JP2004318751A - Medical practice time measurement system and doctor/hospital labor division organization system - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a medical practice time measurement system and a doctor/hospital labor division organization system, which have excellent impartiality, measure a medical practice time of a doctor or the like in a large hospital tending to exceed a prescribed medical examination time, construct an efficient labor division system between doctors or between hospitals by using the measurement time, and accurately measure a results contribution degree of an individual such as a doctor by interlocking with medical treatment fee point totaling. <P>SOLUTION: This system has: a card reader 12 reading a hospital card; a medical practice time data production means 17; a medical practice time monthly results totaling means 18; a medical practice standard time calculation means 19; an extraction means 20 of medical practice with standard time reduction as a target; an extraction means 21 of the medical practice with inter-doctor labor division reorganization as a target; an extraction means 22 of the medical practice with inter-hospital labor division reorganization as a target; an extra-position medical examination distribution test calculation means 23 with an all-round doctor as a target; a medical treatment fee calculation means 24; and a medical practice division plan setting means 27. <P>COPYRIGHT: (C)2005,JPO&NCIPI

Description

[0001]
BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a medical practice time measuring system for measuring the medical practice time of a medical professional such as a doctor in a hospital, and an efficient division of labor between doctors by utilizing the measured time. The present invention relates to a doctor hospital division of labor organization system that accurately measures the contribution of medical professionals to performance by establishing a division of labor system between hospitals and linking it with the calculation of medical remuneration points.
[0002]
2. Description of the Related Art Conventionally, medical professionals such as physicians at hospitals are divided into physicians belonging to medical departments and specialists such as X-ray examinations. The basic pattern is to take charge of afternoon hours. Many hospitals use an appointment system for re-examinations in order to equalize the number of patients treated. Further, an additional basic pattern of doctors is when the number of patients is too large and the medical care system cannot be turned around with the current personnel. Although the prescribed number of doctors and the number of doctors at hospitals are regulated by the facility standards of the Medical Law, according to a survey, the number of hospitals that meet the legally required number of doctors is small. The fact is that the number of doctors is quite short of the number of patients. Until now, hospitals have introduced medical cards to increase the efficiency of medical expenses calculation, but this did not directly support the efficiency of medical professionals such as doctors. It is determined whether an optimal number of medical professionals are arranged because medical data such as doctors and other medical professionals are not managed in detail because no past medical record data has been accumulated. There was no data.
[0003] In addition, due to the revision of the medical fees in April 2002, the medical expenses of hospitals that do not meet the institutional standards such as the number of surgical cases will be reduced to 70% of the regular medical expenses, and hospitals will become specialized hospitals. And hospital management skills have led to the selection of hospitals, but most of the hospitals have their current strengths and which medical fields to invest in the future. He did not have objective data to help him make a decision.
[0004]
Among the prior arts, Japanese Patent Application Laid-Open No. 2002-279132 discloses an invention for creating an efficient team formation plan by focusing on the capabilities of workers. A program has been proposed. In a workplace where a large number of people are sharing multiple duties, if the capabilities of the workers are not uniform due to differences in the work content and the number of duties that each worker can handle, the required minimum This is a system for creating a staffing plan or team formation plan for the number of people. The target work of this system is a long-term span job with a collective order contract, and the team formation cost is assumed to be zero, but the best doctors are formed for each patient's medical treatment at the hospital It is too expensive and unsuitable for application. In addition, the optimization conditions of this system are applied only once at the time of staffing planning, but since the medical treatment of hospital patients occurs repeatedly throughout the day, the optimization problem must be solved many times, and as a result, The collection of the optimal solutions for each patient was not a solution to the problem of optimal allocation of time allotted to medical professionals such as doctors in the hospital as a whole. As a similar known case of a medical time management system using a computer, there is a medical time management system in JP-A-11-120225. This makes it possible to predict and calculate the number of patients waiting for medical treatment on the day and the end time of medical treatment from the patient's queue of the day, past patient reception result information and standard time required for medical treatment, and adjust and manage the doctor's medical treatment pace distribution. System. The problem of this system is the problem of allocating time allotted on a physician personal basis, and not the physician assignment or medical time distribution among a plurality of physicians in the department to which the doctor belongs or the entire physician in a hospital.
[0005] The problem of the optimal assignment of medical professionals such as doctors is not to arrange the optimal staffing on the premise of work as in "Personnel assignment system and staff assignment program" in JP-A-2002-279132. Rather, as in a car production line, patients who flow in front of medical professionals such as doctors who wait in each of the divided roles are given medical treatment in a minimum amount of time. In other words, solving the optimal time allocation problem of whether a patient can be treated. How to efficiently allocate finite medical hours for medical professionals such as doctors to stabilize management as a hospital. For that purpose, it is necessary to know the specialty fields of medical professionals such as doctors who are the members of the hospital, and also to know the time required for medical treatment for each doctor. Also, medical professionals such as physicians will have great pride in their knowledge and skills, so it will be difficult to relocate or change the division of labor for division of labor. However, if the assumption that the division of labor at the hospital contributes to the management stability of the hospital as a result and that the contribution of one's business performance is measured and evaluated properly is satisfied, the division of labor is also cooperative. Must be.
SUMMARY OF THE INVENTION The present invention has been made to solve such a problem, and a medical practice time measuring system for measuring the medical practice time of a medical professional such as a doctor in a hospital, and utilizing the measured time. Provide a doctor-hospital division of labor system that accurately measures the contribution of medical professionals by linking with the calculation of medical remuneration points by establishing an efficient division of labor between doctors and between hospitals. It is an object.
[0007]
A feature of a medical practice time measuring system according to claim 1 of the present invention is a medical practice time measuring system for measuring a medical practice time of a medical professional such as a doctor in a hospital. , A medical practice type code setting change means for setting a medical practice to be measured, a card reader for reading a hospital card of a medical professional such as a physician or a patient, and, in the case of a patient, after reading the card from the reception to leaving the hospital Medical action time data creation for creating a medical action time data file that records the medical action type, medical action staff, medical action start time, end time, interruption time, and actual medical action time Means, medical practice time monthly results totalizing means for totalizing the number of medical activities per month, time, and average time for each physician belonging to each medical department, and the medical practice time data Medical practice standard time calculation means for creating a medical practice standard time data file for calculating the average time of medical practice data for several months from the file and calculating and recording the standard time for each physician belonging to each medical department It is in.
[0008] By adopting such a configuration, once the classification setting of the medical practice type of a medical professional such as a physician and the role carrier system of the medical professional in a hospital or a medical department are determined, After that, at the start and end points of the patient's visit to the hospital and performing the medical practice, simply pass the patient's hospital card through the card reader and select the type of medical practice, and the medical professional's medical practice time data is automatically created, This is the basic data for analyzing and examining the allocation, division of labor, and time allocation of medical professionals such as doctors. In addition, by using the accumulated medical practice time data, it is possible to obtain basic data that can be used to calculate the number of medical procedures performed by medical professionals on a monthly basis, the time and average time, and to know the load situation. The average time for each medical practice of the medical professional is calculated from the medical practice time data of the medical professional, and by using this as the standard time, basic data is obtained that enables the medical professional to proceed with efficient division of labor.
The feature of the doctor hospital division of labor system according to the second aspect of the present invention is that the medical practice standard time in the first aspect is that the equipment used for the medical practice, the degree of proficiency in them, the amount of experience of the medical practitioner, etc. When the amount of knowledge raises or lowers the medical practice time, the average time is calculated for several months of medical practice data in order to equalize the fluctuations due to patient factors, and the average time is calculated for each doctor and medical department. The point is to calculate the standard time.
[0010] By adopting such a configuration, the standard time for each doctor and each medical department and each medical practice depends on the machinery and equipment of the hospital, but also the proficiency level of those machinery and the medical professional. It can be used as an index that objectively represents the amount of experience and the amount of knowledge.
