 21, the control unit 11 selects a problem item corresponding to one or a plurality of medicines to be instructed selected on the medicine history screen P <b> 1 in the storage unit 12. Read based on the problem information D21 stored in the information storage unit 123.

  Here, FIGS. 8A, 8B, and 8C show the case where “medicine M1”, “medicine M2”, and “medicine M3” are selected in the drug history screen P1. It is a figure which shows an example of the said problem item read by said step S21. In the example shown in FIG. 8A, the problem items corresponding to “medicine M1” include the problem items whose internal codes are “0001” and “0004” to “0009”. In the example shown in FIG. 8B, the problem items corresponding to “medicine M2” include the problem items whose internal codes are “0005” to “0009”. Further, in the example shown in FIG. 8C, the problem items corresponding to “medicine M3” include the problem items whose internal codes are “0007” to “0009”. Here, as described above, in the problem information D21 (see FIG. 3), the problem items whose internal codes are “0007”, “0008”, and “0009” are added to the check item “Contraindication check”. ”,“ Pregnant / Lactating Woman Administration Restriction ”, and“ Dose ”are associated with each other.

<Step S22>
Next, in step S22, the control unit 11 obtains a check result of the prescription check performed on prescription data when one or more medicines to be instructed are dispensed. Here, the acquisition process is executed by the acquisition processing unit 111 and is an example of a first step according to the present invention. Specifically, the control unit 11 stores the check result information stored in the storage unit 12 in the step S13 or the step S122 as a check result of the prescription check executed in the prescription check process (see FIG. 4). D12 is acquired.

  For example, the prescription check date is “2013/12/10” as the check result of the prescription data including “medicine M1” to “medicine M3” as prescription drugs with the taking date “2013/12/11” The check result information D12 corresponding to the data is read from the storage unit 12. In addition, when the medicine is selected without selecting the date on the medicine history screen P1, the control unit 11 performs the latest prescription data including the medicine as the prescription medicine among the prescription data corresponding to the patient. It is also conceivable to read out the check result information D12 at the time of the prescribed prescription check. In addition, when a date is selected without selecting a drug on the drug history screen P1, the control unit 11 includes, as a prescription drug, a drug taken on the date among prescription data corresponding to the patient. It is also conceivable to read the check result information D12 at the time of the prescription check performed for the prescription data.

  In addition, the interval from the date when the prescription check of the prescription data including the medicine selected on the medicine history screen P1 as the prescription medicine to the current date is equal to or longer than a predetermined period. In this case, it may be considered as another embodiment that the check result information D12 is not read out. For example, when the prescription check is performed before the predetermined period, the control unit 11 determines whether the problem item based on the check result information D12 at the time of the prescription check has been confirmed. It is conceivable that all the problem items are handled as the unconfirmed items without executing such a determination. In addition, in said step S22, it is also considered that the said acquisition process part 111 of the said control part 11 acquires the said check result information D12 from the external device which performs the said prescription check.

<Step S23>
In step S23, the control unit 11 specifies the confirmed item from the problem items read in step S21. Specifically, in the step S21, when the problem items shown in FIGS. 8A to 8C are read, the check result information D12 (see FIG. 5) among the problem items. ) Based on the “Contraindication Check”, “Dose”, and “Pregnant / Lactating Woman Restriction” that are determined to be appropriate in the prescription check. Peptic ulcer) ”,“ confirmation of pediatric dose ”, and“ confirmation of pregnant / lactating women ”are identified as the confirmed items. In this case, among the problem items, items other than the confirmed items, such as “Cautions in life (driving the car)”, “Confirmation of taking status (immediately before going to bed / insomnia)”, “Dosing “Confirmation of status (discontinuation etc.)” and “Confirmation of contraindications (myasthenia gravis)” are the unconfirmed items.

<Step S24>
In step S24, the control unit 11 causes the display device 24 to display the medicine-specific explanation screen P2. On the medicine description screen P2, a problem list including the problem items read in step S21 is displayed. Specifically, the control unit 11 generates a problem list including the problem items read out in step S21, and displays the problem list on the medicine-specific explanation screen P2.

