JP7213615B2 - Medical information management system and medical information management method - Google Patents

Description

The present invention relates to a medical information management system and a medical information management method that allow medical institutions to quickly refer to medical information of other medical institutions.

In recent years, electronic medical record systems and the like have become popular in medical institutions, and medical information generated in the medical institutions is stored as electronic data within the medical institutions.

For example, in Patent Document 1, a service providing institution server and patient information providing terminals installed in a plurality of medical institutions are interconnected, and a patient ID, a patient profile, an insurance institution code are stored on the service providing institution server. , medical worker ID, and patient information providing terminal IP address. A system is disclosed in which, when a service provider server receives a patient ID/patient profile from a medical information presentation terminal, the patient's electronic medical record held by the medical institution is searched and displayed on the medical information presentation terminal. there is According to this prior art, there is no need to introduce a huge data server, and it is possible to use the currently used patient information providing terminals while maintaining the security of each medical institution.

Such mutual medical information coordination among multiple medical institutions is important for the functional differentiation of medical institutions and the promotion of team medical care in the region.

JP 2017-097817 A

By the way, when the medical information of another medical institution stored in a storage medium is imported offline into the electronic medical record system within the own medical institution, if the storage format, etc. in the electronic medical record system are different, the medical information may be imported. Requires a lot of human effort to operate. In particular, recent medical information includes image information with a large amount of data, so it takes time to import the medical information. Similarly, when importing medical information from other medical institutions online into an electronic medical record system or the like within one's own medical institution, it takes a great deal of labor and time to import the medical information.

Therefore, when one medical institution imports medical information stored in another medical institution, it takes time to import the medical information, so the medical information of the other medical institutions can be quickly integrated and referred to. Therefore, there is a problem that the efficiency of medical diagnosis is lowered and proper medical diagnosis is hindered. In particular, when the patient's medical information is stored in a plurality of other medical institutions, taking in the medical information further requires a great deal of labor and time.

Here, in Patent Literature 1, the electronic medical record of the patient held by the medical institution is searched, and the medical information to be displayed on the medical information presentation terminal is presented. The medical information stored in the medical institution is not taken into the own medical institution, but is simply presented by connecting to the electronic medical chart system of other medical institutions via the network. Therefore, considering the large amount of medical information data in recent years, when multiple doctors simultaneously refer to medical information from other medical institutions, the limited bandwidth of network lines such as VPNs (Virtual Private Networks) is required. It takes a long time to present medical information, and it is impossible to smoothly refer to medical information.

SUMMARY OF THE INVENTION The present invention has been made to solve the problems (problems) of the prior art described above. The purpose is to provide a management method.

In order to solve the above-mentioned problems, the present invention provides a center server that is installed outside a plurality of medical institutions and stores and manages medical information generated inside each medical institution, and a center server that is installed inside each medical institution. A medical information management system comprising a plurality of local servers arranged and connected to the center server, wherein each local server is a cooperation destination for distributing the medical information of its own local server accumulated in the center server. Medical information that is used for integrated reference of medical information related to the same patient at the other medical institution and has specified data attributes to be delivered to the local server of the other medical institution and a registration request unit for setting distributable setting information including the distributing method thereof and requesting the center server to register the set distributable setting information, wherein the center server receives the requested distributable setting information and a distribution processing control unit for distributing the medical information of the own local server to the other local server based on the registered distributable setting information.

Further, according to the present invention, in the above invention, each local server has a temporary storage unit for temporarily storing medical information distributed from the center server.

Further, according to the present invention, in the above invention, the own local server manually distributes medical information of a designated patient or designated data among medical information that can be distributed by the own local server to the other local server. A manual distribution request unit for making a manual distribution request to the center server, and the center server distributes medical information that can be distributed by the local server for which the manual distribution has been requested to the other local server. characterized by

Further, according to the present invention, in the above invention, the other local server distributes medical information of a designated patient or designated data among medical information that can be distributed by the local server to the other local server. and a manual acquisition request unit for making a manual acquisition request to the center server, and the center server transmits the medical information distributable from the local server for which the manual acquisition is requested to the other local server. characterized by delivering to

Further, according to the present invention, in the above-described invention, medical information and a distribution method capable of distributing medical information of the own local server to the other local server are set in the distributable setting information, and the own local server , when a predetermined event occurs, an automatic distribution request for automatically distributing medical information related to a predetermined event within the distribution source among the medical information that can be distributed by the local server to the other local server. wherein the center server distributes to the other local server the medical information that can be distributed by the self-local server for which automatic distribution has been requested.

Further, according to the present invention, in the above invention, the center server automatically distributes only index information of medical information.

In the present invention, in the above invention, when a predetermined event occurs, the other local server distributes medical information related to a predetermined event within a distribution destination, out of the medical information that can be distributed by the local server. is automatically distributed to the other local server and automatically fetched to the center server, and the center server receives the request for automatic fetching of the self-local server Distributable medical information is distributed to the other local server.

Further, according to the present invention, in the above invention, the predetermined event includes: reception of medical treatment or examination, reservation of medical treatment or examination, execution of examination, medical image generation, diagnosis report creation, medical examination report creation, medical information reference is characterized by including one or more combinations of

Further, in the present invention according to the above invention, when the predetermined event occurs, the other local server provides medical information of a target patient of the predetermined event, which has not been imported into the other local server. The apparatus is characterized by comprising a notification processing unit that, when there is uncaptured medical information, notifies the uncaptured medical information.

In the above-described invention, the present invention is characterized in that the distributable medical information set in the distributable setting information can be selectively set for each data attribute.

Further, the present invention is characterized in that, in the above-described invention, the data attributes are a data type and a clinical department, and the data type can be selected and set for each image data type and each report data type.