A feature of the doctor hospital division of labor organization system according to claim 3 of the present invention is that a medical practice time data file is created in the medical practice time measuring system according to claim 1 and the measured time is used. Build an efficient division of labor between physicians, build a division of labor between hospitals by referring to the medical practice standard time data file for each hospital, and improve the contribution of healthcare professionals to performance by linking with the medical remuneration score data file. A doctor / hospital division of labor system that accurately measures, which is a means of extracting medical practices that targets standard time reduction, a section of extracting medical actions that targets division of labor between doctors, and a target of division of labor between hospitals. Means for extracting medical practice, means for allocating non-affiliated medical care targeting multi-skilled doctors, means for calculating medical fees for doctors and hospitals, A code setting changing means, in that it has a medical practice standards time setting changing means, and a medical practice sharing plan setting changing means.
[0012] By adopting such a configuration, which medical practice should be aimed at shortening the standard time, which medical practice should promote division of labor between doctors, and division of labor between hospitals? Get help from a multidisciplinary physician belonging to another medical department in a medical department where excessive load is placed on doctors etc. in terms of target output for questions such as which medical action to reorganize and medical time To answer questions such as whether it is possible to do so and whether it is possible to grasp the degree of contribution to medical fees in conjunction with medical practice in order to obtain the cooperation of doctors etc. in organizing division of labor of doctors and hospitals Is output. This makes it possible to progressively optimize the division of labor of medical specialists such as doctors and the division of labor in hospitals, using the actual time data and the standard time data of medical practice.
[0013] The feature of the doctor hospital division of labor organization system according to claim 4 is that the medical practice standard time data file for each hospital according to claim 3 is provided. The standard time data that is the smallest among the standard times of doctors with the same action type code is extracted and recorded, and the medical action standard time data of other hospitals is collected and recorded through information exchange between hospitals or through external purchase On the point.
[0014] By adopting such a configuration, the medical practice standard time data of the hospital or other hospital depends on the mechanical equipment of the hospital, but the medical professional standard time data of the medical professionals owned by the hospital. It can be used as an index that objectively represents the proficiency level, the amount of experience, and the amount of knowledge.
[0015] A feature of the doctor hospital division of labor organization system according to claim 5 is that a target destination for a question as to which medical action should be aimed at reducing standard time is output. From the medical practice time data file, among the medical practices in the hospital, the top ten medical practices from the most frequently performed, and especially the top ten medical practices from the large total required time, especially the average time is large The top 10 medical actions are extracted from the medical actions, the duplicated ones are excluded, the average number and standard deviation of the number of medical actions by doctor and the time data are calculated, and the medical actions by department Calculate the average value and standard deviation of the number of cases and time data, and calculate the average number and standard deviation of the number of cases and the time data of the medical practice of the entire hospital, and calculate the average value and standard value of the number of cases and time data in each case. The deviation is printed out. Each of the extracted medical actions has a long total time or a high average time.If the standard time can be reduced by the division of labor by doctors, etc., it is possible to shorten the medical treatment time of the entire hospital. Exhibits tremendous effects. The standard deviation indicates the degree of variation in data, and for medical practices with a large degree of variation between physicians, the medical practice time between physicians can be equalized by organizational support such as division of labor, and the standard time can be reduced. Indicates that there is much room.
A feature of the doctor hospital division of labor organization system according to claim 6 is that a target destination for a question as to which medical practice should proceed division of labor between doctors is output. From the medical practice standard time data file, the average value and the standard deviation of the medical practice standard time of the doctor who has the same department and medical practice type code are calculated, and the standard deviation value of the medical practice standard time is calculated for each department. It is characterized in that the top ten medical actions are extracted from the largest ones and the standard time for each doctor of the medical action is printed out. The standard deviation indicates the degree of data variability, and medical practices with large variances among physicians are taken from doctors with a large standard time and assigned to doctors with a small standard time. Indicates that there is much room for shortening. Each of the extracted medical actions has a large variation in the standard time between doctors, and if the division of labor between doctors can be planned, it will have a tremendous effect on shortening the medical treatment time of the entire hospital.
Further, a feature of the doctor hospital division of labor organization system according to claim 7 is that a target destination for a question as to which medical practice should proceed division of labor between hospitals is output. From the medical practice standard time data file storing the medical practice standard time data of the hospital and other hospitals, the average value and the standard deviation of the medical practice standard time of the hospital having the same medical department and medical practice type code are calculated. The top ten medical actions are extracted from those having a large standard deviation value of the medical practice standard time for each medical department, and the standard time of each medical practice for each hospital is printed out. The standard deviation represents the degree of data variability.Medical activities with large variances between hospitals are taken up from hospitals with large standard time and allocated to hospitals with small standard time, resulting in division of labor between hospitals. This means that there is much room to shorten the consultation time. All of the extracted medical practices have large variations in the standard time between hospitals, and if the division of labor between hospitals can be planned, it will have a tremendous effect on shortening the medical hours at all related hospitals.
A feature of the doctor hospital division of labor organization system according to claim 8 is that, in a medical department where an excessive load is placed on a doctor or the like in terms of medical treatment time, the multi-purpose physician belonging to another medical department receives the help. Is to output a proposed answer to the question of whether it is possible or not. After adding the standard time for medical practice that can be performed by a multi-purpose physician other than the department to which the medical practice belongs to the medical practice standard time data file, the medical practice standard time of the doctor who has the same medical practice type code regardless of the department to which the department belongs Calculate the average value and standard deviation of the medical practice, extract the top 10 medical practices from those with the largest standard deviation of the medical practice standard time for each medical department, and print out the standard time of each doctor for the medical practice. It is characterized by. The standard deviation indicates the degree of variability in data, and medical practices with large variances among doctors can be taken from physicians with large standard times and can be performed by physicians belonging to other medical departments as long as physicians have small standard times. This indicates that there is much room for shortening the total consultation time of hospitals by the division of labor among doctors, which allocates jobs as much as possible. All of the extracted medical actions have large variations in the standard time among doctors, and between doctors who allocate the work of a doctor with a large standard time to a multi-skilled doctor with a small standard time who belongs to another medical department. If it is possible to organize the division of labor, it will have a tremendous effect on shortening the total medical care time of the hospital.
A feature of the doctor hospital division of labor system according to the ninth aspect is that the degree of contribution to medical treatment fees is grasped in conjunction with medical practice in order to obtain cooperation from doctors and the like in promoting division of labor between doctors and hospitals. As a response to the question of whether or not it is possible, a medical treatment fee is calculated. From the medical practice time data file, calculate the medical practice count for each doctor or the entire hospital, refer to the medical reimbursement score data file, calculate the medical remuneration score for each doctor and the entire hospital, and print the medical reimbursement performance table If there is a change in the number of medical practices for each doctor or for the hospital as a whole by shortening the standard time or reorganizing the division of labor between doctors or reorganizing division of labor between hospitals or allocating medical treatments outside the affiliation of a multi-purpose doctor, Change the number of medical actions for each doctor or for the entire hospital to the changed value, refer to the medical remuneration score data file again, calculate the medical remuneration points for each doctor and for the entire hospital, and print the medical remuneration change table It is characterized by outputting. This allows medical professionals, such as doctors, to reorganize hospitals and contribute to the stable management of hospitals, even if the reassignment or division of work is promoted for the purpose of division of labor. Since the premise that they are properly measured and evaluated will be satisfied, they will be cooperative with the division of labor.
[0020]
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS An embodiment of a medical practice time measurement system and a doctor hospital division of labor organization system according to the present invention will be described below with reference to the drawings.
FIG. 1 shows a configuration diagram of a medical practice time measurement system and a doctor hospital division of labor organization system 1 as an example of this embodiment. As shown in FIG. 1, this embodiment mainly includes a main memory 4 in which a medical practice time measurement program 2 and a doctor hospital division of labor organization program 3 are stored, and data necessary for medical practice time measurement and doctor hospital division of labor division. , A central processing unit 6 that performs various arithmetic processing and control processing in accordance with instructions from the medical practice time measurement program 2 and the doctor hospital division of labor organization program 3, and various conditions. It comprises an input / output device 7 for outputting settings and results, a hospital card 10 for medical professionals such as doctors and patients, and a card reader 12 for reading hospital cards.