  At this time, the control unit 11 displays the confirmed item specified in step S23 among the problem items included in the problem list in an output mode different from the unconfirmed item. Specifically, the output mode is a character color, a background color, or a size. That is, among the problem items, the confirmed item and the unconfirmed item are displayed in different character colors, background colors, or sizes. The process for displaying the problem list in this way is executed by the output processing unit 113 of the control unit 11 and is an example of a second step according to the present invention.

  FIG. 9 is a diagram showing an example of the medicine-specific explanation screen P2. As shown in FIG. 9, a header area A10 and a detail area A20 are displayed on the medicine-specific explanation screen P2. In the header area A10, information such as patient ID, patient name, sex, and age included in the prescription data or the patient master is displayed as patient information. In the header area A10, operation keys such as a new medicine key K21, a medicine key K22, a medicine deletion key K23, a registration history key K24, a PRBLM print key K25, a SOAP print key K26, and a registration key K27 are displayed. The On the other hand, in the detail area A20, a medicine list area A21, a problem list area A22, and a SOAP list area A23 are displayed. In the detail area A20, operation keys such as a transition key K28 and a transition key K29 are displayed.

  The new medicine key K21 is an operation key that is operated to newly add a medicine to be output in the problem list displayed in the specification area A20. When the new medicine key K21 is operated, the control unit 11 pops up a predetermined new medicine addition screen. And the said control part 11 displays the chemical | medical agent input by the operation input of the said new chemical | medical agent addition screen on the said chemical | medical agent list area | region A21 of the said specification area | region A20 as a chemical | medical agent used as the output object of the said problem list. The new medicine key K21 can be operated only when the medicine list area A21 can be operated.

  The medicine key K22 is an operation key operated to select and add medicines to be output from the problem list displayed in the specification area A20 from a list of medicines to be taken by the patient. When the taking medicine key K22 is operated, the control unit 11 pops up a predetermined taking medicine addition screen. And the said control part 11 displays the medicine selected by the operation input of the said taking medicine addition screen on the said medicine list area | region A21 of the said specification area | region A20 as a medicine used as the output object of the said problem list. The medicine key K22 can be operated only when the medicine list area A21 can be operated.

  The medicine deletion key K23 is an operation key operated to delete medicines displayed in the medicine list area A21. When the medicine deletion key K23 is operated, the control unit 11 pops up a predetermined medicine deletion screen. And the said control part 11 deletes the chemical | medical agent selected by the operation input of the said chemical | medical agent deletion screen from the said chemical | medical agent list area | region A21. The medicine delete key K23 can be operated only when the medicine list area A21 can be operated.

  The registration history key K24 is an operation key operated to display a problem list registered or provisionally registered in the past. When the registration history key K24 is operated, the control unit 11 pops up a list selection screen for selecting a problem list registered or temporarily registered in the past. Then, when the selection operation of the problem list displayed on the list selection screen is performed, the control unit 11 reads and displays the problem list. When the registration history key K24 is operated while the detail area A20 is being edited and the registration is not performed, the control unit 11 displays a message box notifying that the registration area key K24 is not registered.

  The registration key K27 is an operation key for temporarily registering information input in the detail area A20. When the registration key K27 is operated, the control unit 11 registers the information input in the detail area A20 in the storage unit 12, and displays a registration completion message such as “Registered”. The registration key K27 can be operated only when the SOAP list area A23 is valid.

  The PRBLM print key K25 is an operation key for starting printing of the problem list displayed in the problem list area A22. When the PRBLM print key K25 is operated, the control unit 11 temporarily registers the content displayed in the specification area A20 in the storage unit 12 in the same manner as when the registration key K27 is operated, and then determines in advance. Pop-up the printed screen. The PRBLM print key K25 can be operated only when the SOAP list area A23 is valid.

  The SOAP print key K26 is an operation key for starting printing of the SOAP list displayed in the SOAP list area A23. When the SOAP print key K26 is operated, the control unit 11 provisionally registers the contents displayed in the specification area A20 in the storage unit 12 after the provisional registration in the same manner as when the registration key K27 is operated. Pop-up the printed screen. The SOAP print key K26 can be operated only when the SOAP list area A23 is valid.

  On the other hand, the medicine list area A21 is a display area in which a medicine list including one or a plurality of medicines to be output from the problem list is displayed. Further, the control unit 11 displays a check box (an example of a switching operation unit) for switching the presence / absence of selection of each medicine displayed in the medicine list in the medicine list area A21. And the said control part 11 changes the selection state of the 1 or several chemical | medical agent used as the output target of the said problem list between a check state and an unchecked state according to operation of the said check box or the name display location of a chemical | medical agent. Accept selection operation to switch. This process is executed by the medicine selection unit 116 of the control unit 11.

