JP2002149817A - Consultation data determining system and information storage medium with consultation data determining program computer-readably stored therein - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a consultation data determining system capable of saving the labor for the medical bill inspection which was periodically carried out and contributing to the execution of a proper treatment act by allowing to quickly and precisely confirm whether the treatment action to a sickness or wound is proper or not in the place where the treatment action is performed. SOLUTION: This system comprises a terminal T for generating consultation data Sds including a sickness or wound name and the contents of the treatment act performed to the sickness or wound having this sickness or wound name and outputting the data to a server S, and the server S for determining whether the treatment act shown by the consultation information is matched to a proper consultation act to the sickness or wound having the sickness or wound name in preliminarily regulated proper combinations of sickness or wound with treatment act or not on the basis of the outputted consultation data Sds in real time, generating a determination result Sdp showing the nonconformity when the treatment act is not matched to the proper treatment act, and outputting it to the terminal T in real time. The terminal T displays the outputted determination result Sdp.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention belongs to the technical field of a medical data determination system and an information recording medium on which a medical data determination program is recorded so as to be readable by a computer. Medical information indicating the contents of the medical treatment performed on the injured disease having a name, and a medical data determination system and a medical data determination program for determining whether or not the medical data including the medical data are appropriate. It belongs to the technical field of an information recording medium readable by a computer.

[0002]

2. Description of the Related Art In general, when a medical practice is performed on a patient in a medical institution such as a hospital or a clinic, a so-called receipt (that is, the contents of the medical practice and the cost involved) is performed in the medical institution. Are described in the form of scores).

[0003] The contents of the receipt are examined by a so-called examination and payment organization (for example, the Social Insurance Medical Fee Payment Fund or the Federation of National Health Insurance Organizations), and if the contents of the receipt are appropriate, The medicines of the appropriate type and dosage are administered for the listed injuries and illnesses, and proper medical care (ie, examination, consultation, medical inquiry, prescription making or guidance, etc. other than administration of medicines) is performed. If it is, the reward corresponding to the score described in the receipt will be paid to each medical institution.

[0004] In addition, the check of the receipt is often performed not only at the examination and payment institution but also at the medical institution before submission of the receipt.

[0005]

However, the inspection of the claim at the medical institution is mainly performed by the inspector based on the adaptability data provided by the Ministry of Health and Welfare and by referring to each of the claims, one by one. Was.

[0006] On the other hand, the receipts are usually inspected collectively on a monthly basis. However, in a large-scale medical institution, the number of receipts made in a month reaches several thousand, and this must be manually performed. In order to perform all inspections, enormous labor and cost are required, and since the time allocated to each receipt is short, there is a possibility that the inspection may be omitted.

Accordingly, the present invention has been made in view of the above-mentioned problems, and a problem thereof is to promptly and accurately determine whether or not proper medical treatment has been performed for injuries and illnesses. By making it possible to confirm on the spot where it was made, it is possible to save the labor of checking the receipt that was regularly executed as a result, and to contribute to the execution of appropriate medical care Another object of the present invention is to provide a medical data determination system and an information recording medium in which a medical data determination program for the determination is recorded in a computer-readable manner.

[0008]

In order to solve the above-mentioned problems, the invention according to claim 1 provides a medical treatment showing the names of injuries and diseases, and the contents of medical treatment performed on the injuries having the names of injuries and diseases. And a terminal that generates medical data including, and outputs to the server, based on the output medical data, the medical treatment indicated by the medical treatment information, and a predefined illness and medical treatment. It is determined in real time whether or not the appropriate medical care action for the illness having the name of the illness in the proper combination matches, and when the medical care action and the appropriate medical care action do not match, the mismatch is determined. The server includes: a server that generates a determination result indicating the fact and outputs the determination result to the terminal in real time; and the terminal that notifies the output determination result.

Therefore, it is determined whether or not the combination of the medical care information and the name of the disease included in the medical care data generated by the terminal is appropriate for a predetermined combination, and the result of the determination is determined. Since the reply is made to the terminal in real time, it is possible to quickly and accurately confirm whether or not the appropriate medical treatment has been performed for the injury or illness on the spot where the medical treatment has been performed.

According to a second aspect of the present invention, in the medical data determination system according to the first aspect, the server includes a receiving unit for acquiring the output medical data. First combination information storage means such as an auxiliary storage device for storing information on a combination of injury and medicine, which is a combination of an acquisition unit, a name of the injury and disease, and the prescribed medicine applicable to the injury having the name of the injury and disease; Second combination information storage means such as an auxiliary storage device for storing information on a combination of illness and proper medical care action, which is a combination of the name and the prescribed proper medical care action excluding the administration of a drug applicable to the illness having the name of the illness or disease. And the combination of the name of the disease and the drug administered to the disease having the name of the disease included in the medical treatment data are the first set A first determination unit such as a determination unit that determines in real time whether or not the injury / drug combination information stored in the combination information storage unit matches any of the injury / drug combination information; A plurality of combinations of the name of the disease and the medical treatment except for the administration performed for the disease having the name of the disease included in the medical treatment data are stored in the second combination information storage means. A second determination unit such as a determination unit that determines in real time whether or not any of the injury / illness-appropriate medical care action combination information matches the injury / illness-appropriate medical care action combination information; and the first determination means When at least one of the determination in the above and the determination by the second determination means is a determination that there is a mismatch, the determination result indicating that there is a mismatch And output means of the transmission unit for outputting in real time to the terminal generates and is constituted by.

Therefore, at least one of the injury and disease corresponding to the name of the injury and disease included in the medical care data, the medicine administered to the disease and the medical treatment except for the injury and the medication performed for the injury and the disease are mutually reciprocal. Will be notified when it is not adapted to the disease, so that it is possible to quickly find inadequate points in the combination of the name of the injury and the medical treatment performed and contribute to the execution of appropriate medical treatment be able to.