The medical practice time measurement program 2 and the doctor hospital division of labor organization program 3 issue various commands to execute the medical practice time measurement system and the doctor hospital division of labor organization system 1. The file storage device 5 stores a medical practice time data file 13, a medical practice standard time data file 14, a medical practice standard time data file 15, a medical remuneration score data file 16, a medical practice time measurement and a doctor hospital division of labor. Necessary data is filed.
The central processing unit 6 creates a medical practice time data file 13 for each medical practitioner from the start and end times of the medical practice read from the card reader 12 in accordance with the instructions of the medical practice time measurement program 2. The medical practice time data creating means 17, the medical practice time monthly result totaling means 18 for totalizing the number, the time and the average time of the medical practice in one month for each physician belonging to each medical department, and the medical practice time data file 13 Medical practice standard time calculation means 19 for calculating a medical practice standard time data file 14 for calculating and recording the average time of medical practice data for several months and calculating and recording the standard time for each medical department and physician; A standard medical practice standard time data file 15 is created from the standard medical practice standard time data file 14 and the standard medical practice standard time data of other hospitals. In accordance with the hospital-specific medical practice standard time calculating means 20 and the instructions of the physician hospital division of labor organization program 3, the medical practice targeting the standard time reduction for extracting 30 medical practices targeting the standard time reduction from the medical practice time data file 13 An act extracting means 21; a medical act extracting means 22 targeting the inter-doctoral division of labor which extracts ten medical acts targeting the inter-doctor division of labor from the medical practice standard time data file 14; Extraction means 23 for medical practice targeting reorganization of labor between hospitals that extracts 10 medical practices targeting reorganization of labor between hospitals from the medical practice standard time data file 15 and affiliation from the standard time data file 14 of medical practice Extract 10 medical actions targeting multi-skilled doctors who are able to perform medical procedures outside the department Calculating the number of medical actions for each physician or the entire hospital from the medical practice time data file 13 and the medical practice time data file 13, referring to the medical remuneration score data file 16, It functions as a doctor / hospital medical fee calculation means 25 which calculates the medical fee score for each and the entire hospital and prints out the medical fee record table.
An input / output device 7 for setting various conditions and outputting the results is a medical action type code setting for newly setting, changing or abolishing the type of medical action data stored in the medical action time data file 13. Change means 26, medical practice standard time setting change means 27 for issuing an instruction to overwrite and update the standard time data calculated by medical practice standard time calculation means 19 in medical practice standard time data file 14, and monthly basis of medical practitioner The medical action sharing plan setting changing means 28 for setting and changing the medical action sharing plan is configured to function.
Next, the operations of the medical practice time measurement program 2 and the doctor hospital specialization organization program 3 by the medical practice time measurement system and the doctor hospital division of labor organization system 1 according to the present embodiment will be described with reference to FIGS. .
FIG. 2 is a flowchart showing the overall operation of the medical practice time measuring system and the doctor hospital division of labor organization system 1 in this embodiment. The response differs depending on whether the patient who visited the hospital is a new patient or a revisited patient (step 1). If the patient is a new patient, the patient does not have a hospital card to be used in the system, so the patient fills out the first medical certificate, registers patient information (step 2), and issues a new hospital card (step 2). 3). The patient who has been issued a new hospital card goes to the reception of the examination room. The medical professional reads the patient's hospital card at the beginning and end of the procedure (step 4). A revisited patient who already has a hospital card goes directly to step 4. The medical practice data read from the hospital card is recorded in the medical practice time data file 13 by the medical practice time measurement program 2 each time the medical practice is completed, and monthly medical practice time data is created every month ( Step 5). This completes the monthly medical practice time measurement.
Based on whether or not the actual value of the doctor's total monthly medical time in the monthly medical practice time data created in step 5 exceeds the planned value, the demand and supply of medical practice by doctors and hospitals are determined. The degree of tightness is determined (step 6). If the actual value of the doctor's medical practice time is higher than the planned value, the supply system of medical practice at the hospital is in shortage. Extract medical practices. The medical action extraction means 21 targeting the standard time reduction is executed (step 7), and the medical action extraction means 22 targeting the division of labor between doctors is executed (step 8). The extracting means 23 of the medical practice targeting the division of labor reorganization is executed (step 9), and the non-affiliated medical treatment trial calculating means 24 targeting the multi-skilled doctor is executed (step 10). Print out to When the actual value of the medical practice time of the doctor is less than the planned value, there is no shortage in the supply system of the medical practice at the hospital.
In step 11, referring to the medical remuneration point data file 16, the medical remuneration points for each doctor and for the entire hospital are calculated and the medical remuneration result table is printed out.
When the division of division of labor between doctors and hospitals on a monthly basis is thus completed, the process is divided depending on whether or not a change occurs in the preconditions used for creating medical practice time data from the following month (step 12). As a result of executing the processing from step 7 to step 10 and printing out the extracted data on the printer 9, if the medical action supply system is reviewed, if necessary, the setting change 26 of the medical action type code is executed. (Step 13), execute the setting change 27 of the medical practice standard time (step 14), or execute the setting change 28 of the medical practice sharing plan (step 15). The setting change executed in steps 13 to 15 is used from the creation of the medical practice time data for the next month. When the processes from Step 7 to Step 10 are not executed, the process goes directly to END.
The above is the flow of the medical practice time measurement system and the doctor hospital division of labor organization system 1 that are macroscopically viewed. Next, a conceptual definition of a medical practice type, a medical practice standard time data file, and a monthly medical practice sharing plan of a medical practitioner, which are prerequisites for creating medical practice time data, are shown in FIGS. This will be described with reference to FIG.
FIG. 3 is a flow chart showing medical procedures performed by a doctor and a hospital using the cecum as an example in this embodiment. When a patient enters the examination room, what is wrong with the doctor first? And start a consultation. The patient answers that the stomach is unwell or that the right part of the lower abdomen is tingling (step 21). This is the part of the consultation called the interview. Next, the doctor tells the doctor to examine the patient, lays the patient sideways on a bed, and applies or touches a stethoscope to the affected part (step 22). This corresponds to the palpation part of the examination. If the doctor thinks that a more detailed test is needed to judge the disease based on his condition, he says that he should do an X-ray or blood test (step 23). This is the medical practice of testing. When the test results are clear, it looks like a cecum, and if surgery is to be performed, he will state his diagnostic findings and treatment policy for the medical condition (step 24). This corresponds to the diagnostic findings of the consultation. If the patient accepts the operation in response to the doctor's diagnosis, the operation will be performed (step 25). When the operation is completed, the patient is hospitalized for about one week and recuperated (step 26). This is a medical practice called ward nursing. From the above, medical practice for cecal patients can be broken down into six. The medical practice type in the present embodiment refers to the minimum unit by which a hospital manages time data as one independent medical practice, and in the case of the cecum, one medical doctor is responsible for all six medical practices. For example, one medical practice type code is assigned. If the doctor's labor cost is high, the doctor will be responsible for only the examination and surgery, and the nurse will be responsible for other examinations and ward nursing, so if the interview, palpation and diagnostic findings are combined, one consultation In addition, four medical practice type codes of one test, one surgery, and one ward nursing are assigned. As described above, the setting level of the medical practice type is related to the management policy of the hospital on how to manage the medical practice. However, in the present embodiment, if the cecum is taken as an example, the one The management based on the above-mentioned four medical practice types is more recommended than the management based on the medical practice type codes.
FIG. 4 is a display screen showing a medical practice type code and a medical practice standard time in this embodiment. The standard time for each doctor in the medical practice for surgery, internal medicine, and neurosurgery at Hospitals A and M is described. Physician A can be said to be the veteran chief physician, who has the shortest standard time among physicians at Hospital A for any of the first medical examination 1, re-examination 1, and examination 1 medical practice. On the other hand, doctor C can be said to be the novice doctor with the largest standard time in hospital A. Physician A can also perform a first medical examination 3, re-examination 3, examination 3, and surgery 3 in addition to surgery. The doctors D and E at the hospital A can perform the surgical operations 1 and 2, but compared with the standard times for the surgical operations 1 and 2 of the doctors M, N and O at the hospital M, the standard of the operation 2 The time is shorter for doctors D and E at hospital A than for doctors at hospital M. On the other hand, the standard time for surgery 1 is that doctors M, N and O at hospital M are at hospital A. It turns out that it is smaller than any doctor. The difference in standard time in these medical practices is an important criterion when promoting division of labor between doctors and hospitals and when allocating non-affiliated medical treatments targeting multi-skilled doctors.