  The problem list area A22 is a display area in which the problem list is displayed. Specifically, the control unit 11 generates a problem list including the problem items corresponding to the medicines that are checked in the medicine list area A21, and displays the problem list in the problem list area A22. In the problem list area A22, the problem item E2 corresponding to the confirmed item among the problem items is displayed in a display mode different from the problem item E1 corresponding to the unconfirmed item. Specifically, it is conceivable that the problem item E1 is displayed with black characters, and the problem item E2 is displayed with red characters. Thereby, the pharmacist easily grasps the problem item E2 which is the confirmed item that has already been confirmed to be appropriate in the prescription check among the problem items included in the problem list, and the problem item Confirmation for E2 can be omitted. Therefore, the burden of the medication instruction work performed by the pharmacist is reduced. It should be noted that background colors or sizes may be different as output modes of the problem item E1 and the problem item E2. Further, the difference in output mode between the problem item E1 and the problem item E2 is not limited to that illustrated here, as long as they can be distinguished.

  Further, in the problem list area A22, with respect to the problem items common to a plurality of medicines, a plurality of medicine names are written in the problem items. Thereby, since the display mode is simple and easy to see compared with the case where the problem items are displayed individually for each medicine, the burden of medication instruction work by the pharmacist is reduced. In addition, only when there is a plurality of medicines selected in the medicine list, the control unit 11 writes the medicine name in each of the problem items, and there is one medicine selected in the medicine list. In some cases, it may be possible not to write the drug name in the problem item.

  In the problem list area A22, a check box for switching whether or not each of the problem items displayed in the problem list is selected is displayed. And the said control part 11 is between the check state and the unchecked state in the selection state of the one or some said problem item contained in the said problem list according to operation of the name display location of the said check box or the said problem item. The selection operation and the exclusion operation to be switched are accepted. Specifically, the problem items in the checked state are to be printed at the time of printing the problem list, and the unchecked problem items are excluded from the objects to be printed at the time of printing the problem list. As described above, the process of accepting the operation of selecting each of the problem items included in the problem list as the confirmation item to be printed and the operation of excluding it from the confirmation item to be printed is executed by the output processing unit 113 of the control unit 11. The It is also conceivable that the control unit 11 changes an output mode such as a character color, a background color, or a size of each of the problem items based on a predetermined priority for each of the problem items. For example, only the problem item having the highest priority may be displayed in a blue character color.

  In the SOAP list area A23, the problem item selected in the problem list area A22 and one or more sub-items included in the problem item are “S”, “O”, “A”, “P”. This is a display area of a SOAP list that is classified and displayed as items. The SOAP list is also an example of a problem list. Here, “S” is subjective information (Subjective Information), which is information relating to symptoms that the patient feels subjectively. “O” is objective information, which is information obtained from physical examination, test results, and prescription data. “A” is evaluation information (Assessment Information), which is information relating to evaluation as a pharmacist that can be considered from the information of the subjective information “S” and the objective information “O”. “P” is plan information, which is information related to medication and treatment plans. Furthermore, “P” is an educational plan (EP: Educational Plan) that is information on medication instruction or explanation of medication, an intervention plan (CP: Care Plan) for patient medication, observation of side effects of medication, etc. Observation plan (OP: Observation Plan) etc.

  In the SOAP list area A23, a check box for switching whether or not each of the problem item and the sub item is selected is displayed. And the said control part 11 is one or several said problem item or the said sub item contained in the said SOAP list according to operation of the name display location of the said check box, the said problem item, or the content display location of the said sub item. The selection operation and the exclusion operation for switching the selection state between the checked state and the unchecked state are accepted. Specifically, the confirmation item in the checked state is a print target when the SOAP list is printed, and the confirmation item in the unchecked state is excluded from the print target when the SOAP list is printed. As described above, the process of receiving the operation of selecting each of the problem items and the sub-items included in the SOAP list as the confirmation items to be printed and the operation of excluding them from the confirmation items to be printed is the output processing unit of the control unit 11 113.