According to a third aspect of the present invention, there is provided a medical data determination system according to the first or second aspect, wherein the terminal and the server are installed in one medical institution. ing.

Therefore, since the terminal and the server are installed in one medical institution, it is possible to check in real time whether the combination of the name of the illness and the medical treatment is appropriate.

According to a fourth aspect of the present invention, there is provided a medical data judging system according to any one of the first to third aspects, wherein: At least one of consultation, examination, prescription preparation or guidance is included.

Therefore, it is possible to determine whether or not the medical treatment performed by the doctor is appropriate for the injury or illness and the medical treatment.

[0016] In order to solve the above-mentioned problem, the invention according to claim 5 provides a medical treatment system including a name of a disease and medical treatment, and medical treatment information indicating the contents of a medical treatment performed on the disease having the name of the disease and disease. A computer included in a server connected to a terminal that generates data and announces the determination result, based on the generated medical data, the medical treatment indicated by the medical information, and a predetermined injury and illness. In a proper combination with the medical practice, the appropriate medical practice for the illness having the name of the disease, to determine in real time whether or not coincident, when the medical practice and the appropriate medical practice do not match, The medical data determination program is characterized in that the determination result indicating the mismatch is generated and output to the terminal in real time. To be able to have been recorded.

Therefore, it is determined whether or not the combination of the medical care information and the name of the disease included in the medical care data generated by the terminal is appropriate for a predetermined combination, and the result of the determination is determined. Since the computer functions to reply to the terminal in real time, it is possible to quickly and accurately confirm whether or not appropriate medical treatment has been performed for the injury or illness on the spot where the medical treatment has been performed. it can.

According to a sixth aspect of the present invention, there is provided an information recording medium according to the fifth aspect, wherein the computer acquires the medical care data from the terminal. First and second combination information storage means for storing information on a combination of a disease and a disease, and the prescribed medicine applicable to the disease and the disease having the name of the disease and the disease, and the disease and the disease having the name of the disease and the disease. A second combination information storage means for storing the combination of the prescribed proper medical practice and the prescribed appropriate medical practice except for the drug administration adapted to the medical treatment data, and the name of the casualty and disease included in the medical care data. The combination with the medicine administered for the injury having the name of the injury is stored in the first combination information storage means. First determining means for determining in real time whether or not the disease-drug combination information matches any of the disease-drug combination information; the disease name and the disease name included in the medical care data; The combination with the medical practice other than the administration performed for the illness having the above is the one of a plurality of the morbidity-appropriate medical practice combination information stored in the second combination information storage means. A second determining means for determining in real time whether or not the information matches the injury / proper medical practice combination information; and at least one of the determination by the first determining means or the determination by the second determining means does not match. Output means for generating the determination result indicating the mismatch when the determination is that there is, and outputting the determination result to the terminal in real time. Because the clinical data determining program is recorded so as to be read by the computer.

Therefore, at least one of the injury and disease corresponding to the name of the injury and disease included in the medical care data and the medicine administered to the disease or the medical treatment except for the injury and the medication performed for the injury and disease are mutually associated. The computer functions so that when it is not adapted to the situation, the computer is functioning so that it is possible to quickly find inadequate points in the combination of the name of the disease and the medical treatment performed, and Can contribute to the execution of actions.

According to a seventh aspect of the present invention, there is provided an information recording medium according to the fifth or sixth aspect, wherein the terminal and the server are installed in one medical institution. The medical care data determination program is recorded so as to be readable by the computer.

Therefore, since the terminal and the server are installed in one medical institution, the suitability of the combination of the name of the illness and the medical treatment can be confirmed in real time.

[0022] In order to solve the above-mentioned problem, the invention according to claim 8 is the information recording medium according to any one of claims 5 to 6, wherein the medical treatment except for the administration includes a medical examination. The medical data determination program, which includes at least one of the following: examination, prescription creation, or guidance, is recorded so as to be readable by the computer.

Therefore, it is possible to determine whether or not the medical treatment performed by the doctor is appropriate for the injury and illness and the medical treatment.

[0024]

Next, a preferred embodiment of the present invention will be described with reference to the drawings.

In the embodiment described below, the present invention is applied to a medical data determination system that determines the contents of medical data input from a terminal using an information processing device such as a personal computer. It is an embodiment of the case. (I) Configuration of Medical Data Determination System First, the configuration of the medical data determination system according to the embodiment will be described with reference to FIG.

FIG. 1 is a block diagram showing a schematic configuration of the medical care data determination system according to the embodiment.

As shown in FIG. 1, the medical care data judging system CS according to the embodiment includes a name of an injury and medical information indicating the contents of a medical practice performed by a doctor on the injury having the name of the injury. Based on the medical information Ssd including the terminal T for displaying and outputting a determination result Sdp, which will be described later, output from the server S and outputting the medical data Ssd including the medical data Ssd to the server S. In real time, it is determined in real time whether or not the indicated medical practice and the appropriate medical practice for the injury and illness having the above-mentioned injury name in an appropriate combination of the injury and illness and the medical practice prescribed by the Ministry of Health and Welfare (that is, so-called The determination is made by real-time processing instead of batch processing), and when the medical practice and the appropriate medical practice do not match, the above-mentioned indicating the mismatch is described above. A server S to output in real time to the terminal T to generate a constant result Sdp, it is constituted by.

Here, the terminal T and the server S are arranged in one medical institution, and are connected in one-to-one correspondence by wire or wireless.