Further, in the above invention, the present invention is characterized in that the distributable medical information set in the distributable setting information can be selectively set by dividing the medical information into main information and index information.

Further, in the above invention, the present invention is characterized in that the distributable medical information set in the distributable setting information can be selected and set for each type of medical department targeted for the medical information.

In the above invention, the distributable medical information set in the distributable setting information is the medical information within the storage period retroactively from the present time or the generation of medical information retroactively from the present time. It is characterized in that it can be set so that medical information for the number of times can be delivered.

Further, the present invention is characterized in that, in the above invention, the distributable medical information distributing method set in the distributable setting information can be set to be specified for each data type of medical information or for each patient. and

Further, in the present invention according to the above invention, the distributable setting information can be set to always permit an automatic capture request from the other local server, and the self local server can set the distributable setting information Further, when the setting is made to always permit the automatic acquisition request from the other local server, the setting contents of the automatic acquisition request from the other local server are displayed on the setting screen.

Further, the present invention provides a center server disposed outside a plurality of medical institutions for accumulating and managing medical information generated inside each medical institution; A medical information management method in a medical information management system comprising a plurality of local servers connected to a server, wherein each local server is a cooperation destination for distributing the medical information of its own local server accumulated in the center server. for each other medical institution, medical information that is used for integrated reference of medical information related to the same patient at the other medical institution and has specified data attributes to be delivered to the local server of the other medical institution; Set deliverable setting information including the delivery method, request the center server to register the set deliverable setting information, and the center server registers the requested deliverable setting information, and registers the registered deliverable setting information. The medical information of the own local server is distributed to the other local server based on the distributable setting information.

Further, according to the present invention, in the above invention, each local server temporarily stores the medical information distributed from the center server.

Further, according to the present invention, in the above invention, the self local server manually distributes medical information of a designated patient or designated data among medical information that can be distributed by the self local server to the other local server. A distribution request is sent to the center server, and the center server distributes to the other local server the medical information that can be distributed by the self-local server for which manual distribution has been requested.

Further, according to the present invention, in the above invention, the other local server distributes to the other local server the medical information of the specified patient or the specified data among the medical information that can be delivered by the local server. A manual import request is made to the center server, and the center server distributes the distributable medical information of the local server for which the manual import is requested to the other local server. .

Further, according to the present invention, in the above-described invention, when a predetermined event occurs, the local server transmits medical information related to a predetermined event within the distribution source among medical information that can be distributed by the local server. An automatic distribution request for automatic distribution to another local server is made to the center server, and the center server distributes to the other local server the medical information that can be distributed by the local server for which automatic distribution has been requested. characterized by

Further, in the present invention according to the above invention, when a predetermined event occurs, the other local server transmits medical information related to a predetermined event within a distribution destination, out of the medical information that can be distributed by the local server. An automatic acquisition request is made to the center server for automatic delivery and acquisition to the other local server. It is characterized by delivering to the local server of

According to the present invention, medical institutions can quickly refer to medical information of other medical institutions.

FIG. 1 is an explanatory diagram for explaining the outline of the medical information management system according to this embodiment. FIG. 2 is a functional block diagram showing the configuration of the center server shown in FIG. 1. As shown in FIG. FIG. 3 is a functional block diagram showing the configuration of the local server shown in FIG. 1; FIG. 4 is a flow chart showing a distribution processing control processing procedure by a distribution processing control section of the center server. FIG. 5 is a diagram showing an example of an entire setting screen for distributable setting information displayed on the local server. FIG. 6 is a diagram showing an example of an automatic distribution screen within the setting screen of the distributable setting information. FIG. 7 is a diagram showing an example of a data-designated manual distribution request screen displayed on the local server. FIG. 8 is a diagram showing an example of a patient-designated manual delivery request screen displayed on the local server. FIG. 9 is a diagram showing an example of a patient-designated manual acquisition request screen displayed on the local server. FIG. 10 is a diagram showing an example of a patient-specified manual acquisition request list screen displayed on the local server. FIG. 11 is a diagram illustrating an example of notification processing by the notification processing unit of the local server. FIG. 12 is a diagram showing an example of a patient's other-facility disclosure consent screen.

Preferred embodiments of the medical information management system according to the present invention will be described in detail below with reference to the accompanying drawings. In the example shown below, each local server in a plurality of medical institutions sends medical information generated by each medical institution to a center server on the cloud, and the center server stores and manages the medical information. An example of a medical information management system will be described.

<Overview of medical information management system>
First, an overview of the medical information management system according to the present embodiment will be described. FIG. 1 is an explanatory diagram for explaining the outline of the medical information management system according to this embodiment.

As shown in FIG. 1, this medical information management system has a center server 1 on a cloud 2 and local servers 3a and 3b in medical institutions A and B, respectively. Connected to server 1 . The medical institutions A and B and the local servers 3a and 3b are examples of a plurality of medical institutions and a plurality of local servers, respectively. Also, the "medical institution" is, for example, a hospital, a clinic, a medical examination center, an emergency medical center, or the like.

Medical institutions A and B have modalities 4a and 4b, image servers 5a and 5b, report servers 6a and 6b, and terminal devices 7a and 7b, respectively. Image servers 5a and 5b temporarily store image data generated by modalities 4a and 4b, respectively. The report servers 6a and 6b temporarily hold diagnosis reports that are results of diagnosis by referring to the image data temporarily stored in the image servers 5a and 5b, respectively. The terminal devices 7a and 7b acquire image data to be referred to from the center server 1 via the local servers 3a and 3b when a doctor or the like prepares a diagnostic report, respectively, and temporarily store the image data in the local servers 3a and 3b. Refer to image data.