  When the problem item is selected in the SOAP list area A23, the selection operation and the release operation are performed at once for one or a plurality of the sub items included in the problem item. The control unit 11 sets all the sub items corresponding to the problem items checked in the problem list region A22 among the problem items and the sub items in the SOAP list region A23 at the initial display state. To do. Further, the control unit 11 hides the problem items that are unchecked in the problem list area A22 and the sub items corresponding to the problem items.

  Here, the control unit 11 determines the problem items corresponding to the confirmed items that have already been confirmed to be appropriate in the prescription check among the problem items displayed in the SOAP list area A23. A message indicating that the prescription has already been confirmed is displayed. Specifically, in the example shown in FIG. 9, in the SOAP list area A23, among the above-mentioned problem items, “Confirmation of contraindications (peptic ulcer)”, “Confirmation of pregnant / lactating women”, and “Confirmation of pediatric dose” "Is confirmed that there is no problem with the prescription check", and the check box is checked.

  The transition key K28 is an operation key for confirming the input operation of the medicine list area A21 and shifting the operation object to the problem list area A22 in a state where the operation target is the medicine list area A21. . The transition key K28 is used to return the operation object to the medicine list area A21 when the operation object is the problem list area A22.

  Similarly, the transition key K29 is an operation key for confirming the input operation of the problem list area A22 and shifting the operation object to the SOAP list area A23 in a state where the operation object is the problem list area A22. . The transition key K29 is used to return the operation target to the problem list area A22 when the operation target is the SOAP list area A23.

  Here, the control unit 11 selects the medicine list area A21 as an operation target during the initial display of the medicine-specific explanation screen P2, and the problem list area A22, the SOAP list area A23, and the transition key The operation for K29 is invalidated. Moreover, the said control part 11 invalidates operation with respect to the said medicine list area | region A21 and said SOAP list area | region A23, when the said problem list area | region A22 is selected as operation object. Furthermore, when the SOAP list area A23 is selected as an operation target, the control unit 11 invalidates the operations on the medicine list area A21, the problem list area A22, and the transition key K28.

<Step S25>
Thereafter, in step S25, the control unit 11 determines whether or not a print instruction has been issued. Specifically, the control unit 11 determines that a print instruction has been issued when either the PRBLM print key K25 or the SOAP print key K26 is operated (S25: Yes side), and the process proceeds to step S26. Transition. When the print instruction is not performed (S25: No side), the control unit 11 shifts the process to step S251. In addition, when operation for closing the said medicine description screen P2 is performed during execution of the said medication instruction | indication support process, the said control part 11 complete | finishes the said medication instruction | indication support process, and displays the said medication history screen P1 Let

<Step S251>
In step S251, the control unit 11 determines whether or not an operation for changing a medicine selected as an output target of the problem list on the medicine explanation screen P2 has been accepted. For example, when the new medicine key K21 or the medicine key K22 is operated and the medicine to be output from the problem list is added to the medicine list area A21, the control unit 11 returns the process to step S21. . Moreover, the said control part 11 returns a process to said step S21 also when the selection state in the said medicine list area | region A21 is switched between a check state and an unchecked state. The control unit 11 also returns the process to step S21 when the medicine deletion key K23 is operated and the medicine to be output from the problem list is deleted from the medicine list area A21. As a result, the problem item corresponding to the medicine currently selected in the medicine list area A21 is updated to the latest state and displayed in the problem list area A22. On the other hand, if the medicine to be output in the problem list is not changed (S251: No side), the control unit 11 returns the process to step S25.

<Step S26>
In step S26, the control unit 11 stores the current state of the medicine description screen P2 in the storage unit 12 as temporary registration information. For example, the temporary registration information includes the medicine displayed in the medicine list area A21 and its selection state, the problem item displayed in the problem list area A22 and its selection state, and the problem list area A22. The type of the problem item corresponding to the displayed confirmed item is included. Further, the provisional registration information includes a problem item displayed in the SOAP list area A23 and a selection state thereof, a sub item displayed in the SOAP list area A23 and a selection state thereof, and the SOAP list area A23. And the confirmed message displayed on the screen.

