JP7043235B2 - Bed management business support system - Google Patents

Description

Application of Article 30, Paragraph 2 of the Patent Act On June 1, 2017, on the website of Nissay Information Technology Co., Ltd. (http://www.nissay-it.co.jp/solution/medi-sinus.html). Published

The present invention relates to a bed management business support system for efficiently providing a bed manager with information necessary for bed management in a medical institution such as a hospital.

Bed management refers to managing and adjusting the beds (beds) of inpatients in medical institutions such as hospitals in order to operate them effectively and efficiently. Bed management is an important task that is directly linked to hospitalization income, which accounts for a large part of hospital income, and its main task is to adjust and secure beds for the smooth acceptance of patients who need to be hospitalized. Adjustment of patient's transfer / bed change, discharge adjustment, bed adjustment for reserved hospitalization, etc.

Here, as prior art documents relating to bed management, there are Patent Documents 1 to 4 described below.

Patent Document 1 discloses a system for efficiently executing an allocation simulation for a plurality of beds based on various conditions for hospitalization reservation data.

Patent Document 2 focuses on increasing the utilization rate of beds mainly from a financial point of view, whereas conventional bed management maintains the safety and quality of medical services for patients. In order to improve the situation, we disclose a bed management support system that can identify bed conditions that meet multiple attributes or needs of patients.

In Patent Document 3, the names of inpatients in each room are displayed in a list together with the number of days of hospitalization for all rooms in each ward, and the inpatients in each room displayed in the list are moved in the list display and the data is updated in the room after the movement. Discloses possible hospitalization and discharge management devices.

Patent Document 4 discloses a bed management support system that extracts information on a bed according to a patient's symptom from patient information showing the patient's symptom and map information showing the arrangement relationship between a facility in the ward and the bed. There is.

JP 2009-163378 JP 2012-146249 JP 2013-246793 Japanese Patent Application Laid-Open No. 2014-041439

Looking at the problems in the medical and long-term care fields in Japan, in 2025, one in three people will be 65 years old or older (one in five people will be 75 years old or older). As the demand for medical care and long-term care increases, the national government is revising the medical system with the aim of providing a medical care system that can meet such medical demand.

Regarding the conventional general beds and medical care beds in each medical institution, the medical functions are differentiated, and each bed function is changed to the highly acute phase function (for patients in the acute phase, the medical care density for early stabilization of the condition). Functions that provide particularly high medical care, ICU ward, HCU ward as the main bed classification, Acute phase function (Function to provide medical care for patients in the acute phase for early stabilization of the condition, Main beds General ward as a division), convalescent function (function to provide medical care and rehabilitation for returning home of patients who have passed the acute phase, community comprehensive care ward, convalescent rehabilitation ward as main bed categories), chronic phase function ( A function to hospitalize patients who need medical treatment for a long period of time, a bed function reporting system that reports to prefectures the medical functions (units of wards) that each medical institution is responsible for is adopted. rice field. In the above-mentioned bed classification, the basic hospitalization fee is from high to low in the order of description from the top, but the bed function is further reviewed and the transition from the acute phase to the convalescent phase is being promoted. For each bed category, standard values such as the function and equipment of medical institutions, medical care system, percentage of inpatients with severe illness, average length of stay, return to home rate, etc. are set, and by conforming to these facility standards, Although medical fees are to be added, the facility standard was revised in 2016, and the standard value was changed so that increasing the number of convalescent wards would be effective for hospital management. Due to the revision in FY2018, general wards are expected to be evaluated more severely.

Due to the above amendment, the general ward will treat the severely ill, and the recovery of the condition will make the movement to the recovery period / medical treatment function stricter. It will be more required to consider.

However, when moving a patient (transferring / discharging), it is necessary to make a comprehensive judgment in consideration of not only the convenience of the hospital but also the convenience of the patient. The matters to be considered from each standpoint are listed below.

<Hospital side>
a. Hospitalization income unit price Hospital management needs to make efforts to obtain optimal (higher) medical treatment fees depending on the medical services to be provided to patients, and the following items should be considered.
・ Timing of transfer ・ DPC score / hospitalization period ・ Score of transfer destination ・ Number of hospitalizations and discharges (general ward) ・ Bed occupancy rate (convalescent ward)
b. Maintaining Facility Standards It is necessary to maintain facility standards commensurate with the hospital's medical care provision system and make efforts to obtain optimal (higher) basic hospital charges, and at least the following items should be considered.
・ Average length of stay ・ Average rehabilitation unit ・ Return to home rate ・ Percentage of severely ill patients (percentage of patients who meet criteria for severity and medical / nursing needs)

<Patient side>
c. Medical treatment status Doctors and nurses are required to make judgments regarding the patient's condition and medical treatment schedule. at least,
The following items need to be considered:
・ Test schedule / test result ・ Surgery schedule / surgery result ・ Rehabilitation schedule ・ ADL (Activities of Daily Living) ・ Infectious disease

<Both hospital side and patient side>
d. Adjustment of destination When a patient is transferred or discharged from the hospital, it is necessary to adjust the destination including the situation of the patient and his / her family. At a minimum, the following items need to be considered:
・ Bed adjustment at the hospital / transfer destination ・ Burden of the ward ・ Arrangement of nurses ・ Patient's wishes ・ Family's wishes e. Agreement with stakeholders At least the following agreements with the parties are considered necessary to confirm that the optimal decision has been made.
・ Medical Affairs Division ・ MSW (Medical Social Worker) ・ Rehabilitation ・ Ward Chief ・ Doctor