Each of the local servers 3a and 3b uploads the image data and diagnosis report generated in each medical institution A and B to the center server 1 as medical information DA and DB, respectively, and accumulates them as medical information D in the center server 1. (Step S1). In addition to image data and diagnostic reports, "medical information" includes various medical-related information for patients such as video data (circulatory organ video, intraoperative video, etc.), waveform data (electrocardiogram, electroencephalogram, etc.), medication information, etc. include.

Further, each of the local servers 3a and 3b requests registration of distributable setting information DSA and DSB for setting medical information distributable to other medical institutions B and A among the accumulated medical information DA and DB, respectively. to the center server 1, and the center server 1 registers each of the deliverable setting information DSA and DSB in the deliverable setting information DS (step S2). Among the medical information DA accumulated by the medical institution A, medical information that can be delivered to another medical institution B and a delivery method are set in the deliverable setting information DSA. Medical information that can be delivered to another medical institution A and a delivery method are set in the accumulated medical information DB. The distributable setting information DS defines settings of medical information that can distribute medical information accumulated by one's own medical institution to other medical institutions. are set individually between them. The distributable setting information DS is also a one-way arrangement for setting distributable medical information accumulated by one's own medical institution to other medical institutions. In addition, when a plurality of medical institutions are grouped and each medical institution cooperates to perform the same delivery processing to other medical institutions in the group, the deliverable setting information DS for each grouped medical institution are the same, they may be stored as one deliverable setting information.

When the local server 3a issues a manual or automatic acquisition request to the medical information DB of the medical institution B, the center server 1 performs control to distribute the distributable medical information DB to the local server 3a in another medical institution A (step S3A). In this case, the center server 1 may distribute the medical information DB on condition that distribution permission is obtained from the local server 3b when there is a manual import request or an automatic import request.

Further, when the local server 3b receives a manual distribution request or an automatic distribution request for the medical information DB of its own medical institution B, the center server 1 , control is performed to distribute the distributable medical information DB to the local server 3a in another medical institution A (step S3B).

Similarly, when the local server 3b requests manual or automatic acquisition of the medical information DA of the medical institution A, the center server 1 receives the request of the medical information DA of the medical institution A from the local server 3a. When there is a manual distribution request or an automatic distribution request, based on the setting contents of the distributable setting information DSA set for the medical institution A, the distributable medical information DA is sent to the local server in the other medical institution B. 3b is controlled.

A manual distribution request or a manual acquisition request is a request by a doctor or the like to distribute desired medical information to other medical institutions by manual operation from the terminal devices 7a, 7b or the like, if necessary. In addition, the automatic delivery request or automatic acquisition request automatically delivers medical information to other medical institutions at the timing when a predetermined event occurs based on the deliverable setting information DS set by the delivery source medical institution. is required. Predetermined events in the automatic delivery request or the automatic acquisition request are, for example, medical treatment or examination reception, medical treatment or examination reservation, medical image generation, diagnosis report creation, examination report creation, medical information reference, and the like.

Distributable medical information set in the distributable setting information DS can be selectively set for each data attribute. The data attributes are, for example, data type and department. The data type can be selected and set, for example, for each image data type and each report data type.

In addition, the distributable medical information set in the distributable setting information DS can be selected and set separately for main body information and index information. In particular, when distributing medical information by means of an automatic distribution request or an automatic acquisition request, it is preferable to distribute only the index information in advance as the first stage, because the data volume of main information such as image data is large. After referring to the index information, the delivery destination can take in the body information of the desired medical information. Therefore, it is possible to suppress an increase in the resource environment of the distribution destination.

Further, the deliverable medical information set in the deliverable setting information DS can be selectively set for each type of medical department targeted for the medical information. As a result, for example, gynecology and psychiatry, which are set to be invisible, can be excluded from distribution targets.

In addition, the distributable medical information set in the distributable setting information DS is set so that the medical information within the storage period retroactively from the present time or the medical information for the number of times the medical information is generated retroactively from the present time can be delivered. It can be set according to the storage period of medical information that can be set. For example, it is possible to set only medical information that has been stored for a period of one year or less from the present time as a delivery target. Also, for example, only medical information for the past three times from the current time can be set as distribution targets.

Furthermore, the distributable medical information distributing method set in the distributable setting information can be specified for each data type of medical information or for each patient.

In addition, when the patient identification information of the same patient generated by each medical institution is different, the center server 1 performs linking processing for associating each patient identification information. The center server 1 distributes medical information using the linked information that has been linked.

In addition, when a predetermined event occurs, the local server of the distribution destination, if there is medical information of the target patient of the predetermined event that has not been imported into the local server of the distribution destination, A process of notifying that the included medical information exists may be performed. In particular, if the medical information of a patient who received a medical examination at a medical institution where the local server of the distribution destination is arranged is accumulated in the center server 1 as the medical information of the medical institution where the local server of the distribution source is arranged, the doctor, etc. , by this notification, it is possible to quickly know that the same patient's medical information is accumulated as medical information of another medical institution, and the medical information of the same patient can be integrated by importing the medical information of this other medical institution. can be referenced as

As a result, it is possible to quickly integrate and refer to medical information from other medical institutions, and to improve the efficiency of medical diagnosis and to perform appropriate medical diagnosis.

<Configuration of the center server>
Next, the configuration of the center server 1 shown in FIG. 1 will be described. FIG. 2 is a functional block diagram showing the configuration of the center server 1 shown in FIG. The center server 1 has an input section 11 , a display section 12 , a communication section 13 , a database section 14 and a control section 15 .

