JP2003323492A - Medical and welfare service support system - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide appropriate treatments, care and nursing while cutting waste and alleviating burdens on users by providing a system that enables the users to easily browse information on the histories of the users at service facilities related to medical care and welfare, and integrally managing history information at a plurality of service facilities. <P>SOLUTION: The system includes a user management server 20 for managing information on a user's history of check-ups and history of receiving care or being nursed at a service facility related to medical care or welfare; a terminal device 40 capable of communicating with the user management server via a network; and an ID card 50 given the user's identification information that can be read with the terminal device. The user management server 20 has a database 21 in which the user's history information is stored in association with the user's identification information. From the history information stored in the database, the history information matching the identification information inputted from the terminal device is obtained for transmission to the terminal device. <P>COPYRIGHT: (C)2004,JPO

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a medical / welfare-related service support system for supporting services of medical institutions and welfare institutions.

[0002]

2. Description of the Related Art Due to the rapid progress of networks including the Internet in recent years, various forms of services using networks have been proposed in the fields of medical care, nursing and nursing care. For example, in the medical field, virtual medical treatment and remote treatment by remote control are being realized. Digitalization of medical image information such as X-ray images and MRI images is also progressing, and it has become possible to manage efficiently by the DICOM standard. In addition, an in-hospital network has been built in hospitals, and a system has been generalized in which the registration of receptions is performed by computer using a medical examination card with an identification code. I'm out.

[0003]

[Problems to be Solved by the Invention] However, in spite of the progress of networking as described above, a user who is provided with a medical service or a nursing / nursing care service has his or her medical examination history, medical record, or nursing care. ， Even if I wanted to see the nursing history, I could not browse it easily in the past. Although it may be possible to use a medical examination card, the conventional medical examination card used in medical institutions has a main function of receiving a reception, and is not associated with a medical examination history or a medical chart. In addition, since users often receive medical care across multiple medical institutions, and each medical institution has its own management system, it is necessary to request information disclosure for each medical institution. It is troublesome.

Further, in the conventional management system, even if the medical examination history, nursing care, and nursing history are stored in a database, they are only local information in the medical institution or welfare institution. The user selects a medical institution or welfare institution to use as necessary, and the number of medical institution or welfare institution to use is not limited to one. Therefore, the same examination may be repeatedly performed on the same patient, and there may be cases where appropriate medical treatment cannot be received because there is no past medical history or information on medical treatment received at other medical institutions. The same applies to nursing care and nursing services.

The present invention has been made in order to solve the above-mentioned problems of the prior art, and its purpose is to provide a medical service in which the user can easily browse the history information of the user in a medical institution or a welfare institution. -To provide a welfare service support system. In particular, when receiving medical care and nursing / nursing services from multiple medical institutions and nursing care institutions, these historical information are managed in a unified manner, and each institution can share the information, thereby reducing waste. It is to provide a medical / welfare related service support system that can reduce the burden on users and perform appropriate treatment / nursing / nursing.

[0006]

In order to achieve the above object, the present invention according to claim 1 provides a portable identification card having user identification information, a client terminal device, and the client. And a user management server capable of communicating with the terminal device through a network and managing a usage history in a service providing organization related to the medical care and welfare of the user, wherein the client terminal device reads the identification information of the identification card. And a unit for transmitting a usage history browsing request to the user management server together with the read identification information, and receiving and displaying the usage history information sent from the user management server. Is a database that stores the usage history information of the user in association with the identification information of the user, and the browsing sent from the client terminal device. Characterized in that it comprises a means for transmitting the acquired usage history information corresponding to the identification information from the database to the terminal device based on the identification information along with authenticating the identity of receiving a determined user. Here, the user management server includes not only the case where the server is composed of a single server computer but also the case where the server is composed of a plurality of server computers.

The invention according to claim 2 is characterized in that the client terminal device can directly input the identification information of the user. The invention according to claim 3 is characterized in that the user management server is placed in a data center, and the client terminal device can communicate with the user management server through the Internet.

According to the invention described in claim 4, there are a plurality of service providing organizations, the identification information common to all the service providing organizations is used as the user identification information, and each service is stored in the database of the user management server. The usage history sent to each provider is stored collectively for each user based on the common identification information, and the history information of all the service providers of the user can be searched based on the identification information. It is characterized by According to a fifth aspect of the present invention, each service providing organization is provided with a local user management server capable of communicating with the user management server of the data center via a network, and the local user management server comprises:
A local database that stores the attribute and history information of the user who used the service providing organization together with the identification information of the user, and the attribute and history information of the user stored in the local database to the user management server of the data center. The user management server of the data center is provided with means for transmitting the attribute and history information of the user transmitted from all the service providers and for registering the history information for each user in the database. It is characterized by

According to a sixth aspect of the present invention, the client terminal device is a user's terminal device, and the user management server stores the user's history information based on a search request from the user himself. It is characterized by transmitting to the terminal device. The invention according to claim 7 is characterized in that the terminal device of the user has no reading means and is a device for directly inputting the identification information. In the invention according to claim 8, the client terminal device is a terminal device of the service provider, and the user management server provides the user information to the terminal device of the service provider based on a request from the service provider. It is characterized by

In a ninth aspect of the present invention, the terminal device of the service provider is a terminal device of an examination room of a medical institution, and the user management server examines patient history information based on a search request from a doctor. It is characterized in that it is transmitted to the terminal device in the room. In the invention according to claim 10, the terminal device of the service provider is a mobile communication terminal carried by a caregiver or a nurse of a welfare institution, and the user management server is a search request from the caregiver or a caregiver. Based on the above, the history information of the service user is transmitted to the mobile communication terminal. The invention according to claim 11 is characterized in that the terminal device of the service provider is a reception terminal, and the user management server transmits the user information based on a search request from the reception terminal.

According to the twelfth aspect of the present invention, the identification information is written on the identification card by magnetic information and bar code information. The invention according to claim 13 is characterized in that the identification card is written with the attributes and identification information of the patient, as well as the contents corresponding to the type such as a medical examination ticket, a medical examination card, an employee ID card, and the like. The invention described in claim 14 is characterized in that the history data of the user stored in the database is the attribute data of the user and the usage history at each data service institution. In the invention according to claim 15, the history data in the medical institution includes user attribute data, data on treatment / inspection / prescription, medical examination data, image data, and electronic medical chart data. Is characterized by.

According to a sixteenth aspect of the present invention, the user management server determines a facility and a reservation date by receiving a reservation request from the terminal device and a reservation request from the terminal device, and determines the determined reservation information. It is characterized in that means for notifying the terminal device is provided. The invention described in claim 17 is characterized in that the image data includes an image analysis result analyzed by a specialist at an image analysis center.

According to the eighteenth aspect of the present invention, the image analysis center is connected to the data center via a network, and the image analysis center is provided with a server for delivering the image analysis result to the user management server of the data center. It is characterized by The invention described in claim 19 is characterized in that the inspection data includes analysis data of a clinical inspection result performed by an inspection organization. The invention according to claim 20 is characterized in that the inspection organization is connected to the data center via the Internet, and the inspection organization is provided with a server for distributing analysis data of the inspection result to the user management server of the data center. And

The invention described in claim 21 is characterized in that only the doctor has the authority to access the test result data. In the invention according to claim 22, in the data center, based on an electronic medical record search request from the terminal device of each medical institution, necessary data is searched from the database to create an electronic medical record and transmitted to the terminal device. It is characterized in that it is equipped with a server.

According to a twenty-third aspect of the present invention, the medical examination system and the local user management server can communicate with each other via a network, and the local user management server sends identification information to the medical examination system when a new user is registered. The medical examination data sent from the medical examination system to the local user management server is stored in the local database in association with the identification information, and the medical examination data stored in the local database is transmitted to the user management server of the data center. It is characterized by having a function to do.

According to a twenty-fourth aspect of the present invention, the local user management server can communicate with the medical accounting system via the network, and when the user is newly registered, the identification information is sent to the medical accounting system, and the medical accounting system records the medical information. It is characterized in that it is provided with means for receiving a number and associating and registering a medical record number and card identification information in a local database. In the invention according to claim 25, the local patient management server reads all the existing patient lists of the medical accounting system at the time of system introduction and registers them in the database, and in accordance with the user's new registration request from the reception terminal device, the existing patient list. Is searched, and if there is a target person, the patient attribute data is read from the past patient list in the database, and the user is newly registered with an identification number.

According to a twenty-sixth aspect of the present invention, the local patient management server reads all past medical checkup user lists of the medical checkup system at the time of system introduction and registers them in the database, and a new user from the reception terminal device is registered. Search the medical examination user list according to the registration request, and if there is a target person, read the user attribute data from the medical examination user list, add an identification number, and register a new user. Is characterized by. In the invention according to claim 27, the user management server of the data center and the card management center of the credit card company can communicate with each other via a leased line, and the user management server associates with the database in advance at the time of payment of the usage fee. Equipped with payment processing means that sends the registered user's identification information and credit card payment code to the card management center, and sends payment details to the card management center based on the verification result from the card management center for payment processing. It is characterized by

According to a twenty-eighth aspect of the present invention, each medical institution has a card issuance management terminal connected to a local user management server via a network, and the card issuance management terminal is externally connected by a dedicated line. It is possible to communicate with the card management center of the credit company, and the card issuance management terminal sends the identification information of the user who wants the card payment to the card management center from the card issuance management terminal when the user wants to make the card payment, It has means for receiving credit card payment code information from the card management center, associating identification information with the payment code, and sending them to the local management server.
The local user management server is characterized by including means for registering the information of the payment code transmitted from the card issuing management terminal in the local database.