FIG. 5 is a display screen showing a medical practice sharing plan in the present embodiment. In this example, a physician is used as an example, but the medical practice sharing plan used in this embodiment is created in units of one month, and is divided into three minutes every morning, afternoon, and night for each date. It is a structure in which rough medical practice divisions of initial consultation, re-examination, surgery and duty are assigned. The actual medical practice of the doctor is measured in detail according to the type code, but at the monthly planning level, only a large role assignment and time zone level assignment are performed. Given the costs and operational feasibility of the reassignment of health professionals, a monthly sharing plan in a hospital is necessary and sufficient at this level.
Next, the operation of the medical practice time measuring system shown in steps 1 to 5 in FIG. 2 will be specifically described based on the behavior of the medical practice time measuring program 2 with reference to FIGS. .
FIG. 6 is a flowchart showing the operation when applying the medical practice time data creation logic in this embodiment. The card reader 12 reads the patient's number from the patient's hospital card (step 31). FIG. 7 shows a form of a hospital card according to the present embodiment. Medical specialists such as doctors and nurses and patients can be classified as types, and the number is a unique number assigned to each type. Subsequently, the medical practice time data creating means 17 uses the patient number as a key to check whether or not the reception has already been completed in another examination room or examination room on the day (step 32). If reception has not been completed, a message indicating that reception has not been completed is displayed on the display 8 of the personal computer in the examination room, and the receptionist presses the reception key (step 33). Subsequently, the medical practitioner selects the relevant medical practice from the medical practice list displayed on the display of the personal computer, and presses the start key (step 34). If the reception has been completed, the process directly goes to step 34. The medical practice time data creating means 17 writes the patient number, the accepted signature, the medical practice type, the medical practitioner, and the practice start time in a temporary file (step 35). Subsequently, when the medical practice is completed, the medical practitioner passes the patient's hospital card through a card reader and reads the patient's number (step 36). The medical practice time data creation means 17 displays the patient number, the presence or absence of the accepted sign, the presence or absence of the complete signature, the medical practice type, the medical practitioner, and the act start time on the display 8 of the personal computer in the examination room. If the contents are correct, the medical practitioner presses the end key (step 37). The medical practice time data creating means 17 writes the end time of the medical practice in a temporary file, and thereafter, for all the medical practices started by the patient after the reception time, the patient number, presence / absence of a received signature, presence / absence of a complete signature , The type of medical practice, the medical practitioner, the act start time, and the act end time are displayed on the display 8 of the personal computer in the examination room. The receptionist in the consultation room checks whether or not all medical actions for which the start key has been pressed in the other consultation room or examination room on the day have been completed (step 38). If the end times of all medical activities have been entered and there is no all end sign, the receptionist in the examination room presses the end key (step 39). The medical practice time data creating means 17 corrects the interruption time of the medical practice time data of the patient in the temporary file on the day of the medical practice time data for a case where there is a time overlap due to a plurality of medical practices being performed in parallel. Then, the data is written into the medical practice time data file 13, the data is deleted from the temporary file (step 40), and a series of processing is ended. When the start time is input but the end time is not input for some medical actions, the process returns to step 32 without doing anything.
[0036]
FIG. 8 is a model diagram showing a specific processing method of step 40 shown in FIG. 6; In this example, the patient D accepts the doctor A in the consultation room at 10:00, and starts the consultation 1 of the doctor A at 10:00. However, the examination D of the doctor B is performed from 10:15 to 10:25 on the way. Since the doctor 2 received the examination 2 from 10:25 to 10:40, the examination 1 of the doctor A was completed at 11:00. The 30 minutes from 15 to 10:45 need to be subtracted as the interruption time. In the temporary file, for each patient number, for each medical practice, the act start time and end time are recorded, but when there is a complete end sign that informs all completion of the medical practice on the day of patient D, The medical act time data creating means 17 corrects and sets the act start time 10:00 and the substantial act end time 10:15 measured as the first act with respect to the examination 1 of the doctor A, and substantially modifies the act as the second act. The action start time 10:45 and the measured action end time 11:00 are corrected and set, and the actual medical action time of medical treatment 1 is corrected and set to 30 minutes, and finally written into the medical action time data file 13. I do.
The data written in the medical practice time data file 13 can be referred from the display 8 of the personal computer in each medical office or examination room. FIG. 9 is a display screen showing medical practice time data in the present embodiment. Using the numbers of medical specialists such as doctors and patient numbers as keys, it is possible to refer to the history of medical practice time data from the latest to the past. In the case of a medical professional such as a doctor, it is also possible to know the current queue status of a patient at the time of inquiry by linking it with a temporary file of medical practice time data.
Next, the movement of creating the monthly medical practice time data shown in step 5 in FIG. 2 will be specifically described based on the movement of the medical practice time measurement program 2 with reference to FIGS. I do. The medical practice time monthly performance totaling means 18 uses the data for one month written in the medical practice time data file 13 to create a medical practice performance table for each medical department and doctor in the hospital. FIGS. 10 to 12 are display screens each showing a total of the medical practice time monthly results in the present embodiment. And a total of the average time for each medical practice type. According to this example, according to the total number of cases table for each medical practice type, the doctors B and C perform the same number of 400 initial consultations 1 and 200 re-examinations 1 by the same number. According to the total time table, Physician B spent 4,200 minutes for the first consultation and 2,000 minutes for the first consultation, while Physician C spent 4,800 minutes for the first consultation. And 2,600 minutes for re-examination 1. As a result, while Doctor B and Doctor C are performing the same number of medical activities, Doctor B has a shortage of 2,200 minutes and Doctor C has a shortage of 1,000 minutes for a predetermined planned time of 8,400 minutes. It has become. As a result, the average medical treatment time was 10.5 minutes for the first consultation of Doctor B, 10 minutes for the first consultation, 12 minutes for the first consultation of Doctor C, and 13 minutes for the first consultation for this month. Means that doctor B was 1.5 minutes shorter at first visit and 2 minutes shorter at re-examination 1 than doctor C. Looking at the doctors of the internal medicine, the total time of medical action for all three doctors F, G and H is 1,100 minutes for the predetermined planned time of 8,400 minutes. Exceeded, doctor G exceeded 1,400 minutes, doctor H exceeded 1,300 minutes. It is known that this hospital had a supply system for surgical doctors, but a short supply system for medical doctors.
Next, the medical practice standard time calculating means 19 uses the data for several months written in the medical practice time data file 13 to convert the medical practice standard time data file 14 for each medical department and doctor in the hospital. Create FIG. 13 is a flowchart illustrating an operation when the logic for calculating the standard time according to the present embodiment is applied. First, the medical practice standard time calculation means 19 reads data for several months from the medical practice standard time data file 13 (step 41). The reason for using several months' worth of time data is that the medical professional's medical practice time is fixed at a certain level depending on the machinery and equipment used for medical practice, the level of proficiency in them, and the amount of experience and knowledge of medical professionals. However, in order to reduce the error by leveling the variation caused by the patient factor, the average time of several months of medical practice data is used. Next, the read data is rearranged in ascending order of the codes using the medical department code, the medical practice type code, and the doctor code as keys (step 42). The number of data is counted for the same medical department code, medical practice type code, and doctor code (step 43). For the same medical department code, medical practice type code, and doctor code, the medical practice time data is added (step 44). The average value per medical practice is calculated by dividing the total value of the medical practice time data by the number of data for each medical department code, medical practice type code, and doctor code (step 45). The calculated average time data per medical practice is adopted as the standard time, and the data is written in the medical practice standard time data file 14 (step 46).