The input unit 11 is an input device such as a keyboard or mouse, the display unit 12 is a display device such as a liquid crystal panel, and the communication unit 13 is a communication interface unit for connecting to each of the local servers 3a and 3b. .

The database unit 14 is a storage device composed of a hard disk device, a non-volatile memory, or the like. and the distributable setting information DS including the distributable setting information DSB of the medical institution B is stored.

The control unit 15 is a control unit that controls the entire center server 1 , and has a request reception unit 21 , an information processing control unit 22 , a setting registration unit 23 , a distribution processing control unit 24 and an association processing unit 25 . The control unit 15 stores programs corresponding to these functional units in a storage device such as a non-volatile memory or a magnetic disk device, loads these programs into the memory, and executes them by the CPU. to run the process.

The request acceptance unit 21 accepts information input via the input unit 11 or the communication unit 13 . The information processing control unit 22 performs information processing such as accumulation, viewing, copying, moving, and deletion of medical information D corresponding to a request via the request receiving unit 21, deletion of specific information, and extraction of specific information.

The setting registration unit 23 performs a process of registering the deliverable setting information DSA and DSB requested by the local servers 3a and 3b into the deliverable setting information DS for each of the local servers 3a and 3b. If there is a registration request for new deliverable setting information DSA, DSB after registration, the setting registration unit 23 overwrites and updates the information.

When there is a manual distribution request or automatic distribution request from the local server 3b, and when there is a manual capture request or automatic capture request from the local server 3a, the distribution processing control unit 24 changes the registered distributable settings. Based on the information DSB, a deliverable medical information DB is delivered to the local server 3a. In addition, when there is a manual distribution request or automatic distribution request from the local server 3a, and when there is a manual capture request or automatic capture request from the local server 3b, the distribution processing control unit 24 Distributable medical information DA is distributed to the local server 3b based on the possible setting information DSA.

When the patient identification information for the same patient generated by the local servers 3a and 3b is different, the linking processing unit 25 performs linking processing for linking each patient identification information. The distribution processing control unit 24 performs patient identification using the tying information tying processed by the tying processing unit 25, and controls the distribution of the medical information DA and DB.

<Local server configuration>
Next, the configuration of the local servers 3a and 3b shown in FIG. 1 will be described. Note that the local servers 3a and 3b have the same configuration, and the configuration of the local servers 3a and 3b will be described using the local server 3a as an example. FIG. 3 is a functional block diagram showing the configuration of the local server 3a shown in FIG. The local server 3 a has an input section 31 , a display section 32 , a communication section 33 , a storage section 34 , a temporary storage section 35 and a control section 36 .

The input unit 31 is an input device such as a keyboard or mouse, the display unit 32 is a display device such as a liquid crystal panel, and the communication unit 33 is a communication interface unit for connecting to the center server 1 in the cloud 2. be.

The storage unit 34 is a storage device composed of a hard disk device, a nonvolatile memory, or the like, and stores medical information DA and distributable setting information DSA. Medical information DA is medical information to be uploaded to the center server 1 . The distributable setting information DSA is distributable setting information uploaded and registered in the center server 1 .

The temporary storage unit 35 is a storage device made up of a non-volatile memory or the like, and temporarily stores the medical information D distributed from the center server 1 . The temporary storage unit 35 also temporarily stores medical information D such as image data input from the image server 5a and diagnostic reports input from the report server 6a.

The control unit 36 is a control unit that controls the entire local server 3a. It has a section 46 , an automatic capture request section 47 , a distribution permission section 48 and a notification processing section 49 . The control unit 36 stores programs corresponding to these functional units in a storage device such as a non-volatile memory or a magnetic disk device, loads these programs into the memory, and executes them by the CPU. to run the process.

The request accepting unit 41 accepts information input via the input unit 31 or the communication unit 33 . The information processing control unit 42 performs processing request control such as storage, viewing, copying, moving and deleting of the medical information D to the center server 1 .

The registration request unit 43 requests the center server 1 to register the distributable setting information DSA.

The manual distribution request unit 44 manually designates the medical information set in the distributable setting information DSA among the medical information DA of the own medical institution A accumulated in the center server 1, and distributes the medical information to other medical institutions. The center server 1 is requested to distribute to another local server, for example, the local server 3b in the medical institution B.

The manual acquisition request unit 45 manually designates the medical information set in the distributable setting information DSA from among the medical information DB in another medical institution, for example, the medical institution B, which is accumulated in the center server 1. , the center server 1 is requested to distribute to the local server 3a.

When a predetermined event occurs in the medical institution A, the automatic distribution request unit 46 selects the medical information DA of the own medical institution A stored in the center server 1, which is set in the distributable setting information DSA. is automatically selected, and a request is made to the center server 1 to distribute it to another local server in another medical institution, for example, the local server 3b in the medical institution B.

When a predetermined event occurs in the medical institution A, the automatic acquisition request unit 47 retrieves the distributable setting information DSA from the medical information DB in another medical institution accumulated in the center server 1, for example, the medical information DB in the medical institution B. automatically select the medical information set in , and request the center server 1 to distribute it to the local server 3a.

When there is a manual distribution request or a manual capture request from a local server of another medical institution, for example, the local server 3b of medical institution B, the distribution permitting unit 48 receives a request from another medical institution, for example, the local server of medical institution B. It returns to the center server 1 whether or not the distribution of the medical information DA to the server 3b is permitted.

The notification processing unit 49, when the medical institution A is the delivery destination medical institution and a predetermined event occurs in the medical institution A, is the medical information of the target patient of the predetermined event, which is captured in the local server 3a. If there is uncaptured medical information, the display unit 32 or the terminal device 7a is notified of the existence of this uncaptured medical information and is output.