The invention according to claim 29 has a password management system for managing a password for accessing the patient management server of the data center, and the password management system is the password from the patient management server of the data center. It is characterized by having a function of receiving new registrant information from the patient management server based on an issuance request, automatically creating a password, and issuing a password notice.

According to a thirtieth aspect of the present invention, the user management server of each facility and the local management server of the security system are connected via a network, and when the user management server registers / issues a new identification card. The security information is added to the identification card together with the identification information, the identification information and the security information are transmitted to the local management server of the security system, and the local management server of the security system registers the identification information and the security information in the local database and also It has a function of converting and transmitting to the center server of the security system.The center server of the security system receives the converted identification information and security information, and based on the security information, corresponds to the door opening and closing security system of each facility. Stored in the security management database,
It is characterized by having a function of distributing the information of the identification card to the card registration device that registers the card for the door opening / closing crime prevention system of the facility through the distribution / operation terminal.

According to a thirty-first aspect of the present invention, the usage history information of users in a plurality of service providing organizations related to medical care and welfare is associated with common user identification information through all service providing organizations for each user. And a means for receiving a browsing request from the client terminal device to authenticate the user's identification information, and acquiring and transmitting usage history information corresponding to the identification information from the database based on the identification information. It is characterized by having and. According to a thirty-second aspect of the present invention, a local database that stores the attribute and history information of the user who has used the service providing organization together with the identification information of the user, and the data stored in the local database are managed by the user of the data center. It is characterized in that it is provided with means for carrying out batch transfer to the server on a regular basis.

[0022]

BEST MODE FOR CARRYING OUT THE INVENTION The present invention will be described below based on the illustrated embodiments. FIG. 1 is a conceptual diagram of a medical / welfare related service support system according to an embodiment of the present invention. This medical / welfare related service support system 10
Is a system in which a plurality of service providers related to medical care and welfare subscribe to the system, and the history information of users who have used the service providers subscribed is unified by the user management server 20 installed in the data center 60. It is managed by the institution, and history information can be shared and used by all institutions.
The medical / welfare related service support system 10 is configured to communicate with a user management system 20 that manages history information such as consultation history, nursing care, and nursing history of users of service providers, and a user management server 20 through a network 30. It is equipped with a possible terminal device 40 and an ID card 50 as a portable identification card owned by the user. The ID card 50 has a user identification information ID that can be read by the terminal device 40. An ID number is used as the identification information ID. The ID number includes not only numbers but also letters such as alphabets and various symbols.

The service providing institutions include medical institutions and welfare institutions, as well as out-of-hospital pharmacies and health insurance associations. The medical institutions may be clinics, clinics, clinics, hospitals, etc. of any size. Welfare institutions include health facilities, nursing homes and nursing stations. A system in which only medical institutions are connected by a network or a system in which only welfare institutions are connected by a network may be used, but a configuration in which a network including both institutions is connected is preferable. The user management server 20 stores a database 2 that stores user history information in association with user identification information.
1 and a search unit 22 that searches the history information stored in the database 21 for history information matching the identification information input from the terminal device and sends the history information to the terminal device 40. The terminal device 40 is provided in each medical institution (reference numerals 40A, 40B, 40C in the figure) and in a welfare institution (40X, 40Y, 4 in the figure).
0Z) and the user's personal terminal device (40H, 40 in the figure)
I) is also included, and is configured to be communicable with the data center 60 through the network 30.

User management server 20 of data center 60
You may make it perform the authentication for accessing. The authentication is performed using, for example, an ID number and a password. If the network is an open network such as the Internet, a firewall or the like is provided to prevent unauthorized access. A service providing organization related to medical care and welfare may have its own local management system for managing users of each organization, and a terminal device 40 for accessing the data center 60 is provided. You can just do it.

The terminal device 40, as shown in FIG.
U44, a memory 43 in which various programs and data are installed, and an input device 46 such as a keyboard and a mouse
And a display device 42 such as a CRT and a reading device 43.
Is connected to the CPU 44 via a bus. By directly inputting the ID number with the input device 46 without using the ID card 50, the medical examination history can be browsed. By using the ID card 50, even a user such as an elderly person who is not accustomed to the machine can easily access and construct a highly convenient system. The medical history information of each medical institution is centrally managed by the data center 60 based on the ID number of the ID card 50,
Unified management of personal medical history information, including medical history at other medical institutions.

On the other hand, the medical institution and the welfare institution send the user's consultation history and nursing / nursing care history to the data center 60 sequentially or by batch processing, and the data center 6
At 0, the management server 22 receives the transmitted information and registers it in the database 21 in association with the user identification information.

The users are the terminal devices 40A to 40C, 40X to which are arranged in the facilities of each medical institution or welfare institution.
40Z or the browser of the terminal device 40H, 40I of one's own, and the user management server 20 of the data center 60
When you access, a portal site is displayed on the display screen, and you can select whether to have a medical history or medical / nursing history. As a browsing menu of history information in a medical institution, as shown on the display screen 42a, menus such as medical examination history display, physical examination result browsing, medical chart browsing, and result display analysis regarding various clinical examinations are displayed. When an item to be searched is selected, a search request is sent to each data center 60, the corresponding data is searched by the search means 22, the search data is sent to the terminal device, and the search data is displayed on the terminal device.

As a history information browsing menu in the welfare institution, for example, as shown in the display screen 42b, in addition to nursing care and nursing history, medical care information, health examination data relating to nursing care, various clinical examinations, as well as medical information. The menu for result display analysis etc. is displayed. It can also be accessed from the terminal devices in the clinics such as each medical institution and welfare institution, and doctors can obtain information such as past medical history, treatments received at other medical institutions, medications being administered, etc.
Appropriate treatment can be given. Also, during treatment, M
It is also possible to obtain image data from a specialized medical institution 70 equipped with advanced equipment such as RI and precision inspection data from an inspection institution 71 such as a research institution. Further, it is possible to obtain an analysis report by an expert and also to view advanced image data such as MRI. Therefore, even without a high-level facility, it is possible to obtain information similar to that of a university hospital while staying in a small clinic, and it is possible to obtain the findings of a specialist who is good at image interpretation.

FIG. 3 shows an outline of the overall network structure related to medical care and welfare. The illustrated network includes a data center 2010, a medical institution 2020, a nursing care institution 203.
0, a pharmacy (including in-hospital and out-of-hospital) 2040, a health insurance association 2050 that conducts a health examination, a medical institution related person 2060 such as a doctor, and an individual user 2070 are involved. Each medical institution 2020 is provided with a computer 2024 that manages a database of user data 2021, medical system data 2022 such as electronic medical records, and prescription data 2023. Each pharmacy 2040 is provided with a computer 2042 that manages a prescription database 2041.

Each health insurance association 2050 has a computer 2 that manages a database 2051 relating to medical examination data.
052 is provided. Also for the care facility 2030, a computer 2032 for managing the care system database 2031 is provided. The data of the care record of each caregiver is transmitted to the database 2034 of the mobile center 2033 through the mobile communication terminal,
It is transmitted from 33 to the data center 2010 together with the care system data. The data held by each of these institutions is sent to the data center 2010 and is centrally managed by the data center 2010.

The data center 2010 has user data 2011 of all institutions, medical data 2012 of all medical institutions, and care data 201 of all nursing institutions.
There are three databases, and these databases are managed by the data center server 2014. A person 2070 involved in a medical institution such as a doctor can use the terminal device 2071 installed in the medical institution 2020 to access the Internet 2
It is possible to connect to the data center 2010 through 080. The individual user 2060 can also access the data center 2010 through the Internet 2080 by using a terminal device 2061 such as a personal computer owned by the user. Further, the network includes an image analysis center 2
090 and inspection organization 2100 are members. Inspection organization 2
A database 210 stores inspection data 100.
A computer 2102 that manages 1 is provided.
Further, the computer 2102 of this inspection organization 2100 is connected to the data center 2010 by a dedicated line.

FIG. 4 is a schematic diagram showing the network configuration of the "disease-diagnosis" cooperation processing between hospitals taken out of the integrated network. That is, in the data center 2010,
Consultation history data 2015, treatment / inspection / prescription data 20
16, a database classified into medical checkup data 2017, image data 2018, electronic medical record data 2019, health data 2019, and care information data 2013 is provided. Of these, medical treatment data such as treatment / inspection /
The prescription data 2016, the medical examination data 2019, the image data 2018, and the electronic medical chart data 2019 are layered below the medical examination history data 2015. The data center 2110 includes patient management 2111, clinical data management 2112, image management 2113, chart management 2114, and medical management 2114 of each institution.
Performs business as an ASP (application service provider) data center that performs care management 2115.

On the other hand, each hospital 2020 and clinic 2020A
The medical institution has a database of in-hospital users 2
Computers 2024 and 2024A that manage 025 are provided. The data center 2010 can be accessed from the user's individual terminal device 2061 through the Internet. That is, the terminal device 2061
Is equipped with browser software, data center 2010
The data center server 2024 has a Web server function, and browses the Web screen generated by the data center server using the browser software of the terminal device. As a method of accessing the database via the Web server, a CGI may be provided in the Web server, an application server may be installed between the Web server and the database, and various other methods can be applied.

FIG. 5 shows a display example of the Web screen. For example, when an individual user launches the browser software of the terminal device 2061, the data center server 2014 of the data center 2010 is accessed, and the portal site 2201 generated by the Web server function unit is displayed (FIG. )reference). Portal site 2201
Button 2202, 2203 indicating whether it is an individual member, a corporate member (general) or a corporate member (medical institution, health insurance association, etc.).
2204 is arranged. Individual member button 2202
When clicked, the data center server 2014 creates a login screen 2210 for individual members and creates the terminal device 206.
Send to 1. The user logs in the login screen 22 of the terminal device.
Enter the member ID 2211 and the password 2212 in 10, and click the login button 2213. When the data center server 2014 is authenticated as an authorized user, the data center server 2014 creates a personal initial menu screen 2220, and the terminal device 20
Send to 61. If you are a corporate member, you can browse the medical examinations and medical history of employees. In the case of a health insurance association, health checkups and medical history of members can be viewed.