The terminal T is constituted by a keyboard, a mouse, and the like. When the name of the illness and the medical treatment performed by the doctor are input, the terminal T generates input data Sdt including the name of the illness and the medical treatment. An input unit IN to be generated, a data generation unit DM that generates the medical data Ssd for determination in the server S based on the input data Sdt and outputs the medical data Ssd to the server S, and contents of a determination result Sdp from the server S And a display unit DP configured by a display or the like that displays the image in a visible manner.

On the other hand, the server S receives the medical treatment data Ssd transmitted from the terminal T, and generates reception data Srd including the medical treatment information and the name of the disease and the like included in the received medical treatment data Ssd. Receiving unit RV as an obtaining means for outputting the received data Srd to the converting unit CH1 and a converting unit CH for converting the received data Srd into a format in which the above determination is possible, generating converted received data Sin and outputting it to the determining unit CK.
1 and the medical treatment data S included in the converted reception data Sin.
Based on the contents of sd, the determination unit CK that executes the determination processing as the server S in real time and outputs result data Sout indicating the result, and a format that can return the format of the result data Sout to the terminal T And a conversion unit CH for generating transmission data Std and outputting it to the transmission unit TR
2 and a transmission unit TR as an output unit that transmits the transmission data Std to the terminal T as the determination result Sdp.

Next, the configuration and operation of the judgment section CK for executing the judgment processing in this embodiment will be described with reference to FIGS.

As shown in FIG. 2, the determination unit CK of the embodiment
Is constituted by a personal computer or a normal server, and includes a CPU 1 serving as a first judgment unit and a second judgment unit, a first combination information storage unit constituted by an HDD (Hard Disk Drive) or the like, and a first combination information storage unit. And an auxiliary storage device 2 as combination information storage means.

Further, the CPU 1 includes a memory 1a which can be read and written a plurality of times as a work area in which various tables and the like are developed in a determination process described later.

Next, the general operation of the determination unit CK will be described.

First, the converted received data Sin input to the determination unit CK is input to the CPU 1 as it is.

When the converted received data Sin is input, the CPU 1 determines the contents included in the converted received data Sin (that is, the contents of the medical practice performed on the patient or the administered medicine), The contents are compared with the contents of a database described later stored in the auxiliary storage device 2 and are appropriate for the name of the medical treatment or the name of the illness including the contents of the medicine included in the converted received data Sin. It is determined whether or not.

At this time, the CPU 1 makes the above determination while transmitting and receiving the data signal Sd to and from the auxiliary storage device 2. Details of this determination processing will be described later.

Thereafter, if the result of the determination is improper, the fact and the specific contents of improperness are output to the conversion unit CH2 as the result data Sout. (II) Configuration of Database Next, the configuration of the database stored in the auxiliary storage device 2 will be described with reference to FIGS.

FIG. 3 is a block diagram showing a schematic configuration of the database, FIG. 4 is a diagram showing the contents of data input as converted received data Sin, and FIG. FIG. 3 is a block diagram illustrating a configuration of a master.

As shown in FIG. 3, in the external storage device 2, as a database, a medicine name master 20, a general name master 21, an efficacy master 22, and a disease name master 23 are stored.
, An adaptive disease master 25, and a medical practice master 24, and the masters can exchange data with each other.

In the medical practice master 24, an examination master 24a and a treatment master 24a are stored as detailed data.
b and the instruction master 24c.

Among these, the name of the drug supplied from the Ministry of Health and Welfare (specifically, the one notified in the official gazette; the same applies hereinafter) is stored in the drug name master 20 (that is, the name of each drug company). The name of the company-named pharmaceutical product) is stored.

Next, in the generic name master 21, a generic name corresponding to each drug name stored in the drug name master 20 (that is, the name of the active ingredient contained in each drug and the content thereof). And one common name may correspond to a plurality of drug names.).

Further, the disease name master 23 stores the names of injuries and the like supplied from the Ministry of Health and Welfare.

In the examination master 24a in the medical practice master 24, names of examinations supplied from the Ministry of Health and Welfare are stored.

Further, in the treatment master 24b in the medical practice master 24, names of treatments (for example, treatments such as injection and medication) supplied from the Ministry of Health and Welfare are stored.

Further, in the instruction master 24c in the medical practice master 24, each instruction (specified disease, dermatology specific disease, etc.) supplied from the Ministry of Health and Welfare (in this case, described in the medical medical treatment reward table) is provided. The names of pediatric medical treatment, pediatric identification, and guidance for intractable diseases) are stored.

Next, in the efficacy master 22, based on the materials supplied from the Ministry of Health and Welfare, the disease name stored in the disease name master 23 and the disease corresponding to the disease name are indicated ( That is, the combination with the general name of the drug (which is permitted to be administered to a patient having the disease) is stored as one or more sets of combination information.

Further, based on the data supplied from the Ministry of Health and Welfare, the disease name stored in the disease name master 23 and the disease corresponding to the disease name are stored in the adaptive disease master 25. A set with a possible medical practice name (that is, permitted to be performed on a patient having the disease) is stored as one or a plurality of sets of combination information.

The storage contents of each master will be described in detail together with the detailed processing described later.

Next, the specific contents of the data input as the above-mentioned converted reception data Sin (medical treatment data Ssd) will be described with reference to FIG.

As shown in FIG. 4, the converted received data Sin
Is a terminal identification code (that is, a terminal identification code for identifying the terminal T including the input unit IN in which the input data Sdt corresponding to the converted received data Sin is generated) 10 as header information of the converted received data Sin. A patient identification code 11 for identifying a patient having a sick or illness that has undergone medical treatment included in the input data Sdt as the header information; and one or more illness / illness records 12 including a illness name of the patient And a plurality of summary records 13 including the name of the medicine administered to the patient or the name of the practice performed.

Next, specifically, for each record, first, the disease name record 12, the medical treatment start date, and the outcome category (that is, healed) are specified in order to specify the disease related to the corresponding patient. , Death, or cessation of medical care).