<Delivery processing control processing by the delivery processing control unit of the center server>
Next, a distribution processing control processing procedure by the distribution processing control unit 24 of the center server 1 will be described. FIG. 4 is a flow chart showing a distribution processing control processing procedure by the distribution processing control section 24 of the center server 1. As shown in FIG. It is assumed that the distributable setting information DS whose registration is requested by each of the local servers 3a and 3b is registered in advance.

As shown in FIG. 4, first, the distribution processing control unit 24 determines whether or not there is a manual distribution request (step S101). When there is a manual distribution request (step S101; Yes), the medical information corresponding to the distributable setting information of the requesting local server is distributed to the requested local server (step S102), and this processing is executed. finish.

If there is no manual distribution request (step S101; No), the distribution processing control unit 24 further determines whether or not there is an automatic distribution request (step S103). If there is an automatic distribution request (step S103; Yes), the medical information corresponding to the distributable setting information of the requesting local server is distributed to the requested local server (step S102), and this processing is executed. finish.

If there is no automatic distribution request (step S103; No), the distribution processing control unit 24 further determines whether or not there is a manual capture request (step S104). If there is a manual capture request (step S104; Yes), it is determined whether or not the requested local server has permitted distribution (step S105). If the local server of the request destination permits distribution (step S105; Yes), the medical information corresponding to the distributable setting information of the local server of the request destination is distributed to the local server of the request source (step S106). , the process ends. If the local server to which the request is made does not permit the distribution (step S105; No), this processing is terminated.

If there is no manual capture request (step S104; No), the distribution processing control unit 24 further determines whether or not there is an automatic capture request (step S107). If there is an automatic capture request (step S107; Yes), it is determined whether or not the requested local server has permitted distribution (step S105). If the local server of the request destination permits distribution (step S105; Yes), the medical information corresponding to the distributable setting information of the local server of the request destination is distributed to the local server of the request source (step S106). , the process ends. If the local server to which the request is made does not permit the distribution (step S105; No), this processing is terminated. On the other hand, if there is no automatic capture request (step S107; No), this process is terminated. Note that the above-described processing is periodically repeated.

<An example of setting screen for distributable setting information>
Next, an example of a setting screen for distributable setting information will be described. FIG. 5 is a diagram showing an example of an entire setting screen for distributable setting information displayed on the local server 3b. FIG. 6 is a diagram showing an example of an automatic distribution screen within the setting screen of the distributable setting information. The setting screen of the distributable setting information is a screen displayed on the display unit 32 of the local server 3b. It is also possible to display a setting screen for the distributable setting information on the terminal device 7b and set the distributable setting information on the terminal device 7b side.

As shown in FIG. 5, the setting screen for the distributable setting information has a cooperation destination setting screen area E1, a manual distribution setting screen area E2, and an automatic distribution setting screen area E3. In addition, on the setting screen for setting information that can be delivered, there are an add link button B1 for adding a delivery destination medical institution, a delete button B2 for deleting setting contents, a registration button B3 for registering setting contents, and a closing button for closing the setting screen. button B4.

The destination medical institution is set in the cooperation destination setting screen area E1. Multiple medical institutions can be set as delivery destinations. In FIG. 5, medical institution A is selected. Therefore, on the setting screen of the distributable setting information shown in FIG. 5, the setting for distributing the medical information of the medical institution B to the medical institution A is performed. It should be noted that the medical institution of the delivery destination can press the cooperation destination addition button B1, select the medical institution displayed after that, and add it to the cooperation destination.

The manual delivery setting screen area E2 is used to make settings related to manual delivery. That is, manual distribution to medical institution A by medical institution B and manual distribution to medical institution A according to a manual acquisition request from medical institution A are set. In the manual distribution setting screen area E2, distribution permission setting by data attribute is performed. The data attribute is set with data type and clinical department. Data types are set separately for image data and report data.

In FIG. 5, the setting is made to permit the distribution of all image data, and the distribution of only specified types of report data is permitted. is permitted, and the transmission of ultrasound, tooth, MRI (Magnetic Resonance Imaging), general radiography, and mammography data is not permitted. Also, in FIG. 5, only specified types of clinical departments are permitted, and only internal medicine, surgery, dermatology, dentistry, neurosurgery, and endoscopy are permitted to be distributed, and gynecology and psychiatry are not permitted. .

Further, in the manual delivery setting screen area E2, a delivery method of medical information is set. The delivery method is set separately for manual delivery by medical institution B to medical institution A and manual delivery to medical institution A in response to a manual acquisition request from medical institution A. In FIG. 5, regarding manual distribution to medical institution A by medical institution B, the user (doctor, etc.) of medical institution B designates medical information, and the user (doctor, etc.) of medical institution B designates a patient. and are both selected. In manual distribution to medical institution A in response to a manual acquisition request from medical institution A, a setting is made to distribute when the user of medical institution B approves the manual acquisition request from medical institution A. FIG. In this case, a setting is also selected to notify the medical institution A when there is medical information for the same patient as the patient in the manual acquisition request.

The automatic delivery setting screen area E3 is used to make settings related to automatic delivery. The settings related to this automatic distribution include automatic distribution by medical institution B to medical institution A, automatic distribution request by medical institution B to medical institution A, and automatic distribution by automatic acquisition request from medical institution A. .