As mentioned above, in recent bed management work, comprehensive judgment is required in consideration of various circumstances on the hospital side and the patient side. On the other hand, the techniques disclosed in Patent Documents 1 to 4 described above focus on how to allocate beds for hospitalization reservations or manage beds in each ward. It does not provide a sufficient solution to bed management work that requires comprehensive judgment. In addition, although systematization in hospitals is progressing centering on electronic medical records, the functions for bed management are insufficient with electronic medical records alone, as described below. Specific problems with respect to the above-mentioned items a to e are described below.

a. Unit price of hospitalization income ・ It is unclear when the unit price of hospitalization income can be maximized by transferring or leaving the hospital.
・ It is necessary to order DPC information from the medical affairs section.

b. Maintaining facility standards ・ There is no way to consider the movement of patients throughout the hospital while considering the need for nursing and the return-to-home rate.
・ There is no way to check the rehabilitation intervention status and average unit.

c. Medical status ・ Information is managed on a patient-by-patient basis in electronic medical records, and it takes a lot of time and effort to collect information on multiple patients.
・ The description and method of the medical record are not unified, and it is difficult to find out where to look.

d. Adjusting the destination ・ When adjusting the hospital bed, it is difficult to understand the burden on other wards and the vacant bed.
・ It is necessary to obtain information from social workers regarding the adjustment status of the discharge destination.

e. Agreement with related parties ・ Information necessary for deciding whether to transfer or leave the hospital cannot be centralized, and it cannot be confirmed and judged efficiently.
・ There is no way to get a bird's-eye view of the usage status of the entire hospital and confirm that optimal patient movement is being performed.

The present invention has been made to solve the above-mentioned problems, and in particular, patient information necessary for determining the optimum timing of transfer / discharge is automatically extracted and displayed in an easy-to-understand manner, and further. , The purpose is to provide a function that can share information on the side of each related party related to the timing determination.

The bed management business support system according to the present invention receives an instruction from an electronic terminal and displays a bed management business that displays a transfer / discharge adjustment screen display for providing information necessary for adjusting the patient's transfer / discharge timing. It is a support system that stores basic patient information including the patient's name, date of birth, and gender code in association with the patient ID, and one record is created for each patient in the hospital. In-hospital information storage means for storing in-hospital patient information including ward code, ward code, bed code, medical department code, chief doctor code, chief doctor name, and date of admission, and data related to each ward in association with the ID. It is a master to manage, a ward master storage means that stores data including building structure number, ward name, ward / bed classification, and number of beds in association with the ward code, and a master that manages data related to medical departments. , A medical department master storage means that manages data including a medical department name and a medical department name (abbreviation) in association with a medical department code, in-hospital patient information stored in the in-hospital patient information storage means, and in-hospital. Basic patient information acquired from the basic patient information storage means based on the patient ID included in the patient information, and the medical department master storage means based on the medical department code and ward code included in the acquired in-hospital patient information. By acquiring the medical department name and the ward name from the ward master storage means, the patient ID, patient name, age, ward name, medical department name, and chief physician name are displayed for each inpatient, and the patient's name is displayed. It is characterized by being equipped with a display processing means for displaying an input field for inputting comments of related persons for each of the medical condition / medical treatment status, the discharge destination securing status, and the rehabilitation status.

In the above-mentioned bed management business support system, the above-mentioned display processing means calculates the length of hospital stay from the date of admission included in the inpatient information and the date of the day when the transfer adjustment screen display is displayed. The length of hospital stay is further displayed for each patient.

The above bed management business support system creates one record for each transfer reservation, and includes the scheduled transfer date, ward code, room code, and bed code in association with the patient ID and the transfer decision order number. A transfer decision order information storage means for storing transfer decision order information, and one record is created for each discharge reservation, which is associated with the patient ID and discharge decision order number, and discharge decision order information including the scheduled discharge date. The discharge decision order information storage means for storing the patient ID, and the display processing means include the patient ID included in the transfer decision order information and the discharge decision order information, and the inpatient patient acquired from the inpatient information storage means. From the patient ID included in the information, the adjustment category column is further displayed, which displays that fact for patients who have made a transfer reservation or discharge reservation, and displays that the remaining inpatients have not been adjusted. Let me.

In the above bed management work support system, one record is created every day for each patient, and patient ID, hospitalization date, medical treatment date, ward code, ward code, ward / bed classification, medical department code, evaluation sheet, A. Further provided with a nursing necessity information storage means for storing nursing necessity information including an evaluation, a B evaluation, a C evaluation, and a critically ill person determination flag, the display processing means is based on a patient ID acquired from in-hospital patient information. When a record corresponding to the patient ID is acquired from the nursing necessity information, and the medical treatment date included in the record is the day before the current day and the critically ill person determination flag indicates that the patient is severely ill. , Display that the patient is a seriously ill person, or automatically exclude the display of the patient by setting additional exclusion conditions.

The above-mentioned bed management business support system creates one record for each surgery appointment, and records surgery information including patient ID, surgery order number, scheduled surgery date, surgery implementation date, surgery name, and hospitalization request classification. Further provided with a surgical information storage means to be stored, the display processing means acquires a record corresponding to the patient ID from the surgical information based on the patient ID acquired from the in-hospital patient information, and the surgical schedule included in the record. If the data is entered on the date or the date of surgery and it is a date after that date, the display of the patient is automatically excluded by setting additional exclusion conditions.

