JP2005063162A - Informed consent recording and management device - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To precisely confirm the content when giving informed consent. <P>SOLUTION: This device 10 for managing a conversation record for obtaining informed consent comprises a voice fetching part 5 for converting conversations between a medical expert and a patient to voice data; a voice recording means 41 for making a voice data storage part 31 hold the voice data in conformation to patient data for identifying the patient; and a voice data retrieval means 42 for retrieving voice data corresponding to the patient data instructed by the medical expert from the voice data storage part, and supplying the voice data concerned to a voice reproduction part 6. <P>COPYRIGHT: (C)2005,JPO&NCIPI

Description

  The present invention received explanations from medical personnel such as doctors and nurses regarding treatment contents, risk of treatment, expected effects of treatment, side effects of treatment, treatment costs, etc. It relates to an apparatus for managing records for informed consent to obtain consent from a patient.

Medical personnel such as doctors, nurses, clinical technologists, pharmacists, and counselors, when performing medical treatment such as treatment, surgery, medication, etc., treatment content, risk of treatment, expected effect of treatment, treatment Informed consent (consent based on notice) is obtained to give consent from the patient after explaining the side effects and treatment costs.
Records of informed consent are managed by doctors taking notes on medical records and saving radiographs and affected area images as image data. An apparatus that supports such informed consent record management is disclosed in Patent Document 1.

According to Japanese Patent Laid-Open No. 2004-260, an apparatus for managing image data by adding information indicating date and time to the image data is disclosed.
However, even if a medical person later reads a memo written on the medical record together with an image based on this image data, the medical person is reminding the contents of the informed consent conversation accurately because the medical person examines multiple patients. This was a problem. In addition, since the sense of reality such as voice tone, intonation, and conversation tempo at the time of informed consent is not recorded in a comprehensible manner, the psychological situation of patients and medical personnel cannot be felt, which is also a problem. It was.
JP-A-10-94520

  Accordingly, an object of the present invention is to provide an informed consent record management apparatus capable of accurately grasping contents when informed consent is performed.

The present invention adopts the following configuration in order to solve the above points.
An apparatus for managing a conversation record for obtaining informed consent, a voice capturing unit for converting a conversation between a medical staff and a patient into voice data, and patient data for identifying the voice data as the patient A voice recording means for storing the voice data in the voice data storage unit in correspondence with the voice data corresponding to the patient data instructed by the medical staff from the voice data storage unit and supplying the voice data to the voice reproduction unit And voice data search means.

  The voice recording means, when receiving a marking instruction from the medical personnel during the conversation, causes the elapsed time data storage unit to store elapsed time data indicating an elapsed time from the start of the conversation, and the voice data search means When the elapsed time data instructed by a medical person is acquired from the elapsed time data storage unit, the cue position of the searched audio data is determined based on the elapsed time data, and at least the audio after the cue position A data portion can be extracted from the audio data, and the audio data portion can be supplied to the audio reproduction unit.

  The voice data search means can determine a cueing position of the searched voice data based on an important conversation start time that is a predetermined time later than the elapsed time indicated by the elapsed time data.

Furthermore, the informed consent record management apparatus can include a foot switch for receiving the marking instruction from the medical staff.
Furthermore, the informed consent record management apparatus can include a communication unit for acquiring the patient data from an input device connected via a transmission path.

  Further, the informed consent record management apparatus includes an image data acquisition unit that acquires image data to be referred to during the conversation, and an image that stores the acquired image data in the image data storage unit in association with the conversation data. It comprises recording means and image data search means for acquiring image data corresponding to the conversation data acquired by the voice data search means from the image data storage section and supplying the image data to a display section. To do.

  According to the informed consent record management apparatus of the present invention, the conversation data between the medical staff and the patient is recorded in correspondence with the patient data that can identify the patient, and then the voice corresponding to the patient data instructed by the medical staff. By acquiring and playing data, you can check the content of informed consent conversations, including voice tone, conversation tempo, and intonation. A sense of reality that cannot be fully understood can be obtained, and the contents of informed consent can be confirmed accurately.

Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings.
This embodiment will be described using an example of a record management apparatus for informed consent in dentistry.

  As shown in FIGS. 1 and 2, the informed consent record management apparatus 10 according to the first embodiment includes a processing device 1 such as a personal computer, a keyboard 2 connected to the processing device, a mouse 3, and a display unit. A display 4, a microphone 5 as an audio capturing unit, a speaker 6 as an audio reproducing unit, and a foot switch 7 are provided. The processing device 1 includes a storage unit 30, a recording management unit 40, and a conversation progress. It includes a time management unit 50, a drawing data generation unit 60, and a control unit 20 that performs overall control of the units and units.

  The keyboard 2 and the mouse 3 are input devices for receiving inputs from medical personnel such as doctors, nurses, clinical laboratory technicians, pharmacists, and counselors. Characters input from the keyboard 2 are displayed at predetermined positions on the screen of the display 4. The mouse 3 is a pointing device for pointing a point corresponding to an operation of a medical person on the screen of the display 4 and has a function of accepting an execution instruction called “click”.

