CN107273700A - Intelligent remote medical system - Google Patents
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- CN107273700A CN107273700A CN201710557339.5A CN201710557339A CN107273700A CN 107273700 A CN107273700 A CN 107273700A CN 201710557339 A CN201710557339 A CN 201710557339A CN 107273700 A CN107273700 A CN 107273700A
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Abstract
The present invention relates to a kind of Telemedicine System, the system includes video conference component and the information-based component of tele-medicine, the information-based component of the tele-medicine includes long-distance intelligent system for distribution of out-patient department, the long-distance intelligent system for distribution of out-patient department includes memory and processor, wherein be stored with expert database in the memory, and the processor includes：Receiving module, retrieval module, search module and screening module.The system of the present invention can automatically utilize the data variables number that whether there is the variable of matching in the default predetermined search rule search application case-data of expert and determine matching, then candidate expert corresponding with the predetermined search rule matched is found in database with can customizing, and result is examined using the expert corresponding to the predetermined search rule of all candidates as final point, then it is connected with carrying out long-distance video by a point client where the expert examined.
Description
Technical field
The invention belongs to medical internet arena, in particular it relates to which a kind of Telemedicine System, the system includes video council
Component and the information-based component of tele-medicine are discussed, the information-based component of the tele-medicine includes long-distance intelligent system for distribution of out-patient department.
Background technology
Tele-medicine (Telemedicine) refer to using telecommunication technique, hologram technology, new electronic technology and
Computer Multimedia Technology provides Telemedicine information and service.At present, the telemedicine service realized by tele-medicine
Project covers all medical activities such as remote diagnosis, remote medical consultation with specialists and nursing, long-distance education, tele-medicine information service.
In all telemedicines service carried out at home at present, remote medical consultation with specialists is to carry out widest telemedicine service
Project.Remote medical consultation with specialists service typically passes through single Tele-consultation System or the remote medical consultation with specialists mould being integrated in Telemedicine System
Block is realized.Telemedicine System or Tele-consultation System generally comprise tele-medicine information system, and (including hardware and software is flat
Platform, its system requirements and basic parameter can defend what planning commission write referring specifically to country《Tele-medicine Information System configuration technology refers to
Southern (version in 2014)》), communications platform, the network platform, data and storage platform etc..In general, Telemedicine System is by video
Conference components and the information-based component of tele-medicine are constituted, and wherein video conference component is responsible for applying for long-range between end and expert end
Video UNICOM and multimedia show, and the information-based component of tele-medicine be responsible for the upload of clinical data, download, browse, analyzing and
Storage etc..
Fig. 1 shows elementary organization's way to manage of remote medical consultation with specialists.Fig. 2 shows the typical process of remote medical consultation with specialists.Such as Fig. 1
With shown in 2, point examining in remote medical consultation with specialists is typically mainly completed, rather than realized automatically by Telemedicine System by manpower
's.Perform the staff point examined and typically seldom possess very strong general family medicine or training medical ground, thus often according only to
The consultation of doctors asks the related section office of case and disease major class roughly to distribute expert or specify expert to distribute according to application hospital.
However, in practice, because the subject subdivision degree of higher level hospital (especially section hospital) is very high, so if
Rough to distribute expert according to subject, then some expert of some allocated subject might not may be best suitable for applying for that the consultation of doctors is suffered from
The state of an illness of person.If patient can match the professional expert of suitable subdivision, it is very beneficial for the diagnosis and treatment and prognosis of the patient.Phase
Instead, the inexact matching of expert is actually the waste to high-quality medical resource.Therefore, if not solving accurate matching expert's
Problem, by tele-medicine, easily network connection and powerful data transmission capabilities solve the advantage of difficult and complicated illness then at a high speed
Have a greatly reduced quality.
Therefore, this area needs a kind of intelligent system for distribution of out-patient department to carry out automatic simulation expert to the primary dcreening operation of case to realize disease
Precisely dividing for example is examined.In addition, the system should also provide follow-up artificial intelligence (AI) extended capability, so that expert can
Constantly adjustment and Optimized Matching strategy.At present, any system or method there is no to realize in this area intelligent automatic
Divide process of examining, or intelligence point is provided and examine strategy.
The content of the invention
To solve the above mentioned problem in this area, applicant devises a kind of intelligent automatic point and examines strategy, and utilization should
The corresponding intelligent automatic system for distribution of out-patient department of strategy Development.The tactful principle is to allow some or all experts according to oneself to spy
Determine disease or the experiences in diagnosis and treatment and achievement in research of morbid state, presetting search rule, (search rule can include multiple
Keyword or multiple conditions composition, can also include the data information such as image, audio frequency and video) and it is stored in the memory of system
In.Applying for that hospital submits consultation of doctors request and during case related data, the intelligent automatic system for distribution of out-patient department is with default search
The related data of the rule search case, it is every that the search rule conduct of matching variable can be searched in the case related data
Candidate, then filters out final matching results by candidate according to predetermined screening rule.