In the above-mentioned bed management business support system, one record is created for each hospitalization, and in relation to the patient ID, the hospitalization date, SEQ (number for managing hospitalization and discharge re-hospitalization on the same day), Form 1 hospitalization date, main Injury / illness name, hospitalization opportunity Injury / illness name, most invested medical resources Injury / illness name, DPC code, DPC name, comprehensive classification (0: volume, 1: comprehensive), not subject to comprehensive evaluation (0: comprehensive evaluation, 1: not subject to comprehensive evaluation) , Reasons for exemption from comprehensive evaluation, Year of application of revision of medical fees, Hospitalization period I points, Hospitalization period II points, Hospitalization period III points, Hospitalization period I days, Hospitalization period II days, Hospitalization period III days, Hospitalization period expiration I years Further, a DPC information storage means for storing DPC information including items of hospitalization period II expiration date and hospitalization period III expiration date is further provided, and the above display processing means is used for the patient ID included in the in-hospital patient information. Based on this, DPC information including the patient ID is acquired from the DPC information storage means, and for the patient, the hospitalization period II score calculated by multiplying the hospitalization period II score by the hospital institution-specific coefficient. The number of days remaining in the hospitalization period II calculated from the number of days in the hospitalization period II and the number of days in the hospital, the score of the hospitalization period III calculated by multiplying the score of the hospitalization period III by the coefficient for each hospital institution, and the number of days of the hospitalization period III and the hospitalization. The number of remaining days of hospitalization period III calculated from the number of days is further displayed.

The above-mentioned bed management business support system is a master that manages the basic hospitalization fee of the ward to which the ward is transferred from a general sickbed, etc. The hospitalization basic charge master storage means for storing data including classification, hospitalization basic charge name, and score is further provided, and the above display processing means obtains comprehensive care points from the hospitalization basic charge master storage means. The difference from the comprehensive care score is calculated according to the following calculation method and displayed further.

・ If the length of hospital stay is I or less, the comprehensive care score- (Hospitalization I score x Coefficient by medical institution)
・ If the length of hospital stay is II or less, comprehensive care points- (Hospitalization period II points x Coefficient by medical institution)
・ If the length of hospital stay is III or less, comprehensive care points- (Hospitalization period III points x Coefficient by medical institution)
・ If the length of hospital stay does not correspond to the above: Comprehensive care score- (Hospitalization period III score x Coefficient by medical institution)

In addition, the above-mentioned bed management business support system is a master that manages the basic hospitalization fee of the ward to which the ward is transferred from a general sickbed, etc. / A hospitalization basic charge master storage means for storing data including a bed classification, a hospitalization basic charge name, and a score is further provided, and the above display processing means obtains a recovery rehabilitation score from the hospitalization basic charge master storage means. , The difference from the recovery rehabilitation score is calculated according to the following calculation method, and further displayed.

・ If the length of hospital stay is I or less, recovery rehabilitation score- (Hospitalization period I score x Coefficient by medical institution)
・ If the length of hospital stay is II or less, recovery rehabilitation score- (Hospitalization II score x Coefficient by medical institution)
・ If the length of hospital stay is III or less, recovery rehabilitation score- (Hospitalization III score x Coefficient by medical institution)
・ If the length of hospital stay does not correspond to the above, recovery rehabilitation score- (hospitalization period III score x coefficient by medical institution)

According to the present invention, the patient information necessary for determining the optimal timing of transfer / discharge is displayed in an easy-to-understand manner, and further, the information of each related party related to the timing determination is shared to transfer / discharge the patient. It provides a function that can appropriately adjust the discharge time.

It is a figure which shows an example of the transfer | discharge adjustment screen display by embodiment of this invention. It is a block diagram which shows the outline of the hardware composition and processing by embodiment of this invention. It is a block diagram which shows the detail of the data included in the bed management work support database 3 and the bed management work support master group 5. It is a figure which shows the item of the record of the patient basic information 301. It is a figure which shows the item of the record of the in-hospital patient information 302. It is a figure which shows the item of the record of the transfer decision order information 304. It is a figure which shows the item of the record of discharge decision order information 305. It is a figure which shows the item of the record of the nursing necessity information 306. It is a figure which shows the item of the record of the operation information 310. It is a figure which shows the item of the record of DPC information 313. It is a figure which shows the item of the record of the ward master 501. It is a figure which shows the item of the record of the clinical department master 505. It is a figure which shows the item of the record recorded by the hospitalization basic charge master 511. It is a figure which shows the outline of the item of the patient which is displayed in the transfer | discharge adjustment screen display. It is a figure which shows the outline of the item of the patient which is displayed in the transfer | discharge adjustment screen display. It is a figure which shows the item of the record which the rehabilitation information records.

Hereinafter, embodiments of the bed management business support system (hereinafter referred to as “the present system”) according to the present invention will be described with reference to the drawings.

First, an example of a screen displayed for adjusting the time of transfer / discharge, which is the main function of this system, will be described with reference to FIG. 1.

FIG. 1 is an example of a screen displayed by this system for adjusting the transfer / discharge time (this screen display is hereinafter referred to as “transfer / discharge adjustment screen display”). This display allows the bed manager and related parties to list the information necessary for transfer / discharge adjustment in an easy-to-read format. Information about patients who are candidates for transfer to the hospital is displayed line by line for each patient. In FIG. 1, the items indicated by reference numerals a1 to a7 indicate information on patients as candidates for transfer / discharge. Items indicated by reference numerals b1 to b4 are items that can be displayed by medical institutions that handle DPC information, and items that provide important information for determining the timing of transfer / discharge from the medical fee system (income side). Is. The items indicated by the symbols c1 to c3 are columns in which each person in charge can write comments and judgments at any time regarding the medical condition required for the transfer / discharge decision, the status of securing the discharge destination, and the rehabilitation information. The item indicated by d is an item for displaying the current status of the discharge decision or the transfer decision for the patient who is a candidate for transfer, and in the example of FIG. 1, "not yet" (indication indicating unadjustment) is displayed. (See FIGS. 14 and 15 for the items indicated by each reference numeral).

