JP2001346870A - Artificial home dialysis supporting system - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an artificial home dialysis supporting system which supports the optimization of the maintenance of a blood dialyzing device in a home medical treatment, and the administration of a treatment result regarding the dialysis performance. SOLUTION: An artificial home dialysis device is equipped with a medical information- inputting means for inputting medical information regarding the dialysis, an equipment information-detecting means for detecting dialyzing equipment information during the dialysis and/or the preparation for the dialysis, an equipment information-judging means for judging whether the dialyzing equipment information is normal or not, and a transmitting means for transmitting the medical information, the equipment information and the judgment result of the equipment information-judging means to a central information-collecting center. A central information-collecting device is equipped with a receiving means for receiving the information transmitted from a patient residence, an information-converting means for converting the received information into graphs and characters as medical information for diagnosis and equipment control information, and a transmitting means for transmitting the medical information for diagnosis to a hospital which is responsible for the patient. A medical information-receiving device is equipped with a receiving means which is arranged in the hospital and receives the medical information for diagnosis transmitted from the central information-collecting center. Then, the artificial home dialysis supporting system is provided with the above artificial home dialysis device, the central information-collecting device, and the medical information-receiving device.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to home dialysis treatment, in which the state of a patient and the state of dialysis can be grasped by remote monitoring by remote monitoring.
It is an object of the present invention to provide a home-based artificial dialysis device capable of grasping the degree of deterioration of components constituting the device and a home-based artificial dialysis support system using the same.

[0002]

2. Description of the Related Art As the number of patients with renal insufficiency increases, the number of patients undergoing hemodialysis also tends to increase. Such patients are usually forced to undergo hemodialysis at a hospital or dialysis center once every few days for several hours, and at present, only renal transplants can be used to resolve this.

[0003] In recent years, the progress of home nursing and home medical care,
As a method of solving the problem of dialysis patients going to the hospital, a home-use artificial dialysis machine that performs dialysis by the patient himself at home has been developed, and the possibility of clinical application is increasing. For this reason, in order to perform dialysis at home, in the past, hospitals had to manage medical data of patients on dialysis and equipment management of dialysis equipment, which were performed by medical staff such as doctors, nurses, and clinical engineers. Myself,
Alternatively, it is necessary for the caregiver to do this, but it is impossible to do it completely, and it is necessary to remotely monitor the management of the device and medical information. However, at present, home dialysis therapy itself is in a trial stage, and there is no system for monitoring it at present.

In recent years, in hospital hemodialysis treatments, Japanese Patent Application Laid-Open Nos. Hei 7-132141 and
As described in Japanese Patent Publication No. 8, a central monitoring system is being introduced, in which a plurality of hemodialyzers as therapeutic devices are collectively monitored by a central monitoring device. In this system, a hemodialysis device having a communication function and a central monitoring device are connected to a communication network of a central monitoring system installed in a hospital, and treatment records and the like are centrally managed.

[0005]

A conventional central monitoring system for hemodialysis treatment is premised on operation in a hospital, and should be improved if hemodialysis treatment is to be performed at home. Had difficulties.

First, maintenance of a hemodialysis machine in a hospital is usually performed by hand, as represented by medical staff such as nurses and clinical engineers.
In the case of home treatment, medical staff will not be present at the actual treatment site. Therefore, the service staff regularly patrols each patient's home for maintenance and inspection.However, if the time between patrols is too long, the patient must be treated in a state where the equipment does not meet the specifications. Is too short,
In many cases, the cost was increased.

Second, in the home treatment, since the patient or the caregiver operates the hemodialysis apparatus, it is necessary for the doctor to compare the scheduled dialysis execution and the actual treatment results of the actual dialysis at a later date. The patient's own or his or her caregiver had to fill in the results of the treatment, which not only required the trouble of filling out, but also had the possibility of erroneous entry.

Third, in the case of a system in which a patient's home is directly connected to a hospital, the hospital needs to manage and maintain the system, which may further increase the burden on busy medical sites. Was.

Accordingly, an object of the present invention is to provide a home-based artificial dialysis support system for supporting maintenance optimization of a hemodialysis machine in home treatment and management of the treatment results related to dialysis execution.

[0010]

The inventor of the present invention has made intensive studies on such problems, and as a result, an artificial dialysis apparatus capable of transmitting medical information and equipment information, receiving the information, and sending the medical information to a hospital. The information is distributed to the equipment management center, and a system that supports efficient and safe home dialysis is found.