<Step S27>
In step S27, the control unit 11 displays a print screen for printing the problem list, and the printer 4 prints the problem list in response to a predetermined print start operation. Specifically, when the PRBLM print key K25 is operated, a problem list including a checked problem item among the problem items displayed in the problem list area A22 is printed. When the SOAP print key K26 is operated, a SOAP list including the checked problem items and sub items among the problem items and the sub items displayed in the SOAP list area A23 is printed. . FIG. 10 shows an example of the print result P3 of the problem list, and FIG. 11 shows an example of the print result P4 of the SOAP list.

  When the client terminal 2 is a mobile terminal such as a smartphone or a tablet terminal, a pharmacist may perform confirmation work according to the problem list while referring to the display device 24 of the client terminal 2. . In this case, the printing process in step S27 can be omitted. In addition, when display on the display device 24 of the client terminal 2 is unnecessary, it is possible to omit the display process in step S24 and execute the problem list print process in step S27.

  By the way, when printing the problem list or the SOAP list, the control unit 11 omits the printing of the problem items corresponding to the confirmed items determined to be appropriate in the prescription check among the problem items. However, it is conceivable to print only the problem items corresponding to the unconfirmed items excluding the confirmed items. This is because the confirmed items have been confirmed to be appropriate by the prescription check and need not be confirmed by a pharmacist. As a result, the contents printed on the problem list are simplified, and the burden of checking the problem list by the pharmacist is reduced.

[Confirmation history registration process]
Next, a confirmation history registration process executed by the control unit 11 of the server 1 will be described with reference to FIG.

  The control unit 11 executes the confirmation history registration process when a predetermined user operation is performed using the client terminal 2. Specifically, the control unit 11 is predetermined when the progress record key K13 is operated on the medicine history screen P1 (see FIG. 7) using the operation device 25 of the client terminal 2. A guidance record screen is displayed on the display device 24. And the said control part 11 displays the list of the said temporary registration information memorize | stored in the past about the patient corresponding to the said medicine history screen P1 according to user operation in the said instruction | indication recording screen, and the said temporary registration by user operation When the information is selected, the confirmation history registration process is started.

<Step S31>
First, in step S31, the control unit 11 reads the temporary registration information selected on the instruction recording screen from the temporary registration information temporarily registered in step S27 and displays the temporary registration information on the medicine-specific explanation screen P5. FIG. 13 is a diagram showing an example of the medicine-specific explanation screen P5. The medicine-specific explanation screen P5 is a display screen similar to the medicine-specific explanation screen P2. However, as shown in FIG. 13, the medicine-specific explanation screen P5 displays a record reflection key K30 in the header area A10. ing. The record reflection key K30 is an operation key for registering the temporary registration information as a confirmation history of the problem list and storing it in the storage unit 12.

<Step S32>
Next, in step S32, the control unit 11 accepts input of the confirmation result of each of the problem item and the sub item in the SOAP list area A23 in the medicine-specific explanation screen P5. Specifically, the control unit 11 has a check box (an example of a first switching operation unit) for switching the confirmation state of the problem item to either confirmed or unconfirmed, and the confirmation state of the sub-item has been confirmed and unconfirmed. A check box (an example of a second switching operation unit) for switching to any of the above is displayed. And the control part 11 receives the input of the confirmation result of the said problem item and the said sub item according to operation of each said check box. This processing is executed by the confirmation receiving unit 114 of the control unit 11. When the medicine-specific explanation screen P5 is displayed, only the SOAP list area A23 is an operation target in the medicine-specific explanation screen P5, and the control unit 11 controls the medicine list area A21 and the problem. The operation for the list area A22 is invalidated.

  Here, on the medicine-specific explanation screen P5, the problem item and the sub-item whose selection state is the check state on the medicine-specific explanation screen P2 are similarly checked. Thereby, the pharmacist does not need to check the problem item and the sub item again, and the burden of registration work is reduced. In addition, when the said control part 11 displays the said description screen P5 classified by chemical | medical agent, it resets the selection state of the said problem item and the said subitem, and inputs again reliably about the presence or absence of the confirmation of the said problem item and the said subitem. It is also conceivable as another embodiment.