It should be noted that the number of injury / illness records 12 is the same as the number of injury / illness related to one patient.

In the summary record 13, each data of a medical treatment code, a usage amount and the number of times (in the case of a medicine, the number of days of administration) is specified in order to specify the medical treatment performed on the corresponding patient. It is included.

When there are a plurality of medical treatments corresponding to one patient, the summary record 13 indicates that the number of the medical treatments corresponding to the one patient corresponds to the number of the medical treatments, that is, the patient is administered to the patient. Only the number of medicines or the number of tests and procedures performed are included.

Next, the data included in the efficacy master 22 and the adaptive disease master 25 will be described with reference to FIG.

As shown in FIG. 5, the effect master 22 of the embodiment includes a plurality of effect data 22a, and one effect data 22a has a corresponding disease name code indicating one injury name. , A generic name code indicating the general name of the drug approved by the Ministry of Health and Welfare that can be administered for the disease, dose data indicating the dose at the time of administration, and administration days indicating the permitted administration days The data includes long-term classification data indicating the long-term classification of the drug, and disease name supplementary data that is supplementary data for the disease name code.

Here, the efficacy data 22a is included in the efficacy master 22 by the number of different combinations of the injuries and diseases and the common names of the medicines approved for the same.

The adaptation disease master 25 includes a plurality of adaptation disease data 25a.
5a, like the efficacy data 22a, shows a code of a medical practice that has been approved by the Ministry of Health and Welfare as being executable for a patient with the injury and disease corresponding to the injury and disease name code indicating one injury and disease name. It contains the medical treatment code.

Further, the adaptation disease data 25a is included in the adaptation disease master 25 by the number of different combinations of injuries and illnesses and medical treatments approved for them.

Then, in the database of this embodiment,
When the wound name record 12 is input, the necessary effect data 22a and the applicable disease data 25a can be referred to by using the wound name code included therein as a clue. (III) Embodiment of Judgment Process in Judgment Unit CK Next, a judgment process according to the embodiment will be described with reference to FIG.

FIG. 6 is a flowchart showing the entirety of the determination processing, and is a flowchart mainly showing processing executed in the CPU 1.

As shown in FIG. 6, in the determination processing according to the embodiment, first, the masters shown in FIG. 3 are mutually connected as a database (step S1).

Next, a one-day treatment table and a duplicate inspection table are created in the memory 1a (step S2).

Here, the daily treatment table is, for example,
When multiple treatments are performed on one patient in one day, it may be permitted to perform only one of the multiple treatments in one day. It is a table used to determine whether or not a treatment that is not permitted is being performed.

On the other hand, the duplicate test table is, for example, a test that is prohibited from being repeatedly performed on one patient. It is a table used to determine whether there is an inspection.

When the one-day treatment table and the duplicate inspection table are created, it is next determined whether or not the determination processing has been executed for all of the medical data Ssd input as the converted reception data Sin (step S3). If the determination processing has been completed for all the medical data Ssd (step S3; Y), the termination processing is performed as it is, while if the determination processing has not been completed (step S3;
N) Then, each table created on the memory 1a is initialized (step S5).

Then, it is determined whether or not the processing of steps S7 and S8 described later has been completed for all the injuries and illnesses in one piece of converted received data Sin (step S6), and if it has been completed (step S6; Y) ) Go to step S9,
On the other hand, if it is not completed (step S6; N), the illness name record 12 of the unending illness name is read (step S7). An adaptation table is created on the memory 1a (step S8), and the process returns to step S6 to repeat the same process for the next injury / disease name record 12.

Here, the above-mentioned effect table is based on the disease name code in the disease name record 12 read in step S7 and the effect data 22a (FIG.
This is a reference table created by reading out the reference) from the efficacy master 22 and including the injured and illnesses, the medicines authorized to be administered for the injured diseases and their doses, and the like.

The adaptation table is obtained by reading out the adaptation disease data 25a (see FIG. 5) corresponding to the injury and disease from the adaptation disease master 25 based on the injury and disease name code in the injury and disease name record 12 read in step S7. , A reference table created including the injuries and illnesses and medical treatments authorized to be performed on the injuries and illnesses.

Therefore, after the processing in steps S6 to S8 is performed on all the disease name records 12, all the medicines and their pharmaceuticals applicable to all the diseases included in one converted received data Sin are obtained. The effect table including the dose and the like and the adaptation table including all the medical treatments applicable to all the injuries and diseases are created on the memory 1a.

When the creation of the efficacy table and the adaptation table has been completed for all the injuries and diseases included in the converted received data Sin (step S6; Y), all the medical treatments corresponding to one converted received data Sin are performed. It is determined whether or not the processing of steps S10 to S16 described below has been completed (step S9).
9; Y) The process proceeds to step S17. On the other hand, if the medical treatment has not been completed (step S9; N), the summary record 13 indicating the medical treatment and the administration of the medicine that have not been completed is read (step S10).

Then, the read summary record 13 is read.
Is determined to be the summary record 13 relating to the administration of the drug (step S11). If it is related to the administration of the drug (step S11; Y), then the administration content (the name of the drug) , Dose and number of administrations) and the injuries and doses contained in the above-mentioned efficacy table and the administrable drugs and their doses, etc., are compared with the injuries and diseases actually contained in the converted reception data Sin. Is checked for each summary record 13 as to whether or not the combination matches the approved combination (stored in the efficacy table) (step S1).
2).

If the contents of the summary record 13, that is, the combination of the administration contents of the actually administered medicine and the injury / disease do not match the approved combination on the efficacy table, The content of the mismatch is written as error information in an error information area (not shown) in the database (step S14).