Next, the medical practice standard time calculating means 20 for each hospital calculates the standard time of the doctor who makes the medical department code and the medical practice type code the same from the medical practice standard time data file 14 for the data of the hospital. The standard time data of the smallest hospital is extracted and recorded as the standard time of the hospital, and the medical practice standard time data of other hospitals are collected by exchanging information between hospitals or by external purchase. An action standard time data file 15 is created. As a result, the medical practice standard time data for each hospital is used as an index that objectively indicates the level of proficiency, experience, and knowledge of the machinery and equipment of medical professionals, while relying on the machinery and equipment of the hospital. It can be used for reorganization of division of labor between hospitals. FIG. 14 is a flowchart illustrating an operation when applying the logic for calculating the hospital-specific standard time according to the present embodiment. First, the medical practice standard time calculation means 20 for each hospital reads the standard time data of the hospital from the medical practice standard time data file 14 (step 51). The data is rearranged in ascending order of codes using the medical department code and the medical practice type code as keys, and the data having the same medical department code and medical practice type code are rearranged in ascending order of the doctor's standard time (step 52). . The smallest standard time data is extracted from the standard times having the same medical department code and medical practice type code (step 53). The minimum standard time data extracted for each medical department code and medical practice type code is written to the hospital-specific medical practice standard time data file 15 as the standard time data of the hospital (step 54). The medical practice standard time data of other hospitals is obtained by exchanging information between hospitals or by external purchase, and is input from the input / output device 7 of the personal computer in the hospital office to directly enter the medical practice standard time data file 15 for each hospital. Write to.
Next, the operation of the doctor hospital division of labor organization system shown in steps 6 to 11 in FIG. 2 will be specifically described based on the operation of the doctor hospital division of labor organization program 3 with reference to FIGS. .
FIG. 15 is a flow chart showing the operation when applying the logic for extracting the medical action targeting the standard time reduction according to the present embodiment corresponding to step 7 in FIG. The medical practice extraction means 21 (step 61) for shortening the standard time reads the medical practice time data of the current month from the medical practice time data file 13, and sorts them in ascending order using the medical practice type code as a key (step 62). ). The number of data items for each medical action type code is counted (step 63), and the top 10 medical action type codes are extracted from those having the largest number of data items for each medical action type code (step 64). The object is that if the standard time for medical treatments with a large number of cases can be reduced in a hospital, it can greatly contribute to shortening the medical treatment time of the entire hospital. Next, the required time is added up for the same medical practice type code (step 65), and the top ten medical practice type codes are extracted from those with the largest total of required time for each medical practice type code (step 65). 66). An object of the present invention is to make it possible to greatly reduce the medical practice time of the hospital as a whole if the standard time of the medical practice requiring much time in the hospital can be reduced. Next, the total time required for each medical practice type code is divided by the number of data to calculate an average time per medical practice type (step 67), and the average time per medical practice type for each medical practice type code is calculated. The top ten medical practice type codes are extracted from the most common ones (step 68). An object of the present invention is to make it possible to reduce the standard time of medical practice requiring a long average time in a hospital, which can greatly contribute to shortening the medical practice time of the entire hospital. Next, with respect to the 30 medical practice type codes extracted above, the number of the medical practice and the average value and the standard deviation of the time data of each medical practice are calculated for each doctor, excluding the duplicate counts, and Calculate the average value and standard deviation of the number of medical actions and time data of the relevant medical practice, calculate the average value and standard deviation of the number of medical actions and the time data of the entire hospital, and calculate the number of cases and time data for each case. The average value and the standard deviation are printed out (step 69). The purpose of calculating the standard deviation as a reference index is that the standard deviation indicates the degree of variability in data, and for medical practices with a large degree of variance in required time between doctors, standardization is performed by leveling the required time by organizational responses such as division of labor. There is a lot of room to save time. Next, for each of the 30 extracted medical practice type codes, the contents of the medical practice, whether they can be squeezed in common if a specialist is created, can be left to a nurse, or can be replaced with medical equipment , And subdivides the medical practice type code (step 70). The setting change of the subdivided medical practice type code is performed by the medical practice type code setting change 26 from the input / output device 7 in step 13 of FIG. With the above, the operation of the medical practice extracting means 21 targeting the standard time reduction is completed.
FIG. 16 is a model diagram showing a specific processing method of step 70 shown in FIG. When doctor A performs medical treatment by himself, the time required for medical treatment for patient D is 45 minutes, but the consultation, which is the first consultation, is divided into four, and the X-ray examination is performed by the X-ray doctor. With the change to a woman-in-charge, physician A can see another patient E during the examination time of patient D, and his X-ray examination time has been reduced by 5 minutes and his blood test has been reduced by 3 minutes. . As a result, physician A was able to consult two patients, with an average consultation time of 22.5 minutes, which is half the time of performing all medical procedures alone. Furthermore, when a blood test was replaced by a nurse by a blood test apparatus, the blood test time was reduced to 5 minutes, which was reduced to half the time required by the original doctor A. In the same way, the contents of the medical practice are examined for the 30 extracted medical practice type codes, and if a specialist is created, it can be squeezed out in common, left to a nurse, or replaced by a medical device. It is broken down into what can be done, and the medical practice type code is subdivided.
FIG. 17 is a flow chart showing the operation when applying the logic for extracting the medical practice targeting the division of labor between doctors according to the present embodiment corresponding to step 8 in FIG. The medical practice extraction means 22 (step 71) targeting the division of labor between doctors reads the medical practice standard time data from the medical practice standard time data file 14 (step 72), and sets the affiliation department and the medical practice type code. The average value and the standard deviation of the standard time of medical treatment of the same doctor are calculated (step 73). The purpose of calculating the standard deviation is that the standard deviation indicates the degree of variation in the data, and medical practices with a large degree of variation in the required time between doctors are taken from doctors with large standard times and assigned to doctors with small standard times. This indicates that there is much room to reduce the total medical hours of the hospital by the division of labor. Next, the top 10 medical practice type codes are extracted from those having a large standard deviation value of the medical practice standard time for each medical department (step 74). Each of the extracted medical actions has a large variation in the standard time between doctors, and if the division of labor between doctors can be planned, it will have a tremendous effect on shortening the medical treatment time of the entire hospital. Next, with respect to the ten medical practice type codes extracted for each medical department, which are extracted in step 74, the standard time for each doctor of the medical practice is calculated and printed out (step 75). Next, a medical practice sharing plan is created for the extracted 10 medical practices for each of the medical departments, in which the physician with the shortest standard time is assigned as the dedicated staff (step 76). The setting change of the medical practice sharing plan is performed by the medical practice sharing plan setting change 28 from the input / output device 7 in step 15 of FIG. With the above, the operation of the medical act extraction means 22 targeting the division of labor between doctors is completed.
FIGS. 18 and 19 are model diagrams showing a specific processing method of step 76 shown in FIG. Looking at the standard time and standard deviation of the medical practice of the physician belonging to Hospital A, the standard deviation is the largest in Test 4 at 16.33, the second is 3.27 in Test 3, and the third is 1.27 in Test 2. 63, the fourth is 0.81 of inspection 1. First, when examining the doctor's standard time for the examination 4 having the largest standard deviation, doctor F is 40 minutes, doctor H is 80 minutes, and doctor F can perform examination 4 in half the time of doctor H. I understand. Therefore, the doctor H has the doctor F share the examination 4 without performing the examination 4. As a result, the number of the examinations 4 of the doctor F increases by 25 and the required time increases by 1,000 minutes, but the number of the examinations 4 of the doctor H becomes 0 and the required time decreases by 2,000 minutes. The total time required by Hospital A has decreased by 1,000 minutes. Next, when examining the doctor's standard time for Exam 3 with the second largest standard deviation, Doctor F is 16 minutes, Doctor H is 24 minutes, and Doctor F takes Exam 3 in half the time of Doctor H. You know what to do. Therefore, the doctor H has the doctor F share the examination 3 without performing the examination 3. As a result, the number of the examinations 3 of the doctor F increases by 40 and the required time increases by 650 minutes. However, the number of the examinations 3 of the doctor H becomes 0 and the required time decreases by 1,000 minutes. The total time required by the hospital was reduced by 350 minutes. Next, when examining the standard time of the doctor for the test 2 having the third largest standard deviation, the doctor F is 8 minutes and the doctor H is 12 minutes. Is not as large as Test 4 and Test 3. Therefore, in order to reduce the work of the doctor F who has increased the required time due to the sharing of the examination 4 and the examination 3, the doctor F has the doctor H share the examination 2 without performing the examination 2. As a result, the number of the examinations 2 of the doctor H increases by 250 and the required time increases by 3,000 minutes, but the number of the examinations 2 of the doctor F becomes 0 and the required time decreases by 2,100 minutes. The total time required by Hospital A has increased by 900 minutes. Due to the division of labor between the physicians, the number of medical practices in Hospital A remained the same, but the overtime of Doctor F was reduced by 450 minutes, and the overtime of Hospital A was also reduced by 450 minutes. .