Automatic distribution from medical institution B to medical institution A is automatic distribution from medical institution B to medical institution A by requesting automatic distribution from medical institution B to the center server when a predetermined event occurs at medical institution B. is the case. In FIG. 6, automatic distribution timing, that is, setting for selecting a predetermined event is performed. That is, when medical information is generated at the medical institution B is not set as a predetermined event, but when a patient visits the medical institution B or when a visit is booked is set as a predetermined event. In FIG. 6, all index information is set to be automatically distributed when a set predetermined event occurs. Also, in FIG. 6, setting for main body information delivery at the occurrence of a predetermined event is performed, and main body information delivery for data types such as CT, MRI, mammography, and ultrasound is selected. In this case, it is set so that main body information for the past 3 times for CT, for the past 1 year for MRI, for the past 3 times for mammography, and for the past 1 year for ultrasound is distributed. In other words, the main body information to be selected for delivery can be set with medical information within the storage period that goes back from the current time and medical information that goes back from the current time and has been generated for the number of times the medical information has been generated.

In the automatic acquisition request from medical institution B to medical institution A, the content of the request for automatic acquisition of medical information to medical institution A is set. That is, when a predetermined event set by medical institution B occurs, an automatic acquisition request is made to medical institution A to distribute the index information of the patient's medical information at this timing. In FIG. 6, regarding the automatic acquisition request, the occurrence of medical information at the medical institution B is not set as the predetermined event, but the time when the patient visits the medical institution B or the time when the visit is booked is set as the predetermined event. . However, the delivery contents of this automatic acquisition request are only requested by the medical institution B side according to the setting contents of the deliverable setting information DSA set by the other medical institution A. Also, the body information distribution can be set in the same manner as the automatic distribution from the medical institution B to the medical institution A, but this is only a request.

In FIG. 6, the settings related to automatic distribution based on an automatic capture request from medical institution A permit distribution based on an automatic capture request from medical institution A. In FIG. In other words, all automatic import requests set by the medical institution A are automatically permitted. It should be noted that in FIG. 6, the setting contents of this automatic capture request are obtained and displayed in the area E3a. It should be noted that the content of permission for the automatic capture request may be set in detail. Basically, medical institution B determines delivery settings for medical information of medical institution B. FIG.

When requesting the registration of the distributable setting information from the medical institution B set in this way to the medical institution A, it is executed by pressing the registration button B3. In order to delete this distributable setting information, a deletion request is transmitted to the center server 1 by pressing the delete button B2, and the distributable setting information registered in the center server 1 is deleted. Also, when closing the setting screen of this distributable setting information, the close button B4 is pressed.

<Example of manual distribution request screen for specifying data>
Next, an example of a manual distribution request screen for specifying data will be described. FIG. 7 is a diagram showing an example of a data-designated manual distribution request screen displayed on the local server 3b. This data-designated manual distribution request screen is displayed on the display unit 32 by the manual distribution request unit 44 . As shown in FIG. 7, on the data specification manual delivery request screen, by specifying data of desired medical information among the medical information in medical institution B, the specified medical information is delivered to other medical institutions. be able to. In FIG. 7, one checked image data and one report data are designated as data to be delivered to the medical institution A, respectively.

Note that in FIG. 7, a delivery deadline can also be set, and when the delivery deadline has passed, data-designated medical information cannot be delivered. A manual delivery request for medical information specified by data is transmitted to the center server 1 by pressing a delivery button on the screen.

<Example of patient-specified manual delivery request screen>
Next, an example of a patient-designated manual distribution request screen will be described. FIG. 8 is a diagram showing an example of a patient-designated manual delivery request screen displayed on the local server 3b. This patient-specified manual distribution request screen is displayed on the display unit 32 by the manual distribution request unit 44 . As shown in FIG. 8, on the patient-designated manual distribution request screen, by designating desired medical information among the medical information in medical institution B, the designated patient's medical information can be sent to other medical institutions. can be delivered. In FIG. 8, patient identification information, patient's name, patient's date of birth, and distribution destination are specified. Also, a delivery deadline is set. Furthermore, in FIG. 8, there is a comment entry column. A manual distribution request for medical information designated by a patient is sent to the center server 1 by pressing a distribution button on the screen. Pressing the cancel button on the screen causes the information on the specified screen to return to its default state of waiting for input.

<Example of patient-specified manual import request screen>
Next, an example of a patient-designated manual capture request screen will be described. FIG. 9 is a diagram showing an example of a patient-specified manual capture request screen displayed on the local server 3a. This patient-designated manual capture request screen is displayed on the display unit 32 by the manual capture request unit 45 . As shown in FIG. 9, on the patient designation manual import request screen, settings are made to designate a desired patient and import the patient's medical information from the medical institution B side. In the patient-designated manual capture request screen of FIG. 9, the medical institution A and the name are automatically set as the login user who requests the manual capture. In FIG. 9, the name, date of birth, and sex of the patient are set as the patient identification information of the specified patient. Further, in FIG. 9, there is a column for comment entry, in which a comment such as "Stomach cancer is suspected. Please distribute the patient data tree." is entered. A manual import request for patient-specified medical information is sent to the center server 1 by pressing an import button labeled "request data import" on the screen. When the user presses the cancel button labeled "Do not request data capture" on the screen, the specified information on the screen returns to its default state of waiting for input.

<Example of manual import request list screen by patient designation>
Next, an example of a patient-specified manual capture request list screen will be described. FIG. 10 is a diagram showing an example of a patient-specified manual capture request list screen displayed on the local server 3b. This patient-designated manual capture request list screen displays a list of manual capture requests requested by the manual capture request unit 45 of the other medical institution on the display unit 32. This is an example of processing. As shown in FIG. 10, on the patient-specified manual capture request list screen, a list of the requester, the requester, the request date, and the comment, which are other medical institutions, is displayed. In this list display, the content requested by setting on the patient-specified manual acquisition request screen shown in FIG. 9 is also displayed. When distribution is permitted, a request to be distributed is selected from among the listed manual capture requests, and the distribution is permitted by pressing a permission button labeled "data distribution permitted". If distribution is not permitted, select a request for which distribution is not permitted from among the listed manual capture requests, and press the disapproval button labeled "data distribution disapproved" to disallow distribution. , is sent back to the requester and deleted from the list display.