On the initial menu screen 2220, the user's name 2221, menu button 2222, notification 2223, today's schedule 2224, health examination appointment status 2225, etc. are displayed. As shown in FIG. 6A, the menu button 2222 displays buttons such as a medical examination reservation 2222b, personal information management 2222c, and logout 2222d in addition to the reception history 2222a. When the reception history button 2222a is clicked, the terminal device 26
1, the reception history request is transmitted to the data center server 2014, and the data center server 2014 receives the reception history data 2025 corresponding to the ID number of the user from the database.
To create a reception history screen 2230 and send it to the terminal device 2061. The medical examination history screen 2230 is divided into upper and lower parts, and the attribute information of the user is displayed in the listing and the history information is displayed in the lower column. Name, date of birth, ID number, medical record number, etc. are displayed as the user attribute information. As for the medical record number, all the medical record numbers of the medical institutions that have been examined can be viewed. As the history information, treatment / prescription / inspection contents are displayed for each consultation day / consecutive facility. For example, if you click Checkup / Dock, the results of the checkup dock are displayed. As for the display, as shown in FIG. 6B, the detailed menu is selected from the pull-down menu of the medical checkup. In the illustrated example, body measurement is selected, and the results of height, weight, degree of obesity, body fat percentage, determination of obesity, instruction, visual acuity test, etc. are displayed.

Various network configurations are possible. FIG. 7 is a basic system configuration example. This system is an example of one hospital, and the patient management server 120
Is constructed in a hospital, and the terminal device 140 can communicate via the network 131. This network 131 is a hospital network such as an intranet.
The patient management server 120 includes a consultation ID card application server 122a, a patient management application server 122b, a patient database 121a that stores patient information, and a history local database 121b that stores history information, which are connected to a LAN or the like. They are connected by the network 131. Furthermore, a patient management Web database server 180 is connected to the patient management server 120 via a router 170 and a dedicated line 132. In the following description, when the expressions are redundant, "application" is "AP", "database" is "DB", and "web database" is "Web".
"DB" is abbreviated as appropriate.

The patient DB 121a stores patient attribute information and the like. The history local DB 121b stores the history of patients who have visited the hospital. The patient management WebDB base server 180 is installed in an external data center, and information of all patients including history information of other hospitals is stored and can be browsed. In this configuration, when the ID card 150 is read by the terminal device 140, the ID card AP server 122a first reads out the patient information corresponding to the ID number and sends it to the terminal device 140, and attributes such as the patient's name and address. Display information.

Further, the patient management AP server 122b searches the history local DB 121b for the consultation history information at the hospital corresponding to the ID number, and the search result is the terminal device 14
0, and the transmitted information is displayed on the display device.
Further, the request is sent to the WebDB server 180 connected by the private line 132 via the router 170, and the We
It is also possible to read the data stored in the bDB server 180 and display it on the terminal device 140.

FIG. 8 shows an example of system configuration using a public line network as a network. In this system, an authentication server 223 that authenticates the legitimacy of the access right to the patient management system is installed. Patient management server 220
Is a configuration including a patient management WebAP server 222 and a Web database 221. When the browser software of the terminal device 240 is started, the ID card 250 is read into the terminal device 240, and the WebAP server 222 is accessed, a menu screen is displayed on the display screen of the terminal device 240. In the search menu, for example, items such as an examination date, a medical institution, a treatment, a prescription, and an inspection are displayed. When each item is clicked, data corresponding to the ID number is searched from the Web database 221 and transmitted to the terminal device 240. ,
The transmitted data is displayed on the display screen of the terminal device 240.

FIG. 9 shows an example of system configuration for connecting to a data center via the Internet. In this example, each terminal 340 is connected to the data center 3 through the public line 333.
It is possible to communicate with 60 patient management servers 320,
Authentication server 3 for accessing the data center 360
23 are provided. The data center 360 is provided with a patient management WebAP server 322, and the patient management WebAP server 322 has a system configuration capable of retrieving all consultation histories at a plurality of medical institutions stored in the Web database 321. ..

FIG. 10 shows an example of a system configuration in which management systems of a plurality of medical institutions are connected to a data center via the Internet. The terminal device 440 of each medical institution can communicate with the data center server 422 (Web server) of the data center 460 through the Internet 430, and an authentication server 423 for accessing the data center server 422 is provided. Further, the data center 460 is provided with a firewall 461 and an L4-SW (layer 4 switch) 462 for preventing unauthorized access.

A patient management WebAP server 422 is provided between the data center server 460 and the Web database, and a request from each terminal device 440 is sent to the data center 42.
2 is sent to the patient management WebAP server 422 via
Web database 4 by WebAP server 422
The system configuration is such that it is possible to retrieve all medical examination histories stored in a plurality of medical institutions stored in 21. A local DB 441 is provided in each medical institution to manage the medical examination history of patients in each medical institution, and all the data in each local database 441 is batch-transferred to the Web database 421 on a regular basis. Data has been updated.

FIG. 11 shows an example of system configuration that models one hospital. That is, a local patient management server 520 that manages patient attribute information and consultation history information of patients who visit the hospital, and each terminal device 540A as a client placed in a reception, clinic, examination / treatment room, rehabilitation room, or radiation room, 540B, 540C, 540D, 5
40E, 540F, a card issuing system 544, a medical accounting system 570, and a medical examination system 560 are provided, and these are the in-hospital network 5 such as an intranet.
Connected at 43. The patient management server 520 has a database server function and includes a database 521 that stores patient attribute information and medical chart information.

The hospital network 543 is connected to the data center 660 via the Internet 630. The data center 660 is provided with a center server 652 that manages a database 651 that stores patient reception history information at all medical institutions. Reception terminal 5
In 40A, the information of the ID card 550 is read by the card reader, the information of the user is retrieved from the local database 521 or the database of the data center 660 and displayed, it is confirmed whether or not the user is the user, and a reception order is created. It This reception order is registered as items such as diagnosis, treatment, medicine only, injection, rehabilitation, blood test, and X-ray test, and is output as a printed matter. Based on the reception order, the patient receives an examination in the examination / treatment room, takes an image of the affected area in the radiation room, and receives medical examination from the doctor in the examination room.

At the terminal device 540B in the examination room, the doctor receives the ID card 550 from the patient, reads the ID number with the card reader of the terminal device 540B, and displays the reception history from the database 520 of the data center. In addition to displaying the electronic medical record from the reception history, medical history etc. at other medical institutions and examination data are referred to as necessary, and when medical treatment is over, rehabilitation is performed in the rehabilitation room as necessary,
Receive the drug at the pharmacy, and finally pay the medical bill at the accounting to finish.

FIG. 8 shows a specific system configuration example of the data center 660. That is, the data center server is composed of a plurality of server computers. That is, a Web connected to the Internet 630
Server 661 and data conversion application server 6
62 and an access server 66 connected to the public line 633
3, a plurality of types of application servers, and a plurality of types of database servers. Web server 6
61 is a firewall 664 and a layer 4 switch 6
It is connected to the Internet 630 via 65, receives a request from a terminal device owned by a patient or installed in a hospital, causes each application server to process the request, and transmits the result to the user terminal. Web server 66
Two units 1 are connected in parallel to distribute the load from users. The number of Web servers 661 can be increased or decreased according to the number of users.

The firewall 664 is for preventing unauthorized access from the outside. The layer 4 switch 665 is a switch for connecting to one of the web servers 661. Data conversion AP server 66
2 uses the data from the patient common database 623 as Web
It is for the gateway to convert to the data format that can be browsed above. The access server 663 is the public line 6
Control access from 33. Each medical institution accesses the access server 663 from the public line 633.

As the application server, the medical examination A
P server 672, WebAP server 671, electronic medical record AP server 673, image AP server 674, medical accounting A
A P server 675 is provided. Further, as the database server, a common DB server 623A that stores the data transmitted from the access server as it is, a history DB
Server 622, patient common DB server 623, order DB
Server 624, image result DB server 625, receipt D
A B server 626 is provided. These application server and database server are duplicated to ensure reliability and high-speed processing. Of course, depending on the number of users, one system may be used, or triplex or more multiplex may be used. Furthermore, a clinical WebDB server 628 accessible through the router 670 and a care WebDB server 6
29 are provided.

Next, the ID card used will be described. As shown in FIG. 13, an ID number as identification information and attribute information such as a user's name and address are duplicated on the ID card 550 by two types of recording methods, magnetic information a and barcode information b. Is written in. By making it redundant, the ID number can be read by both the magnetic card reader and the bar code reader. The barcode reader is small and portable and convenient. On the other hand, the magnetic reader is not suitable for carrying, but has an advantage that a large amount of information can be recorded. Therefore, the bar code information stores the minimum information necessary for the search, and the magnetic information stores various information. Of course, other media such as an IC card can also be used.

As the ID card, various cards can be prepared according to the purpose. For example, it may be created as a medical examination card for outpatient visits, a medical examination card for docks and medical examinations, an insurance card that can be used for both, or an employee ID card of a company affiliated with a hospital. It is also possible to create as. For example, a medical institution that participated in this system can use an examination card created at one hospital for outpatient examinations at other hospitals, and can also undergo examinations and docks. In addition, as for the card, both the outpatient medical examination card and the medical examination card may be created at each hospital,
You may issue multiple copies for each hospital. When issuing multiple copies, the code of each hospital and facility is added to the unique identification number of the user so that they can be distinguished. Bar code information b
B-1) ID number and b-2) ID card type are recorded in the, and magnetic information a includes a-1) member information (for example, payment card type (credit card)), a-2) I.
D card type, a-3) ID number (membership number), a-
4) As other member information, sign / number of health insurance card,
Names of insured person, date of birth, sex, classification of person / family, blood type (ABO type / Rh type), date of ID card issuance, etc. are registered. The ID card type is, for example, a medical examination card, a medical examination card, an employee ID card, an insurance card, or the like.
The credit number is registered when a credit card payment is desired. The ID card is issued at each hospital at the time of new registration.