  In step S32, the control unit 11 selects one of the sub-items previously associated as a pair of sub-items among the sub-items displayed in the SOAP list area A23. When the confirmation state of one of the sub items is switched to confirmed by the operation of the check box corresponding to, it is conceivable to switch the confirmation state of the other sub item to unconfirmed. For example, the sub-items “Driving” and “Operating dangerous machinery” and “Don't do dangerous tasks such as driving” for “Caution on life (driving a car, etc.)” Because the contents conflict, they do not hold at the same time. Therefore, it is conceivable that such sub items are associated in advance as a pair of confirmation items. Thereby, in the confirmation history registration process, a pharmacist can easily perform an alternative confirmation operation. For example, when one of the sub-items “Driving” and “Operating the machine with danger” is switched to the confirmation state, the control unit 11 performs a sub-step “Don't do dangerous work such as driving”. The item switches to unconfirmed. In addition, when the control unit 11 switches to the sub-item confirmation state of “Do not perform dangerous work such as driving”, the sub-items of “Run” and “Operate the dangerous machine” are unconfirmed. Switch. In particular, such a configuration is suitable when the problem list is checked with reference to the display device 24 without printing the problem list. In addition, when any one of the three or more sub items associated in advance is switched to the confirmation state, the remaining two or more sub items may be switched to the unconfirmed state. By the way, when the control unit 11 displays the medicine-specific explanation screen P2, the plurality of sub-items that are determined in advance as a pair of sub-items are stored in the check boxes corresponding to any one of the sub-items. When the sub item is switched to a checked state by an operation, it is also conceivable to switch the confirmation state of the other sub item to an unchecked state. This makes it possible to eliminate printing of unnecessary sub-items when the problem list is printed.

<Step S33>
Thereafter, in step S33, the control unit 11 determines whether or not an operation for recording information being displayed on the medicine explanation screen P5 as a confirmation history has been performed. Specifically, when the record reflection key K30 is operated (S33: Yes side), the control unit 11 shifts the process to step S34, and until the record reflection key K30 is operated ( S33: No side), the process returns to step S32.

<Step S34>
In step S34, the control unit 11 generates a confirmation history based on the problem list edited on the medicine explanation screen P5, and executes a registration process for storing the confirmation history in the storage unit 12.

  Specifically, the control unit 11 displays all the problem items displayed on the medicine-specific explanation screen P5 on the record reflection screen P6 before recording the confirmation history. Thereby, the pharmacist can be made to recognize all the contents of the problem item recorded as the confirmation history. In particular, in the record reflection screen P6, the confirmed item and the unconfirmed item among the problem items are shown in a distinguishable manner. FIG. 14 is a diagram showing an example of the record reflection screen P6. As shown in FIG. 14, in the confirmation history displayed on the record reflection screen P6, the problem item corresponding to the unconfirmed item among the problem items included in the problem list and confirmed by the pharmacist. For, the contents of the sub-items that are the confirmation contents are shown. On the other hand, in the confirmation history, for the problem item corresponding to the confirmed item among the problem items, the content of “confirmed that there is no problem by prescription check” indicating that is shown. Thereby, in the confirmation history, it is possible to distinguish and grasp the problem item that is the unconfirmed item confirmed by the pharmacist and the problem item that is the confirmed item confirmed by the prescription check. In the record reflection screen P6, the text can be directly edited for the confirmation history. For example, as shown in FIG. 14, the location of “@@” of “Occupation (@@)” in “Caution on life (car driving etc.)” displayed in the SOAP list area A23 of FIG. It is possible to change to a specific occupation type such as “carpenter”. Then, when the reflection key K61 displayed on the recording reflection screen P6 is operated, the control unit 11 stores the confirmation history displayed on the recording reflection screen P6 in the storage unit 12.

  As described above, in the medication instruction support system 10, among the problem items included in the problem list, the confirmed items corresponding to the check items that have already been determined to be appropriate in the prescription check. It can be easily grasped. And about the said confirmed item, the fact that it was confirmed by the said prescription check is recorded on the said confirmation log | history. Therefore, the pharmacist can safely omit the confirmation work of the confirmed items, and can reduce the burden of the confirmation work of the problem list in the medication instruction work. For example, the pharmacist can use the time shortened by the confirmation work of the problem list for other work included in the medication instruction work.