The display 4 performs display based on data (hereinafter referred to as drawing data) held in the image memory 9. This drawing data is data for displaying, for example, each control screen shown in FIGS. 3 and 15 on the display 4, and is generated for each screen by the drawing data generation unit 60.
The control screen shown in FIG. 3 is an example of a display screen when the informed consent record management apparatus 10 is activated. The screen includes a patient number for managing a plurality of patients, a patient name managed by the patient number, a conversation record start / stop button, a conversation record confirmation button, and the like.

By clicking a button on the screen using a pointing device, a processing screen corresponding to the button is displayed.
For example, on the screen shown in FIG. 3, the patient number and name are entered with the keyboard, and the conversation with the medical staff, such as the patient, their family, relatives and acquaintances (hereinafter simply referred to as the patient) is recorded. When the confirmation button is clicked with a mouse, a control screen for confirming conversation recording shown in FIG. 15 is displayed.

  The control screen shown in FIG. 15 includes a patient number, a patient name corresponding to the number, a recorded conversation playback button, a temporary playback stop (pause) button, a fast forward button, a fast reverse button, an end button, Conversation recording time, playback time at the recording time, playback time transition graph showing the relationship between playback time at the conversation recording time, recording start date and time and number of times medical personnel marked important points during the conversation It consists of a table showing This control screen will be described by the operation of the informed consent record management apparatus 10 described later.

The microphone 5 is electrically connected to the processing device 1 in a wired or wireless manner so as to collect the conversation between the medical staff and the patient and convert the electrical signal of the collected conversation as voice data in the processing device 1. Yes. The microphone 5 may be either directional or non-directional, and is appropriately selected so that conversation between a medical staff and a patient can be collected optimally.
The above-described microphone 5 may be incorporated in a treatment chair, a lighting device that illuminates the affected area, or the like, and a medical person may wear a small microphone called a pin microphone as necessary.

The speaker 6 as an audio reproduction unit has a function of reproducing a conversation based on an electrical signal obtained by converting audio data held in an audio data storage unit of the storage unit 30 to be described later. Earphones, headphones, or the like having the above may be used.
The foot switch 7 is a switch for performing marking for easily cuing the recorded conversation in later reproduction processing when a medical staff judges that the conversation content is important. By performing marking with the foot switch 7, the elapsed time from the start of the conversation is held as elapsed time data in an elapsed time data storage unit described later.
By using a foot switch, even during treatment, marking can be easily performed with the foot, which is hygienic.

  The control unit 20 of the processing device 1 includes a storage unit 30, a recording management unit 40, a conversation elapsed time management unit 50, and an input from the keyboard 2, mouse 3, microphone 5, and foot switch 7 connected to the processing device 1. A function for comprehensively controlling each part of the drawing data generating unit 60 and a control for outputting data processed by each part to the display 4 and the speaker 6 are performed.

The storage unit 30 includes an audio data storage unit 31 and an elapsed time data storage unit 32.
The voice data storage unit 31 holds, as voice data, a conversation between a medical person and a patient collected by the microphone 5 in correspondence with the patient data indicating the patient number.
The elapsed time data storage unit 32 holds elapsed time data indicating the elapsed time from the start of the conversation. This elapsed time data is generated based on the time managed by the conversation elapsed time management unit 50, which will be described later, and when the medical person presses the foot switch 7 while recording the conversation between the patient and the medical person. Indicates the time.

  The recording management means 40 includes a voice recording means 41 and a voice data search means 42. The voice data search means 42 includes markings designated by the user, that is, a process designated by the user, in conversation playback. In order to reproduce a conversation from a predetermined number of seconds before the elapsed time indicated by the time data, a cue position determining means 43 for determining a cue position of the audio data is provided.

  When the user inputs an instruction to start recording a conversation with the input device, the voice recording unit 41 converts the conversation collected by the microphone 5 as voice data based on the instruction from the control unit 20 that has received the input. Then, processing for storing the audio data in the audio data storage unit 31 is performed. At this time, the voice recording unit 41 stores the time managed by the conversation elapsed time management unit 50 described later in the voice data storage unit 31 in association with the voice data.

The voice data search means 42 searches for the cue position of the voice data based on the result determined by the cue position determination means 43. The search for the cue position is performed by searching for a cue position a predetermined number of seconds before the elapsed time indicated in the elapsed time data designated by the user. In the present embodiment, a position 10 seconds before the elapsed time designated by the user is searched as a cue position. As a result, it is determined that the medical personnel are having an important conversation, and the conversation record can be reproduced from the cue position of the voice data 10 seconds before the timing when the foot switch 7 is pressed. It is possible to easily reproduce the conversation record from the cueing position that seems to have started.
The voice data searched by the voice data search means 42 is converted into an electric signal and output to the speaker 6.