FIG. 14 shows an ID card acceptance / issue processing flow. The reception process is processed by the reception terminal device 540A and the patient management server 520. The reception terminal and the patient management server 520 are also Web-based, and the reception terminal device 540A has browser software,
20 has a WWW server function unit. When the browser software of the reception terminal 540A is activated, the star menu screen created by the local patient management server 520 is displayed on the reception terminal 540A (901).

When the patient has an ID card 550, the ID is read by the card reader of the reception terminal 540A of the hospital.
The card 550 reads the ID number and sends a search request with the ID number to the local patient management server 520,
The patient information accumulated in the local database 521 is searched, and if not found, a search request is automatically transmitted to the data center 660 and the data center 66 is searched.
The database in 0 is searched. Data center 660
Then, for example, in the case of the configuration shown in FIG. 8, the attribute information of the patient stored in the history database 622 is searched through the Web server 661 and the WebAP server 666, and the search result is received through the Web server 661 at the reception terminal 540A. And the search result screen is displayed (9
02).

When the target person is found, for example,
The attribute information of the patient is displayed on the reception terminal 540A, and if the information is correct, the medical examination section is selected on the day (907) and the reception process proceeds. In addition, the history can be searched and displayed (921).
If there is no target person, a message indicating no target person is displayed, and new registration is performed as necessary.

For new registration, select new registration from the start menu and display a new registration screen on the reception terminal 540A (904). When necessary information is entered in the new registration screen and transmitted to the local patient management server 520, the local server 520 acquires a new ID number that does not overlap with other ID numbers, and registers the ID number and patient attribute information in association with each other. The content is transmitted to the reception terminal 540A. Reception terminal 540
In A, the newly registered content is displayed and the content is confirmed (90
5). If the registration contents are correct, a confirmation signal is transmitted to the local patient management server 520. Upon receiving the content confirmation, the local patient management server 520 registers the new patient in the local database 521 and transmits the content of the new registration result to the reception terminal 540A. The registration result screen is displayed on the reception terminal 540A (906). When this new registration is completed, a new card is issued by the card issuing system 544 (931).

FIG. 13B shows a table stored in the local database 520 in each medical institution.
Since this data is batch-transferred to the patient common database 623 of the data center 660, the tables in the patient common database 623 are also the same. This table contains the I, such as the medical examination card and medical examination card mentioned above.
D card type 1001, consultation category 1002, disease category 1
003, facility code 1004, ID number (membership number) 1
005, credit number 1006, chart number 100
7, name (kana name) 1008, name (kanji name) 10
09, blood type / sex 1010, address / telephone number (postal code / address) 1011, member email address 1012, company facility code 1013, company name 1014, employee number 1
015, mobile phone number 1016, member date of birth 101
7, registration date / update date 1018, other member attributes 1019
The insured symbol and number (issue date / expiration date) are stored as.

The facility code 1004 records the facility of the issuer of the card. The ID number 1005 is uniquely assigned to users through all affiliated institutions. The method of selecting only one number is, for example,
It may be selected from ID numbers given to affiliated institutions in advance, or may be a combination of a code number assigned to a hospital or welfare institution and an individual number, or a data center database. You may refer, and there are various methods. By registering the member e-mail address 1012, it is possible to provide various services by using e-mail. Corporate facility code 101
3. Company name 1014 and employee number 1015 are registered in the case of employee ID card.

The medical record number 1007 is managed by the medical accounting system 570.
Get from 0. Since medical records are created for each hospital,
A medical record number is assigned to each hospital. On the other hand, a card issuing system 544 is provided in the hospital, and the registration information of the new patient is transmitted from the local patient management server 520 to the card issuing system 544, and a new ID card 550 is created. When the new registration is completed, the reception process is proceeded, such as selection 907 of the consultation on the day.

Next, the registration process for a user who has visited the hospital in the past will be described. For patients who have undergone outpatient treatment, medical accounting system 55
0 remains in the list of therapists, and in the case of a user who has undergone a physical examination such as a physical checkup, it remains in the list of users of the medical examination system 560. Therefore, in order to effectively utilize these data, when introducing the card system of the present invention,
The past patient list and medical chart information of the medical accounting system 570 and the past patient list of the medical examination system 560 are all transferred to the local database 521 of the patient local patient management server 520.

For example, when a patient who has received outpatient treatment in the past comes to the hospital, a patient registration screen for an existing medical examination ticket is displayed (908). Then, the past history patient list (patient list of existing medical examination tickets) is searched by using the name, address, age, etc. as a key, and if there is a target person (90
9) Register the patient information of the medical examination ticket (911). The local patient management server 520 acquires a new ID number that does not overlap with other ID numbers, and transmits the registration content in which this ID number and the patient attribute information are associated to the reception terminal 540A.
The new registration contents are displayed on the reception terminal 540A, and the contents are confirmed (912). If the registration contents are correct, a confirmation signal is transmitted to the local patient management server 520. Upon receiving the content confirmation, the local patient management server 520 registers the new patient in the local database 521 and transmits the content of the new registration result to the reception terminal 540A. Reception terminal 540A
Then, a registration result screen is displayed (906). When this new registration is completed, a new card is issued by the card issuing system 544 (931).

By doing so, it is not necessary to input the patient attribute information when creating the card, and the history information such as the treatment details remaining in the accounting can be effectively utilized. Since a medical record is always created for an outpatient, a medical record number is attached to the data of the medical accounting system 570, and this medical record number is also automatically registered. The ID number is passed to the medical accounting system 570. If there is no subject in the past patient list of the medical examination ticket, the patient attribute information itself is not registered, so new registration is performed (904).

Next, a patient registration screen of another existing card such as an existing medical examination card is displayed. Then, the list of past medical examinees stored in the local database 521 is searched using the name, address, age and the like as keys. If there is a target person, the processing differs depending on whether or not the medical record number has been registered. If the medical record number is already registered (91
6) Since the patient has received an outpatient consultation, the user is registered by associating the registered patient attribute information with the ID number as in the case of the outpatient consultation (911, 912, 9).
13).

If the medical record number is not registered (91
5) Register the patient information by using the registered patient attribute information as it is (918). The local patient management server 520 acquires a new ID number that does not overlap with other ID numbers, passes the ID number to the medical accounting system 570, acquires the medical record number from the medical accounting system 570, and acquires these numbers as patient attributes. The registration content associated with the information is transmitted to the reception terminal 540A. The newly registered content is displayed on the reception terminal 540A and the content is confirmed (91
9). If the registration contents are correct, a confirmation signal is transmitted to the local patient management server 520. Upon receiving the content confirmation, the local patient management server 520 registers the new patient in the local database 521 and transmits the content of the new registration result to the reception terminal 540A. The registration result screen is displayed on the reception terminal 540A (920).

Upon completion of this new registration, the card issuing system 544 issues a new card (93).
2). Also, if there is a change in the master information,
A master maintenance menu is selected (922). On the screen, ID card type (923), disease classification (924),
Consultation division (925), facility (926), points (92)
Items such as 7) are displayed, and each master information can be added or changed. The points are service points such as accumulating points according to the number of medical examinations and discounting the medical examinations when a predetermined number of points are accumulated. When the reception is completed, a history inquiry menu is displayed on the screen, and the history can be displayed (921). When the search request is transmitted to the data center 660, the history database 622 is transmitted by the Web server 661 and the WebAP server 666 of the data center.
The corresponding history information is searched for and read out, the read information is transmitted to the reception terminal 540A, and the history information is displayed on the reception terminal 510A.

FIG. 15A shows a table structure of the medical examination history stored in the history database. In the consultation history table, for example, total points 1020,
ID number (member number) 1021, blood type 1022, member date of birth 1023, consultation date 1024, consultation classification code 1
025, consultation facility code 1026, medical record number 102
7, the medical care source code 1028, the examination category 1029, and the like are stored. The history data is regularly sent from each hospital to the data center 660, and the history database 622 is updated.

FIG. 15B shows a conversion table in the data conversion application server 662.
That is, the data accumulated in the local database 521 in the hospital is transferred to the data center 660 by batch processing once a day (1030). Data is converted from the database 623A by the data conversion application server 662 and stored in the common database 623 and the history database 622. The local database 521 is generally composed of SQL, but in the data center 660, the data is converted into a common database 623 and a history database 622 in order to process information on the Web.

First, the update date is checked (103)
1). As for the check of the update date, the update for the previous day and the update for the current day are checked (1033), and the line 121 months before the consultation date is deleted (1034). As a result, 10 years of history information is left. In the history database 622, various masters are copied (10
35), the history table is inserted (1036), the previous day record is inserted into the history table (1038), and the duplication of history information is checked by the primary key (013).
9). The history table (1036) is inserted in order to record to what extent the transfer history information has been transferred to the data center.

FIG. 16 shows a database structure stored in the history database 622 thus converted. That is, the history database 622 includes the patient information table 1050 and the master information table 106.
0 and a medical examination result creation table 1070 are provided. In the patient information table 1050, the header record 1051 and the item record 1052 of the history consultation data,
A header record 1053 and an item record 1054 of the medical examination result consultation data are included. Master information table 1
060 includes a card type master 1061, a disease classification master 1062, a medical examination classification master 1063, a medical examination (facility) master 1064, a medical treatment source master 1065, and an examination classification master 1066. In the medical examination result creation table 1070, the examinee attribute data 1071 and the medical examination result data 10
72 and health examination comprehensive finding data 1073.