On the other hand, if it is determined in step S11 that it is not related to the administration of the drug (step S1).
1; N) Then, since the summary record 13 read out in step S10 relates to a medical practice (examination, treatment or guidance, etc.), the read medical practice and the summary information 13 are included in the adaptation table. Compare the injuries and illnesses that can be performed with the practicable medical treatments, and compare the combination of the injuries and illnesses included in the converted received data Sin with the actually performed medical treatments (authorized combinations (stored in the adaptation table). Is checked for each summary record 13 (step S13).

If the contents of the summary record 13, that is, the combination of the actually performed medical treatment and the injury / disease do not match the permitted combination on the adaptation table, the mismatch is determined. The contents are written as error information in the error information area (step S14).

The details of the processing in steps S12 and S13 will be described later.

When the determination process using the efficacy table and the adaptation table is completed, next, using the drug summary record 13 read out in step S10, the dose and the dose of the drug described in the summary record 13 are determined. It is determined whether or not the number of administration days matches the dose and the number of administration days described in the efficacy data 22a corresponding to the illness, disease and drug (step S15), and the content of the summary record 13, that is, If the combination of the administered dose of the drug, the number of days administered, and the illness does not match the approved combination on the efficacy table, the content of the mismatch is written in the error information area as error information. (Step S16), the above-mentioned steps S10 to S
The process returns to step S9 to execute the process of No. 16.

The details of the determination of the dose and the number of days in step S15 will be described later.

On the other hand, in the judgment in step S9, all the medical treatments corresponding to one patient are judged in step S10.
When the processing of steps S16 to S16 has been completed (step S16).
9; Y) Next, using the one-day treatment table and the duplicate inspection table created in step S2, the contents of the one-day treatment and the duplicate inspection are determined (step S17), and the approved contents (step S17) If not, the content of the mismatch is written to the error information area as error information (step S18), and the next converted received data Sin (medical care data Ssd) is written. The process returns to step S3 to execute the processes of steps S5 to S18.

The details of the processing executed in step S17 will be described later.

When the above-described series of processing is repeated, and the appropriateness determination for one piece of converted received data Sin is completed, the error contents written in steps S14, S16 and S18 are listed as a list, and Sout is output to the conversion unit CH2. At this time, the disease name, the medicine name, or the medical treatment name used for displaying or printing the determination result is read from the disease name master 23, the medicine name master 20, or the medical treatment master 24, respectively.

A program corresponding to the flowchart showing a series of medical data determination processing shown in FIG. 6 can be used by any personal computer or the like if this program is recorded on a flexible disk or a hard disk as an information recording medium. The determination processing of the embodiment can be performed.

Next, the contents of the preparation of the efficacy table in step S8 and the determination of the drug in step S12 will be described with reference to FIG.

FIG. 7A is a block diagram conceptually showing the contents of the preparation of the efficacy table and the judgment of the medicine.

First, as for the creation of the effect table in step S8, as shown in FIG. 7A, the effect master 22 is stored in the effect master 22 based on the disease name code included in the disease name record 12 read in step S7. The reference is made to the efficacy data 22a corresponding to the name of the disease and the name of the disease, the name of the name of the disease, the name of the disease, the general name code, the dose data, the number of days of administration and the long-term classification data described in the efficacy data 22a (That is, an efficacy table including a general name, a dose, and the like of a medicine to be administered for a disease corresponding to the disease name code) is created (registered) in the memory 1a.

Next, in the determination of the medicine in step S12, as shown in FIG. 7A, the medicine name in the medicine name master 20 is determined based on the code data indicating the medicine in the summary record 13 on the medicine read in step S10. By referring to the data corresponding to the code data, it is determined whether or not the general name code included in the corresponding data is registered in the created effect table.

When the information is registered, it is determined that the medicine and the illness included in the converted received data Sin are adapted. On the other hand, if not registered, it is determined that the medicine and the illness are not adapted, and error processing (step S14) is performed.

Next, as for the creation of the adaptation table in step S8, as shown in FIG. 7 (b), the adaptive disease master data is stored based on the disease name code included in the disease name record 12 read in step S7. 22, referring to the adaptive disease data 25a corresponding to the disease name code,
Using the injury name code and the medical care data described in the applicable disease data 25a, one adaptation table (that is, a medical care action code indicating a medical care action to be performed for the injury corresponding to the damage name code) Is created (registered) in the memory 1a.

Next, in the determination of the medical practice in step S13, as shown in FIG. 7 (b), the code data indicating the medical practice in the summary record 13 relating to the medical practice read in step S10 is applied to the created adaptive data. It is determined whether or not it is registered in the table.

When the information is registered, it is determined that the medical treatment and the illness included in the converted received data Sin are adapted. On the other hand, if you are not registered,
An error process (step S14) is performed assuming that the medical treatment and the illness are not adapted.

Next, the determination of the dose and the number of days of administration in step S15 will be described with reference to FIG.

FIG. 8 is a block diagram conceptually showing the contents of the determination of the dose and the number of administration days.

In step S15, as shown in FIG. 8, based on the usage data and the frequency data in the summary record 13 regarding the medicine read in step S10, the contents of the usage data and the frequency data are converted to the contents in step S8. It is determined whether it is within the range of the amount of use and the number of times registered in the effect table created in the above.

When the value falls within the range, it is determined that the dose and the number of days of administration of the medicine contained in the converted reception data Sin and the illness are appropriate. On the other hand, if it exceeds the range, it is determined that the dose, the number of days of administration and the illness are not adapted, and error processing is performed (step S16).

Next, the details of the various determinations performed in step S17 will be described with reference to FIGS.

First, among the determinations performed in step S17, the determination regarding the adaptability of the inspection determination will be described with reference to FIG.

FIG. 9 is a block diagram conceptually showing the contents of the determination of the adaptability of the inspection determination.