Next, an outline of the hardware configuration and processing according to the embodiment of this system will be described with reference to FIG. The bed management business support server 1 shown in FIG. 2 executes processing related to execution of each function provided by this system by linking a computer program and computer hardware.

The bed management business support server 1 includes electronic medical record information from the electronic medical record system 11 of the medical institution, or electronic form of patient information and medical information in other formats (for example, from medical office work / DPC system 12 and the like). (DPC information, etc.) Information necessary for bed management work is acquired at regular intervals, data reorganization, registration, update, etc. are executed, and the bed is used as a file format necessary for function execution in this system. Save in the management business support database 3. It is not essential to execute the process for generating in the file format for saving in the bed management business support database 3 in this system, and the file generated by another system may be acquired.

The bed management business support server 1 also functions as a Web server, is accessed from the electronic terminal 4 of the medical institution via a network such as the intranet or the Internet, and is instructed to display the transfer / discharge adjustment screen 8 from the electronic terminal 4. According to this, necessary information is extracted from the bed management work support database 3, necessary information of the bed management work support master group 5 is acquired, and based on the data obtained from both sides, the transfer / discharge adjustment screen is displayed. The necessary bed management information 6 is generated, the display process is executed based on the bed management information 6, the transfer ward discharge adjustment screen display 8 is generated, and the display 8 is provided to the electronic terminal 4.

Although the bed management business support server 1 is represented as one block in FIG. 2, it is not necessarily limited to a single piece of hardware and may be configured by a plurality of servers.

FIG. 3 is a diagram showing details of the data included in the bed management work support database 3 and the bed management work support master group 5 shown in FIG.

In order to display the transfer / discharge adjustment screen display 8, the essential information files that capture information at regular intervals and store it in the bed management work support database 3 include basic patient information 301 and inpatient information 302, and further. , Transfer decision order information 304, discharge decision order information 305, nursing necessity information 306, surgery information 310, DPC information 313, etc., to increase the items to be displayed on the transfer decision discharge adjustment screen display 8. Exclusion conditions for candidate extraction can be increased.

Further, among the bed management work support master group 5 owned by the bed management work support server 1 in order to display the transfer discharge adjustment screen display 8, the essential masters are the ward master 501 and the clinical department master 505. Furthermore, by possessing the hospitalization basic charge master 511 and the like, it is possible to increase the items to be displayed on the transfer / discharge adjustment screen display 8.

Next, the details of each information file stored in the bed management business support database 3 will be described. 4 to 10 are diagrams showing the contents of record items stored in each information file. In these figures, items marked with ◎ or ○ in the key column are required items, and ◎ indicates the primary key.

FIG. 4 shows the item of the record of the patient basic information 301. The patient basic information 301 is created in one record for each patient, and includes items such as a patient ID, a patient kana name, a patient name (Kanji), a patient date of birth, and a gender code.

FIG. 5 shows the item of the record of the in-hospital patient information 302. One record of inpatient information 302 is created for each inpatient, and the patient ID, ward code, ward code, bed code, clinical department code, attending physician code, attending physician name, hospitalization date, and rescue category name are created. Includes items.

FIG. 6 shows the item of the record of the transfer decision order information 304. One record of the transfer decision order information 304 is created for each transfer reservation, and the patient ID, the transfer decision order number, the transfer decision date, the planned transfer date, the ward code, the hospital room code, and the bed. Includes code, department code, and items.

FIG. 7 shows a record item of discharge decision order information 305. The discharge decision order information 305 is created in one record for each discharge reservation, and includes items such as a patient ID, a discharge decision order number, a discharge decision date, and a scheduled discharge date.

FIG. 8 shows the item of the record of the nursing necessity information 306. Nursing necessity information 306 records the evaluation results of inpatients at 24:00 on a daily basis based on the evaluation of "severity, medical / nursing necessity", and the evaluation at the time of discharge is performed on the discharge day. Recorded. One record of nursing necessity information 306 is created every day for each patient, and patient ID, hospitalization date, medical treatment date, ward code, ward code, ward / bed classification (general ward, community-based comprehensive care ward, recovery period). (Indicates one of the rehabilitation ward), medical department code, evaluation sheet, A evaluation, B evaluation, C evaluation, severely ill person judgment flag (0 for severely ill or less, 1 for severely ill). include.

FIG. 9 shows the record items of the surgical information 310. The operation information 310 is created as one record for each operation appointment, and includes items such as patient ID, operation order number, scheduled operation date, operation date, operation name, and hospitalization request classification.

FIG. 10 shows a record item of DPC information 313. One record of DPC information 313 is created for each hospitalization, including patient ID, hospitalization date, SEQ (number for managing hospitalization and discharge re-hospitalization on the same day), discharge date, form 1 hospitalization date, and main injury / illness name. , Hospitalization opportunity Injury and illness name, Medical resource most invested injury and illness name, DPC code, DPC name, Comprehensive classification (0: Volume, 1: Comprehensive), Not covered by comprehensive evaluation (0: Comprehensive evaluation, 1: Not covered by comprehensive evaluation), Comprehensive Reasons for non-evaluation, medical fee revision application year, hospitalization period I points, hospitalization period II points, hospitalization period III points, hospitalization period I days, hospitalization period II days, hospitalization period III days, hospitalization period expiration I years, hospitalization Includes items for period II expiration date and hospitalization period III expiration date.