That is, the present invention provides medical information input means arranged at each patient's home for inputting medical information related to dialysis, and equipment information detecting means for detecting dialysis equipment information during dialysis and / or preparation for dialysis. Device information determining means for determining whether the dialysis device information is normal or abnormal, and transmitting means for transmitting the medical information, the device information, and the determination result of the device information determining means to a central information collection center. Home treatment artificial dialysis device, and a receiving means for receiving information transmitted from the patient's home, which is arranged at the central information collection center, and receives the received information as charts for medical information for diagnosis and device management information. A central information collection device having information conversion means for converting the information into characters, transmission means for transmitting the medical information for diagnosis to a hospital in charge of a patient, There is provided a home dialysis support system comprising a medical information receiving apparatus comprising receiving means for receiving the diagnostic medical information transmitted from the information collection center.

Further, according to the present invention, the medical information input means includes dialysis execution information input means for inputting a set value of dialysis conditions for artificial dialysis, and the device information detecting means includes an actual measured value of dialysis conditions during artificial dialysis. Dialysis execution information detection means for detecting
The device information determination means includes dialysis execution information determination means for determining whether the detection result of the dialysis execution information detection means is normal or abnormal. A means for inputting at least one of a scheduled schedule, a dialysis time set value, a blood flow rate set value during dialysis, and a dialysate flow rate set value, wherein the dialysis execution information detecting means performs the actual dialysis ( And a means for detecting at least one of a blood flow rate measured during dialysis, and a dialysate flow rate.

The present invention also provides a home artificial dialysis support system characterized in that the medical information input means includes means for inputting the weight of the patient before and after dialysis and the body temperature before and after dialysis.

Further, according to the present invention, the device information detecting means may include a dialyser test value, an extracorporeal blood circuit test value, a pyrogen filter test value, a reverse osmosis membrane test value, a blood pump flow rate calibration value, and a water removal. A home dialysis support system comprising means for detecting at least one piece of information of a calibration value of a pump flow rate, wherein the device information determining means includes a preset alarm operation point and / or a forecast operation. Means for comparing the point and the detection result of the device information detecting means, and means for determining whether the operation state of the home treatment artificial dialysis apparatus corresponds to any of a normal state, a forecast state, and an alarm state. It is intended to provide a home-use artificial dialysis support system characterized by the following.

Further, according to the present invention, the central information collecting device includes a transmitting means for transmitting the device management information to the device management center, and is arranged at the device management center to receive the device management information. The present invention provides a home artificial dialysis support system characterized by comprising a device management information receiving device provided with a receiving means for receiving the information.

According to the present invention, medical information input means is provided at each patient's home for inputting medical information relating to dialysis, and equipment information detecting means for detecting dialysis equipment information during dialysis and / or preparation for dialysis. Device information determining means for determining whether the dialysis device information is normal or abnormal, and transmitting means for transmitting the medical information, the device information, and the determination result of the device information determining means to a central information collection center. It is intended to provide an artificial dialysis device for home treatment.

[0017]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Preferred embodiments of the present invention will be described below with reference to the drawings. The present invention relates to medical information input by a patient, an artificial dialysis device capable of transmitting information on whether or not dialysis was actually performed and information on a change over time of a component device determined by the dialysis device itself, and information transmitted thereto. It is a home dialysis support system consisting of a centralized center that can receive and transmit medical information to the hospital, and transmit information on the aging of the constituent devices to the device management center.

The physical location of the central information collection center and the device management center may be the same,
It is preferable that the operation of the entire system is performed by a person in charge of the central information collection center so that the device management work is not imminent. Also, the receiving equipment installed in the hospital should be equipment that is easy to maintain and manage, such as a fax, so as not to increase the burden on the medical site. It is preferable to be able to refer to the stored information.

1 and 2 show an embodiment of the present invention. FIG. 1 shows the entire configuration, and FIG. 2 shows details of an artificial dialysis machine (10) having a communication function installed at home.

In FIG. 1, (1) is a home in which a patient lives, and the patient performs home-based artificial dialysis using an artificial dialysis device (10).

As will be described in detail later, the artificial dialysis apparatus is provided with a medical information input interface (15) having a touch panel, in addition to information during dialysis, a set value of dialysis time, body weight before and after dialysis, body temperature before and after dialysis. , The set value of the blood flow rate during dialysis, and the set value of the dialysate flow rate. These pieces of information are transmitted by a modem (12) as a transmitting means.
The information is transmitted to a computer (21) installed in a central information collection center (20) via a public telephone line (51).