  In addition, since the confirmed item has been confirmed to be appropriate in the prescription check, and is not an item that the pharmacist needs to confirm by himself / herself or confirm with the patient, It is also conceivable that they are not displayed on the explanation screens P2 and P5. However, in the medication instruction support system 10, all the problem items including the confirmed items and the unconfirmed items are displayed on the medicine-specific explanation screens P2 and P5. Thereby, the pharmacist can surely grasp all the problem items recorded as the confirmation history of the problem list by referring to the explanation screens P2 and P5 classified by medicine, and particularly the confirmation. The completed item and the unconfirmed item can be distinguished and grasped. Therefore, in the medication instruction support system 10, it is possible for a pharmacist to check on the explanation screens P2 and P5 for each medicine whether or not there is an excess or deficiency of the problem items to be recorded as the confirmation history, thereby realizing high convenience. Is done.

[Other Embodiments]
By the way, the medication instruction support system 10 may have a non-display function for hiding a problem item that does not satisfy a predetermined display condition among the problem items included in the problem list read in step S21. Conceivable. Specifically, the non-display function is implemented when the determination processing unit 112 executes the processes of steps S211 to S212 between the steps S21 and S22 in the medication instruction support process. The non-display function can be arbitrarily switched between valid and invalid in the initial setting of the medication instruction support system 10, and the non-display function is invalid in the medication instruction support process (see FIG. 6). The case where it is set to has been described.

  Hereinafter, an example of the medication instruction support process executed when the non-display function is set to be effective will be described. FIG. 15 is a flowchart showing another example of the medication instruction support process. In addition, about the process sequence similar to the said medication instruction | indication support process (FIG. 6), the same code | symbol is attached | subjected and the description is abbreviate | omitted.

<Step S211>
First, in step S211, the control unit 11 executes a process for specifying display items and non-display items from the problem items included in the problem list read in step S21. Specifically, the control unit 11 determines whether each of the problem items satisfies a display condition predetermined for each problem item, and specifies a confirmation item that satisfies the display condition as a display item. A confirmation item that does not satisfy the display condition is specified as a non-display item (an example of a fifth confirmation item).

  Specifically, FIG. 16 is a diagram showing problem information D22 which is another example of the problem information D21. In the problem information D22, in addition to the content of the problem information D21, one or a plurality of display conditions are defined corresponding to each problem item. Specifically, the display conditions include patient information such as “sex”, “age”, “drinking”, “smoking”, and “disease name”. In the problem information D22, for example, it is defined as the display condition that the age is “18 years or older” for “attention on daily life (car driving, etc.)” in the problem item. Among the problem items, “Precautions for life (alcohol)” is defined as the display condition that the age is “20 years or older” and the drinking is “Yes”. Further, regarding the “problem confirmation of contraindication (peptic ulcer)” among the above-mentioned problem items, it is defined as the display condition that the disease name is “peptic ulcer”. In addition, regarding the “pregnant and lactating women” among the problem items, the gender is “female” as the display condition. It is defined as the display condition that it is “14 years old or younger”. Although omitted in FIG. 16, regarding the “prohibition of contraindication (myasthenia gravis)” among the above-mentioned problem items, the display condition is that the disease name is “myasthenia gravis”. .

<Step S212>
In step S212, the control unit 11 excludes the non-display item specified in step S211 from the output items among the problem items included in the problem list read in step S21. Specifically, the control unit 11 sets a confirmation item excluding the problem item corresponding to the non-display item from the problem list read in step S21 as an output target. Moreover, when the said control part 11 outputs the said problem list, it outputs the said confirmed item in the output aspect used as the said unconfirmed item floor among the said remaining problem items from which the said non-display item was excluded. Accordingly, the non-display items are not displayed in the problem list area A22 and the SOAP list area A23 when the problem list is displayed in the step S24. Also, the non-display items are not printed when the problem list is printed in step S27. For example, FIG. 17 shows “problems on life (driving a car)”, “confirmation of contraindications” as the non-display items among the problem items displayed on the medicine-specific explanation screen P2 shown in FIG. (Myasthenia gravis), “Confirmation of pregnant and lactating women”, and “Confirmation of pediatric dose” are omitted.

  As a result, among the problem items included in the problem list, the non-display items that clearly do not need to be confirmed based on patient information are not displayed or printed, so that the problem list is simplified as much as possible. Therefore, the burden of the confirmation work of each of the problem items performed by the pharmacist according to the problem list is reduced.