FIG. 20 is a flowchart showing the operation when applying the logic for extracting the medical practice targeting the division of labor between hospitals according to the present embodiment, which corresponds to step 9 in the flowchart of FIG. The medical practice extraction means 23 (step 81) targeting the division of labor between hospitals reads the standard medical practice time data by hospital from the standard medical practice time data file 15 by hospital (step 82). The average value and the standard deviation of the medical practice standard time of the hospital having the same type code are calculated (step 83). The purpose of calculating the standard deviation is that the standard deviation indicates the degree of variability in data, and medical practices with large variations in required time between hospitals are taken from hospitals with large standard times and allocated to hospitals with small standard times. This means that there is much room for shortening the medical hours at any of the hospitals involved. Next, for each medical department, the top 10 medical action type codes are extracted from the medical action standard time with the largest standard deviation value. (Step 84). All of the extracted medical practices have large variations in the standard time between hospitals, and if the division of labor between hospitals can be planned, it will have a tremendous effect on shortening the medical hours at the related hospitals. Next, for the ten medical practice type codes for each medical department extracted in step 84, the standard time for each hospital in the medical practice is calculated and printed out (step 85). Next, a medical action sharing plan is created for the extracted 10 medical actions for each medical department, with the hospital having the smallest standard time as the dedicated hospital (step 86). The setting change of the medical practice sharing plan is performed by the medical practice sharing plan setting change 28 from the input / output device 7 in step 15 of FIG. With the above, the operation of the medical action extracting means 23 targeting the division of labor between hospitals is completed.
FIGS. 21 and 22 are model diagrams showing a specific processing method of step 86 shown in FIG. Looking at the standard time and standard deviation of hospital A, hospital M, and hospital R regarding the medical treatment of surgery, the standard deviation is the largest in operation 4 and operation 3 with 16.3, and the second is in operation 2 and operation 1 with 8. It is one. First, regarding the operation 4 with the largest standard deviation, looking at the standard time of the hospital, hospital A is 40 minutes, hospital R is 80 minutes, and hospital A can perform operation 4 in half the time of hospital R. I understand. Therefore, the hospital R has the hospital A share the operation 4 without performing the operation 4. As a result, the number of operations 4 at Hospital A increases by 30 and the required time increases by 1,200 minutes, but the number of operations 4 at Hospital R decreases to 0 and the required time decreases by 2,400 minutes. Thus, the total required time between Hospital A and Hospital R has been reduced by 1,200 minutes. Next, for the operation 3 with the largest standard deviation, the standard time at the hospital is as follows: hospital R is 40 minutes, hospital A is 80 minutes, and hospital R is operated at half the time of hospital A. It turns out that it does. Therefore, the hospital A does not perform the operation 3, but has the hospital R share the operation 3. As a result, the number of operations 3 at Hospital R increases by 30 and the required time increases by 1,200 minutes. However, the number of operations 3 at Hospital A decreases to 0 and the required time decreases by 2,400 minutes. Thus, the total required time between Hospital A and Hospital R has been reduced by 1,200 minutes. Next, regarding operation 2 with the second largest standard deviation, looking at the standard time of the hospital, hospital A has 50 minutes, hospital M has 60 minutes, and hospital A has operation 2 in 10 minutes less than hospital M. It turns out that it does. Therefore, the hospital M has the hospital A share the operation 2 without performing the operation 2. As a result, the number of operations 2 at Hospital A increases by 40 and the required time increases by 2,000 minutes, but the number of operations 2 at Hospital M decreases to 0 and the required time decreases by 2,400 minutes. Thus, the total required time between the hospital A and the hospital M is reduced by 400 minutes. Next, for the operation 1 with the second largest standard deviation, looking at the standard time of the hospital, hospital M has 50 minutes, hospital A has 60 minutes, and hospital M has less operation time than hospital A in 10 minutes. It turns out to perform 1. Therefore, the hospital A does not perform the operation 1 but has the hospital M share the operation 1. As a result, the number of operations 1 at Hospital M increases by 40 and the required time increases by 2,000 minutes. However, the number of operations 1 at Hospital A decreases to 0 and the required time decreases by 2,400 minutes. Thus, the total required time between the hospital A and the hospital M is reduced by 400 minutes. Due to the division of labor between hospitals, there is no change in the total number of medical treatments at Hospital A, Hospital M, and Hospital R, but the required time at Hospital A is reduced by 1,600 minutes and is within the predetermined time. The overtime hours of the hospital M are reduced by 400 minutes, the required time of the hospital R is reduced by 1,200 minutes and settled within a predetermined time. Within a predetermined period of time, a margin of 700 minutes was created.
FIG. 23 is a screen for inquiring doctor data. About a doctor, basic information, such as a subject which can be treated, its medical treatment level, and clinical experience, is displayed. In the medical practice time measuring system and the doctor hospital division of labor organization system according to the present invention, the doctor data is not used directly, but in step 10 of FIG. When adding a standard time of medical practice that can be performed outside the department to which the physician belongs by using the medical practice standard time setting change 27 from the input / output device 7, the reference is made when finding a target doctor. .
FIG. 24 is a flow chart showing the operation corresponding to step 10 in FIG. 2 when applying the logic for performing trial calculation of non-affiliation medical treatment targeting a multi-purpose doctor in this embodiment. When a multi-purpose doctor capable of performing medical treatments in a plurality of departments is found, the standard time for medical treatments that can be performed in a department other than the department to which the multi-purpose doctor can be treated by using the medical practice standard time setting change 27 from the input / output device 7. Is set, and the data is written in the medical practice standard time data file 14 (step 91). Next, the non-affiliation medical care allocation trial calculation means 24 targeting a multi-purpose doctor is executed (step 92), and the medical practice standard time data is read from the medical practice standard time data file 14 (step 93), and the department to which the medical department belongs is designated. Regardless of the medical practice type code, the average value and the standard deviation of the medical practice standard time of the doctor having the same medical practice type code are calculated (step 94). The purpose of calculating the standard deviation is that the standard deviation indicates the degree of variation in the data, and medical practices with large variations in the required time between doctors are taken from doctors with large standard times, and if doctors with small standard times are used, other medical treatments This indicates that there is much room to reduce the total medical hours of the hospital by the division of labor among physicians who assign the work as much as possible even if they belong to the department. Next, for each of the departments to which the medical practice belongs, the top 10 medical practice type codes are extracted from the medical practice standard time with the largest standard deviation value (step 95). Each of the extracted medical actions has a large variation in the standard time between doctors, and if the division of labor between doctors can be planned, it will have a tremendous effect on shortening the medical treatment time of the entire hospital. Next, with respect to the ten medical action type codes for each medical department extracted in step 95, the standard time for each doctor of the medical action is calculated and printed out (step 96). Next, for the extracted 10 medical practices for each medical department, the doctor with the smallest standard time is assigned to the dedicated staff, and for medical doctors outside the medical department who have time convenience, the standard time of medical practice and the number of cases are assigned. (Step 97). The setting change of the medical practice sharing plan is performed by the medical practice sharing plan setting change 28 from the input / output device 7 in step 15 of FIG. With the above, the operation of the non-affiliated medical care assignment trial calculation means 24 targeting the multi-purpose doctor is completed.