Here, the adaptability of the examination judgment means the adaptability of the examination actually performed and the judgment of the doctor accompanying the examination (that is, whether or not the doctor makes any judgment on the examination not performed). Or).

As shown in FIG. 9, in the determination of the adaptability of the examination determination, each medical practice stored in the medical practice master 24 based on the summary record 13 of the medical practice read in step S10. Refer to the examination and other conduct judgment categories and the examination and others conduct judgment group divisions (all of which are medical practice actions that are predetermined by the Ministry of Health and Welfare).
For each of the groups, a judgment / execution flag 30 indicating whether the inspection and the judgment are actually performed is created in the memory 1a.

That is, based on the summary record 13 of the medical practice, for example, if an examination belonging to group 1 is being executed, a flag “1” is set in the corresponding execution column to execute the examination. If not, the flag "0" is set.

Similarly, if a judgment belonging to group 1 is made, a flag “1” is set in the corresponding judgment column, and if it is judged, a flag “0” is set.

After the setting of the above-mentioned flags is completed for all the groups, the execution flag and the judgment flag are compared for each group.

By this comparison, if both flags match, it can be determined that proper inspection and judgment have been made.

On the other hand, if the judgment flag is "1" despite the execution flag being "0", it means that the judgment is for a test that has not been executed.
In this case, the judgment is impossible and the error processing (step S1)
8) is done.

When the determination flag is "0" in spite of the fact that the execution flag is "1", the inspection actually performed (therefore, the determination corresponding to the performed inspection is made). Has not been determined, and in this case, it is determined that no determination has been made, and error processing (step S18) is also performed.

Next, among the determinations made in step S17, the determination regarding the content of the duplication check is performed together with the generation of the duplication check table in step S2 as shown in FIG.
This will be described with reference to FIG.

FIG. 10 is a block diagram conceptually showing the creation of the duplication check table and the contents of the duplication check.

Here, the duplication test means whether or not a test which is prohibited from being repeatedly performed for one patient is performed using the duplication test table created in step S2. Is determined.

First, as shown in FIG. 10, step S2
In the above, the overlap table 31 (table number data, branch number data, item number data (inspection or treatment approved to be performed for each group) as shown in FIG. ), And a duplicate test table 32 indicating the number of authorized test items belonging to the group and a specific test is created in the memory 1a on the basis of the above. I do.

In the determination of the duplicate test in step S17, the duplicate test table 32 is referred to based on the summary record 13 on the medical practice read in step S10, and is actually executed for each group. The execution flag 33 is created by setting the flag “1” in the inspection column.

After the execution flag 33 is confirmed for all the groups based on the summary record 13 relating to the medical practice, the number of execution items in each group is compared with the number of execution items in the duplicate inspection table 32. If the number of items of the test for which the execution flag is set is larger than the number of items to be executed on the duplicated inspection table 32, an error process is performed (step S18) because there is a treatment or an inspection that has been performed even though it cannot be performed repeatedly.

On the other hand, if the number of items of the inspection for which the execution flag 33 is set is smaller than the number of execution items in the duplicate inspection table 32 or both are equal, it is determined that no duplicate inspection has been performed, and no error processing is performed.

Next, among the determinations made in step S17, regarding the determination regarding the contents of the one-day treatment, the creation of the one-day treatment table in step S2 and FIG.
This will be described with reference to FIG.

FIG. 11 is a block diagram conceptually showing the creation of the daily treatment table and the determination of the contents of the daily treatment.

Here, the judgment of the contents of the one-day treatment means that when one patient is subjected to a plurality of treatments in one day using the one-day treatment table created in step S2, the plurality of treatments are performed. Alternatively, it is possible that a medical fee can be charged for only one of the tests, and based on this provision, it is determined whether or not a treatment or a test that cannot be originally charged is excessively performed.

First, as shown in FIG. 11, step S2
, A daily treatment table 34 indicating approved treatments belonging to the group is stored in the memory 1a for each date based on the overlap table 31.
Create on top.

In the determination of the contents of the one-day treatment in step S17, the one-day treatment table 34 is referred to based on the summary record 13 relating to the medical practice read in step S10, and the actual The number of treatments executed for each group is integrated for each date to create an integration table 35, and the number of treatments for one month is calculated for each group.

When the integration of the number of treatments for one month is completed for all groups, the result is compared with the actual number of days in the corresponding month. Alternatively, it is determined that the inspection is excessively performed, and error processing is performed (step S18).

On the other hand, if the integrated value is smaller than the actual number of days or if they are equal to each other, no error processing is performed because it is not performed excessively.

Finally, the guidance determination among the determinations performed in step S17 will be described with reference to FIG.

FIG. 12 is a block diagram conceptually showing the guidance determination.

Here, the guidance test is for determining whether or not proper guidance is given to a characteristic disease or intractable disease designated by the Ministry of Health and Welfare as being capable of providing guidance.

In the guidance fee determination, first, as shown in FIG. 12, based on the disease name code in the disease name record 12 read in step S7, a specific disease or the like stored in the disease name master 23 is determined. Referring to the target category and the target category such as intractable disease (all of which are instructable categories designated by the Ministry of Health and Welfare), for each of the names of injuries included in the converted received data Sin, A specific disease table 36 and an intractable disease table 37 indicating whether or not there is any of them (each flag is set to "1" when guidance is possible) are created in the memory 1a.

Next, based on the code data in the summary record 13 relating to the medical practice of the guidance read in step S10, the injured and illness-related categories and the target categories such as intractable diseases for which the guidance corresponding to the code data were provided are:
In the specific disease table 36 and the incurable disease table 37, it is confirmed whether the flag is “1”, which indicates the injured disease-related category and the intractable disease target category.

When the instructed injury / disease name-related category and intractable disease / etc. Target category are the injury / disease name-related category and intractable disease / etc. Target category in which the flag “1” is not set in the specific disease etc. table 36 and the incurable disease etc. table 37, Is processed as an error (step S18).