Next, the details of the essential masters among the master group 5 for supporting bed management work will be described. 11 to 13 are diagrams showing the contents of record items stored in each master. In these figures, the item in which the number surrounded by a circle is displayed in the PK column indicates the primary key. In addition, the item in which the number surrounded by a circle is displayed in the Index column is an item that becomes an index at the time of search.

FIG. 11 shows the record items recorded by the ward master 501. The ward master 501 is a master that manages the ward name, the number of beds, etc., and is a ward code, a building structure number, a ward name, a ward name (abbreviation), a ward / bed classification (for example, a general ward, a community-based comprehensive care ward, recovery). Code indicating one of the stage rehabilitation wards), number of beds, display order, bed occupancy rate threshold (current status), severely ill person threshold (current status), bed occupancy rate threshold (monthly cumulative total), severely ill person threshold (monthly cumulative total) ), Ward bed details classification, etc. are included.

FIG. 12 shows the items of the record recorded by the clinical department master 505. The clinical department master 505 is a master that manages the clinical department name and the like, and includes items such as a clinical department code, a clinical department name, a clinical department name (abbreviation), a display order, a display category, and a valid category.

FIG. 13 shows the items of the record recorded by the hospitalization basic charge master 511. The basic hospitalization fee master 511 is a master that manages the basic hospitalization fee of the ward to which the ward is transferred from a general sickbed, etc. , Points, etc. are included.

Next, how the data included in the bed management information 6 shown in FIG. 3 is generated from the information included in the bed management work support database 3 and the master included in the bed management work support master group 5. Further, what kind of processing is performed to display the transfer / discharge adjustment screen display 8 will be described. Note that FIG. 14 shows an outline of the items shown in the left half of the information items displayed line by line for each patient in the example of the transfer discharge adjustment screen display 8 shown in FIG. .. Further, FIG. 15 shows an outline of the items shown in the right half of the information items displayed line by line for each patient in the example of the transfer discharge adjustment screen display 8 shown in FIG. ..

First, the display of patient data indicated by the reference numerals a1 to a7 in FIG. 14 will be described. The data of the patients who are candidates for transfer / discharge are acquired from the in-hospital patient information 302 and the basic patient information 301. That is, the patient ID, the ward code, the clinical department code, the attending physician code, and the attending physician name are acquired from the in-hospital patient information 302. Further, based on the patient ID acquired from the in-hospital patient information 302, the patient name, gender code, and patient birth date are acquired from the patient basic information 301.

The display of the ward shown by a1 causes the ward name or its abbreviation stored in the ward master 501 to be displayed from the ward code. The display of the clinical department shown by a2 displays the clinical department name or its abbreviation stored in the clinical department master 505 from the clinical department code. The display of the attending physician shown in a3 and the patient ID shown in a4 are displayed according to the data stored in the in-hospital patient information 302. The patient name indicated by a5 is displayed according to the data stored in the patient basic information 301. The age display indicated by a6 is calculated from the patient's date of birth stored in the patient basic information 301 and the display date of the latest transfer discharge adjustment screen display 8 (hereinafter referred to as "the date of the day"). To display. The display of the length of hospital stay indicated by a7 is calculated and displayed from the date of hospitalization stored in the inpatient information 302 and the date of the current day. In addition, according to the gender code included in the patient basic information 301, the patient name can be displayed by color (for example, blue for men and red for women). Further, according to the ward code included in the in-hospital patient information 302, the information of the patients who are candidates for transfer / discharge is sorted and displayed by ward.

Next, the display of the adjustment category indicated by d will be described. In this item, if there is a record corresponding to the patient ID from the transfer decision order information 304 and discharge decision order information 305 based on the acquired patient ID, if there is a record corresponding to the patient ID, the corresponding patient is displayed in the adjustment category. , Display the transfer decision or discharge decision. For other patients, the adjustment category is displayed to indicate that it has not been adjusted. By setting in advance, patients who have been decided to transfer or have been discharged can be automatically excluded from the candidates for transfer / discharge, and only unadjusted patients can be displayed.

Further, based on the patient ID acquired from the in-hospital patient information 302, a record corresponding to the patient ID is acquired from the nursing necessity information 306, and the medical treatment date included in the record is the day before the current day. Further, when the severely ill person determination flag indicates that the person is a seriously ill person, the patient can be further indicated as being a seriously ill person. Similarly, based on the acquired patient ID, data on the scheduled operation date and the operation date are acquired from the operation information 310, and if the data is input on the operation date, the operation and date are performed. If no data has been entered for the date of surgery, the surgery schedule and date can be further displayed.

Severely ill patients and patients scheduled for surgery can be automatically excluded from transfer / discharge candidates by setting additional exclusion conditions.

Next, in FIG. 15, the display of the comment input field of the person concerned, which is indicated by the reference numerals of c1 to c4, will be described. These comment input fields are displayed by program control. The display indicated by c1 is a comment input field relating to a medical condition / medical condition, and is input by a bed manager such as a nurse chief. The display indicated by c2 is a comment input field regarding the status of securing a discharge destination, and is input by a social worker or the like. The display indicated by c3 is a comment input field relating to the rehabilitation situation, and is input by a person in charge of rehabilitation or the like. Along with these comment input fields, items for the person in charge and judgment are provided. Since it is assumed that users who access this system, including those who enter these comments, register as users in this system in advance, the person in charge column shows each person in charge. The login process displays the name of the person in charge. Further, in the determination field, the set item can be selected and input by the pull-down display.