FIG. 17 shows the correspondence relationship between the electronic medical chart related database 6240 of the data center 660 and the electronic medical chart local database 521 in the hospital. That is, only the order for each patient is stored in the local database 521 of the electronic medical record in the hospital, and the amount of data is made as small as possible. The items of the order include, for example, the disease name corresponding set order 541c and the prescription order 5
41d1, injection order 541d2, examination order 541
e, an image order 541f, a rehabilitation order 541g, and the like. Of course, the local database 521 may also store the order result.

On the other hand, in the electronic medical record related database 6240 of the data center 660, a facility database 624A storing information of each medical institution, a patient ID database 624B storing patient IDs, and a disease name correspondence database 6 are stored.
24C, examination database 624E, prescription / treatment database 624D, image database 624F, and rehabilitation database 624G are included.

The electronic medical chart related database 6240 and the local database 521 of the data center 660 can communicate with each other via the Internet 630.
In association with the facility code and patient ID, the disease name corresponding set order 541c, prescription order 541d1, injection order 54
1d2, examination order 541e, image order 541f, and rehabilitation order 541g are stored in the disease name correspondence database 624C, examination database 624E, prescription / treatment database 624D, image database 624F, and rehabilitation database 624G together with the result data. Corresponding to the server configuration of FIG. 12, databases 624C, 624E, 624D related to orders,
History database 6 that stores 624G and its results
22, the electronic medical record AP server 673 reads out necessary data from the image result DB 625 and the like to create an electronic medical record, and these together form a single electronic medical record related database 6240.

FIG. 18 shows a processing flow for associating with the electronic medical chart system. That is, the ID number of the ID card is read by the card reader of the consultation room terminal of the hospital (14-1), the patient management local database 521 and the patient management common database 623 of the data center 660 are referred to, and the ID number is checked. The existence of user data is confirmed (14-2). When the existence of user data is confirmed, the operator's authentication is confirmed using a hospital password or the like (14-3), and the medical examination history can be searched. As shown in FIG. 6, the display of the medical examination history includes attribute information of the medical examination patient, the medical examination date, the medical examination facility,
The medical examination classification (outpatient, medical examination, etc.) is displayed. The doctor has a dedicated authentication IC card, authenticates the access right to the electronic medical record (14-5), and can search the electronic medical record.

For example, when the electronic chart number on the display screen is clicked, a search request is sent to the electronic chart AP server 625. The electronic medical record AP server 622 selects and reads out the patient data necessary for displaying the electronic medical record from the history database 622, the electronic medical record screen is created by the Web server 661, and the terminal device 540 in the consultation room is selected.
It is displayed on B (14-6). On this display screen, the doctor
Search by patient (14-6a)) Prescription inquiry (14-6)
b), inspection reservation inquiry (14-6c), image result inquiry (1
Various information such as 4-6d) can be inquired.

The inspection reservation inquiry and the image result inquiry are also linked from the electronic medical chart screen to the inspection system and the image analysis system. While referring to these data, the doctor examines the patient and inputs an inquiry / finding to the electronic medical record (14-7), and various orders are registered in the local database 520 of the electronic medical record (14-
8). The order is registered by, for example, a disease name corresponding set order (14-8a), prescription order (14-8b), injection order (14-8c), examination order (14-8d), image order (14-8e), rehabilitation. Order (14-8f)
Etc. are included. The data registered in the local database 520 is transmitted to the data center 660 by batch transfer processing once a day, and is distributed and stored in the history DB server 622, the order DB server 624, and the like. Only the order data is stored in the local database 520 to reduce the load, and the result data such as the inspection result is stored in the data center 660.

FIG. 19 shows a network configuration for image analysis. That is, the advanced medical institution 581 and the image analysis center 580, which have facilities such as MRI,
At the image analysis center 580, a specialist interprets images such as CT scan images and MRI images that are connected to the data center 660 via the Internet 630 and measured at each medical institution 582 and advanced medical institution 581 that have joined the system. Then, the analysis result is transmitted to the data center 660 to be used as a reference for diagnosis. The image analysis result may be connected to the data center 660 by a dedicated line. Further, the analysis result may be transmitted to the data center 660 via each medical institution.

Next, with reference to FIG. 20, a processing flow for associating with the image analysis system will be described. That is, the ID number of the ID card is read by the card reader of the examination room terminal of the hospital (15-1), the patient management local database 521 and the patient management common database 623A of the data center 660 are inquired, and the ID number is checked. Presence of user data is confirmed (1
5-2). When the existence of user data is confirmed, the operator's authentication is confirmed with a hospital password or the like (15-3), and the medical examination history can be searched. As shown in FIG. 6, the display of the medical examination history includes the attribute information of the medical examination patient,
The consultation date, consultation facility, consultation category (outpatient, medical examination, etc.) are displayed.

The doctor has a dedicated authentication IC card,
The access right to the image data is authenticated (15-5), and the image data can be searched for the image data. Images can be searched by patient-specific result list (15-6) and image result list (15-6).
-7) and can be searched from the inspection item list (15-8). On the other hand, the reservation information (15-
9), various image measurements (15-10) and image result registration information (15-11) are sent to the image analysis center 580 in association with the patient ID number, and this image analysis center 580
The image analysis result is registered and distributed from the distribution server 580A placed in the center to the data center 660 and stored in the image analysis result database 625.

Next, a clinical test system for managing clinical test data will be described. FIG. 21 shows an inspection ordering system. That is, the inspection host computer 591 of the inspection laboratory 590 as an inspection body is connected to the Internet 630. The inspection host computer 591 includes a data center 660 and a dedicated line 63.
Connected by three. A sample barcode Sb is attached to the sample S collected at each hospital 582. The sample barcode Sb includes inspection items and the like.

The inspection sales representative of the inspection laboratory 590 reads the sample barcode Sb on the mobile terminal M when collecting the sample,
Access the data center and select patient I from the patient attribute information.
The information such as the inspection order set set according to D and the patient is read, and the patient ID + barcode information + request item (addition, etc.) is stored in the computer 596 of the sample collection point 595 such as a branch office or sales office, and the host of the inspection lab. Computer 59
1, and the sample S itself is transported to the sample collection point 595. At the sample collection point 595, the sample S and the transmission information list from the sales person are checked, and the sample S is transported to the inspection laboratory 590.

On the other hand, the examination order issued by the doctor through the terminal device 540 of each hospital 582 is the Internet 6
30 to the inspection host computer 591 of the inspection laboratory 590. Also, the inspection order data is
It is also sent to the data center. The inspection host computer 591 of the inspection laboratory 590 is patient ID + request item +
The sample barcode information is matched with the ID of the inspection order previously received from the patient management system, and the sample inspection is performed.

The inspection result is transmitted from the host computer 591 of the inspection laboratory 590 to the data center 660 through the dedicated line 633. A distribution server 592 is connected to the host computer 591, and the clinical test results of the user are transmitted from the distribution server 592 sequentially or by batch processing and accumulated in the history database 622. The examinations are stored in the clinical result database in the clinical examination history database. It is to be noted that the specimen is distinguished from the clinical examination and the specimen examination in the medical examination / dock, and the examination in the medical examination / dock is separately stored as the medical examination / dock result.

FIG. 22 shows a flow of associating the clinical test system with the ID card. That is, the ID number of the ID card is read by the card reader of the consultation room terminal of the hospital (17-1), the patient management local database 521 and the patient management common database 623 of the data center 660 are inquired, and the ID number is checked. The existence of user data is confirmed (17-2).
When the user's data is confirmed, the operator's authentication is confirmed using the hospital password (17-
3) It is possible to search the medical examination history.

The display of the medical examination history is as shown in FIG.
Attribute information, consultation date, consultation facility, consultation category (outpatient, medical examination, etc.) of the patient under examination are displayed (17-4). further,
The access right to the test result database is authenticated by the authentication IC card dedicated to the doctor (17-5), and the clinical test result is displayed from the history database 622 in which the clinical test result database is constructed (17-6). Corresponding to FIG. 12, when the search request is sent to the Web server 661, the Web server 661 sends the WebAP server 671.
Then, the WebAP server 671 selects and retrieves the clinical test result corresponding to the patient ID from the history database and sends it to the Web server 661. We
The b server 661 creates a search result screen and sends it to the terminal device. In addition, regarding the display of test results during medical examinations and docks, it is displayed without any particular doctor's authentication.
7-7).

Click on the health checkup dock results
A history database 622 in which the medical examination AP server 672 stores the medical examination / dock results according to an instruction from the server 661.
The medical examination dock result is searched from, the Web page is created by the Web server 661, and the medical examination and dock result is displayed on the terminal device (17-7). The display form of any inspection result can be displayed in various forms such as a time series or a graph.

FIG. 23 shows a display screen of the inspection result. Figure 23 (A) shows a doctor's dedicated clinical test basic screen 3
It is 000. The screen is divided into upper and lower two stages. Attribute information 3010 such as patient name is displayed in the upper left half, and examination conditions 3020 are displayed in the upper right half. In the patient attribute information 3010, a patient name, patient gender, medical record number, reception number, etc. are displayed. The search condition 3020 includes the reception date,
The display item selection menu is displayed. Also, the data display button 3 for displaying the data after setting the conditions
030 and 3031 and a reset button for resetting the conditions are provided.