On the other hand, when the instructed injury / disease name-related category and intractable disease / etc. Target category are the injured / disease name-related category and intractable disease / etc. Target category in which the flag “1” is set in the specific disease etc. table 36 and the incurable disease etc. table 37. , No error handling is performed because the instruction is valid.

As described above, according to the determination processing of the embodiment, the combination of the medical care information and the name of the illness included in the medical care data Ssd generated by the terminal T is appropriate for the combination defined in advance. Is determined, and the result of the determination is returned to the terminal T in real time, so that it is possible to quickly and accurately determine whether or not appropriate medical care has been performed for the injury or illness. You can check it on the spot.

Further, the injuries and illnesses corresponding to the names of injuries and illnesses contained in the medical treatment data Ssd,
Or, when at least one of the medical treatment except for the injury and the medical treatment performed for it is not compatible with each other, that fact will be notified, so the combination of the name of the injury and the medical treatment performed Insufficient points can be found quickly, and it can contribute to the execution of appropriate medical care.

Further, since the terminal T and the server S are installed in one medical institution, the suitability of the combination of the name of the illness and the medical treatment can be confirmed in real time.

Further, the medical treatment except for the administration of medicines includes at least one of medical examination, examination, prescription preparation, and guidance. It can be determined whether or not is adapted.

[0133] In addition to the above-mentioned medical treatments and examinations of the contents of medication, for example, the date of abolition of a drug (the date on which the drug is banned) or the date of transitional measures (if the drug can be used with a future deadline) ) And consistency with the medical treatment month, judgment of consistency between the abolition date of the medical practice (the day when the medical practice is banned) and the medical treatment month, the medical practice and whether it was performed on the hospitalized patient Alternatively, it may be configured to judge the consistency of the operation performed on the outpatient.

[0134]

As described above, according to the first aspect of the present invention, the combination of the medical information and the name of the illness and disease included in the medical data generated by the terminal is determined by the combination defined in advance. To determine whether the medical treatment is appropriate and return the result of the determination to the terminal in real time, so that it is possible to quickly and accurately determine whether the appropriate medical treatment has been performed for the injury or illness. Can be confirmed on the spot where it was made.

[0135] Therefore, it is possible to quickly and accurately confirm whether or not appropriate medical treatment has been performed for an injury or illness on the spot where the medical treatment has been performed. Inspection of the specification can be labor-saving, and it can contribute to execution of appropriate medical care.

According to the invention described in claim 2, according to claim 1
In addition to the effects of the invention described in the above, at least the medical treatment except for the injury and illness corresponding to the name of the injury and illness included in the medical care data, and the pharmaceuticals administered thereto, or the injuries and medicaments administered thereto If either of them is not adapted to each other, the fact will be notified, so that it is possible to quickly find out the deficiency in the combination of the name of the illness and the medical treatment performed, and to perform the appropriate medical treatment. Can be performed.

According to the third aspect of the present invention, the first aspect is provided.
Or, in addition to the effect of the invention described in 2, since the terminal and the server are installed in one medical institution, it is possible to confirm the suitability of the combination of the name of the disease and the medical treatment in real time.

According to the invention set forth in claim 4, according to claim 1,
In addition to the effects of the invention according to any one of to 3, since the medical practice except administration of pharmaceuticals includes at least one of consultation, examination, prescription creation or guidance,
Regarding the details of the medical treatment performed by the doctor, it is possible to determine whether or not the illness and the medical treatment are adapted.

According to the fifth aspect of the present invention, whether or not the combination of the medical care information and the name of the disease included in the medical care data generated by the terminal is appropriate for the predetermined combination. The computer functions so as to return the result of the determination to the terminal in real time, so that it is possible to quickly and accurately determine whether an appropriate medical treatment has been performed for the injury or illness. You can check it on the spot.

Therefore, it is possible to quickly and accurately check whether or not a proper medical treatment has been performed for an injury or illness on the spot where the medical treatment has been performed. Inspection of the specification can be labor-saving, and it can contribute to execution of appropriate medical care.

According to the invention described in claim 6, according to claim 5,
In addition to the effects of the invention described in the above, at least the medical treatment except for the injury and illness corresponding to the name of the injury and illness included in the medical care data, and the pharmaceuticals administered thereto, or the injuries and medicaments administered thereto The computer functions so that when one of them does not adapt to the other, the computer will be notified so that it is possible to quickly find defects in the combination of the name of the disease and the medical treatment performed In addition, it can contribute to the execution of appropriate medical care.

According to the invention described in claim 7, according to claim 5,
Or, in addition to the effect of the invention described in 6, since the terminal and the server are installed in one medical institution, the suitability of the combination of the name of the illness and the medical treatment can be confirmed in real time.

According to the invention of claim 8, according to claim 5,
In addition to the effects of the invention according to any one of to 6, since the medical practice except administration of pharmaceuticals includes at least one of consultation, examination, prescription preparation or guidance,
Regarding the details of the medical treatment performed by the doctor, it is possible to determine whether or not the illness and the medical treatment are adapted.

[Brief description of the drawings]

FIG. 1 is a block diagram illustrating a schematic configuration of a medical care data determination system.

FIG. 2 is a block diagram illustrating a schematic configuration of a determination unit.

FIG. 3 is a block diagram showing a configuration of a database.

FIG. 4 is a diagram showing a configuration of converted reception data (medical care data).

FIG. 5 is a diagram showing a relationship between an injury name record, an efficacy master, and an adaptive disease master.

FIG. 6 is a flowchart illustrating an entire medical data determination process.