Therefore, in the first aspect, the invention provides a kind of Telemedicine System, the system includes video conference group
Part and the information-based component of tele-medicine, the information-based component of the tele-medicine are able to carry out the intelligence point side of examining comprised the following steps
Method：1) receive from the consultation of doctors request for applying for client, the consultation of doctors request is made up of one or more request variables, described to ask
Variable is asked to include request purpose variable and multiple data variables, the request purpose variable is crucial by one or more request purposes
Word is constituted, and the request purpose keyword at least includes the title or the name of one or more clinical departments of one or more diseases
Claim, the data variable is the one or more clinical datas or data related to patient；2) it is crucial using the request purpose
Word retrieves the expert title associated with asking purpose keyword at least one described, expert's title in expert database
It is stored in advance in association in the expert database with specific disease name or clinical department title, wherein described special
Also respective predetermined search rule, the predetermined search are respectively provided with family's database in advance for part or all of expert's title
Rule includes one or more predetermined search keywords and/or one or more predetermined search conditions, and the predetermined search is crucial
Word and/or the predetermined search condition are relevant with the diagnosis or treatment of the specific disease；3) from the expert database
Read and step 2) in each expert's title for being retrieved it is associated predetermined search it is regular；4) in many of the consultation of doctors request
In turn search step 3 in individual data variable) in the predetermined search keyword that is included of each predetermined search rule for being read
And/or search meets step 3) in the data variable of predetermined search condition that is included of each predetermined search rule for being read；
5) when in step 4) in search in search predetermined search rule in the data variable of the consultation of doctors request and included
At least one predetermined search keyword and/or at least one data variable of consultation of doctors request meet predetermined search rule
During at least one predetermined search condition then included, using the regular predetermined search regular record as candidate of the predetermined search
And store, while recording and storing the predetermined search keyword that is searched in the predetermined search rule of the candidate and meet
The number of predetermined search condition；With 6) record and store respectively with expert's name corresponding to the predetermined search of all candidates rule
Claim, and result is examined using the expert corresponding to the predetermined search rule of all candidates as final point；It is determined that final point is examined result
Afterwards, entered by the video conference component and the client where the described final point expert examined corresponding to result of the system
Row long-distance video is connected.
In second aspect, the present invention relates to a kind of Telemedicine System, the system includes video conference component and remote
Journey medical information component, the information-based component of the tele-medicine includes long-distance intelligent system for distribution of out-patient department, and the long-distance intelligent point is examined
System includes memory and processor, wherein the expert database that is stored with the memory, the processor includes：1) connect
Receive module, the receiving module be configured to receive from application client the consultation of doctors request, it is described the consultation of doctors request by one or
Multiple request variable compositions, the request variable includes request purpose variable and multiple data variables, the request purpose variable
By one or more request purpose crucial phrases into the request purpose keyword at least includes the title of one or more diseases
Or the title of one or more clinical departments, the data variable is the one or more clinical datas or number related to patient
According to；2) module is retrieved, the retrieval module is configured to examine in the expert database using the request purpose keyword
Rope with asking the associated expert's title of purpose keyword at least one described, expert's title and specific disease name or
Clinical department title is stored in advance in the expert database in association, wherein being also in advance in the expert database
Part or all of expert's title is respectively provided with respective predetermined search rule, and the predetermined search rule includes one or more
Predetermined search keyword and/or one or more predetermined search conditions, the predetermined search keyword and/or the predetermined search
Condition is relevant with the diagnosis or treatment of the specific disease；3) search module, the search module is configured to from described special
The predetermined search rule associated with each expert's title retrieved by the retrieval module is read in family's database, described
The predetermined search that each predetermined search rule that in turn search is read in multiple data variables of consultation of doctors request is included is closed
Keyword and/or search meet the data variable for the predetermined search condition that each predetermined search rule read is included；Wherein
When the search module searches a predetermined search rule is included at least one in the data variable that the consultation of doctors is asked
Individual predetermined search keyword and/or at least one data variable of consultation of doctors request meet the predetermined search rule and included
At least one predetermined search condition when, using the predetermined search rule as candidate predetermined search regular record and store,
Record simultaneously and store the predetermined search keyword that is searched in the predetermined search rule of the candidate and predetermined searching of meeting
The number of rope condition；With 4) screening module, the screening module be configured to record and store in the processor respectively with institute
Have after expert's title corresponding to the predetermined search rule of candidate, the expert corresponding to the predetermined search rule of all candidates is made
Result is examined for final point.
The advantage of the present invention
The system of the present invention automatically using in expert's default search rule search application case-data with the presence or absence of
The search variables (for example, keyword or condition) matched somebody with somebody and the search variables number for determining matching, thus found in database with
The corresponding candidate expert of preset search rule of matching, one required for then being filtered out further according to default screening rule or
Multiple expert's names are referred to as final point and examine result.
The system of the present invention not only creatively simulates the diagnosis and treatment thinking of expert by using preset search rule, also leads to
Cross customization ground setting search condition and/or predetermined filtering rule to optimize preliminary matches result, so as to reach to special
The accurate matching of family and the dual purpose that appropriate experts are neatly further selected according to various requirement, it is possible thereby to meet specially
Family, application end hospital and system operator examine the various requirement that result carries out intelligentized control method to dividing.