<Example of notification processing by notification processing unit>
Next, an example of notification processing by the notification processing unit 49 will be described. FIG. 11 is a diagram showing an example of notification processing by the notification processing unit 49 of the local server 3a. In FIG. 11, a doctor makes a diagnosis by referring to image data, and this diagnosis corresponds to a predetermined event. For this reason, the notification processing unit 49 causes the center server 1 to search whether or not the patient's medical information of this image data is also accumulated in other medical institutions' medical information, and if it is not captured by the local server 3a When there is uncaptured medical information, the fact that there is uncaptured medical information is notified on the screen of the image data being referred to. The notification is an icon indicating that there is uncaptured medical information. When the doctor presses this icon, the patient-designated manual capture request screen shown in FIG. 9 is displayed, and the uncaptured medical information is displayed. Other accumulated medical institutions are also displayed. Since the patient of the image data being referred to is specified on the manual import request screen by patient designation, uncaptured medical information can be captured by pressing the import button. This allows the doctor to integrate and refer to the unloaded medical information and quickly make an appropriate medical diagnosis.

The medical information stored in the center server may be stored after performing distributed processing including secret sharing and location sharing.

Further, in the collaborating medical institutions, for example, when a patient generates image data at medical institution A and stores it in the center server 1, and then receives a diagnosis at medical institution B, medical institution B Image data accumulated on the side can be captured. After that, the diagnostic report generated by the medical institution B is stored in the center server 1 as the medical information of the medical institution B. FIG. Later, when the patient is further diagnosed at Medical Institution A, Medical Institution A can retrieve the diagnostic report generated at Medical Institution B.

In the present embodiment, each local server sets distributable setting information to other local servers for the medical information of its own local server accumulated in the center server, and sets the set distributable setting for each other local server. Information is requested to be registered in the center server, the center server registers distributable setting information for which registration is requested, and distributes the medical information of its own local server to other local servers based on the registered distributable setting information. Since the system is based on this system, necessary medical information from other medical institutions can be integrated and quickly referred to. As a result, the efficiency of medical diagnosis is improved, and proper medical diagnosis can be performed.

In addition, in this embodiment, medical information referred to by each local server is accumulated and managed in the center server, and when the local server has necessary medical information, it includes medical information of other medical institutions and sends it to the local server side. Since the information is captured and temporarily stored, the storage function on the local server side can be reduced, and the configuration on the local server side can be simplified.

Furthermore, in this embodiment, the medical information that can be delivered to other medical institutions is set with the direction of delivery from the delivery source medical institution to the delivery destination medical institution. It is possible to simplify the distribution relationship of medical information that can be distributed between institutions, and facilitate setting processing and management of distributable setting information.

By the way, in the above series of explanations, the explanation about the patient's consent for information disclosure to other facilities was omitted, but the information regarding the patient's consent to disclosure (hereinafter referred to as "other facility disclosure consent information") It is also possible to manage the information on the cloud 2 and use the patient's consent information disclosed to other facilities as a condition at the time of distribution or acquisition. For example, on the patient's other facility disclosure consent screen shown in FIG. I agree to disclose the data of A and D to the other facility disclosure consent information on the cloud 2.

In this case, the medical staff receives the consent form from the patient, manages the original of the consent information disclosed to other facilities, and inputs the consent information on behalf of the patient. The example of FIG. 12 shows a situation in which "Kazuo Yamamoto", who is a facility staff member of the B facility, inputs on behalf of the patient "Jiro Nakata". The reason for this is that not all patients have an environment for receiving e-mails. However, at the timing when the patient information is about to be disclosed to other facilities, the patient is sent a disclosure consent request email (including link information to the patient's other facility disclosure consent screen shown in FIG. 12), and the patient It can also be configured to access and consent to the other facility public consent screen from the link on the request mail.

It should be noted that each configuration illustrated in the above embodiment is a functional schematic, and does not necessarily need to be physically configured as illustrated. That is, the form of distribution/integration of each device is not limited to the illustrated one, and all or part of them can be functionally or physically distributed/integrated in arbitrary units according to various loads and usage conditions. Can be configured.

A medical information management system and a medical information management method according to the present invention is a case in which medical information generated by a medical institution is accumulated in an external server and managed, and each medical institution obtains necessary medical information of other medical institutions. Useful for quick reference.

1 center server 2 cloud 3a, 3b local server 4a, 4b modality 5a, 5b image server 6a, 6b report server 7a, 7b terminal device 11, 31 input section 12, 32 display section 13, 33 communication section 14 database section 15, 36 Control unit 21, 41 Request receiving unit 22, 42 Information processing control unit 23 Setting registration unit 24 Distribution processing control unit 25 Linking processing unit 35 Temporary storage unit 43 Registration request unit 44 Manual distribution request unit 45 Manual capture request unit 46 Automatic Delivery request unit 47 Automatic acquisition request unit 48 Delivery permission unit 49 Notification processing unit A, B Medical institution B1 Add link button B2 Delete button B3 Register button B4 Close button D, DA, DB Medical information DS, DSA, DSB Distributable Setting information E1 Link destination setting screen area E2 Manual distribution setting screen area E3 Automatic distribution setting screen area E3a area

Claims (22)