FIG. 7 is a diagram showing a specific example of each table and processing;
(A) is a conceptual diagram showing creation of an efficacy table and an efficacy test of a medicine, and (b) is a conceptual diagram showing creation of an adaptation table and an adaptability test of medical treatment.

FIG. 8 is a conceptual diagram illustrating determination of a dose and the number of administrations.

FIG. 9 is a conceptual diagram illustrating determination of consistency between determination and execution.

FIG. 10 is a conceptual diagram illustrating determination of an overlap inspection.

FIG. 11 is a conceptual diagram showing determination of a one-day treatment.

FIG. 12 is a conceptual diagram illustrating determination of coordination of guidance.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 ... CPU 1a ... Memory 2 ... Auxiliary storage device 10 ... Terminal identification code 11 ... Patient identification code 12 ... Injury and disease name record 13 ... Abstract record 20 ... Drug name master 21 ... Generic name master 22 ... Efficacy master 22a ... Efficacy data 23 ... Disease name master 24 ... Medical practice master 24a ... Examination master 24b ... Treatment master 24c ... Guidance master 25 ... Adapted disease master 25a ... Adapted disease data 30 ... Judgment / execution flag 31 ... Duplicate table 32 ... Duplicate test table 33 ... Execution flag 34 ... Daily treatment table 35... Integration table 36... Specific disease table 37... Intractable disease table CS... Medical care data determination system T. Terminal S. Server DP .display unit IN .input unit DM .data generation unit RV... , CH2 conversion unit TR transmission unit CK determination unit Sin converted reception data sd ... clinical data Sdp ... determination result Sdt ... input data Srd ... reception data Sout ... result data Std ... transmission data Sd ... data signal

Claims (8)

[Claims] 1. A terminal for generating medical data including a name of a illness and medical information indicating the content of medical care performed on the illness having the name of the illness, and outputting the generated medical data to a server; Based on the medical care data, whether the medical care action indicated by the medical care information and the appropriate medical care action for the illness and the illness having the name of the illness in the appropriate combination of the predefined illness and illness are the same or not. The real-time server determines whether or not the medical practice and the appropriate medical practice do not match, the server generates a determination result indicating the mismatch and outputs the result to the terminal in real time, A medical data determination system, comprising: the terminal for notifying the output determination result. 2. The medical data determination system according to claim 1, wherein the server obtains the output medical data, a name of a disease and a disease, and the specified name adapted to a disease having the name of the disease. A first combination information storage means for storing information on a combination of a illness and a medicine, which is a combination of the medicine and the name of the illness; A second combination information storage unit that stores information on a combination of injury and disease-appropriate medical care practice, which is a combination of the above, and the medicine administered to the injury and disease having the injury name and the injury name included in the medical treatment data. Is the illness / drug / drug combination information stored in the first combination information storage means. First determining means for determining in real time whether or not the drug combination information matches the medicine combination information; and the administration performed on the injury and disease having the injury name and the injury name included in the medical care data. Whether the combination with the medical treatment except for the above matches any one of the plurality of wound / morbid / proper medical treatment combination information stored in the second combination information storage means. The second determination means for determining whether or not the determination is made in real time; and when at least one of the determination by the first determination means or the determination by the second determination means is a determination that they do not match, it is determined that the two do not match. Output means for generating the determination result indicating the fact to the effect and outputting the result to the terminal in real time. 3. The medical data determination system according to claim 1, wherein the terminal and the server are installed in one medical institution. 4. The medical care data determination system according to claim 1, wherein the medical care except the administration includes at least one of a medical examination, an examination, a prescription creation, and a guidance. Medical data determination system characterized in that: 5. A server connected to a terminal for generating medical data including a name of a disease and medical information indicating the contents of a medical treatment performed on the disease having the name of the disease and for notifying a judgment result. The computer included in the, based on the generated medical data, the medical treatment indicated by the medical treatment information, the appropriate combination of injury and illness with the name of the disease in the appropriate combination of the prescribed medical treatment and illness The medical practice is determined in real time whether or not the medical treatment is coincident, and when the medical practice and the appropriate medical practice do not match, the terminal generates the determination result indicating the mismatch and generates the determination result. An information recording medium in which a medical data determination program is recorded so as to be readable by a computer. 6. The information recording medium according to claim 5, wherein the computer is configured to obtain the medical care data from the terminal, a name of a disease and a disease, and the rule adapted to a disease having the name of the disease. The first and second combination information storage means for storing information on the combination of wounds and illnesses-drugs, which is a combination of the medicines, and the prescribed medical treatment prescribed above, excluding the administration of the medicines corresponding to the injuries and illnesses having the injuries and disease names, A second combination information storage unit that stores information on a combination of injury and disease-appropriate medical care practice, which is a combination of the medical care data, wherein the medicine administered to the injury and disease having the injury name and the injury name is included in the medical treatment data. Of the wound-disease-drug combination information stored in the first combination information storage means. First determining means for determining in real time whether or not the drug combination information is coincident with the combination information, wherein the administration performed on the injury name and the injury having the injury name included in the medical care data. Whether the combination with the medical treatment except for the above matches any one of the plurality of wound / morbid / proper medical treatment combination information stored in the second combination information storage means. A second determination unit that determines whether or not the determination is made in real time; and when at least one of the determination by the first determination unit or the determination by the second determination unit is a determination that they do not match, the mismatch is determined. Output means for generating the determination result indicating that there is a certain result and outputting the determination result to the terminal in real time. Information recording medium beam is recorded to be read by the computer. 7. The information recording medium according to claim 5, wherein the terminal and the server are installed in one medical institution, and the medical data determination program is executed by the computer. An information recording medium recorded readable. 8. The information recording medium according to claim 5, wherein the medical treatment except the administration includes at least one of a medical examination, an examination, a prescription creation, and a guidance. An information recording medium on which the medical data determination program is recorded so as to be readable by the computer.