The conversation elapsed time management unit 50 has a clock function, and outputs the time at that timing to the recording management means 40 in response to an input from the foot switch 7.
The drawing data generation unit 60 acquires screen configuration data from a screen configuration data storage unit (not shown) to display a screen for controlling the informed consent record management apparatus 10 on the display 4, and converts the acquired screen configuration data into the acquired screen configuration data. Processing for incorporating necessary data is performed, and processing for holding the data as drawing data in the image memory 9 is performed. The screen configuration data described above is acquired from the screen configuration data storage unit in response to an instruction when the informed consent record management apparatus 10 is activated or a button pressed by the user with a pointing device.

Next, the operation of the informed consent record management apparatus 10 will be described with reference to a flowchart. The informed consent record management apparatus 10 performs conversation recording and reproduction of the recorded conversation.
First, the operation of the informed consent recording management apparatus 10 during conversation recording will be described with reference to the flowchart of FIG.

  When the informed consent record management apparatus 10 is activated, the drawing data generation unit 60 acquires the screen configuration data at the time of activation from a screen configuration data storage unit (not shown), and performs processing for incorporating necessary data into the screen configuration data. A process of holding this as drawing data in the image memory 9 is performed. The display 4 displays the control screen during conversation recording shown in FIG. 3 based on the drawing data held in the image memory 9.

Based on the control screen shown in FIG. 3, a medical staff inputs a chart number that can identify a patient and a patient name as a patient number using an input device such as a keyboard 2 or a mouse 3. (Step 10)
The control unit 20 outputs the input content to the voice recording unit 41 of the recording management unit 40 as patient data on the control screen shown in FIG.

  In addition, when a conversation of a certain patient has already been recorded, the voice recording means 41 is a patient in which the patient name is associated with the patient number in order to automatically display the patient name corresponding to the input patient number on the display 4. The voice data storage unit 31 holding the data is referred to, and a control instruction for causing the drawing data generation unit 60 to generate drawing data for displaying the patient name acquired by this reference on the display 4 is output.

Thereafter, when the user clicks the conversation recording start / stop button shown on the control screen of FIG. 3 with the mouse 3 (step S20), a conversation recording start control instruction is sent to the voice recording means 41 via the control unit 20. . The voice recording means 41 acquires the time at which the control instruction is received from the conversation elapsed time management unit 50 (step S30).
Thereafter, the voice recording means 41 performs control for associating the acquired time and patient data with the voice data generated based on the conversation collected by the microphone 5 and holding it in the voice data storage unit 31 (step S40). .
Further, in order to indicate on the screen that the conversation is being recorded, the drawing data generation unit 60 that has received the control instruction from the voice recording unit 41, as shown in FIG. Generates drawing data for displaying time.

When a medical person presses down the foot switch 7 while recording a conversation between a medical person and a patient, a control instruction indicating the pressing is sent to the voice recording means 41 via the control unit 20 (step S50).
When the voice recording means 41 receives a control instruction for pressing the foot switch 7, the voice recording means 41 acquires the time at that time from the conversation elapsed time management unit 50, and stores the time as elapsed time data in the elapsed time data storage unit 32 (step S1). S60). The elapsed time data stored in the elapsed time data storage unit 32 is associated with voice data generated for each conversation recording.
Thereafter, the voice recording unit 41 continues the process of step S40 described above.

  In the control screen shown in FIG. 3, when the medical staff clicks the conversation recording start / stop button again (step S <b> 70), a conversation recording stop instruction is sent to the voice recording means 41. Upon receiving the instruction, the voice recording unit 41 stops the process of holding the voice data in the voice data storage unit 31 at the stop timing, and acquires the time at the stop time from the conversation elapsed time management unit 50. The acquired conversation recording stop time is held in the voice data storage unit 31 together with the conversation recording start time and patient data (step S80).

  Since the medical staff can arbitrarily specify the period from the start of conversation recording to the stop of conversation recording, the audio data is variable-length data reflecting the conversation time, and this audio data is generated for each conversation recording, The speech data storage unit 31 holds the conversation recording start time and the conversation recording stop time in association with the patient data.

Next, the operation of the informed consent recording management apparatus 10 when the recorded conversation is reproduced after the conversation recording will be described with reference to the flowchart of FIG.
When the informed consent record management device 10 is activated, the drawing data generation unit 60 acquires screen configuration data at the time of activation from a screen configuration data storage unit (not shown) so as to display the control screen shown in FIG. Then, processing for incorporating necessary data into the screen configuration data is performed, and processing for holding this data as drawing data in the image memory 9 is performed.

  When a medical person inputs a patient number using an input device such as the keyboard 2 or the mouse 3 based on the control screen shown in FIG. 3, the patient number is recorded via the control unit 20 and the record management means 40. To the voice data search means 42 (step S100). The voice data search means 42 that has acquired the patient number acquires the patient data of the patient number from the voice data storage unit 31, and displays the patient name indicated in the patient data on the display 4. A control instruction is output to 60.