Inspection data is displayed in the lower part.
The inspection items 3041 are arranged vertically, and the respective data are arranged horizontally. Each inspection item 3041 has a number,
The item name, inspection result (current / previous), unit, and normal value are displayed. In addition, there are check boxes for graph display, radar display, and time series display. The graph, radar, and time series heading characters are selection buttons. When you click the selection button, the check boxes are checked. The data is displayed in the selected format.

FIG. 23B is a time series data screen. This time-series data screen 3100 has the same patient attribute information as the basic screen in the upper part, but has a display date selection unit 3021 as a search condition, and a date can be selected. In the time-series inspection data 3140 in the lower row, each inspection result is displayed in numerical order in the selected inspection date.

FIG. 23C is a time series graph screen of clinical examination. In this time series graph screen 3200, the patient attribute information in the upper row is the same as the basic screen, but the search condition is only the reference date. Lower time series graph data 32
40 is displayed as a line graph together with the numbers of the inspection results.

FIG. 23D is a radar chart screen. The radar chart screen 3300 has the same patient attribute information as the basic screen in the upper row, and is designed to set an inspection date as an inspection condition. Lower radar chart 3
340 is a plot of the data of each item on the inspection date on the radiation, and the inspection date is set as a search condition in the upper column.

FIG. 24 shows an example of the database structure of the data center 660 for clinical examination. This clinical examination database 628 includes a patient information table 62.
8a and a master information table 628b. The patient information table 628a has a header record 628a1 and item record 628a2 for clinical examination consultation data, a header record 628a3 for bacterial examination consultation data, and an item record 628a4. In the master information table 628b, the report master 628b1, the special item master 628b2, the combination item master 628b3, the result value conversion master 628b4, the bacterial species master 628b5,
Bacterial result G value master 628b6, bacteria item master 628
b7, hospital master 628b8, code master 628b
9, item master 628b10, set master 628b1
1. There are bacteria comment master 628b12 and bacteria free comment master 628b13.

The report master 628b1 includes biochemical reports and the like. In the special item master 628b2,
Includes precision measurements. Combination item master 628b3
The combination contents are defined as, for example, 4 items of blood and 3 items of biochemistry. Result value conversion master 6
28b4 is to convert the display such that the display of 1-2 is + and the display of 2-3 is +2. The bacteria result master 628b6 is, for example, “1.
○ It is the master of the sentence of the result such as "A bacterium is recognized".

The bacteria item master 628b7 is a master of the inspection order. The hospital master 628b8 is the same as the hospital facility master. The code master 628b9 is a code indicating the type of bacteria. Item master 628b10
Is the item name of bacteria. Set master 628b11
Is an indication of whether the drug works or not. In the bacteria comment master 628b12, for example, a comment such as "1. O157 is doubtful" is entered.

FIG. 25 shows a flow of association with the medical examination system. The medical examination results are accumulated in the medical examination / dock database 561 of the medical examination system shown in FIG. 11, and this report data is transmitted to the patient management local server 520 of the medical institution by checking the report flag and the local database. It is stored in 521. The user for the medical examination / dock is also accepted by using the ID card. In the case of a new user, a new card is issued and the ID number is registered. Therefore, the data stored in the medical examination / dock database 561 of the medical examination system 560, and the patient management local database 5
The data transferred to 21 is associated with the ID number.

This patient management local database 521
Data in the data center 6 via the Internet
60 is transferred to the patient management common database 523 and converted into the history database 622. This medical examination / docking history is also searched by reading the ID card 550.

That is, the ID card is read by the card reader of the examination room terminal 540C of the hospital (19-
1), refer to the patient management local database 521 and the patient management common server 623 of the data center 660,
The ID number is checked (19-2). After collating the ID numbers, the Web server 66 of the data center 660
A request is made to retrieve the medical examination history of the patient in 1 (19-3), and the medical examination / dock results are displayed from the history database 6271 (19-4).

FIG. 26 shows the processing flow for associating with the medical accounting system. That is, the medical accounting system 550 side is activated (20-1) and starts processing (20
-2), waiting for a connection request from the patient local management server 540 (20-9). When there is a processing request, the data is received (20-4), the transmission / reception history log file is created, the received data is written (20-5), and the medical accounting system table is updated (20-6). , A transmission / reception history log file is created at the time of data transmission, transmission data is written (20-7), data is transmitted (20-8), and a routine for returning to the connection request waiting (20-3) is repeated. When finished, the system is finished (20-9).

First, when there is a patient registration request from the patient management local server 521 (), the medical accounting system 550
Then, get the chart number (), insert the basic patient information into the table of the medical accounting system 550, and register (),
The chart number is notified to the patient management local server 520 (). The table contains past data for accounting such as a patient basic master, a patient supplement master, and a numbering file.

On the patient local management server side, it is checked whether or not there is an error in the input information of the new patient, and if there is an error, it is corrected () and the medical record number is stored in the local database 5
21 is registered, and the completion of registration is notified to the medical accounting system (). Upon receipt of the registration completion notification, the medical accounting system registers the ID number () and notifies the patient management local server of the registration completion (). Patient management local server 5
The basic patient information is returned from 20 (), and the system ends. A log file of transmission / reception history to / from the medical accounting system during this period is created, and the consultation data and the transmission data are written so that it can be checked later. The information on the new patient registered in the local management server 520 of the hospital is registered in the common database 663 and the history database 622 of the data center 660 by batch processing transfer once a day (20-10).

FIG. 27 shows a processing flow for associating with card payment. This is a processing flow for enabling credit card payment at a medical institution supporting the support system, including a credit card payment code and an ID card 550.
By linking with the ID information of, without a credit card,
It enables card payments.

That is, at the time of new registration, it is selected whether or not a card settlement is desired. When the operator wishes to pay by credit card, the operator authenticates and accesses the center server 700 of the credit card card management company from the card issuing terminal of the card issuing management system 544, and transmits the attribute information and ID number of the user. (21-1). The center server 700 of the card management company registers the ID card information, writes the payment code in the ID card information, and sends it to the card management issuing terminal (21-2). The payment code received is registered in the patient information of the local database 521 (21-3), and the ID card 550 is issued. The payment code is a code indicating that card payment is possible.

Payment is made by accepting the ID card at the accounting terminal of the hospital, authenticating the ID information, and if card payment is desired, card payment processing is performed, and payment details are issued (2
1-10, 21-11). The payment details are stored in the local database 521 as historical data, and are transferred from the local database 521 to the common database 623 by batch transfer once a day together with other data (21-12), and data conversion is performed to the historical database 6
It is accumulated in 22 (21-13). Data center 660
Then, the data of the payment details of the card payment is transmitted to the center server 590 of the card management company (21-1
4), the center server 590 of the card management company matches the ID number and the payment code (21-15), and if they match, the card management company pays each hospital (2).
1-16), and issue a bill to the patient together with the usage statement (21-17).

FIG. 28 shows a processing flow for associating with the care support system. The data center configuration of FIG. 12 is a configuration example mainly for medical support of a hospital, and illustrates an example of a configuration in which the care web database server 629 is connected to the data center 660 by a dedicated line. A care information record database 627 is constructed in the center 660, and like the medical institutions, care data is collected from the local database by the local management server of the care support system 525 placed in each care institution.
The nursing care information record database 627, which has been distributed to and is placed in the data center, has been updated.

The ID card is read by the card reader (not shown) of the terminal device of the care facility (22-1), and the local database of the user of the care facility and the user management common server 623 of the data center 660 are queried.
The D number is checked (22-2).

Authentication of the operator of the care facility is confirmed (22
-3), when a search request for the user's consultation history is made to the Web server 661 of the data center 660 (22-4), We
The bAP server 662 retrieves the usage data for each user from the care information record data in the history database 622, and the Web server 661 creates a Web screen of a usage list screen for each user and sends it to the terminal device (2
2-5). The usage list screen is for visiting nursing search (22-
6), visiting care search (22-7), nursing care product search (22)
-8) There is a search menu. In the visiting nursing search, the nursing record reference (22-7a) and the nursing record (22-7b) can be referred to. In the visiting care search, care plan (22-8
You can refer to a) and service record (22-8b). Further, in the care product search, the care product (22-9a) and the result by user (22-9b) can be referred to.

FIG. 29 shows a processing flow for making various reservations / information searches from home using the Internet. The system consists of a user management server 720 that manages member information of service users of medical institutions and welfare institutions, history information such as consultation history, nursing care, and nursing history, and a reservation that manages outpatient appointment and medical examination appointment information. The data center 760 in which the server 710 is installed and the terminal device 740 of each user who can communicate with this data center through the network 730 are provided.

In order to access the data center 760, the ID number and password are used for authentication. An ID card may be read by a card reader for inputting the ID, but since a card reader is not common in personal computers owned by individuals, it is preferable to enter the ID number. User management server 720
A database of member information 721, reception history 722, nursing history 723, etc. is constructed in the information managed by. The reservation information managed by the reservation server 710 includes information on an outpatient reservation 711 and a medical examination reservation 712.
Information of facility selection 713, reserved subject selection 714, desired reservation date input 715, and reservation date decision notification 716 is entered.

As a browsing method, the authority to access the data center is authenticated by the ID number and the password, and the data center 760 is accessed. If you browse the various history information, for example, browse medical history,
The consultation history screen 742a is displayed, and the consultation history is displayed (diagnosis / treatment / prescription / inspection), medical examination result browsing, clinical test result browsing, medical chart browsing, and each result display analysis (time series, graph, each form display, etc.). You can get information.

[0107] Also, when the browsing of the care history or nursing history is selected, the care / nursing history display screen 742b is displayed, and the care / nursing history display (information such as service / care plan / care supplies), health check result browsing, clinical It is possible to obtain information on inspection result inspection, medical record inspection, and analysis of each result display.
When the user clicks on the reservation of the reception date, the reservation server 710 of the data center transmits a selection screen of facilities, reserved subjects, and a desired reservation date to the user terminal, retrieves outpatient reservation information and medical examination reservation information, and determines the reservation date. To notify you.