The system of the present invention is from principle with passing through searching for Internet, bibliographic data base or electronics using conditions of patients data
The method that reference book obtains treatment recommendations (for example, IBM Watson doctor) is entirely different.The latter is substantially still a kind of search
Instrument or method, in specific operation process, Watson doctor will search related to the state of an illness of input in database
Diagnosis and treatment opinion is listed by confidence level size and selected for doctor, can also be given references behind every kind of opinion, and smooth with confidential interval
Doctor oneself is told to rate to have much assurance.Searched for however, this searching method is only to aid in doctor, although providing
It is recommended that, but do not change the basic clinical thinking of doctor.However, the difference of medical expert and general doctor are not only in that knowledge
The gap with clinical experience is measured, often the gap in terms of diagnosis and treatment thinking.Therefore, only doctor enumerates various treatment possibilities
It can not improve doctor's treatment level and judgment, and for the therapeutic schemes of each individual patients, can not be based only on can
The numerical value of energy property is just selected！
Therefore, of the invention essence and advantage are to be diagnosis according to what the present invention was searched or treat certain particular condition
Relevant clinical diagnosis and treatment thinking, so as to find corresponding expert, by expert in follow-up remote medical consultation with specialists further according to the specific state of an illness
There is provided most suitable individuation diagnosis and treatment opinion, i.e. be not limited only to provide therapeutic scheme in itself.The reason is that difficult
The diagnosis and treatment of disease are not diagnosis and treatment various symptoms, various complication, the simple combination of comorbidity, and appropriate diagnosis and treatment are thought
Dimension is extremely important in the diagnosis and treatment of difficult diseases, only under clearly diagnosis and treatment thinking, could with a definite target in view find and most preferably control
Treatment scheme combine, rather than enumerate various therapeutic scheme possibilities height it is so simple.And Watson doctor can not provide this
The diagnosis and treatment thinking of sample, help of the therapeutic scheme that it is provided to doctor is only limitted to the quick search of data.
Brief description of the drawings
The present invention is illustrated and described herein with reference to multiple accompanying drawings, wherein：
Fig. 1 illustrates elementary organization's schematic diagram of typical remote medical consultation with specialists.
Fig. 2 illustrates the typical flowchart of remote medical consultation with specialists.
Fig. 3 illustrates the composition of an embodiment of the Telemedicine System of the present invention.
The intelligent remote point that Fig. 4 is illustrated performed by the long-distance intelligent system for distribution of out-patient department of the present invention examines an embodiment party of method
The flow chart of case.
Embodiment
Definition：
Telemedicine System：In the present invention, the implication of Telemedicine System will include both hardware and softwares, for example, wrap
Include remote medical information system hardware and software, communication equipment hardware and software, network platform hardware and software, data and storage
Platform hardware and software etc..
Medical test is reported：Refer to the various body fluid that human body is checked using physico-chemical process means in the present invention, with
It is preceding to be referred to as laboratory examination, including clinical examination, biochemical test and bacterium and serologic test etc..
Pathologic finding is reported：Checked in the present invention including exfoliative cytology inspection, biopsy, histochemistry,
Immunohistochemical detection, flow cytometry, electron microscopy, molecular pathology inspection, rapid pathology inspection.
Medical imaging：Include X-ray imaging, CT examination, Magnetic resonance imaging (MRI), positive electron hair in the present invention
Penetrate computerized tomograph (positron emission tomography PET, PET-CT), ultrasonic examination, electrocardiogram inspection
Look into, the various imageological examinations that cardioelectric monitor, EEG(electrocardiogram) examination, electromyogram, audiogram etc. are clinically used.CT examination includes flat
Sweep CT, enhanced CT and cisternography CT etc..CT equipment includes common CT and spiral CT etc..It is how general that ultrasonic examination includes B ultrasound, colour
Strangle ultrasound, Color Sonography, three-dimensional color ultrasound etc..
Data：The data being previously mentioned in the present invention include numeric data, grouped data, alphabetic data, observation data, reality
Test the various statistics types such as data, cross-section data, time series data.
In the present invention, diagnosis and treatment section office include internal medicine, surgery, paediatrics, emergency department, prevention and health section or functionally similar section
Room and the professional section office further segmented；Assisting in diagnosis and treatment section office include the professional section office that technical support is provided for clinic, for example
Pharmacy, dept. of radiology, Ultrasonography, pathology department, operating room, the department of physiotherapy, Nutriology Dept., supply room, Endoscopy Room etc., but do not include pipe
Natural sciences room or department, nursing sector and logistics section office or department.
ICD classification refers to International Classification of Diseases (International Classification of Diseases).
Fig. 1 illustrates the conventional remote medical consultation with specialists used point at present and examines organizational form.In Fig. 1, application end is to initiate the consultation of doctors
The client of request, generally medical institutions of subordinate, Fen Zhen centers are then general to be controlled by higher level medical institutions medical department, Zhuan Jiaduan
The client that i.e. the processing consultation of doctors is asked.Method of examining is divided to include tri- steps of S1-S3 shown in Fig. 1.Wherein in S1, by applying for that end is carried
Go out consultation of doctors application；In S2, divide and examine the distribution that center managers carry out expert according to consultation of doctors application control Fen Zhen centers；In S3, point
Examine center and the result of distribution is notified into application end and expert end respectively.From figure 1 it appears that expert participates in dividing examining in person
Process.
Fig. 2 illustrates the typical flowchart of remote medical consultation with specialists.Clearly find out from Fig. 2, the operation at expert end is independently of pipe
The operation of reason person, is not participating in point the examining of Fen Zhen centers.