  Thereafter, when the medical staff clicks the conversation recording / playback button shown on the control screen of FIG. 3 with the mouse 3 (step S110), the voice recording means 42 receives a control instruction for the conversation recording / playback via the control unit 20. Sent to. At this time, a conversation recording / reproduction control instruction is also sent to the drawing data generation unit 60. In accordance with this control instruction, the drawing data generation unit 60 acquires screen configuration data from a screen configuration data storage unit (not shown) to display the control screen at the time of conversation playback shown in FIG. Processing for incorporating necessary data into the data is performed, and this is stored in the image memory 9 as drawing data (step S120).

  As shown in FIG. 15, the control screen at the time of conversation playback displayed on the display 4 includes the date and time when the conversation between the medical personnel and the patient is recorded in addition to the patient number and the patient name. The number of times marked by the foot switch 7 during recording of each conversation is also shown in a table that can be grasped. For example, in the control screen at the time of conversation playback shown in FIG. 15, two conversation records, that is, a conversation record from 13:44 on June 16, 2003, and 15:23 on June 10, 2003, are recorded. The conversation record from the minute is shown in the table, and in the conversation record from 13:44 on June 16, 2003, the three markings were made during the recording of the conversation. "(Hereinafter referred to as a marking button).

  The display of the marking button is based on elapsed time data associated with the audio data in the audio data storage unit 31, and the drawing data generation unit 60 displays the number of markings corresponding to the table on the control screen. The elapsed time data storage unit 32 that holds the elapsed time data to be used is referred to. The control screen shown in FIG. 15 shows the date and time as the conversation recording start time, but the elapsed time data is managed by adding the second to the date and time. .

In the control screen at the time of conversation playback shown in FIG. 15, when a medical person shows and clicks any one of the three marking buttons with a mouse in order to play back the conversation record (step S130), Information indicating the clicked marking button is sent to the voice data search means 42 via the control unit 20.
By the way, in this embodiment, a conversation for 10 seconds before and after the time indicated in the elapsed time data corresponding to the clicked marking button is reproduced. That is, when the marking time indicated in the elapsed time data is 13:48:10 on June 16, 2003, the time from 13:48:00 on June 16, 2003 to 13:00 on June 16, 2003 Play 20 seconds up to 48 minutes 20 seconds. The playback time of the conversation record can be arbitrarily set by a medical staff, and the set value is held in a set value storage unit (not shown).

  The voice data search unit 42 acquires elapsed time data corresponding to information indicating the clicked marking button with reference to the elapsed time data storage unit 32 (step S140).

After acquiring the elapsed time data, the voice data search means 42 is the voice data corresponding to the elapsed time data, that is, the voice data recorded from 13:44 on June 16, 2003 in the control screen shown in FIG. Is identified with reference to the audio data storage unit 31 (step S150).
At this time, the voice data search means 42 acquires the conversation recording start time and the conversation recording end time held in the voice data storage unit 31 together with the specified voice data (step S160).

Thereafter, the cue position determination means 43 of the voice data search means 42 determines the cue position of the specified voice data based on the marking time indicated in the elapsed time data and the acquired conversation recording start time and conversation recording end time. That is, the following calculation is performed in order to determine which address position should be reproduced from the audio data managed with an address (step S170).
Cue position = {(marking time−10 seconds) −conversation recording start time} / (conversation recording end time−conversation recording start time)

  For example, the conversation recording start time is 13: 44: 00: 00 on June 16, 2003, the conversation recording opening end time is 13: 50: 0 on June 16, 2003, and the marking time is June 16, 2003. When it is 13:48:10, the value substituted for this as a parameter is 2/3. That is, in the voice data specified by the voice data search means 42, the address indicating the position of 2/3 of the total data amount is set as the cueing position.

After determining the cueing position, the audio data search means 42 sequentially reads out the audio data from the audio data storage unit 31 in order to reproduce the audio data (audio data part) for 20 seconds from the position on the speaker 6. The signal is converted into an electric signal that can be reproduced by the speaker 6, and the signal is supplied to the speaker 6.
The speaker 6 reproduces the recorded conversation based on the supplied signal (step S180).

The time during which the signal continues to be supplied to the speaker 6 is based on the value held in the set value storage unit (not shown) and is 20 seconds in this embodiment.
As described above, this supply time is determined based on the time acquired from the conversation elapsed time management unit 50, in addition to obtaining and controlling the address position of the audio data whose reproduction should be stopped by the calculation using the formula. The time sequentially read from the data storage unit 31 may be controlled by a timer. Specifically, for example, 20 seconds is added to the time when the control for reading the voice data from the voice data storage unit 31 is started, and the voice data is read out until the time is reached.

  On the other hand, when the user specifies the number of conversations and the conversation recording start time without specifying the marking button in step S130 and presses the playback start button with the mouse 3, information indicating the voice is transmitted via the control unit 20 to the voice. It is sent to the data search means 42. The voice data search means 42 sequentially reads the voice data at the designated conversation start time from the voice data storage unit 31, converts it into an electrical signal that can be reproduced by the speaker 6, and supplies the signal to the speaker 6.

