JP2005063253A - Clinical flow execution method and clinical flow execution system - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To enable a medical staff to surely execute examination service by performing a process management by use of a computer in a medical institute, thereby enabling the visual display and sharing of executing states of services including medical practice. <P>SOLUTION: The clinical flow system 1 comprises a plurality of terminals 6 and portable terminals 7 used by medical staffs in the medical institute, and a clinical flow server 2 connected to these terminals through a network 5. The clinical flow server 2 executes a plurality of medical service modules according to a predetermined execution order, transmits a message to the terminal 6 or portable terminal 7 used by each medical staff according to the executing state of the medical service modules, and executes the medical service modules according to instructions transmitted in response to the message. <P>COPYRIGHT: (C)2005,JPO&NCIPI

Description

  The present invention relates to a clinical flow execution method and a clinical flow execution system for supporting the performance of business including medical practice in a medical institution.

  In recent years, operations performed in medical institutions, that is, operations including medical practices have become significantly more complicated. This is due to characteristics such as an increase in work due to the development of new diagnostic methods and the like, the existence of various treatment methods, operation based on the experience of medical staff themselves, organization and staffing at each facility. Most medical institutions responded to this situation mainly by the personal efforts of medical staff such as doctors and nurses. For this reason, the medical staff has been forced to bear a heavy burden of having to perform operations that change in a complicated manner year by year in a safe and efficient manner.

  By the way, a workflow system is conventionally known as a method for supporting the execution of complicated tasks (see, for example, Patent Document 1).

JP 2000-207474 A

  The workflow system is a process in which a computer system is used to manage the progress of business operations that have been performed by humans. As a result, the efficiency of the process, the prevention of mistakes, and the evaluation of the process efficiency are improved by clarifying the division of work, clarifying the business process, sharing the degree of work progress by related parties, managing the execution status, and warning about the neglected state, etc. Is possible.

  However, many of the examples in which a workflow system is introduced in a medical institution are intended for medical expenses accounting processing and the like, and there is no example in which a workflow system is applied to business including medical practice.

Factors that have hindered the introduction of workflow systems in medical institutions include the following problems.
First, since the equipment such as medical equipment and the detailed procedure of inspection differ for each medical institution, it is necessary to customize the workflow system in accordance with the business procedure for each medical institution. However, the conventional workflow system has a problem that the labor required for changing the business procedure is very large, and the cost of customization is increased. Furthermore, even in a single medical institution, a change in work procedure occurs on a daily basis, but as described above, an operation for changing a workflow procedure has not been easily performed.

  Second, a single medical institution may have independent work procedures in the department, ward, medical assistance department, etc. Considering that the procedure varies depending on the day of the week and time of day, there are a great many You need to define and maintain a workflow. Furthermore, an approach to standardize in advance before introducing the workflow was tried, but more time had to be adjusted to standardize the complex elements as described above.

  Due to the above first and second problems, even if a workflow system is introduced in a medical institution including a medical practice, the business cannot be effectively supported and a sufficient effect cannot be obtained. Met.

The present invention visually displays and shares who is doing what and when and how it is performed among healthcare professionals by performing process management using a computer system for work including medical practice in medical institutions. The purpose is to ensure that medical staff can carry out medical services.
It is a further object of the present invention to provide a workflow system that can easily cope with a change in business procedure and can cope with various business procedures.

  In order to solve the above-described problem, the first invention executes a clinical flow that supports the performance of a business including a medical practice in a medical institution, and therefore the medical business module constituting the clinical flow and the execution order of each medical business module When multiple order tray information is defined, any one of the order tray information is specified, and further processing target data to be processed is specified based on the order tray information. The order tray instance is generated by combining the specified order tray information, processing target data, and information indicating the execution state of the clinical flow to generate an order tray instance, and calling the medical service module based on the generated order tray instance. As well as the medical business module And updates the information indicating the execution status of the order tray instance according to the row.

  In addition, the second aspect of the present invention shifts the order tray instance to the suspended state when the order tray instance being executed enters a state of waiting for an input instruction from the user or information input from another device. The execution of the order tray instance is resumed when there is a request to resume the order tray instance in the state, and the execution of the order tray instance is canceled when there is a request to cancel the order tray instance in the suspended state. To do.

  The third invention is characterized in that the order tray information is described in XML (eXtensible Markup Language).

  The fourth invention is characterized by executing a process queue transmission module for transmitting a process queue to a designated destination when notifying a user during execution of an order tray instance.

  According to a fifth aspect of the present invention, when a process queue destination is specified when a process queue is transmitted by the process queue transmission module, an organizational authority, responsibility, role, group in a medical institution is associated with the specified destination. A process queue is transmitted to a predetermined destination based on one or more of the configurations.