As can be seen here, expert is passive in point the examining of existing tele-medicine, therefore expert can not select it on one's own initiative
The case be good at or be best suitable for.If the expert relevant with application case that be possible to allowed in database enters to case in advance
Row screening, it is likely that accurately matched to application case, but this is unpractical in real work, because this will expend
The substantial amounts of energy of higher level's hospital expert, influences the normal work and reduction consultation of doctors efficiency of expert on the contrary.For example, for breast cancer lung
Which section and who expert in patient, distribution Breast Surgery, thoracic surgery, Internal Medicine-Oncology are shifted, for not certain tumour
It is extremely difficult for the personnel of training experience.If blindly dividing the situation generation for examining and will result in and repeatedly holding a consultation, cause doctor
Treat the waste of resource.
Although in some cases, patient's physician of application hospital can directly select higher level's hospital expert and reach
Semi-automatic point is examined, but this requires that there is the doctor of application hospital higher diagnosis and treatment ability (that is, to be not only well understood by the thin of expert
Divide specialty and be at least also equipped with patient disease being sub-divided into the ability of subdivision specialty or research direction).In view of long-range at present
Medical treatment is often directed to basic hospital and outlying district, and such case proportion is very small.
Fig. 3 illustrates the composition of the Telemedicine System of the present invention.As shown in figure 3, the Telemedicine System bag of the present invention
Include video conference component and the information-based component of tele-medicine.Tele-medicine informationization component includes long-distance intelligent system for distribution of out-patient department, institute
Memory and processor can be included by stating long-distance intelligent system for distribution of out-patient department, and be stored with expert database in memory, processor bag
Include receiving module, retrieval module, search module and screening module.
In the long-distance intelligent system for distribution of out-patient department of the present invention, receiving module may be configured to receive from application client
Consultation of doctors request, the consultation of doctors request can be made up of one or more request variables, and the request variable can include request mesh
Variable and multiple data variables, the request purpose variable can be by one or more request purpose crucial phrases into described
Purpose keyword is asked at least to include the title or the title of one or more clinical departments of one or more diseases, it is described
Data variable can be the one or more clinical datas or data related to patient.
Retrieval module is configured to the request purpose keyword and retrieve in the expert database and extremely
The associated expert's title of a few request purpose keyword, expert's title can be with specific disease name or facing
Bed section office title is stored in advance in the expert database in association, wherein can also be in advance in the expert database
Respective predetermined search rule is respectively provided with for part or all of expert's title, the predetermined search rule can include one
Or multiple predetermined search keywords and/or one or more predetermined search conditions, the predetermined search keyword and/or described pre-
Determining search condition can be relevant with the diagnosis or treatment of the specific disease.
Search module may be configured to from the expert database read with by it is described retrieve module retrieve it is every
The associated predetermined search rule of individual expert's title, in turn search is read in multiple data variables of the consultation of doctors request
Each predetermined search predetermined search keyword for being included of rule and/or search meet each predetermined search rule read
Comprising predetermined search condition data variable；Wherein searched when in data variable of the search module in the consultation of doctors request
At least one of at least one predetermined search keyword that rope is included to predetermined search rule and/or consultation of doctors request
When data variable meets at least one predetermined search condition that the predetermined search rule is included, by predetermined search rule
As candidate predetermined search regular record and store, while record and store the candidate predetermined search rule in be searched
To predetermined search keyword and the number of predetermined search condition that meets.
The predetermined search that screening module may be configured to record and store in the processor respectively with all candidates is advised
Then after corresponding expert's title, one or more experts name required for being filtered out further according to default screening rule is referred to as
Final point is examined result.
In one embodiment, screening module can according to ranking method, by the predetermined search rule of each candidate according to
The summation of the number for the predetermined search keyword being searched and/or the number of the predetermined search condition met is by from big to small
Order sorts, and the expert corresponding to the predetermined search rule of one candidate of selected and sorted highest examines result as final point.
In another embodiment, screening module can make the expert corresponding to the predetermined search rule of all candidates
Result is examined for final point.
In another embodiment, if processor may be configured to expert's title that the retrieval module is retrieved
In the absence of associated predetermined search rule, then the processor enters rower in the expert database to expert's title
Remember to point out to set expert's title associated predetermined search rule.
Also in another embodiment, processor may be configured to further to freeze expert's title to cause right
Expert's title sets the regular foregoing description retrieval module of predetermined search not retrieved to expert's title.
In one embodiment, data variable can include the main suit of the patient, present illness history, past medical history, family history,
One in physical examination, diagnosis, antidiastole, progress note, medical test report, pathologic finding report, medical imaging report
Item is multinomial, and related various types of data.
In the various embodiments of the present invention, request variable can be text formatting, and data variable can include text
The data variable of form and various image formats, preferably whole data variables use text formatting.
In one embodiment, search module can include comparator, and the comparator may be configured to compare figure
As the data variable of form.Preferably, the comparator can be using various image recognition intelligent algorithms or software come real
It is existing, it would however also be possible to employ to be realized using the hardware of various image recognition intelligent algorithms or software.
In the various embodiments of the present invention, the classification of disease can use ICD classification, preferably ICD-10.
The intelligent remote point that Fig. 4 is illustrated performed by the long-distance intelligent system for distribution of out-patient department of the present invention examines an embodiment party of method
The flow chart of case.
As shown in figure 4, in step S101, receiving the consultation of doctors request from application client.In the present invention, the consultation of doctors please
Asking can be made up of one or more request variables, and the request variable can include request purpose variable and multiple data become
Amount, the request purpose variable can be with into, the request purpose keyword by one or more request purpose crucial phrases
At least include the title or the title of one or more clinical departments of one or more diseases, the data variable can be and trouble
The related one or more clinical datas of person or data.