FIG. 25 is a model diagram showing a specific processing method of step 97 shown in FIG. In Hospital A, Doctor F, Doctor G, and Doctor H belong to internal medicine, while Doctor A belongs to surgery. The working hours of all three doctors in the internal medicine exceed the prescribed working hours of 8,400 minutes, and on the contrary, Doctor A has a spare time of 1,260 minutes. The spare time of 1,260 minutes for the doctor A is the same as the time slot of the medical practice of the three doctors belonging to the internal medicine. Looking at the standard time and standard deviation of the four doctors, the standard deviation is the largest at 14.14 for Test 4, the second at 2.83 for Test 3, the third at 1.41 for Test 2, and the fourth at 1.44. Inspection 1 is 0.71. First, when examining the doctor's standard time for examination 3 with the second largest standard deviation, doctor F is 16 minutes, doctor A is 20 minutes, and doctor F takes examination 3 in less time than doctor A by 4 minutes. You know what to do. Since the current purpose is to eliminate overtime work of Doctor F, Doctor A shares three cases with Doctor F for examination 3. As a result, the number of examinations 3 of doctor A increases by 3 and the required time increases by 60 minutes, but the number of examinations 3 of doctor F decreases by 3 and the required time decreases by 50 minutes. Takes 10 minutes. Next, when examining the doctor's standard time for examination 2 having the third largest standard deviation, doctor G is 10 minutes, doctor H is 12 minutes, doctor A is 10 minutes, and doctor A is doctor G and It can be seen that the examination 2 is performed in a shorter time than the doctor H. Therefore, having the doctor A share the examination 2 between the doctor G and the doctor H is also convenient for the purpose of eliminating overtime work between the doctor G and the doctor H. As a result, the number of the examination 2 of the doctor A increases by 110 and the required time increases by 1,100 minutes, but the number of the examination 2 of the doctor G decreases by 60, the required time decreases by 600 minutes, and the doctor H The number of the examinations 2 of the hospital A is reduced by 50, the required time is reduced by 600 minutes, and the total required time of the hospital A is reduced by 100 minutes. By the above-mentioned out-of-affiliation medical treatment allocation targeting multi-purpose doctors, the number of medical treatments in Hospital A as a whole does not change, but the overtime work of three doctors belonging to internal medicine can be eliminated, and I could use my spare time.
FIG. 26 is a flow chart showing the operation when applying the logic for calculating the doctor's hospital medical fee in this embodiment, which corresponds to step 11 in the flow chart of FIG. The doctor hospital medical fee calculation means 25 reads the previous month's data in the medical practice time data file 14, and creates a medical practice result data file for each doctor and a medical practice count data file for the entire hospital (step 101). Next, it is determined whether or not to correct the number of medical actions for each doctor or for the entire hospital (step 102). When Steps 7 to 10 in FIG. 2 are executed, changes occur in the medical practice type, the medical practice standard time, and the medical practice assignment plan, but the changes in the preconditions are reflected in the time data unless the next month or later. It will not be done. Before that, if it is desired to simulate the effect of the change of the preconditions on the medical treatment fee of the doctor hospital, the number of medical treatments for each doctor or the entire hospital is corrected (step 103), and the medical treatment score data file 16 is read. (Step 104). FIG. 27 is a layout of a medical fee score data file according to the present embodiment. A reward score is determined for each medical practice code, and a medical practice to which the facility standard is applied may be deducted from the regular reward score if the annual number of cases is below the reference value. If there is no need to correct the number of medical actions for each doctor or for the entire hospital, the procedure goes directly to step 104. Next, using the medical practice type code as a key, a medical remuneration score corresponding to the case data condition of the entire hospital is set, and a medical remuneration score for each doctor is calculated (step 105). Next, the medical remuneration performance table for each doctor and for the entire hospital is printed out (step 106). FIG. 28 is a display screen showing the total medical remuneration results of doctors and hospitals in the present embodiment. In the example, the number of cases and the reward points for each medical practice are displayed for each physician belonging to each medical department, and the total reward points for one month for each doctor are displayed. As a result, the doctor's contribution to the hospital's performance can be clearly grasped. When the number of medical treatments for each doctor or the entire hospital is corrected to simulate the influence on the medical treatment fee in the obtained medical fee record table for each doctor and the entire hospital for one month, the process returns to step 103. . If there is no correction in the number of medical treatments, a series of movements ends (step 107).
FIGS. 29 and 30 are model diagrams showing a specific processing method of step 103 shown in FIG. In the case where the division of labor between doctors is advanced in step 8 in FIG. 2, the doctor F shares the examination 2 with the doctor H, and shares the examination 3 with the doctor H. As a result, the burden on the doctor F is reduced, and Although the burden increased, the reward points of Doctor F decreased and the reward points of Doctor G increased in conjunction with it, so that both Doctor F and Doctor G would be convinced, and the reward points of the entire hospital would not change. . In the case where the inter-hospital division of labor reorganization in step 9 of FIG. 2 is advanced, hospital A shares operation 1 with hospital M, shares operation 2 with hospital M, shares operation 3 with hospital R, and performs operation 4 with hospital R. As a result of maintaining the status quo, Surgery 2 met the facility standard of 70 cases per year, and the reward score increased by 1,750 points. Hospital M shared surgery 1 from hospital A and shared surgery 2 to hospital A. As a result, surgery 1 met the 70 facility-specific annual cases, but the remuneration score was 19,550. It was maintenance. As a result of sharing the operation 3 from the hospital A, the hospital R satisfies the annual number of cases of 70 for the facility standard, and the reward point has increased by 10,500 points. Remuneration points have increased by 11,850 points in total for the three hospitals, and the reorganization of labor between hospitals will be satisfactory to the three hospitals. Through the discussion between the three hospitals, it is possible to distribute the increased reward points to the hospital M where the reward points have not been increased. In the case where the medical practice outside the department to which the multi-purpose physician belongs in step 10 in FIG. 2 is performed, the doctor F allocates 300 tests 3 to the doctor A, and the doctor G allocates 4,200 tests 2 to the doctor. A is assigned to the doctor A, and the doctor H assigns the 3,500 examinations 2 to the doctor A, so that the doctor A shares the 7,700 examinations 2 and the 300 examinations 3. As a result, the burden on Doctor F, Doctor G and Doctor H is reduced, and the burden on Doctor A is increased. However, in conjunction with this, the reward points of Doctor F, Doctor G and Doctor H decrease, and Doctor A loses the burden. Since the reward points have increased, the doctor F, the doctor G, the doctor H, and the doctor A will be satisfied, and the reward points of the entire hospital will not change.
[0053]
As described above, according to the first and third aspects of the present invention, the medical practice time of a medical professional such as a doctor can be easily and accurately measured at a hospital, and the measured time can be reduced. By using it, it is possible to build an efficient division of labor between doctors and between hospitals, and it is possible to accurately measure the contribution of medical professionals by linking with the calculation of medical remuneration points And so on.
According to the second aspect of the present invention, in addition to the effects of the first or third aspect of the present invention, the application of the standard time to the medical practice objectively represents the technical level of the medical professional. It can be used as an index.
According to the fourth aspect of the present invention, the application of the standard time to the hospital makes it possible to use the medical facilities held by the hospital and the technical level of medical professionals as objective indicators. It can also be used for comparison between hospitals.
According to the ninth aspect of the present invention, since the medical treatment fee of each doctor or hospital is calculated in synchronization with the division of labor between doctors and hospitals, the effect of division of labor is directly measured. The system configuration is easy to obtain the cooperation of doctors and hospitals.
[Brief description of the drawings]
FIG. 1 is a configuration block diagram showing an example of an embodiment of a medical practice time measurement system and a doctor hospital division of labor organization system according to the present invention.
FIG. 2 is a flowchart showing an overall operation of the medical practice time measurement system and the doctor hospital division of labor organization system in the present embodiment.
FIG. 3 is a flow chart of medical practice performed by a doctor and a hospital with the cecum as an example in the present embodiment.
FIG. 4 is a display screen showing a medical practice type code and a medical practice standard time in the embodiment.
FIG. 5 is a display screen showing a medical practice sharing plan according to the present embodiment.
FIG. 6 is a flowchart illustrating an operation when applying the medical practice time data creation logic according to the present embodiment.
FIG. 7 shows a form of a hospital card according to the embodiment.
FIG. 8 is a model diagram showing a specific processing method of step 40 shown in FIG. 6;
FIG. 9 is a display screen showing medical practice time data according to the present embodiment.
FIG. 10 is a display screen 1 showing monthly totaling of medical practice hours according to the embodiment.