  As described above, according to the informed consent recording management apparatus 10 of the first embodiment, the medical switch marks the conversation that seems important by the foot switch 7 while the informed consent conversation is recorded as voice data. Since the elapsed time from the start of the conversation is retained as elapsed time data, when playing back the recorded conversation, the audio data can be cued based on the retained elapsed time data. It is possible to quickly confirm the content of the conversation that seems to be.

Next, the informed consent record management apparatus 100 that also reproduces an image referred to during informed consent when the conversation record is reproduced will be described.
As shown in FIG. 6, the informed consent record management apparatus 100 according to the second embodiment includes a keyboard 2, a mouse 3, a display 4, a microphone 5, a speaker 6, and a foot switch 7 connected to the processing apparatus 101. It has. The processing apparatus 101 performs overall control of the image data acquisition unit 8, the storage unit 300, the recording management unit 400, the conversation elapsed time management unit 500, the drawing data generation unit 600, and the units and units. And a control unit 200.

  The image data acquisition unit 8 has a function as a communication unit in order to acquire image data obtained by photographing an affected part of a patient through a transmission path such as a network. The acquired image data is data obtained by converting a photograph taken by a conventionally known X-ray imaging apparatus or electrophotographic apparatus into an image format. In addition to acquiring image data from the imaging apparatus, image data may be acquired from an ultrasonic diagnostic apparatus or various inspection apparatuses.

  The acquired image data is displayed as an image on the screen of the display 4 and is referred to during a conversation between a medical staff and a patient, that is, informed consent. The image referred to by informed consent may be an image showing the treatment progress of another patient in addition to an image obtained by photographing the affected area of the patient, and the image is held in a database (not shown). The data database is connected to the network, and the requested image data is output to the image data acquisition unit 8 via the network.

  The storage unit 300 includes an audio data storage unit 31, an elapsed time data storage unit 32, and an image data storage unit 33. Since the audio data storage unit 31 and the elapsed time data storage unit 32 are the same as those in the first embodiment, description thereof will be omitted. The image data storage unit 33 stores image data of an image referred to by informed consent, and the image data is associated with the audio data stored in the audio data storage unit 31.

  The recording management unit 400 includes an audio recording unit 41, an audio data search unit 42, a cue position determination unit 43, an image recording unit 44, and an image data search unit 45. Since the voice recording means 41, the voice data search means 42, and the cue position determination means 43 are the same as those in the first embodiment, the description thereof is omitted. The image recording unit 44 performs control to hold image data of an image referred to by informed consent in the image data storage unit 33. When reproducing the conversation record, the image data retrieval unit 45 performs control to acquire image data of an image referred to in the reproduced conversation from the image data storage unit 33 and output the image data to the drawing data generation unit 600. .

The conversation elapsed time management unit 500 has the same function as the conversation elapsed time management unit 50 of the first embodiment, and manages the time in informed consent.
The drawing data generation unit 600 generates a desired screen from a screen configuration data storage unit (not shown) to generate drawing data for the display screens shown in FIGS. 7, 8, 9 and 10 different from the first embodiment. The configuration data is acquired, and processing for incorporating still image data or the like into the acquired screen configuration data as necessary is performed, and control is performed to store this in the image memory 9 as drawing data. The drawing data held in the image memory 9 is displayed on the display 4 as an image.
Each screen displayed on the display 4 will be described in detail in the operation of the informed consent record management apparatus 100.

Next, the operation of the informed consent record management apparatus 100 will be described with reference to a flowchart.
The informed consent recording management apparatus 100 according to the second embodiment includes a recording mode for recording an informed consent conversation and a reproduction mode for reproducing the conversation recorded in the recording mode. The recording mode consists of an audio recording mode that records only informed consent conversations, and an audio image recording mode that records informed consent conversations and the images referenced at that time, and the playback mode is the recorded conversations. Audio reproduction mode for reproducing only the sound, and audio image reproduction mode for reproducing the image together with the sound.

  In the informed consent recording management apparatus 100 according to the second embodiment, the voice recording mode and the voice reproduction mode are the same as the operation of the informed consent recording management apparatus 10 according to the first embodiment, and the description thereof is omitted. The operation in the audio image recording mode and the audio image reproduction mode will be mainly described.

The operation of the informed consent recording management apparatus 100 in the audio image recording mode is shown in the flowchart of FIG. 11 and will be described along the flowchart.
When the informed consent record management apparatus 100 is activated, the drawing data generation unit 600 acquires screen configuration data at the time of activation from a screen configuration data storage unit (not shown), and stores the data in the image memory 9 as drawing data. The display 4 displays the control screen at the time of conversation recording shown in FIG. 7 based on the drawing data held in the image memory 9.