According to the first invention, in order to execute the clinical flow, the medical operation module for performing the business process related to the medical practice, the medical operation module constituting the clinical flow, and the execution order of each medical operation module are defined. Since order tray information is used, when changing the procedure of medical work, that is, the contents of the clinical flow, it is possible to respond quickly by rewriting the order tray information, and it is necessary to change the medical work module that is the actual processing program, etc. Absent. For this reason, it is easy to customize the clinical flow according to the situation of each medical institution, and it is possible to obtain an effect that it is possible to quickly respond to changes in the clinical flow. In addition, when using many clinical flows to support various medical operations, the medical operation modules can be called as necessary when executing each clinical flow. It is only necessary to prepare a large amount of order tray information. Thereby, since many clinical flows can be prepared with little effort, the effect that it can respond to various medical work is acquired. Also, when executing the clinical flow, the order tray information and the processing target data are combined to generate an order tray instance, and the generated order tray instance is executed. Therefore, the order tray information itself is executed during the execution of the clinical flow. Is never occupied. Furthermore, since the order tray instance includes processing target data, the clinical flow can be executed based only on the order tray instance. Thereby, since a plurality of order tray instances can be executed in parallel, a large number of clinical flows can be executed in parallel in a medical institution. Accordingly, it is possible to simultaneously execute clinical flows regarding a plurality of patients in a medical institution, and in addition, there is an effect that various needs in the medical institution can be met.
Furthermore, according to the present invention, when the clinical flow is executed, the execution state of the order tray instance is updated according to the execution of the medical service module, so that it is possible to easily check the execution state of the clinical flow. .

  According to the second aspect of the invention, it is possible to release the hardware resources used for processing the order tray instance by setting the order tray instance in the standby state to the suspended state. For this reason, the effect that the processing efficiency at the time of performing several order tray instances in parallel can be acquired.

  According to the third invention, since the contents of the order tray information can be easily changed, an effect that it is possible to easily cope with a change in the clinical flow or the like is obtained. In addition, since it is possible to create and edit order tray information even if you do not have specialized knowledge of computer programs, you can customize the clinical flow according to the actual situation of each medical institution, more efficiently The effect of being able to support the performance of medical work is obtained.

  According to the fourth invention, it is possible to quickly notify a message to the user together with information indicating the importance or urgency of the message.

  According to the fifth invention, as the destination of the process queue, not only the designated destination but also an appropriate destination according to organizational authority, responsibility, role, group configuration, etc. in the medical institution is set. The effect that the sharing of the information about can be realized is obtained.

Hereinafter, the best embodiment of the present invention will be described with reference to the drawings.
FIG. 1 is a diagram showing a schematic configuration of a clinical flow system in the present embodiment. A clinical flow system 1 shown in FIG. 1 is configured around a clinical flow server 2, a network 5, a terminal 6, and a mobile terminal 7. A database server 3 is connected to the clinical flow server 2, and an external subsystem 41 is connected via the network 5. The clinical flow server 2 is connected to a portable telephone 42 and a FAX 43 through a local / public line 40 by an adapter 28 described later, and to a label printer 44 and a printer 45.

  The clinical flow is a process of combining a plurality of medical operation modules and executing them in a predetermined order in order to support medical operations (including medical practice) in a medical institution. The medical service module is a processing program for performing business processing in a medical institution.

The clinical flow server 2 is an application server that executes a clinical flow. The clinical flow server 2 reads various information stored in the database server 3 in accordance with instructions from the terminal 6 connected via the network 5 and executes the clinical flow. During execution of the clinical flow, the clinical flow server 2 accesses the external subsystem 41 via the network 5 as necessary, and transmits and receives various types of information including processing requests to the external subsystem 41 and processing result reports.
Further, during the execution of the clinical flow, the clinical flow server 2 outputs an audio signal to the portable telephone 42 via the local / public telephone line 40 by the adapter 28, or sends it to the FAX 43 via the local / public telephone line 40. Information is transmitted and printed, or the label printer 44 and the printer 45 are controlled to print labels and forms.

  The database server 3 stores various types of information processed in the clinical flow system 1, retrieves and extracts information according to a request from the clinical flow server 2, and provides the information to the clinical flow server 2. The database server 3 stores, for example, personal information of a patient in a medical institution where the clinical flow system 1 is installed, information related to an electronic medical record, and the like.

  The external subsystem 41 is various devices (for example, medical devices such as test devices, a reception computer, a department system, etc.) that process information related to medical work, and is connected to the clinical flow server 2 via the network 5. Then, information is transmitted to and received from the clinical flow server 2 by executing a predetermined protocol.