In this system, exclusive control of comment input by users is performed in units of patient + comment field type, so even though it is a Web system, continuous input to multiple patients in a list format by multiple users is possible. It is possible, and efficient input work becomes possible. Therefore, it is possible to efficiently collect information from a plurality of related parties.

The value of the "rehabilitation average" shown in c4 can be displayed when the rehabilitation information not included in FIG. 3 is included in the bed management work support database 3. FIG. 16 describes the items recorded by the rehabilitation information record. One record of rehabilitation information is created for each rehabilitation reservation, and includes items such as rehabilitation date, rehabilitation name, rehabilitation unit, and start date in association with the patient ID and rehabilitation order number. Based on the acquired patient ID, all the records corresponding to the patient ID are acquired from the rehabilitation information, and from the implementation date and the current date included in the record, from the day before the current date 7 Calculated by dividing the total of daily rehabilitation units by 7, and calculate and display the average of daily rehabilitation units. If the length of hospital stay is 7 or less, the average number of rehabilitation units per day is calculated and displayed by dividing the total number of rehabilitation units up to the day before the current day by the length of hospital stay-1. Let me.

Next, in FIG. 14, the display of the portions indicated by the reference numerals b1 to b4 will be described. These display parts can be displayed by the bed management business support database 3 holding the DPC information 313 and the hospitalization basic charge master 511, but the transfer / timing from the viewpoint of the medical fee system (hospital income side). This is useful information for making decisions about.

Based on the patient ID acquired from the in-hospital patient information 302, a record including the patient ID is acquired from the DPC information 313. As the name of the medical resource most input injury / illness of b1, the name of the medical resource maximum input injury / illness included in the record of DPC information 313 is displayed. For the display of b2, b3 and b4, from the record of the patient ID of the DPC information 313, the hospitalization period I days, the hospitalization period I points, the hospitalization period II days, the hospitalization period II points, the hospitalization period III days, the hospitalization period Obtain the data of III points and obtain the comprehensive care points from the basic hospitalization fee master 511. Comprehensive care points are scored from records from the basic hospitalization fee master 511, where the date of application is included in the application start date and time and the application end date and time, and the ward / bed classification is the condition for being a community comprehensive care ward. To get. In b4 of FIG. 14, the difference from the community-based comprehensive care score is displayed, which is an example of the display for examining the possibility of transfer from the general ward to the community-based comprehensive care ward. As a display for examining the possibility of transfer from the general ward to the convalescent rehabilitation ward, "difference from the convalescent rehabilitation score" is displayed in b4. When displaying the score of the convalescent rehabilitation ward, the recovery rehabilitation score is obtained from the basic hospitalization fee master 511 by changing the designation of the ward / bed classification.

Next, the difference between the length of hospitalization I days and the length of stay (see the explanation about a7) is defined as the number of days remaining in the hospitalization period I. The hospitalization period I score is calculated by multiplying the hospitalization period I score obtained from the DPC information 313 by the coefficient for each medical institution. The remaining days displayed in the hospitalization period II of b2 is displayed by calculating the difference between the hospitalization period II days and the hospitalization days obtained from the DPC information 313. The score displayed in the hospitalization period II is calculated by multiplying the hospitalization period II score obtained from the DPC information 313 by the coefficient for each medical institution. The remaining days displayed in the hospitalization period III of b3 is displayed by calculating the difference between the hospitalization period III days and the hospitalization days obtained from the DPC information 313. The score displayed in the hospitalization period III is calculated by multiplying the hospitalization period III score obtained from the DPC information 313 by the coefficient for each medical institution.

The display of the difference column from the community-based comprehensive care score of b4 is calculated as follows according to the length of hospital stay.
・ If the length of hospital stay is I or less, the comprehensive care score- (Hospitalization I score x Coefficient by medical institution)
・ If the length of hospital stay is II or less, comprehensive care points- (Hospitalization period II points x Coefficient by medical institution)
・ If the length of hospital stay is III or less, comprehensive care points- (Hospitalization period III points x Coefficient by medical institution)
・ Others (when the length of hospital stay exceeds the length of stay III, etc.)
Comprehensive care score- (Hospitalization period III score x Coefficient by medical institution)
If the number displayed in the item b4 is +, it is desirable to transfer or leave the hospital from the viewpoint of hospital income.

If the display in the column b4 is "difference from the recovery rehabilitation score", calculate as follows according to the length of hospital stay.
・ If the length of hospital stay is I or less, recovery rehabilitation score- (Hospitalization period I score x Coefficient by medical institution)
・ If the length of hospital stay is II or less, recovery rehabilitation score- (Hospitalization II score x Coefficient by medical institution)
・ If the length of hospital stay is III or less, recovery rehabilitation score- (Hospitalization III score x Coefficient by medical institution)
・ Others (when the length of hospital stay exceeds the length of stay III, etc.)
Recovery rehabilitation score- (Hospitalization period III score x Coefficient by medical institution)
Regarding item b4, if one hospital has a general ward, a community-based comprehensive care ward, and a recovery rehabilitation ward, the list screen will show "difference from the community-based comprehensive care score" and "difference from the recovery rehabilitation score". It will be a specification to display both of.