In step S102, retrieved first with request purpose keyword in expert database and at least one described request mesh
The associated expert's title of keyword, expert's title and specific disease name or clinical department title are pre- in association
It is first stored in the expert database, then calls associated with the expert's title retrieved predetermined search from expert database
Rope rule Rn(for example, from R1Start).In expert database each predetermined search rule in advance with the expert in expert database
Association (each expert in experts database can be provided with predetermined search rule or only part expert provided with predetermined search rule), it is wrapped
Include one or more predetermined search keywords and/or one or more predetermined search conditions, the predetermined search keyword and/or
The predetermined search condition is relevant with the diagnosis or treatment of the specific disease, the diagnosis and treatment thinking typically with associated expert
It is relevant, for example, expert custom is using these keywords or condition diagnosis and treatment certain diseases.
In step S103, the predetermined search rule called in multiple data variables of consultation of doctors request in search step S102
Then Rn(for example, R1) the predetermined search keyword that is included and/or search meet step predetermined search rule Rn(for example, R1) wrapped
The data variable of the predetermined search condition contained.In this step, if there is no any search result, it is back to step
S102 calls the next predetermined search retrieved rule (for example, R2), repeat above-mentioned search procedure.
In step S104, when searching predetermined search at least one data variable of consultation of doctors request in step s 103
Regular Rn(for example, R1) at least one data of at least one predetermined search keyword for being included and/or consultation of doctors request becomes
Amount meets predetermined search rule Rn(for example, R1) included at least one predetermined search condition when, by the predetermined search rule
Rn(for example, R1) as candidate predetermined search regular record and store, while record and store candidate predetermined search rule in
The number of the predetermined search keyword being searched and the predetermined search condition met.Recording and storing the predetermined search of candidate
Rule is (for example, R1) after, it is back to step S102 and calls next predetermined search rule (for example, R2), repeat above-mentioned search procedure straight
Untill all predetermined search rules retrieved are all searched.
In step S105, result is examined using the expert corresponding to the predetermined search rule of all candidates as final point.
After acquisition finally divides and examines result, result can be sent to application client and expert clients respectively.
It is noted that in the present invention, the predetermined screening rule can be according to application client (for example, application
Hospital) and expert clients (for example, according to requirement of expert) requirement change, can also be changed by system manager.Example
Such as, expert at any time or periodically can adjust preset search rule so as to future more accurately according to result and consultation of doctors feedback point is examined
Matching, system manager can also at any time or periodically be adjusted as required by predetermined filtering rule, or even can also be according to a certain
The requirement change predetermined filtering rule of multiple or whole client application hospitals, such as set and only filter out matching degree highest
One expert, or filter out the special rules such as 2-3 experts of matching degree highest.System manager can also doubt according to some
Difficult disease formulates special screening rule, for example, screening the 2-3 experts' progress of matching degree highest to the liver cancer patient of some types
The joint consultation of doctors.
In one embodiment, if associated predetermined search is not present in the expert's title retrieved in step s 102
Rope rule (i.e. the expert is not provided with predetermined search rule), then do not perform follow-up step and described to expert's title
Expert's title is marked in expert database to point out to set expert's title associated predetermined search rule
Then.Preferably, further freeze expert's title cause to expert's title set predetermined search rule before it is not right
Expert's title performs searching step S102.
In long-distance intelligent point of the invention examines each embodiment of method, data variable can include the master of patient
Tell, present illness history, past medical history, family history, physical examination, diagnosis, antidiastole, progress note, medical test report, pathologic finding report
One or more in announcement, medical imaging report, and related various types of data.It can be text to ask variable
Form.Data variable can include the data variable of text formatting and various image formats, and preferably whole data variables can be with
Using text formatting.As described above, the classification of disease can use ICD classification, preferably ICD-10.
Embodiment
Applicant is simulated test in the real work of remote medical consultation with specialists using the system and method for the present invention, and
And carried out entry evaluation with reference to remote medical consultation with specialists result and clinical effectiveness in simulation test work.
First, expert's situation：
A, B, C, D and E expert in expert database is the well-known expert for treating lung cancer, but in Different hospital work, A
Expert is good at lung cancer and precisely treated in the Internal Medicine-Oncology work of general hospital, and B expert is put Cancer Hospital
Treatment section works, and is good at the accurate radiotherapy of tumour, and C expert is good at surgical oncology in the thoracic surgery work of a general hospital,
D expert is good at the chemotherapy of lung cancer, E expert is in a Cancer Hospital in the Respiratory Medicine work of a general hospital
Section works, and is good at lung cancer chemotherapy and immunization therapy.A, B and E expert are provided with predetermined search rule R in database in advance1, R2
And R3, C and D experts are not provided with.
2nd, predetermined search rule：
Lung cancer is divided into ED-SCLC (SCLC) and non-small cell lung cancer (NSCLC), and wherein NSCLC accountings are up to 80%,
Mainly include adenocarcinoma of lung and lung squamous cancer.The NSCLC patient that there are about 70% has been late period when making a definite diagnosis, and treats unwise to chemicotherapy
Sense, causes the death rate high, median survival interval is only 3 months, and five-year survival rate is only 15%.In recent years, clinic has discovered that
A series of driving gene of lung cancer, including ALK, EGFR, BRAF, KRAS and HER2 mutation etc..In asian ancestry's patients with lung adenocarcinoma,
87% patient is found known drive gene, wherein the clear and definite targeted inhibition agent, 66% trouble of 81% driving gene
Person can receive the individuation targeted therapy of marketed drug.Accurately can suitably it be targetted for selection of clinical with diagnostic result
Medicine provides strong foundation, so as to help the customized therapeutic regimen of patient, makes patient be possible to obtain maximum
Survival advantage.