As for such communication means, a public telephone line is used in this example, but any means capable of data communication is not limited to a telephone line such as a wired, cellular phone, PHS, etc. Various communication means can be used. However, medical information is personal information and is also used as data for physicians to perform diagnostic treatment based on the data.Therefore, it is necessary to ensure data reliability and security issues. It is preferable to connect the dialysis machine at the patient's home directly to the central information center.

[0023] A modem (22) is connected to the central information processing device so that communication with each home can be performed. Information transmitted from each home is recorded and managed in a large-capacity storage device (24). Here, the following three types of reports are generally prepared for the stored information, each for doctor's diagnosis and for device management, according to the intended use. That is, an emergency report, a regular report, and a monthly report.

The form of the information sent from the home is a character string or a numerical string obtained by quantizing the blood flow velocity fluctuation and the like. For this reason, the medical information is converted into an image in the above-mentioned report format and installed in a hospital (30) where a patient goes to a hospital via a public telephone line (52) from a modem with a facsimile function (23) connected to a computer. The fax is sent to the facsimile (31) and delivered to the doctor in charge. The device information is similarly converted into a report format and then transmitted to the device management center (40) via the public telephone line (53), and the computer (41) installed in the device management information center is connected to a modem. The data received by (42) is converted into a report format and output from the printer (43).

Next, an artificial dialysis machine (10) having a communication function will be described with reference to FIG. This artificial dialysis machine has a CPU
(11) a modem (12) for performing data communication with a computer of the central information collection center via a public telephone line;
An artificial dialysis circuit (13) and sensors (14) such as a pressure sensor, a flow sensor, and a temperature sensor in the circuit, and a patient receiving dialysis time, weight before and after dialysis, body temperature before and after dialysis, blood flow rate during dialysis, and dialysis. Interface having touch panel for inputting medical information such as liquid flow rate setting value (15)
And a calendar function unit (16) for performing time management
And a sound generator (17) such as a buzzer.

In the artificial dialysis machine, when a fixed time is reached by the calendar function, the sound generation unit informs the patient that the measurement time has come, and prompts the user to input necessary input items. The patient inputs the dialysis time, weight, body temperature, and the like displayed on the liquid crystal display while operating the touch panel. Thereafter, the actual dialysis is started according to the instructions on the liquid crystal display screen. After the dialysis is completed, the weight, body temperature, etc. after the dialysis are input while operating the touch panel according to the display on the liquid crystal display. One medical data measurement is completed by inputting whether or not the result is urgently delivered to the doctor.

On the other hand, the operation information from the artificial dialysis circuit of the artificial dialysis apparatus is always taken into the CPU, and information on the change over time in the blood flow rate and dialysate flow rate during dialysis is created. In the home treatment dialysis machine, after dialysis is completed, preparation for dialysis is automatically started in preparation for the next dialysis, washing and sterilization of the dialysate circuit, dialyzer, pyrogen filter, reverse osmosis membrane, etc. Test and dialysate preparation. The data measured during the preparation before dialysis and the calculated calibration values are incorporated in the CPU, and information on the change with time of the equipment constituting the dialysis circuit is created.

The test value of the dialyzer is, for example, a pressure value after filling the inside, for example, the hollow fiber membrane constituting the dialyzer with water, pressurizing the outside with air to a specified pressure, and maintaining the pressure for a certain time. Yes, it is a test value that confirms the reliability of the hollow fiber membrane type dialyzer utilizing the fact that the pressure value is slightly lower than the applied pressure even if it is normal, but is significantly lower if a hole is formed. For the test value of the pyrogen filter, the method is the same as the test value of the dialyzer.

The test value of the extracorporeal blood circuit means, for example, that the extracorporeal blood circuit is filled with air, pressurized to a certain pressure,
It is a pressure value after holding for a certain period of time and a test value for confirming whether the extracorporeal blood circuit is normal.

The test value of a reverse osmosis membrane is a test value of a reverse osmosis membrane for purifying water used for dialysis. For example, a certain amount of reverse osmosis water is generated through the reverse osmosis membrane, The measured time is measured. If the time is shorter than a predetermined range, a hole is formed. If the time is longer than the predetermined time, clogging is caused.

The calibration value of the blood pump flow rate and the calibration value of the water removal pump flow rate are used to calibrate a blood pump for circulating blood during dialysis and a water removal pump for removing water during dialysis. Calibration is performed by, for example, rotating the pump at a constant rotation speed, measuring the time required to send a fixed amount of water, and calculating the amount of liquid sent per rotation. .