1 Bed management work support server 3 Bed management work support database 4 Electronic terminal 5 Bed management work support master group 6 Bed management information 8 Transfer of hospital discharge adjustment screen display 11 Electronic medical record system 12 Medical office / DPC system

Claims (6)

A patient basic information storage means for storing basic patient information including the patient's name, date of birth, and gender code in association with the patient ID.
One record is created for each patient in the hospital, and the inpatient information including the ward code, the room code, the bed code, the medical department code, the attending physician code, the attending physician name, and the date of admission is stored in association with the patient ID. Hospital patient information storage means and
A master that manages data related to each ward, and a ward master storage means that stores data including the building structure number, ward name, ward / bed classification, and number of beds in association with the ward code.
A master that manages data related to clinical departments, and a clinical department master storage means that manages data including the clinical department name and clinical department name (abbreviation) in association with the clinical department code.
The in-hospital patient information stored in the in-hospital patient information storage means and the patient basic information acquired from the patient basic information storage means based on the patient ID included in the in-hospital patient information are acquired and acquired in the hospital. By acquiring the medical department name and the ward name from the medical department master storage means and the ward master storage means based on the medical department code and the ward code included in the patient information, the patient ID, the patient name, and the patient ID can be obtained for each inpatient. In addition to displaying the age, ward name, medical department name, and chief physician name, an input field for inputting comments from related parties regarding the patient's medical condition / medical treatment status, discharge destination securing status, and rehabilitation status is displayed. With display processing means,
It is a bed management work support system that displays a transfer / discharge adjustment screen display to provide information necessary for adjusting the patient's transfer / discharge time in response to instructions from an electronic terminal.
One record is created for each transfer reservation, and the transfer decision order information including the scheduled transfer date, ward code, ward code, and bed code is stored in association with the patient ID and transfer decision order number. Building decision order information storage means and
One record is created for each discharge reservation, and the discharge decision order information storage means for storing the discharge decision order information including the scheduled discharge date in association with the patient ID and the discharge decision order number is further provided.
The display processing means is a transfer reservation or discharge reservation from the patient ID included in the transfer decision order information and the discharge decision order information and the patient ID included in the in-hospital patient information acquired from the in-hospital patient information storage means. A bed management work support system that displays that fact for patients who have been treated, displays that it has not been adjusted for the remaining inpatients, and further displays the adjustment category column. A patient basic information storage means for storing basic patient information including the patient's name, date of birth, and gender code in association with the patient ID.
One record is created for each patient in the hospital, and the inpatient information including the ward code, the room code, the bed code, the medical department code, the attending physician code, the attending physician name, and the date of admission is stored in association with the patient ID. Hospital patient information storage means and
A master that manages data related to each ward, and a ward master storage means that stores data including the building structure number, ward name, ward / bed classification, and number of beds in association with the ward code.
A master that manages data related to clinical departments, and a clinical department master storage means that manages data including the clinical department name and clinical department name (abbreviation) in association with the clinical department code.
The in-hospital patient information stored in the in-hospital patient information storage means and the patient basic information acquired from the patient basic information storage means based on the patient ID included in the in-hospital patient information are acquired and acquired in the hospital. By acquiring the medical department name and the ward name from the medical department master storage means and the ward master storage means based on the medical department code and the ward code included in the patient information, the patient ID, the patient name, and the patient ID can be obtained for each inpatient. In addition to displaying the age, ward name, medical department name, and chief physician name, an input field for inputting comments from related parties regarding the patient's medical condition / medical treatment status, discharge destination securing status, and rehabilitation status is displayed. With display processing means,
It is a bed management work support system that displays a transfer / discharge adjustment screen display to provide information necessary for adjusting the patient's transfer / discharge time in response to instructions from an electronic terminal.
One record is created every day for each patient, patient ID, hospitalization date, medical treatment date, ward code, ward code, ward / bed classification, clinical department code, evaluation sheet, A evaluation, B evaluation, C evaluation, severe illness. Further equipped with a nursing necessity information storage means for storing nursing necessity information including a person judgment flag,
The display processing means acquires a record corresponding to the patient ID from the nursing necessity information based on the patient ID acquired from the in-hospital patient information, and the medical treatment date included in the record is the current date. If it is the day before and the critically ill person determination flag indicates that the patient is seriously ill, the patient is displayed as being severely ill, or the display of the patient is automatically excluded by setting additional exclusion conditions. , Bed management business support system. A patient basic information storage means for storing basic patient information including the patient's name, date of birth, and gender code in association with the patient ID.
One record is created for each patient in the hospital, and the inpatient information including the ward code, the room code, the bed code, the medical department code, the attending physician code, the attending physician name, and the date of admission is stored in association with the patient ID. Hospital patient information storage means and
A master that manages data related to each ward, and a ward master storage means that stores data including the building structure number, ward name, ward / bed classification, and number of beds in association with the ward code.
A master that manages data related to clinical departments, and a clinical department master storage means that manages data including the clinical department name and clinical department name (abbreviation) in association with the clinical department code.
The in-hospital patient information stored in the in-hospital patient information storage means and the patient basic information acquired from the patient basic information storage means based on the patient ID included in the in-hospital patient information are acquired and acquired in the hospital. By acquiring the medical department name and the ward name from the medical department master storage means and the ward master storage means based on the medical department code and the ward code included in the patient information, the patient ID, the patient name, and the patient ID can be obtained for each inpatient. In addition to displaying the age, ward name, medical department name, and chief physician name, an input field for inputting comments from related parties regarding the patient's medical condition / medical treatment status, discharge destination securing status, and rehabilitation status is displayed. With display processing means,