  As shown in FIG. 7, this control screen is composed of a patient number, a patient name, the number of medical treatments, a doctor name in charge, a marking button, a voice recording mode button, a voice image recording mode button, an end button, and the like. . When the recording mode button or the audio image recording mode button is clicked with the mouse, recording is started in the clicked mode, and when the button is clicked again, the recording is stopped.

  The patient number, patient name, number of medical treatments, name of medical doctor in charge, etc. on the control screen of FIG. (Step S210). In order to display the patient data on the display 4, the drawing data generation unit 600 generates drawing data in which the patient data is incorporated, and outputs the drawing data to the image memory 9.

  By the way, the acquisition of the patient data described above may be acquired via a transmission path such as a LAN (Local Area Network) as shown in FIG. 12, for example, shown in an examination ticket submitted by the patient at reception. The reception staff may refer to the patient number, patient name, and the like, and input using the input terminal device connected to the network.

After the patient data is acquired, when a medical person clicks the sound image recording mode displayed on the screen of the display 4 with the mouse 3 (step S220), a control instruction in the sound image recording mode is sent via the control unit 20. To the audio recording means 41 and the image recording means 44. The voice recording means 41 acquires the time when the control instruction is received from the conversation elapsed time management unit 500 (step S230).
After that, the voice recording unit 41 associates the recording start time and the patient data with the voice data generated based on the conversation collected by the microphone 5 and performs control to hold it in the voice data storage unit 31.

On the other hand, the image recording unit 44 performs control to acquire tooth image data by the image data acquisition unit 8 and output the image data to the drawing data generation unit 600. When the image data acquisition unit 8 acquires image data, an image data name is specified on a screen (not shown), and the image data specified on this screen is acquired from a photographing apparatus connected via a network.
Upon receiving the image data from the screen configuration data storage unit (not shown), the drawing data generation unit 600 receives the data indicating the screen configuration and performs processing for incorporating the tooth image data into the screen configuration data. As shown in FIG. The display 4 displays a recording screen shown in FIG. 8 based on the drawing data of the image memory 9.

  As shown in FIG. 8, this screen displays the patient number, patient name, tooth image indicating the affected area, image data name of the image, buttons for enlarging / reducing the tooth image, and tooth image. It consists of buttons for moving up. On the screen, a so-called pointing device that is drawn according to the operation of the mouse 3 is shown. Informed consent is performed while pointing the image of the affected area with this pointing device. At this time, the image recording unit 44 controls the image data storage unit 33 to store image data indicating the combined image in order to record a combined image obtained by combining the still image of the tooth and the moving image of the pointing device ( Step S240).

By the way, the image data stored in the image data storage unit 33 is associated with the audio data of the audio data storage unit 31, that is, the recording start time and the patient data are also associated with the image data. Referenced in mode processing.
The image data stored in the image data storage unit 33 is data obtained by recording the movement of the pointing device at predetermined time intervals so that the movement of the pointing device can be reproduced frame by frame on the still image of the tooth. As a result, the storage capacity of the image data storage unit 33 can be reduced as compared with recording a normal moving image. Further, in order to reduce the storage capacity of the image data storage unit 33, the image data storage unit 33 may hold only data of still images of teeth.
Further, the still image to be displayed on the display 4 may be switched while the informed consent is being performed. In this case, other image data is acquired by the image data acquisition unit 8, and the time at that time is obtained from the conversation elapsed time management unit 500. To be acquired. The acquired time is attached to the image data as image change time data and held in the image data storage unit 33.

When a medical person presses down the foot switch 7 while recording a conversation between a medical person and a patient, a control instruction indicating the pressing is sent to the voice recording unit 41 via the control unit 200 (step S250).
When the voice recording means 41 receives a control instruction for pressing the foot switch 7, the voice recording means 41 acquires the time at that time from the conversation elapsed time management unit 50 and holds the time as elapsed time data in the elapsed time data storage unit 32 ( Step S260), the processing from step S240 described above is continued.

  On the control screen shown in FIG. 7, when the medical staff clicks the voice recording mode button again (step S270), a recording stop instruction is sent to the voice recording means 41 and the image recording means 44. Upon receiving the instruction, the voice recording unit 41 stops the process of holding the voice data in the voice data storage unit 31 at this stop timing, and the image recording unit 44 also holds the image data in the image data storage unit 33 at this stop timing. And the time at the time of stoppage is acquired from the conversation elapsed time management unit 50. The acquired recording stop time is held in association with the audio data and image data generated by this recording (step S280).

Here, the content held in the storage unit 300 is shown in FIG. 13 and will be described with reference to FIG.
Patient number, patient name, number of medical treatments and name of doctor in charge as patient data, recording start time, recording end time, recording mode, marking time, audio data, and image data are associated with each recording. Being held. The image data is data indicating a tooth image for each screen to be referred to during implementation of informed consent, and an image change time on each screen is associated as image change time data.