FIG. 30A shows a flow of association with the password management system. For example, as shown in FIG. 30 (B), the password management system manages the password connected to the patient management data center server 620 via the network, and the password management server 812.
And a staff terminal 811 (not shown) connected to the password management server 812. When the data center server 620 corresponds to the configuration of FIG. 12, for example, the data center server 620 is configured by a Web server 661 and a WebAP server 671.

An ID and password are set for the staff, a login menu for the password management server 812 is displayed (24-1), and when the staff ID and password are authenticated (24-3), password management is performed. The data of the issuing menu is transmitted from the server 812 to the staff terminal, and the issuing menu is displayed (24-4). On the issuing menu, a search screen for a password issuance target person is displayed (24-5). Issued by Data Center 660
A list is displayed from the common database 622 of. For example, a new display is added next to the patient list. The person to be issued is selected, the member information is read from the common database 622 and displayed on the staff terminal (24-6).

There is a password issue history menu in the member information. When the issue history menu is selected and requested, the password management server 812 reads the issue history information from the password database 813 and displays it on the staff terminal (24- 7). The issuance history is confirmed, and if not issued, a new issue is sent to the password management server 812, and if reissued, a request for reissue is sent to the password management server 812. The password management server 812 automatically creates an unused password based on the issuance request (24-8), stores it in the database 812 in association with the member information, and sends the registration result to the staff terminal 811 for the staff. The registration result is displayed on the terminal 811, and the issuance result is confirmed (24-9).

After confirming the display, when the staff terminal 811 sends a notification issuance request to the password management server 812, the password management server 812 issues a password notification (24-10). The password is issued, for example, by reading the mail address from the member information in the database and transmitting the mail, or by reading the address and name and printing out on a printer for direct mail.

FIG. 31 shows a processing flow for associating with the security system. Security system that automatically locks the facility door for crime prevention 8
In the case where the ID card 20 is provided, the opening and closing of the door is controlled by using the ID card as a card key by associating the ID card with the security system 820. This ID card is created as an employee ID card when a company joins the system of the present invention as a corporate member, and the facility is, for example, the facility of the company. Security information 26 for identifying the authority to use the facility is written in the security system along with the ID number. Security information 2
6, the users are divided into groups by combining the ID card type and block information.

For example, 11 is a general card, 14 is an almighty, 31 is a card for a management company,
Differentiate into multiple types. For example, the authority to release the security system is distinguished by time, and the security system functions when the time is over. Also, regarding the blocks of the facility, usable blocks are divided, for example, 0 is a common part, 1 is an A dedicated part, and 2 is a B dedicated part. The security system can be divided into various groups. For example, the blocks to be inserted for each card type may be determined and specified as a group, or even if the types of each card are the same, by combining the block information, a group that differentiates the blocks to be inserted even though they are the same type It is also possible to specify.

When a new ID code is registered / issued (25-11), the ID number is registered in the local database 521 of the user management server 520 of each hospital, and at the same time, the ID number and the security information 26 are stored. Sent to the local management server 820 of the security system. The local management server 820 of the security system is
The identification information and the security information are registered in the local database, and the data is converted and transmitted to the center server of the security system 830 (25-12).

The security system 830 receives the converted identification information and security information, stores them in the crime prevention management database in correspondence with the door opening / closing crime prevention system of each facility based on the security information, and through the distribution / operation terminal of the facility. It has a function of distributing the information of the identification card to the card register 834 which registers the card key for the door opening / closing crime prevention system. The facility is provided with a card reader, and the ID number of the ID card is read by this card reader (25-1), and when authenticated (25-2), the security information registered in the card register 624 is converted into security information. Based on this, locking / unlocking of the door opening / closing security system and alarm are controlled, and the gate of the block is selectively opened according to the setting in the security information (25-3).

FIG. 32 is a conceptual diagram of a "medicine-diagnosis" network for linking a pharmacy with each medical institution. That is, a database including in-hospital local data 4111 and prescription data 4111 regarding the user is built in the computer 4110 of the medical institution 4100, and the prescription data 4111 is transferred to the data center 4300 via the Internet 4200.

The patient data 4 is stored in the data center 4300.
As 310, a database including prescription data 4311 and pharmacy-specific prescription data 4312 is constructed. The data transfer from the medical institution 4100 to the data center may be carried out by batch transfer once a day together with other data, but in the case of an out-of-hospital pharmacy, it is preferably carried out in real time. The outpatient prescription pharmacy 4400 is also provided with a computer 4410 connected to the data center 4300 via the Internet 4200. The computer 4410 is provided with a card reader for reading an ID card. By reading the ID card 4000, prescription data corresponding to the ID number is searched.

When the prescription is searched, the medicine is prescribed according to the prescription and the prescription data 4411 is stored in the computer 44.
Register in the database managed by 10. Prescription issue data 4412 is registered as the prescription data.
In addition, general pharmacies 4500 and Internet 4200
A computer 4510 connected to the data center 4300 via the computer is provided. This computer 451
0 is also provided with a card reader for reading the ID card 4000. By bringing the ID card 4000 by the user, the data center 43 can be accessed via the Internet 4200.
By accessing 00 and inquiring about the prescription from the reception history, the pharmacist can sort out the appropriate over-the-counter drug for the user.
You can choose.

Further, the user's house 4600 is also provided with a computer 4610 connected to the data center 4300 via the Internet 4200, and can access the data center to browse his / her prescription data. It is also possible to request delivery to the out-of-hospital pharmacy 4400 via the Internet. When you request home delivery, the medicine will be delivered from the outpatient pharmacy based on the prescription,
The courier searches / inquires the prescription on the mobile communication terminal, confirms that the delivery is correct, and registers for receipt.

[0120]

As described above, according to the present invention,
By using the ID card, a user who has been provided with a medical service or nursing / nursing service can easily browse his / her medical examination history, medical record, nursing care, and nursing history. In particular, even when using a plurality of service providing organizations, it is possible to easily browse one's own usage history with one identification card.

[0121] In addition, with one identification card, patient consultation history,
Nursing / nursing history information can be shared, and efficiency at medical and welfare sites such as "hospital-hospital cooperation", "hospital-medical care cooperation", and "medical care-medical care cooperation" can be achieved. Therefore, it is possible to reduce wasteful medical expenses and facilitate follow-up of service users,
Appropriate medical and nursing / nursing services are available. Furthermore, time series data of various inspection results can be utilized. Also,
Services such as virtual medical care and remote treatment can also be easily used by utilizing the Internet network.

[Brief description of drawings]

FIG. 1 is a conceptual diagram of a medical / welfare related service support system of the present invention.

FIG. 2 is a block diagram of the terminal device of FIG.

FIG. 3 is a schematic diagram of a network configuration of the present invention.

FIG. 4 is a schematic diagram of a “disease-diagnosis” network configuration.

FIG. 5 is a diagram showing a transition of a reception history search screen.

6A and 6B are diagrams showing a transition of a reception history search screen.

FIG. 7 is a diagram showing a basic system configuration example of the present invention.

FIG. 8 is a diagram showing another system configuration example of the present invention.

FIG. 9 is a diagram showing another system configuration example of the present invention.

FIG. 10 is a diagram showing another system configuration example of the present invention.

FIG. 11 is a diagram showing a system configuration example taking one hospital as an example.

FIG. 12 is a diagram showing a configuration example of a data center.

13A is a diagram showing a data table stored in an ID card, and FIG. 13B is a diagram showing a data table stored in a local database and a common database.

FIG. 14 is a diagram showing an ID card reception / issue processing flow.

FIG. 15A is a diagram showing a data table storing a medical examination history, and FIG. 15B is a conversion table for registering the medical examination history and common data in a data center.

FIG. 16 is a diagram showing a patient management database structure.

FIG. 17 is a diagram showing a database structure of an electronic medical record.

FIG. 18 is a diagram showing a processing flow for associating an electronic medical chart system with an ID card.

FIG. 19 is a diagram showing a system configuration example of an image analysis center.

FIG. 20 is a diagram showing a processing flow for associating an image analysis system with an ID card.

FIG. 21 is a schematic diagram of a network for clinical laboratory ordering.

FIG. 22 is a diagram showing a processing flow for associating a clinical examination system with an ID card.

23A to 23D are diagrams showing display examples of a clinical examination screen.

24 (A) and (B) are diagrams showing a clinical examination database structure.

FIG. 25 is a diagram showing a processing flow for associating a medical examination system with an ID card.

FIG. 26A is a diagram showing a processing flow of associating a medical accounting system with an ID card, and FIG. 26B is a diagram showing a procedure of associating work of FIG.

FIG. 27 is a diagram showing a processing flow of associating a card payment with an ID card.

FIG. 28 is a diagram showing a processing flow for associating a care support system with an ID card.

FIG. 29 is a diagram showing various reservation and information search processing flows via the Internet.

FIG. 30 is a diagram showing a processing flow for associating a password management system with an ID card.

FIG. 31 is a diagram showing a processing flow for associating a security system with an ID card.

FIG. 32 is a schematic diagram of a “medicine-diagnosis” network.