It is a bed management work support system that displays a transfer / discharge adjustment screen display to provide information necessary for adjusting the patient's transfer / discharge time in response to instructions from an electronic terminal.
One record is created for each surgery appointment, and it is further equipped with a surgery information storage means that stores surgery information including patient ID, surgery order number, scheduled surgery date, surgery implementation date, surgery name, hospitalization request classification. ,
The display processing means acquires a record corresponding to the patient ID from the surgery information based on the patient ID obtained from the in-hospital patient information, and the scheduled surgery date or the surgery implementation date included in the record. A bed management business support system that automatically excludes the patient's display by setting additional exclusion conditions when data is entered and it is dated after the date of the day. A patient basic information storage means for storing basic patient information including the patient's name, date of birth, and gender code in association with the patient ID.
One record is created for each patient in the hospital, and the inpatient information including the ward code, the room code, the bed code, the medical department code, the attending physician code, the attending physician name, and the date of admission is stored in association with the patient ID. Hospital patient information storage means and
A master that manages data related to each ward, and a ward master storage means that stores data including the building structure number, ward name, ward / bed classification, and number of beds in association with the ward code.
A master that manages data related to clinical departments, and a clinical department master storage means that manages data including the clinical department name and clinical department name (abbreviation) in association with the clinical department code.
The in-hospital patient information stored in the in-hospital patient information storage means and the patient basic information acquired from the patient basic information storage means based on the patient ID included in the in-hospital patient information are acquired and acquired in the hospital. By acquiring the medical department name and the ward name from the medical department master storage means and the ward master storage means based on the medical department code and the ward code included in the patient information, the patient ID, the patient name, and the patient ID can be obtained for each inpatient. In addition to displaying the age, ward name, medical department name, and chief physician name, there is also an input field for inputting comments from related parties regarding the patient's medical condition / medical treatment status, discharge destination securing status, and rehabilitation status, as well as hospitalization. A display processing means that calculates the length of hospital stay from the date of hospitalization included in the patient information and the date of the day when the transfer adjustment screen display is displayed, and further displays the length of hospital stay for each patient. With,
It is a bed management work support system that displays a transfer / discharge adjustment screen display to provide information necessary for adjusting the patient's transfer / discharge time in response to instructions from an electronic terminal.
One record is created for each hospitalization, and it is associated with the patient ID, hospitalization date, SEQ (number to manage hospitalization and discharge re-hospitalization on the same day), Form 1 hospitalization date, main injury / illness name, hospitalization opportunity injury / illness name, medical treatment. Most input of resources Injury and illness name, DPC code, DPC name, comprehensive classification (0: volume, 1: comprehensive), not covered by comprehensive evaluation (0: comprehensive evaluation, 1: not covered by comprehensive evaluation), reason for not covered by comprehensive evaluation, medical fee Revision application year, hospitalization period I points, hospitalization period II points, hospitalization period III points, hospitalization period I days, hospitalization period II days, hospitalization period III days, hospitalization period I expiration date, hospitalization period II expiration date, Further equipped with a DPC information storage means for storing DPC information including items of hospitalization period III expiration date,
The display processing means acquires DPC information including the patient ID from the DPC information storage means based on the patient ID included in the in-hospital patient information, and for the patient, the name of the most invested medical resources and the hospitalization period II. The score of hospitalization period II calculated by multiplying the score by the coefficient by hospital institution, the remaining days of hospitalization period II calculated from the number of days of hospitalization II and the length of stay, and the score of hospitalization period III multiplied by the coefficient by hospital institution. A bed management work support system that further displays the calculated score of hospitalization period III and the remaining number of days of hospitalization period III calculated from the number of hospitalization period III days and the number of hospitalization days. It is a master that manages the basic hospitalization fee of the ward to which the ward is transferred from a general ward, etc. Further equipped with a basic hospitalization fee master storage means to store data including
The bed management according to claim 4, wherein the display processing means obtains a comprehensive care score from the hospitalization basic charge master storage means, calculates a difference from the regional comprehensive care score according to the following calculation method, and further displays it. Business support system.
・ If the length of hospital stay is I or less, the comprehensive care score- (Hospitalization I score x Coefficient by medical institution)
・ If the length of hospital stay is II or less, comprehensive care points- (Hospitalization period II points x Coefficient by medical institution)
・ If the length of hospital stay is III or less, comprehensive care points- (Hospitalization period III points x Coefficient by medical institution)
・ If the length of hospital stay does not correspond to the above: Comprehensive care score- (Hospitalization period III score x Coefficient by medical institution) It is a master that manages the basic hospitalization fee of the ward to which the ward is transferred from a general ward, etc. Further equipped with a basic hospitalization fee master storage means to store data including
The bed management operation according to claim 4, wherein the display processing means obtains a recovery rehabilitation score from the hospitalization basic charge master storage means, calculates a difference from the recovery rehabilitation score according to the following calculation method, and further displays the difference. Support system.
・ If the length of hospital stay is I or less, recovery rehabilitation score- (Hospitalization period I score x Coefficient by medical institution)
・ If the length of hospital stay is II or less, recovery rehabilitation score- (Hospitalization II score x Coefficient by medical institution)
・ If the length of hospital stay is III or less, recovery rehabilitation score- (Hospitalization III score x Coefficient by medical institution)
・ If the length of hospital stay does not correspond to the above, recovery rehabilitation score- (hospitalization period III score x coefficient by medical institution)

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