The research direction of A expert is the accurate targeted therapy of individuation of non-small cell lung cancer and has been provided with certain control
Treatment experience.A expert is provided with following predetermined search rule R in database1：IIb is more than the phase (that is, IIb points in TNM stage
Phase corresponds to T2N1M0, T3N0M0, and this rule isSearch condition), (this rule is adenocarcinoma of lungKeyword, similarly hereinafter), CEA (notes：Tumour
Mark, diagnosis and treatment and assessment for lung cancer), CA125 (notes：Tumor markers, diagnosis and treatment and assessment for lung cancer), ALK dashes forward
Become, EGFR mutation, HER2 mutation, transfer stove, after chemotherapy, SD (notes：Stable disease), PD (notes：Progression of disease).
B expert is good at the accurate radiotherapy of tumour, just hospital introduced a state-of-the art ejected wave knife (Cyber knife, again
Claim " Cyberknife System for Stereotactic Radiosurgery/Radiotherapy ", be global state-of-the art whole body stereotaxic radiosurgery therapeutic equipment).Due to can not
Being resistant to the treatment of the patient of operation of lung cancer can select External radiotherapy, stereoscopic localized radiotherapy and stereoscopic localized radiation outer
Section performs the operation or chemoradiotherapy plus treatment.And the Synchrony breathings tracing system of ejected wave knife can be followed the trail of in treatment delivery process
And the activity of tumour is supplied, therefore in stereoscopic localized radiotherapy field, ejected wave knife is unique in the treatment advantage of lung tumors
's.In addition, for the transfer stove in certain size, ejected wave knife effect is also good.Therefore the predetermined search rule R that he is set2It is：
Lung cancer, tumour stove maximum gauge≤3cm (note：This rule isSearch condition), no surgical indication (note：This rule isSearching bar Part)。
E expert is good at the immunization therapy of the chemotherapy of lung cancer, particularly rising in recent years, especially to PD-1 inhibitor and
The use of PD-L1 inhibitor is reacted to.Therefore, the predetermined search rule R that she is set3It is：IIb is more than the phase, lung squamous cancer, PD-1
Expression, PD-L1 expression, ALK mutation, EGFR mutation, platinum (note：Refer to the application of platinum class medicine, because pembrolizumab
It is mutated for ALK and EGFR is mutated the patient being in progress after negative and platinum-based chemotherapy and has good curative effect), PD (notes：Disease is entered
Exhibition).
3rd, simulation test process：
Apply for that end shows that the consultation of doctors request of the patient is in the application of in September, 2016 in one consultation of doctors case, system：Request
The therapeutic scheme of one patients with lung cancer of oncology expert consultation, data variable includes：Main suit, present illness history, past medical history, family history,
Progress note, diagnosis, antidiastole, laboratory examination, PET-CT audit reports and image data, biopsy pathology audit report,
Electrocardioscopy report, color ultrasound, CT and the report of cranium brain magnetic resonance examination etc..The data of the patient includes following information：
1. tentative diagnosis：After left adenocarcinoma of lung (PT2NxM0 phases) chemotherapy, the 8th rib is shifted behind the right sideCranium brain transfer (note：There is cranium
Brain metastes, the evaluation of patient is the IV phases).
2. biopsy pathology is shown：Upper lobe of left lung tip cancer, tendency gland cancer (cancerous tissue is dispersed in, less).
3. chest CT display centre type lung cancer.
4. progress note is shown：The court's surgical departments consultation of doctors result is wouldn't preferably perform the operation, and 6 cycle of row docetaxel adds cis-platinum
Chemotherapy, SD is evaluated in check after 6 weeks.
5.EGFR, K-ras genetic test result are negative for mutation.
6. cranium brain magnetic resonance is pointed out：The multiple occupy-place of intracerebral, metastatic tumor possibility is big (the greater, 1.6 × 2.2cm).
If traditionally, point examined or intelligent Matching without intelligence, then system can only be carried out between A-E expert with
Machine is matched or simply manually matched, and consultation of doctors effect is difficult to predict.
After the consultation of doctors for receiving the patient is asked, system is become with the predetermined search rule of A, B and E expert in data respectively
The keyword being consistent and condition are searched in amount, matching result is as follows：
A expert's occurrence：1) IIb the conditions more than phase are met in diagnosing；2) adenocarcinoma of lung；3) EGFR mutation check knot
Really；4) transfer stove；5) after chemotherapy；6)SD.
B expert's occurrence：1) lung cancer；2) tumour stove maximum gauge≤3cm；3) condition of no surgical indication is met.
E expert's occurrence：1) IIb the conditions more than phase are met in diagnosing；2) platinum；3) EGFR is mutated inspection result.
The predetermined screening rule of system isBy all candidate experts searchedResult is examined as last point.Therefore obtaining
After the above results, therefore above three expert is defined as by systemFinal point is examined resultAnd it is sent to application client and expert visitor
Family end (note：As described above, system manager, expert and application end hospital can also advise according to the feedback of consultation of doctors effect to screening
Then it is adjusted, so that obtaining most optimal sorting examines result).