Therefore, the device information detecting means of the present invention is a detecting means for performing the above test, and various pressure sensors, flow rate sensors, timer means and the like are used.

Next, the report will be described. The emergency report corresponds to a case where the state is equivalent to a forecast or a state corresponding to an alarm according to the determination result and is urgently delivered to a doctor or a device manager. When the computer of the central information collection center receives the forecast or alarm, it records it in the storage device and immediately reports it to the doctor via facsimile or to the device manager via the computer of the device management center. Send a letter. At this time, by creating a report with the last medical information and device information for several days,
Doctors and equipment managers can perform more appropriate diagnosis, treatment, and coping.

The periodic report is obtained by collecting information received from the artificial dialysis machine for a certain period and compiling the report. The medical information is transmitted to the doctor during the doctor's working hours (usually in the morning of the next morning). The device management information is transmitted to the device management center. The period is individually determined according to the patient's condition, but is usually a one-day cycle, and a stable patient may have a three to seven-day cycle.

The monthly report is a content in which the information received from the artificial dialysis machine is collected for one month, and is capable of grasping the change over time for one month. This is a report that includes the results of

[Brief description of the drawings]

FIG. 1 is a schematic diagram showing the overall configuration of a home dialysis support system of the present invention.

FIG. 2 is a diagram showing details of an artificial dialysis machine (10) having a communication function installed at home.

Claims (8)

[Claims] A medical information input means for inputting medical information relating to dialysis; a device information detecting means for detecting dialysis equipment information during dialysis and / or preparation for dialysis; Home treatment comprising: equipment information determining means for determining whether the dialysis equipment information is normal or abnormal; and transmitting means for transmitting the medical information, the equipment information, and the determination result of the equipment information determining means to a central information collection center. For artificial dialysis equipment, located at the central information collection center, receiving means for receiving information transmitted from the patient's home,
A central information collecting apparatus comprising: information conversion means for converting received information into charts and characters as medical information for diagnosis and device management information; and transmitting means for transmitting the medical information for diagnosis to a hospital in charge of a patient. A home dialysis support system provided with a medical information receiving device disposed in a hospital and provided with receiving means for receiving diagnostic medical information transmitted from the central information collection center. 2. The medical information input means includes dialysis execution information input means for inputting a set value of dialysis conditions for artificial dialysis,
The device information detection means includes dialysis execution information detection means for detecting an actual measurement value of dialysis conditions during artificial dialysis, and the device information determination means determines whether the detection result of the dialysis execution information detection means is normal or abnormal. The home-use artificial dialysis support system according to claim 1, further comprising a dialysis execution information determination unit that performs dialysis. 3. The dialysis method, wherein the medical information input means includes means for inputting at least one of a dialysis execution schedule, a dialysis time set value, a blood flow rate set value during dialysis, and a dialysate flow rate set value. 3. The home artificial system according to claim 2, wherein the execution information detecting means includes means for detecting at least one of information on a time when the dialysis is actually performed, a blood flow rate measured during the dialysis, and a dialysate flow rate. Dialysis support system. 4. The at-home artificial dialysis support system according to claim 1, wherein said medical information input means includes means for inputting a weight of the patient before and after dialysis and a body temperature before and after dialysis. 5. The apparatus information detecting means according to claim 1, wherein a test value of a dialyzer, a test value of an extracorporeal blood circuit, a test value of a pyrogen filter, a test value of a reverse osmosis membrane, a calibration value of a blood pump flow rate, and a flow rate of a water removal pump flow rate. A device for detecting at least one piece of information among calibration values.
4. The at-home artificial dialysis support system according to 4. 6. The home dialysis machine for home treatment according to claim 6, wherein said equipment information determining means includes a comparison means for comparing a preset alarm operating point and / or a forecast operating point with a detection result of said equipment information detecting means. The home artificial dialysis support system according to claim 1, characterized in that it is means for determining whether the operation state corresponds to a normal state, a forecast state, or an alarm state. 7. The central information collection device includes a transmission unit for transmitting the device management information to a device management center,
The home artificial dialysis support system according to claim 1, further comprising a device management information receiving device arranged at a device management center and provided with a receiving unit for receiving the device management information. 8. A medical information input means arranged at each patient's home for inputting medical information related to dialysis, an equipment information detecting means for detecting dialysis equipment information during dialysis and / or during dialysis preparation, Home treatment comprising: equipment information determining means for determining whether the dialysis equipment information is normal or abnormal; and transmitting means for transmitting the medical information, the equipment information, and the determination result of the equipment information determining means to a central information collection center. For artificial dialysis equipment.