  The content of the recording mode indicates either the audio recording mode or the audio image recording mode, and the content of the recording mode is referred to when the recorded content is reproduced in a reproduction mode described later. In other words, in order to check the recorded content, when the playback mode is activated and the desired recording is designated and played back, when the designated recording is recorded only by voice, the voice playback mode is activated and the voice and image are recorded. When recorded, the audio image playback mode is activated.

Next, the operation of the informed consent recording management apparatus 100 for reproducing the recorded conversation after the conversation recording will be described with reference to the flowchart of FIG.
When the informed consent record management device 10 is activated in the playback mode, the drawing data generation unit 600 displays the screen configuration at the time of activation from the screen configuration data storage unit (not shown) to display the control screen illustrated in FIG. 9 on the display 4. Data is acquired, and the screen configuration data is stored in the image memory 9 as drawing data.

  The control screen shown in FIG. 9 includes a patient number, a patient name corresponding to the number, a doctor name in charge, a recorded conversation playback button, a temporary playback stop (pause) button, a fast forward button, and a fast reverse button. And a table showing that the number of treatments can be grasped together with an end button, a conversation recording start time and a recording end time, and a marking button indicating the number of times that the medical staff is determined to be in an important conversation and marking with the foot switch 7. It consists of

  When a medical person inputs the patient number shown in FIG. 9 using an input device such as the keyboard 2 or the mouse 3, the patient number is retrieved from the voice data search means of the record management means 40 via the control unit 20. 42 (step S400). The voice data search means 42 that has acquired the patient number acquires the patient data of the patient number from the voice data storage unit 31, and displays the patient name indicated in the patient data on the display 4. A control instruction is output to 600.

In the control screen at the time of conversation playback shown in FIG. 9, when a medical person points and clicks a desired marking button with a mouse to reproduce a conversation record (step S410), the clicked marking button is clicked. Information shown is sent to the voice data search means 42 and the image data search means 45 via the control unit 20.
Thereafter, the voice data search means 42 acquires elapsed time data corresponding to the clicked marking button in the same manner as in the first embodiment with reference to the elapsed time data storage unit 32 (step S420).

After acquiring the elapsed time data, the voice data search means 42 specifies the voice data corresponding to the elapsed time data with reference to the voice data storage unit 31, and the image data search means 45 selects the image corresponding to the elapsed time data. Data is specified with reference to the image data storage unit 33 (step S430).
At this time, the audio data search means 42 and the image data search means 45 acquire the recording start time and the recording end time associated with the specified audio data and image data (step S440).

  Thereafter, the cue position determination means 43 is assigned a cue position, that is, an address of the specified audio data based on the marking time indicated in the elapsed time data and the acquired conversation recording start time and conversation recording end time. In the audio data managed in this manner, the cue position is determined from which address position to be reproduced. At this time, the cue position determination means 43 also refers to the image change time data and also determines the cue position of the image data synchronized with the reproduction of the audio data (step S450).

  For example, when reproducing an image for 10 seconds before and after the marking time, the cueing position of the image data is obtained by obtaining the time 10 seconds before the marking time and relating the image change time data corresponding to the obtained time. Determine the address location of the data.

After determining the cueing position, the audio data search means 42 can sequentially read out the audio data from the audio data storage unit 31 and reproduce it on the speaker 6 in order to reproduce the audio data for a predetermined time from the position on the speaker 6. The electric signal is converted into an electric signal and the signal is supplied to the speaker 6. The image data search means 45 sequentially reads out the image data at the determined address position from the image data storage unit 33 and outputs the image data to the drawing data generation unit 600 in order to display the image on the display 4 in synchronization with the supplied audio data. To do. The drawing data generation unit 600 sequentially generates drawing data for displaying an image on the display 4 in synchronization with the audio data, and outputs the approximate drawing data to the image memory 9.
The drawing data to be generated is data for displaying on the display 4 a synthesized image in which the moving image of the pointing device is synthesized with the still image of the tooth, that is, on the tooth image in synchronization with the reproduction of the audio data. This is data for displaying on the screen of the display 4 the movement of the pointing device that changes frame by frame with time.

The speaker 6 reproduces the recorded conversation based on the supplied signal, and the display 4 reproduces the image shown in FIG. 10 synchronized with the conversation based on the drawing data in the image memory 9 (step S460). ).
The playback screen shown in FIG. 10 includes a patient number, a patient name corresponding to the number, a recorded image playback button, a temporary playback stop (pause) button, a fast forward button, a fast reverse button, and an end button. The image data name of the image, a button for enlarging / reducing the tooth image, a button for moving the tooth image on the screen, and the like. The movement of the pointing device is also displayed on the screen, and the movement of the pointing device is played back in synchronization with the audio together with the image referenced during the informed consent implementation, so the content of the conversation can be confirmed accurately Can do.