[Explanation of symbols]

10 Medical / Welfare Service Support System, 60 Data Center, 20 User Management Server 20, 30 Network 40 Terminal Device 50 ID Card (Identification Card) 21 Database, 22 Search Means 40A, 40B, 40C Terminal Devices Provided at Medical Institutions 40X, 40Y, 40Z Terminal device 40H, 40I provided in welfare institution User's personal terminal device 41 Device body, 42 reader, 43 display device, 44 CPU, 45 memory, 46 Input device 42a Display screen (medical information) 42b Display screen (nursing, care information)

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[Procedure amendment]

[Submission date] July 23, 2002 (2002.7.2)
3)

[Procedure Amendment 1]

[Document name to be corrected] Drawing

[Correction target item name] All drawings

[Correction method] Change

[Correction content]

[Figure 1]

[Fig. 2]

FIG. 6B

[Figure 3]

[Figure 4]

[Figure 5]

FIG. 6A

[Figure 7]

[Figure 8]

[Figure 9]

[Figure 10]

FIG. 11

FIG. 19

[Fig. 12]

[Fig. 13]

FIG. 14

FIG. 15

FIG. 16

FIG. 17

FIG. 18

FIG. 20

FIG. 21

FIG. 22

FIG. 23

FIG. 24

FIG. 25

FIG. 26

FIG. 27

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FIG. 32

─────────────────────────────────────────────────── ─── Continuation of front page (51) Int.Cl. ⁷ Identification code FI theme code (reference) G06F 15/00 330 G06F 15/00 330B 330G 17/30 110 17/30 110F 170 170Z G06K 17/00 G06K 17 / 00 L 19/00 19/00 Q (72) Inventor Takafumi Koubun 3-673 Tenjin, Konosu City, Saitama Prefecture F-term in Medica Japan (Reference) 5B035 AA14 BB11 BC00 BC01 5B058 CA40 KA02 KA06 KA37 YA20 5B075 KK07 ND20 NK02 PP06 PP22 PQ02 UU40 5B085 AE12 BA06 BG02

Claims (32)

[Claims] 1. A portable identification card to which identification information of a user who uses a service of a service provider related to medical care and welfare is attached, a client terminal device, and communication with the client terminal device through a network. A user management server that manages a usage history of a user's service providing organization, wherein the client terminal device reads the identification information of the identification card, and the identification information read by the user management server. And send a usage history browsing request,
Means for receiving and displaying usage history information sent from the user management server, wherein the user management server stores a database in which the usage history information of the user is stored in association with identification information of the user, and the client And means for receiving the browsing request transmitted from the terminal device, authenticating the identification information of the user, acquiring the usage history information corresponding to the identification information from the database based on the identification information, and transmitting the usage history information to the terminal device. Medical and welfare related service support system characterized by being present. 2. The medical / welfare related service support system according to claim 1, wherein the client terminal device can directly input the identification information of the user. 3. The medical / welfare related service support system according to claim 1, wherein the user management server is placed in a data center, and the client terminal device can communicate with the user management server via the Internet. . 4. There are a plurality of service providing organizations, and the identification information common to all service providing organizations is used as the user identification information, and the information is sent to the database of the user management server for each service providing organization. The medical history according to claim 3, wherein the incoming usage history is collectively stored for each user based on the common identification information, and the history information in all the service providing organizations of the user can be searched based on the identification information.・ Welfare service support system. 5. A local user management server capable of communicating with a user management server of the data center via a network is provided in each service providing organization, and the local user managing server uses the service providing organization. A local database for accumulating the user's attribute and history information together with the user's identification information, and means for transmitting the user's attribute and history information accumulated in the local database to the user management server of the data center. The user management server of the data center comprises means for receiving user attributes and history information transmitted from all service providers and registering history information for each user in the database. The medical / welfare related service support system described. 6. The client terminal device is a terminal device of a user, and the user management server sends the history information of the user to the terminal device owned by the user based on a search request from the user himself. The medical / welfare related service support system according to any one of 1 to 5. 7. The medical / medical device according to claim 6, wherein the user's terminal device has no reading means and is a device for directly inputting identification information.
Welfare service support system. 8. The client terminal device is a terminal device of a service provider, and the user management server provides user information to the terminal device of the service provider based on a request from the service provider. The medical / welfare related service support system according to any one of 5 above. 9. The terminal device of the service provider is a terminal device of the examination room of the medical institution, and the user management server transmits the history information of the patient to the terminal device of the examination room based on the search request from the doctor. The medical / welfare related service support system according to any one of claims 1 to 5. 10. The terminal device of the service provider is a mobile communication terminal carried by a caregiver or a nurse of a welfare institution,
The medical / welfare support service system according to any one of claims 1 to 5, wherein the user management server transmits the history information of the service user to the mobile communication terminal based on a search request from a caregiver or a caregiver. 11. The service provider terminal device is a reception terminal, and the user management server transmits user information based on a search request from the reception terminal. Medical and welfare related service support system. , 12. The identification information is written on the identification card by magnetic information and bar code information.
1. The medical / welfare related service support system according to any one of 1. 13. The identification card has contents such as a medical examination ticket, a medical examination card, an employee ID card, etc. written therein together with the attributes and identification information of the patient. The medical / welfare related service support system described. 14. The medical record according to claim 1, wherein the history data of the user stored in the database is the attribute data of the user and the usage history of each data service institution.・ Welfare service support system. 15. The history data in a medical institution includes user attribute data, treatment / examination / prescription data, medical examination data, image data, and electronic medical chart data. Medical / welfare related service support system. 16. The user management server has a database for storing reservation information, and means for receiving a reservation request from a terminal device to determine a facility and a reservation date, and notifying the determined reservation information to each terminal device. The medical / welfare related service support system according to claim 3 or 4, which is provided. 17. The medical / welfare related service support system according to claim 15, wherein the image data also includes an image analysis result analyzed by a specialist at an image analysis center. 18. The medical system according to claim 17, wherein the image analysis center is connected to the data center via a network, and the image analysis center includes a server for distributing the image analysis result to the user management server of the data center.・ Welfare service support system. 19. The medical welfare service support system according to claim 15, wherein the inspection data includes analysis data of a clinical inspection result performed by an inspection institution. 20. The medical care according to claim 19, wherein the inspection organization is connected to the data center via the Internet, and the inspection organization is provided with a server for distributing the analysis data of the inspection result to the user management server of the data center.・ Welfare service support system. 21. The medical / welfare related service support system according to claim 15, wherein only the doctor has the authority to access the test result data. 22. The data center is provided with a server that searches the database for necessary data based on an electronic medical record search request from a terminal device of each medical institution, creates an electronic medical record, and transmits the electronic medical record to the terminal device. 16. The medical / welfare related service support system according to claim 15. 23. The medical examination system and the local user management server can communicate with each other via a network, and the local user management server sends identification information to the medical examination system when a new user is registered, and the local medical examination system locally Claims are provided with a function of storing medical examination data transmitted to the user management server in association with identification information in a local database, and transmitting the medical examination data stored in the local database to the user management server of the data center. Item 15. The medical / welfare service support system according to Item 15. 24. The local user management server is capable of communicating with the medical accounting system via a network, sends identification information to the medical accounting system when a new user is registered, receives a medical record number from the medical accounting system, and receives a local database. The medical / welfare related service support system according to claim 15, further comprising means for registering the medical record number and the card identification information in association with each other. 25. The local patient management server reads all the existing patient lists of the medical accounting system at the time of system introduction and registers them in the database, and retrieves the existing patient list according to the user's new registration request from the reception terminal device, 16. The medical / welfare related service support system according to claim 15, wherein when there is a target person, the patient attribute data is read from the past patient list of the database, and the user is newly registered with an identification number. 26. The local patient management server reads all past medical examination user lists of the medical examination system at the time of system introduction and registers them in the database, and uses the medical examination according to a new registration request of the user from the reception terminal device. 16. The medical care according to claim 15, wherein the person list is searched, and if there is a target person, the user attribute data of the medical examination user list is read out, and the user is newly registered with an identification number. Welfare service support system. 27. A user management server of a data center and a card management center of a credit card company can communicate with each other via a dedicated line, and the user management server identifies a user registered in advance in association with a database at the time of payment. The payment processing means for transmitting the information and the payment code of the credit card to the card management center, and sending the payment details to the card management center based on the comparison result from the card management center for payment processing. Medical / welfare support system described in. 28. Each medical institution has a card issuance management terminal connected to a local user management server via a network, and the card issuance management terminal is connected to a card management center of an external credit company by a dedicated line. When the user wants to make a card payment, the card issuance management terminal sends the identification information of the user who wants the card payment to the card management center, and the card management center sends the credit card The local user management server has means for receiving the payment code information, associating the identification information with the payment code, and sending it to the local management server. The local user management server registers the payment code information transmitted from the card issuing management terminal in the local database. The medical / welfare related service support system according to claim 6, further comprising means. 29. A password management system for managing a password for accessing a patient management server of a data center, wherein the password management system manages a patient based on a password issuance request from the patient management server of the data center. The medical / welfare related service support system according to claim 6, which has a function of receiving new registrant information from the server, automatically creating a password, and issuing a password notice. 30. The user management server of each facility and the local management server of the security system are connected via a network, and the user management server identifies the security information together with the identification information when registering or issuing a new identification card. It is added to the card and the identification information and security information are sent to the local management server of the security system. The local management server of the security system registers the identification information and security information in the local database and converts the data to the security system center. The security system center server receives the converted identification information and security information, and based on the security information, the center server of the security system responds to the door opening and closing security system of each facility and the security management database. 7. The medical / welfare support system according to claim 6, which has a function of storing the identification card information in a card register for registering a card for a door opening / closing crime prevention system of a facility through a distribution / operation terminal. 31. A database in which the use history information of users in a plurality of service providers related to medical care and welfare is associated with common user identification information through all service providers and stored together for each user. A means for receiving a browsing request from the client terminal device, authenticating the identification information of the user, and acquiring and transmitting the usage history information corresponding to the identification information from the database based on the identification information. A characteristic user management server. 32. A local database for accumulating attribute and history information of a user who has used a service providing organization together with identification information of the user, and the data accumulated in the local database is regularly stored in a user management server of a data center. And a means for batch transfer to the local user management server.