The invention provides following embodiment：
1. a kind of Telemedicine System, the system includes video conference component and the information-based component of tele-medicine, described
The intelligence point that tele-medicine informationization component is able to carry out comprising the following steps examines method：
1) consultation of doctors request from application client is received, the consultation of doctors request is made up of one or more request variables,
The request variable includes request purpose variable and multiple data variables, and the request purpose variable is by one or more request mesh
Crucial phrase into the request purpose keyword at least includes the title of one or more diseases or one or more clinical sections
The title of room, the data variable is the one or more clinical datas or data related to patient；
2) retrieved using the request purpose keyword in expert database crucial with least one request purpose
The associated expert's title of word, expert's title is prestored in association with specific disease name or clinical department title
In the expert database, wherein being also respectively provided with advance for part or all of expert's title in the expert database
Respective predetermined search rule, the predetermined search rule includes one or more predetermined search keywords and/or one or many
The diagnosis of individual predetermined search condition, the predetermined search keyword and/or the predetermined search condition and the specific disease
Or treat relevant；
3) read and step 2 from the expert database) in each expert's title for being retrieved is associated makes a reservation for
Search rule；
4) the in turn search step 3 in multiple data variables of the consultation of doctors request) in read each predetermined search
The rope predetermined search keyword that is included of rule and/or search meet step 3) in each predetermined search rule for being read wrapped
The data variable of the predetermined search condition contained；
5) when in step 4) in search in search predetermined search rule in the data variable of the consultation of doctors request
At least one the predetermined search keyword then included and/or at least one data variable of consultation of doctors request meet described pre-
When determining at least one predetermined search condition that search rule is included, using the regular predetermined search as candidate of the predetermined search
Regular record is simultaneously stored, while recording and storing the predetermined search keyword that is searched in the predetermined search rule of the candidate
With the number of the predetermined search condition met；With
6) record and store respectively with expert's title corresponding to the predetermined search of all candidates rule, and by all candidates
Predetermined search rule corresponding to expert as final point examine result；
It is determined that final point examine result after, result is examined by the video conference component and described final point of the system
Client where corresponding expert carries out long-distance video connection.
2. the system described in embodiment 1, it is characterised in that if in step 3) in expert's title for retrieving be not present
Associated predetermined search rule, then do not perform follow-up step and in the expert database to institute to expert's title
Expert's title is stated to be marked.
3. the system described in embodiment 2, it is characterised in that further freeze expert's title and cause to described special
Family's title sets and expert's title not retrieved before predetermined search rule.
4. the system any one of embodiment 1-3, it is characterised in that the data variable includes the patient's
Main suit, present illness history, past medical history, family history, physical examination, diagnosis, antidiastole, progress note, medical test report, pathologic finding report
One or more in announcement, medical imaging report, and related data.
5. the system any one of embodiment 1-4, it is characterised in that the request variable is text formatting；It is described
Data variable includes the data variable of text formatting and various image formats, and preferably whole data variables use text formatting.
6. the system any one of embodiment 1-5, it is characterised in that the classification of the disease is classified using ICD
Method, preferably ICD-10.
7. the system any one of embodiment 1-6, it is characterised in that the clinical department include it is all with it is clinical
Medical related diagnosis and treatment section office and assisting in diagnosis and treatment section office, but do not include administrative department, nursing sector and logistics department.
8. a kind of Telemedicine System, the system includes video conference component and the information-based component of tele-medicine, described
Tele-medicine informationization component includes long-distance intelligent system for distribution of out-patient department, and the long-distance intelligent system for distribution of out-patient department includes memory and processing
Device, wherein the expert database that is stored with the memory, the processor includes：
1) receiving module, the receiving module is configured to receive the consultation of doctors request from application client, the consultation of doctors
Request is made up of one or more request variables, and the request variable includes request purpose variable and multiple data variables, described
Ask purpose variable by one or more request purpose crucial phrases into the request purpose keyword at least includes a kind of or many
The title of kind of disease or the title of one or more clinical departments, the data variable one or more face to be related to patient
Bed data or data；
2) module is retrieved, the retrieval module is configured to using the request purpose keyword in the expert database
The middle retrieval expert title associated with asking purpose keyword at least one described, expert's title and specific disease name
Claim or clinical department title is stored in advance in the expert database in association, wherein also pre- in the expert database
First be respectively provided with respective predetermined search rule for part or all of expert's title, the predetermined search rule include one or
Multiple predetermined search keywords and/or one or more predetermined search conditions, the predetermined search keyword and/or described predetermined
Search condition is relevant with the diagnosis or treatment of the specific disease；
3) search module, the search module is configured to read and by the retrieval module from the expert database
The predetermined search rule that each expert's title retrieved is associated, in multiple data variables of the consultation of doctors request in turn
Search for each predetermined search predetermined search keyword that is included of rule read and/or search meets read each pre-
Determine the data variable for the predetermined search condition that search rule is included；Wherein when the search module is in the money of the consultation of doctors request
At least one predetermined search keyword and/or consultation of doctors request that a predetermined search rule is included are searched in material variable
At least one data variable when meeting at least one predetermined search condition that predetermined search rule is included, will be described pre-
Search rule is determined as the predetermined search regular record of candidate and is stored, while recording and storing the predetermined search rule of the candidate
The number of the predetermined search keyword being searched in then and the predetermined search condition met；With
4) screening module, the screening module is configured to record and store in the processor respectively with all candidates'
After expert's title corresponding to predetermined search rule, the expert corresponding to the predetermined search rule of all candidates is regard as final point
Examine result.