  As described above, according to the informed consent record management apparatus 100 according to the second embodiment, the medical staff is recording the informed consent conversation and the image being referred to in the conversation. By marking with the foot switch 7 when it is determined that the user has an important conversation, the elapsed time from the start of the conversation is retained as elapsed time data, so that it is retained when the recorded conversation is played back. Based on the elapsed time data, it is possible to quickly cue up audio data or cue up image data of an image being referred to in the conversation. Thereby, the medical staff can confirm the recorded content quickly and accurately.

In the conversation elapsed time management unit, the elapsed time data is managed by the absolute time, but the present invention is not limited to this, and the elapsed time data may be managed by the count time of the timer.
In the above-described embodiment, the conversation recording for 10 seconds before and after the marking time is reproduced. However, the reproduction time may be changed as appropriate.

Although the informed consent record management device of the present invention has been described in the application example in the dental practice, it is applied to the medical treatment of all subjects such as plastic surgery, orthopedics, neurosurgery, otolaryngology, internal medicine, pediatrics, psychiatry, etc. can do.
Conversations and images recorded with the informed consent record management device of the present invention can be used for informed consent workshops and study meetings, or in-hospital review meetings, and informed consent skills can be improved. .
In addition, since the implementation of informed consent is accurately recorded by the informed consent record management apparatus of the present invention, it can be used as evidence when a problem such as a medical accident occurs.

It is a block diagram of the informed consent record management apparatus of Example 1. FIG. It is a figure which shows the structure of the informed consent record management apparatus of Example 1. FIG. It is a figure which shows the control screen at the time of conversation recording of the informed consent recording management apparatus of Example 1. FIG. It is a flowchart which shows the operation | movement at the time of the conversation recording of the informed consent recording management apparatus of Example 1. FIG. It is a flowchart which shows the operation | movement at the time of conversation reproduction | regeneration of the informed consent recording management apparatus of Example 1. FIG. It is a block diagram of the informed consent record management apparatus of Example 2. FIG. It is a figure which shows the control screen at the time of the recording of the informed consent recording management apparatus of Example 2. FIG. It is a figure which shows the reproduction | regeneration screen at the time of the audio | voice image recording of the informed consent recording management apparatus of Example 2. FIG. It is a figure which shows the control screen at the time of the audio | voice image reproduction | regeneration of the informed consent recording management apparatus of Example 2. FIG. It is a figure which shows the reproduction | regeneration screen at the time of the audio | voice image reproduction | regeneration of the informed consent recording management apparatus of Example 2. FIG. It is a flowchart which shows the operation | movement at the time of recording of the informed consent recording management apparatus of Example 2. FIG. It is a network block diagram using an informed consent record management apparatus. It is a figure which shows the content preserve | saved of a memory | storage part. It is a flowchart which shows the operation | movement at the time of the recording / reproducing of the informed consent recording management apparatus of Example 2. FIG. It is a figure which shows the control screen in which the marking button at the time of conversation reproduction | regeneration of the informed consent recording management apparatus of Example 1 is shown.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Processing apparatus 2 Keyboard 3 Mouse 4 Display 5 Microphone 6 Speaker 7 Foot switch 10 Informed outlet recording management apparatus 20 Control part 30 Storage part 31 Audio | voice data storage part 32 Elapsed time data storage part 40 Recording management means 41 Audio recording means 42 Audio | voice Data search means 43 Cue position determination means 50 Conversation elapsed time management section 60 Drawing data generation section

Claims (6)

A device for managing conversation records to obtain informed consent,
A voice capture unit that converts conversations between medical personnel and patients into voice data;
Voice recording means for holding the voice data in a voice data storage unit corresponding to patient data for identifying the patient;
Informed consent, comprising: voice data search means for searching voice data corresponding to the patient data instructed by the medical staff from the voice data storage section and supplying the voice data to the voice playback section. Record management device. The voice recording means, when receiving a marking instruction from the medical personnel during the conversation, causes the elapsed time data storage unit to store elapsed time data indicating an elapsed time from the start of the conversation,
The voice data search means obtains the elapsed time data instructed by the medical staff from the elapsed time data storage unit, based on the elapsed time data, determines the cue position of the searched voice data, 2. The informed consent record management apparatus according to claim 1, wherein at least an audio data portion after the cueing position is extracted from the audio data, and the audio data portion is supplied to the audio reproduction unit. 3. The voice data search means determines a cueing position of the searched voice data based on an important conversation start time that is a predetermined time backward from the elapsed time indicated by the elapsed time data. Informed consent record management device. The informed consent record management apparatus according to claim 2, further comprising a foot switch for receiving the marking instruction from the medical staff. The informed consent record management apparatus according to claim 1, further comprising a communication unit for acquiring the patient data from an input device connected via a transmission path. . Further, the informed consent record management apparatus includes an image data acquisition unit that acquires image data to be referred to during the conversation;
Image recording means for storing the acquired image data in the image data storage unit in correspondence with the conversation data;
2. An image data search unit that acquires image data corresponding to the conversation data acquired by the voice data search unit from the image data storage unit and supplies the image data to a display unit. The informed consent record management device described.

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