1: Server 11: Control unit 12: Storage unit 13: Communication I / F
14: Operation device 15: Display device 16: Drive device 2: Client terminal 21: Control unit 22: Storage unit 23: Communication I / F
24: Operation device 25: Display device 26: Drive device 3: Dispensing device 4: Printer 10: Medication instruction support system

Claims (17)

An acquisition processing unit that acquires a check result of a prescription check that determines whether one or more first confirmation items are appropriate before dispensing for prescription data;
When outputting a list including one or a plurality of second confirmation items before or after taking a medicine dispensed based on the prescription data, confirmation has been made based on the contents of the check result among the second confirmation items An output processing unit capable of outputting a third confirmation item that can be determined as being different from the fourth confirmation item of the second confirmation item except the third confirmation item;
Medication instruction support system with   The third confirmation item is associated in advance with the same item as the first confirmation item determined to be appropriate by the prescription check or the first confirmation item determined to be appropriate by the prescription check. The medication instruction support system according to claim 1, wherein The medication instruction support system according to claim 1 or 2, wherein the output processing unit is capable of executing either one or both of display and printing of the list .   The medication instruction support system according to any one of claims 1 to 3, wherein the output mode is a character color, a background color, or a size. A confirmation receiving unit for receiving an input of a confirmation result of each of the fourth confirmation items;
A recording processing unit for recording the confirmation result of each of the fourth confirmation items received by the confirmation receiving unit and the fact that the third confirmation item has been confirmed as a confirmation history of the list ;
A medication instruction support system according to any one of claims 1 to 4.   The medication instruction support system according to claim 5, wherein the output processing unit displays all the second confirmation items before recording the confirmation history by the recording processing unit. The confirmation receiving unit displays a first switching operation unit that switches a confirmation state of each of the fourth confirmation items included in the list to either confirmed or unconfirmed, and according to an operation of the first switching operation unit The medication instruction support system according to claim 5 or 6, which receives an input of a confirmation result of the fourth confirmation item.   The confirmation receiving unit displays a second switching operation unit that switches the confirmation state of one or more sub-items included in each of the fourth confirmation items to either confirmed or unconfirmed, The medication instruction support system according to any one of claims 5 to 7, wherein an input of a confirmation result of the sub-item is received according to an operation.   When the confirmation accepting unit switches the confirmation state of one of the sub items to confirmed by operating the second switching operation unit for a plurality of sub items previously associated as a pair of sub items among the sub items. The medication instruction support system according to claim 8, wherein the confirmation state of the other sub-item is switched to unconfirmed. A determination processing unit that determines whether each of the second confirmation items satisfies a display condition predetermined for each second confirmation item;
When the output processing unit outputs the list , the fifth confirmation item that is determined not to satisfy the display condition by the determination processing unit among the second confirmation items can be excluded from an output target, The medication instruction support according to any one of claims 1 to 9, wherein the third confirmation item is output in an output mode different from the fourth confirmation item among the remaining second confirmation items from which the fifth confirmation item is excluded. system.   The medication instruction support system according to claim 10, wherein the display condition includes a condition related to predetermined patient information.   The medication instruction support system according to any one of claims 1 to 11, wherein the acquisition processing unit acquires the check result by executing the prescription check. The medication instruction support system according to any one of claims 1 to 12, wherein the output processing unit prints only the fourth confirmation item among the second confirmation items when the list is printed. After the output processing unit displays the list , the output processing unit can accept an operation of selecting each of the second confirmation items included in the list as a confirmation item to be printed and an operation of excluding it from the confirmation items to be printed. The medication instruction | indication support system in any one of Claims 1-13. An information storage unit storing problem information indicating the correspondence between the second confirmation item and the type of medicine;
The medication instruction support system according to any one of claims 1 to 14, wherein the output processing unit can generate the list including the second confirmation item corresponding to the medicine based on the problem information. A medicine selection unit that accepts a selection operation of one or more medicines to be output from the list ;
The medication instruction support system according to claim 15, wherein the output processing unit can generate the list including the second confirmation item corresponding to one or a plurality of medicines selected by the medicine selection unit. A first step of acquiring a check result of a prescription check for determining whether or not one or more first confirmation items are appropriate before dispensing for prescription data;
When outputting a list including one or a plurality of second confirmation items before or after taking a medicine dispensed based on the prescription data, confirmation has been made based on the contents of the check result among the second confirmation items A second step of outputting a third confirmation item that can be determined to be a different output mode from the fourth confirmation item of the second confirmation item excluding the third confirmation item;
Medication instruction support method comprising.

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