A center server arranged outside a plurality of medical institutions for accumulating and managing medical information generated inside each medical institution; A medical information management system comprising a local server of
Each local server
It is used for integrated reference of medical information related to the same patient at each other medical institution that serves as a cooperation destination for distributing the medical information of its own local server accumulated in the center server, and A registration requesting unit that sets deliverable setting information including medical information with specified data attributes to be delivered to a local server of a medical institution and its delivery method, and requests registration of the set deliverable setting information in the center server. with
The center server
a setting registration unit for registering the distributable setting information requested for registration;
A medical information management system, comprising: a distribution processing control unit that distributes the medical information of the own local server to the other local server based on the registered distributable setting information. 2. The medical information management system according to claim 1, wherein each local server has a temporary storage unit for temporarily storing the medical information distributed from the center server. The local server sends a manual distribution request to the center server for manually distributing the medical information of the designated patient or the designated data among the medical information that can be distributed by the local server to the other local server. It has a manual delivery request unit that performs
3. The medical information management system according to claim 1, wherein the center server distributes to the other local server the medical information that can be distributed by the self-local server for which manual distribution has been requested. The other local server sends a manual import request to the center server to distribute and import the medical information of the specified patient or the specified data among the medical information that can be delivered by the own local server to the other local server. with a manual capture request unit for
3. The medical information management system according to claim 1, wherein the center server distributes to the other local server the medical information that can be distributed by the self-local server for which a manual import request has been made. When a predetermined event occurs, the local server automatically distributes, to the other local server, medical information related to a predetermined event within the distribution source among the medical information that can be distributed by the local server. to the center server, and
3. The medical information management system according to claim 1, wherein the center server distributes to the other local server the medical information that can be distributed by the self-local server for which automatic distribution has been requested. 6. The medical information management system according to claim 5, wherein said center server automatically distributes only index information of medical information. When a predetermined event occurs, the other local server automatically distributes to the other local server medical information related to a predetermined event within a distribution destination among medical information that can be distributed by the local server and captures the medical information. an automatic capture request unit that makes an automatic capture request to the center server for
3. The medical information management system according to claim 1, wherein the center server distributes the distributable medical information of the self-local server requested for automatic import to the other local server. The predetermined event includes a combination of one or more of reception of medical treatment or examination, reservation of medical treatment or examination, execution of examination, medical image generation, diagnosis report creation, medical examination report creation, and medical information reference. The medical information management system according to any one of claims 5 to 7. When the predetermined event occurs, the other local server, if there is medical information of the target patient of the predetermined event that has not been imported into the other local server, 8. The medical information management system according to claim 7, further comprising a notification processing unit that performs processing for notifying the taken-in medical information. The medical information management system according to any one of claims 1 to 9, wherein distributable medical information set in said distributable setting information can be selectively set for each data attribute. . 11. The medical information management system according to claim 10, wherein the data attributes are a data type and a clinical department, and the data type can be selectively set for each image data type and each report data type. The medical information according to any one of claims 1 to 11, wherein the distributable medical information set in the distributable setting information can be selectively set by dividing the medical information into body information and index information. management system. 13. The medical information management system according to any one of claims 1 to 12, wherein the deliverable medical information set in the deliverable setting information can be selectively set for each type of medical department targeted for the medical information. . The distributable medical information set in the distributable setting information can be set to be distributable medical information within the storage period going back from the present time or medical information for the number of medical information generation times going back to the past from the present time. The medical information management system according to any one of claims 1 to 13, characterized by: 15. The method of distributing distributable medical information set in the distributable setting information can be set for each data type of medical information or for each patient. The medical information management system described in 1. The distributable setting information can be set to always permit an automatic capture request from the other local server;
When the local server sets the distributable setting information so as to always permit the automatic capture request from the other local server, the local server sets the setting contents of the automatic capture request from the other local server. 16. The medical information management system according to any one of claims 1 to 15, wherein the information is displayed on a screen. A center server arranged outside a plurality of medical institutions for accumulating and managing medical information generated inside each medical institution; A medical information management method in a medical information management system comprising a local server of
Each local server is used for integrated reference of medical information related to the same patient in each other medical institution that serves as a cooperation destination for distributing the medical information of its own local server accumulated in the center server, Set distributable setting information including medical information with specified data attributes to be distributed to the local server of the other medical institution and its distributing method, and register the set distributable setting information in the center server. request and
The center server registers the distributable setting information requested for registration, and distributes the medical information of the own local server to the other local server based on the registered distributable setting information. medical information management method. 18. The medical information management method according to claim 17, wherein each local server temporarily stores the medical information distributed from the center server. The local server makes a manual delivery request to the center server to deliver medical information of a specified patient or specified data among the medical information that can be delivered by the local server to the other local server,
19. The medical information management method according to claim 17 or 18, wherein the center server distributes the distributable medical information of the own local server for which manual distribution is requested to the other local server. The other local server sends a manual import request to the center server to distribute and import the medical information of the specified patient or the specified data among the medical information that can be delivered by the own local server to the other local server. go against
19. The medical information management method according to claim 17 or 18, wherein the center server distributes to the other local server the medical information that can be distributed by the self-local server for which manual import is requested. When a predetermined event occurs, the local server automatically distributes, to the other local server, medical information related to a predetermined event within the distribution source among the medical information that can be distributed by the local server. to the center server,
19. The medical information management method according to claim 17 or 18, wherein the center server distributes the distributable medical information of the self-local server for which automatic distribution is requested, to the other local server. When a predetermined event occurs, the other local server automatically distributes to the other local server medical information related to a predetermined event within a distribution destination among medical information that can be distributed by the local server and captures the medical information. making an automatic capture request to the center server for
19. The medical information management method according to claim 17 or 18, wherein the center server distributes to the other local server the medical information that can be distributed by the self-local server for which an automatic import request has been made.

Images