FIG. 11 is a display screen 2 showing monthly totaling of medical practice time in the embodiment.
FIG. 12 is a display screen 3 showing the monthly total of medical practice time in the embodiment.
FIG. 13 is a flowchart illustrating an operation when applying a logic for calculating a standard time according to the present embodiment;
FIG. 14 is a flowchart illustrating an operation when applying a logic for calculating a hospital-specific standard time according to the present embodiment;
FIG. 15 is a flowchart illustrating an operation when applying a logic for extracting a medical practice that targets standard time reduction according to the present embodiment.
16 is a model diagram showing a specific processing method of step 70 shown in FIG.
FIG. 17 is a flowchart showing an operation when applying a logic for extracting a medical practice targeting a division of labor between doctors according to the present embodiment;
FIG. 18 is a model diagram 1 showing a specific processing method of step 76 shown in FIG.
19 is a model diagram 2 showing a specific processing method of step 76 shown in FIG.
FIG. 20 is a flowchart showing an operation when applying a logic for extracting a medical practice targeting a division of labor between hospitals according to the present embodiment;
FIG. 21 is a model diagram 1 showing a specific processing method of step 86 shown in FIG. 20;
22 is a model diagram 2 showing a specific processing method of step 86 shown in FIG.
FIG. 23 is a display screen showing doctor data and multi-skill data in the present embodiment.
FIG. 24 is a flowchart showing an operation when applying a logic for performing a trial calculation for out-of-affiliation medical care assignment targeting a multi-purpose doctor in the present embodiment.
FIG. 25 is a model diagram showing a specific processing method of step 97 shown in FIG. 24;
FIG. 26 is a flowchart showing an operation when applying a logic for calculating a medical doctor's medical care fee in the present embodiment.
FIG. 27 is a layout of a medical remuneration score data file according to the present embodiment.
FIG. 28 is a display screen showing a total of medical fee records of doctors and hospitals in the present embodiment.
FIG. 29 is a model diagram 1 showing a specific processing method of step 103 shown in FIG. 26;
FIG. 30 is a model diagram 2 showing a specific processing method of step 103 shown in FIG. 26;
[Explanation of symbols]
1 Medical practice time measurement system and doctor hospital division of labor organization system
2 Medical practice time measurement program
3 doctor hospital division of labor organization program
4 Main memory
5 File storage device
6. Central processing unit
7 I / O device
8 Display
9 Printer
10 hospital card
11 Card issuing device
12 Card reader
13. Medical practice time data file
14 Medical practice standard time data file
15 Medical practice standard time data file by hospital
16 Medical fee score data file
17 Medical practice time data creation means
18 Medical practice time monthly results totaling means
19 Medical practice standard time calculation means
20 Means for calculating standard time of medical practice by hospital
21 Medical Action Extraction Method Targeting Standard Time Reduction
22 Extraction means of medical practice targeting division of labor between doctors
23 Means for Extracting Medical Practice Targeting Reorganization of Division of Labor between Hospitals
24 Estimation means for allocating medical treatment outside the affiliation of a multi-purpose doctor
25 Physician hospital medical fee calculation means
26 Change of medical practice type code setting
27 Change of medical practice standard time setting
28 Medical practice sharing plan setting change

Claims (9)

A medical practice time measuring system for measuring the medical practice time of a medical professional such as a doctor in a hospital, comprising a medical practice type code setting change means for setting a medical practice to be measured, a medical professional such as a doctor, and a patient Card reader that reads the hospital card, and in the case of a patient, after reading the card, from the reception to leaving the hospital, the type of medical treatment, the person in charge of medical treatment, the start time, the end time, and the interruption time of the medical treatment And medical action time data creation means for creating a medical action time data file that records the actual medical action time, and the number of medical actions per month, time, and average time for each physician belonging to each department Medical activity time monthly results totaling means, and average time of medical activity data for several months from the medical activity time data file, and standard time for each medical department belonging to each doctor Medical practice time measuring system and having a medical practice standards time calculating means for creating a medical care standard time data files to be calculated and recorded. In the medical practice standard time in claim 1, when the mechanical equipment used for the medical practice, the degree of proficiency in them, and the amount of experience and knowledge of the medical practitioner fluctuate the medical practice time, the fluctuation part due to the patient factor is leveled. 2. The medical practice time measurement system according to claim 1, wherein an average time is calculated for several months of medical practice data, and a standard time is calculated for each medical practice for each doctor. . After creating the medical practice time data file according to claim 1, an efficient division of labor between doctors is built by using the measured time, and the division of labor between hospitals is referred to by referring to the medical practice standard time data file for each hospital. This is a physician hospital division of labor system that accurately measures the contribution of medical professionals to performance by linking with medical fee score data files. Extraction means for medical practice targeting reorganization of division of labor, extraction means for medical practice targeting reorganization of division of labor between hospitals, means for estimating non-affiliated medical treatment targeting multi-skilled doctors, and calculation of medical fees for doctors and hospitals Means, a medical practice type code setting changing means, a medical practice standard time setting changing means, and a medical practice sharing plan setting changing means, Physician hospital division of labor organization system that. The medical practice standard time data file for each hospital according to claim 3 is the smallest standard time among the standard times of doctors who have the same medical department code and medical practice type code from the medical practice time data file. 4. The doctor hospital division of labor system according to claim 3, wherein time data is extracted and recorded, and the medical practice standard time data of another hospital is collected and recorded by exchanging information between hospitals or by external purchase. 4. The medical action extracting means for shortening the standard time according to claim 3, wherein the medical action time data file is used to select the top 10 medical actions among the most frequently performed medical actions in the hospital, and in particular, the required time. Extract the top 10 medical actions from the one with the largest total and the top 10 medical actions from the one with the most average time, and exclude duplicated ones. Calculate the mean and standard deviation of the data, calculate the mean and standard deviation of the number of medical treatments and time data for each department, and calculate the average and standard deviation of the number of medical treatments and time data for the entire hospital. 4. The doctor / hospital division of labor system according to claim 3, wherein the number of cases and the average value and standard deviation of the time data are printed out in each case. The medical act extraction means targeting the division of labor between doctors according to claim 3, wherein the medical act time data file includes, based on the medical act time data file, the average value of the standard medical act time and the standard value of the medical act standard time of doctors having the same department and medical act type code. Calculating the deviation, extracting the top 10 medical actions from those having a large standard deviation value of the medical practice standard time for each medical department, and printing out the standard time of each doctor of the medical practice. The doctor hospital division of labor system according to claim 3. 4. The medical practice extraction means for targeting reorganization of division of labor between hospitals according to claim 3, wherein the medical practice standard time data file storing the medical practice standard time data of the hospital and other hospitals is used for a medical department and a medical practice. Calculates the average value and standard deviation of medical practice standard time of hospitals with the same type code, and extracts the top 10 medical practices from those with the largest standard deviation of medical practice standard time for each medical department, and 4. The doctor hospital division of labor system according to claim 3, wherein the standard time of each hospital is printed out. The non-affiliated medical treatment trial calculation means targeting the multi-purpose doctor in claim 3 adds a standard time for a medical practice that can be performed by a multi-purpose doctor in a department other than the home department to the medical practice standard time data file, Calculates the average value and standard deviation of the medical practice standard time of doctors who have the same medical practice type code regardless of the department they belong to. 4. The doctor hospital division of labor system according to claim 3, wherein the act is extracted and a standard time for each doctor of the medical act is printed out. The doctor / hospital medical fee calculation means in claim 3 calculates the number of medical actions for each doctor or the entire hospital from the medical action time data file, refers to the medical fee score data file, and performs the medical treatment for each doctor and the entire hospital. Calculate the remuneration points, print out the medical remuneration results table, and further shorten the standard time, reorganize the division of labor between doctors or reorganize the division of labor between hospitals, or distribute the medical treatment outside the affiliation of a multidisciplinary physician. If there is a change in the number of medical treatments for each doctor, change the number of medical treatments for each doctor or for the entire hospital to the changed value, and refer to the medical remuneration score data file again to see 4. The doctor hospital division of labor system according to claim 3, wherein the remuneration points are calculated and the medical remuneration change table is printed out.

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