9. the system described in embodiment 8, it is characterised in that if the processor is configured to the retrieval module inspection
Associated predetermined search rule is not present in expert's title that rope is arrived, then the processor in the expert database to described
Expert's title is marked.
10. the system described in embodiment 9, it is characterised in that the processor is configured to further freeze the expert
Title setting expert's title the regular foregoing description of predetermined search to retrieve module not to expert's title progress
Retrieval.
11. the system any one of embodiment 8-10, it is characterised in that the data variable includes the patient
Main suit, present illness history, past medical history, family history, physical examination, diagnosis, antidiastole, progress note, medical test report, pathologic finding
One or more in report, medical imaging report, and related data.
12. the system any one of embodiment 8-11, it is characterised in that the request variable is text formatting；Institute
Data variable of the data variable including text formatting and various image formats is stated, preferably whole data variables use text lattice
Formula.
13. the system described in embodiment 12, it is characterised in that the search module includes comparator, the comparator quilt
It is configured to the data variable of movement images form.
14. the system any one of embodiment 8-13, it is characterised in that the classification of the disease is classified using ICD
Method, preferably ICD-10.
Although this hair has been illustrated and described herein with reference to the preferred embodiments of the invention and specific embodiment
It is bright, but as readily apparent to a person of ordinary skill in the art other embodiments can perform similar function with embodiment
And/or realize similar result.All such equivalent embodiments and embodiment are included within the spirit and scope of the present invention,
Thus it is expected, and is intended to be covered by following claim.
Claims (8)
1. a kind of Telemedicine System, the system includes video conference component and the information-based component of tele-medicine, described long-range
Medical information component includes long-distance intelligent system for distribution of out-patient department, and the long-distance intelligent system for distribution of out-patient department includes memory and processor, its
In be stored with the memory expert database, the processor includes：
1) receiving module, the receiving module is configured to receive the consultation of doctors request from application client, the consultation of doctors request
It is made up of one or more request variables, the request variable includes request purpose variable and multiple data variables, the request
Purpose variable is by one or more request purpose crucial phrases into the request purpose keyword at least includes one or more diseases
The title of disease or the title of one or more clinical departments, the data variable are the one or more clinical moneys related to patient
Material or data；
2) module is retrieved, the retrieval module is configured to examine in the expert database using the request purpose keyword
Rope with asking the associated expert's title of purpose keyword at least one described, expert's title and specific disease name or
Clinical department title is stored in advance in the expert database in association, wherein being also in advance in the expert database
Part or all of expert's title is respectively provided with respective predetermined search rule, and the predetermined search rule includes one or more
Predetermined search keyword and/or one or more predetermined search conditions, the predetermined search keyword and/or the predetermined search
Condition is relevant with the diagnosis or treatment of the specific disease；
3) search module, the search module is configured to read from the expert database with being retrieved by the retrieval module
The predetermined search rule that each expert's title arrived is associated, is in turn searched in multiple data variables of the consultation of doctors request
The each predetermined search predetermined search keyword that is included of rule read and/or search meet that read each is predetermined to be searched
The data variable for the predetermined search condition that rope rule is included；Wherein when the search module becomes in the data of the consultation of doctors request
Regular at least one the predetermined search keyword included of a predetermined search and/or consultation of doctors request are searched in amount extremely
When a few data variable meets at least one predetermined search condition that the predetermined search rule is included, make a reservation for search by described
Rope rule as candidate predetermined search regular record and store, while record and store the candidate predetermined search it is regular in
The number of the predetermined search keyword being searched and the predetermined search condition met；With
4) screening module, the screening module is configured to record and store in the processor predetermined with all candidates respectively
After expert's title corresponding to search rule, knot is examined using the expert corresponding to the predetermined search rule of all candidates as final point
Really.
2. the system described in claim 1, it is characterised in that if the processor is configured to the retrieval module and retrieved
Expert's title associated predetermined search rule is not present, then the processor in the expert database to the expert
Title is marked.
3. the system described in claim 2, it is characterised in that the processor is configured to further freeze expert's title
So that setting the regular foregoing description retrieval module of predetermined search not retrieved to expert's title to expert's title.
4. the system described in claim 1, it is characterised in that the data variable includes the main suit of the patient, present illness history, both
Toward history, family history, physical examination, diagnosis, antidiastole, progress note, medical test report, pathologic finding report, medical image inspection
One or more looked into report, and related data.
5. the system described in claim 1, it is characterised in that the request variable is text formatting；The data variable includes text
The data variable of this form and various image formats, preferably whole data variables use text formatting.
6. the system described in claim 5, it is characterised in that the search module includes comparator, the comparator is configured to
The data variable of movement images form.
7. the system described in claim 1, it is characterised in that the classification of the disease uses ICD classification, preferably ICD-10.
8. the system described in claim 1, it is characterised in that the clinical department includes all diagnosis and treatment related to clinical treatment
Section office and assisting in diagnosis and treatment section office, but do not include administrative department, nursing sector and logistics department.
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| CN201710557339.5A CN107273700A (en) | 2017-07-10 | 2017-07-10 | Intelligent remote medical system |
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