  The network 5 is a network that connects the clinical flow server 2, the external subsystem 41, the terminal 6, and the mobile terminal 7. The specific implementation form of the network 5 is arbitrary, and may be configured only by a local telephone line network including a local LAN (Local Area Network) or PBX (Private Branch eXchange) installed in a medical institution, or a public network. Includes external communication lines such as VPN (Virtual Private Network) constructed using an external network such as a circuit network, packet communication network, frame relay network, ATM (Asynchronous Transfer Mode) network, various dedicated lines, or the Internet It does not matter whether it is a wired communication line or a wireless communication line.

  The terminal 6 and the portable terminal 7 are used by medical institution staff (including doctors, nurses, medical technicians such as laboratory technicians, and employees in administrative departments such as medical management operations) where the clinical flow system 1 is installed. A plurality of terminal devices can be installed on the network 5. The terminal 6 and the portable terminal 7 are installed at various places in the medical institution (reception, examination room, examination room, treatment room, nurse station, hospital room, etc.), the staff's home, etc., or carried by the staff. In the example shown in FIG. 1, the terminal 6 is a personal computer and the mobile terminal 7 is a PDA (Personal Digital Assistants), but a mobile phone (PDC (Personal Digital Cellular) system, GSM (Global System for Mobile communications) system, Of course, it is also possible to use a mobile phone by each system such as a CDMA (Code Division Multiple Access) system and a PHS (Personal Handyphone System). Note that the numbers of the terminals 6 and the portable terminals 7 are not limited to the numbers shown in FIG. 1 and can be arbitrarily changed.

  The terminal 6 and the portable terminal 7 send and receive various types of information to and from the clinical flow server 2 by functions such as various functions, e-mail functions, browser functions, messaging functions, etc. by a dedicated application program using the network 5, and by staff The process which transmits the input instruction | indication to the clinical flow server 2, and the process which displays the information received from the clinical flow server 2 on a screen are performed.

  In addition, who is using each terminal 6 and the mobile terminal 7 is uniquely determined, and who is using each of the terminals 6 and 7 in the clinical flow server 2. Can be determined. This configuration may be, for example, a configuration in which a user is designated in advance for each terminal, or based on a user name assigned to each user in a domain network having the clinical flow server 2 as a management server. The terminal 6 and the mobile terminal 7 may be logged in.

FIG. 2 is a block diagram showing a functional configuration of the clinical flow server 2 shown in FIG.
For convenience of explanation, FIG. 2 shows each part of the external subsystem 41, the mobile phone 42, the FAX 43, the label printer 44, the printer 45, and the e-mail creation unit 46 that are externally connected to the clinical flow server 2. To do.

As shown in FIG. 2, the clinical flow server 2 includes a clinical flow engine 21, a rule control unit 27, an adapter 28, and a media exchanger 29 that are external components of the clinical flow engine 21.
The clinical flow engine 21 includes functional units such as a clinical flow execution request I / F (interface) 22, a clinical flow control unit 23, a data entity storage unit 24, a medical service module execution unit 25, and a management tool 26. .

  Note that FIG. 2 merely illustrates the functional configuration of the clinical flow server 2 and does not limit the hardware configuration of the clinical flow server 2. 2 may be realized by specific hardware, or various hardware such as a CPU (Central Processing Unit), a main storage device, an auxiliary storage device, and a communication interface device (not shown). May be realized.

Here, the order tray used in the clinical flow system 1 will be described. The order tray is static information that defines the business procedure to be executed in the clinical flow and the execution order of each business procedure.
FIG. 3 is a diagram illustrating an example of an order tray described in XML.

The order tray 100 shown in FIG. 3 includes a property section 101, a control information section 102, and a flow definition section 103.
The property section 101 includes various types of information such as the creator of the order tray 100, the last updater, the creation date / time, the last update date / time, and the revision. The property section 101 is defined by a “clinical_flow_XML_property” tag, and includes “author”, “last_author”, “created_date”, “last_saved”, “revision” ”Or the like.

  The control information section 102 includes information on the ID of a business procedure that is a procedure for starting a clinical flow, the ID of a business procedure that is a procedure for starting an exception process, the processing mode of the clinical flow, and the like. The control information section 102 is defined by a “flow_control” tag, and is described using tags such as “start_process (start procedure)”, “exception_process (exception process start procedure)”, and “process_mode (process mode)”.

  The flow definition section 103 includes information related to a business procedure to be processed when a clinical flow is executed according to the order tray 100. The flow definition section 103 is defined by a “clinical_flow” tag, and includes “process (definition of business procedure)”, “procedure (identification string of a function to be called to process a business procedure)”, “param (process a business procedure) Static parameters to be passed to the function to be called) ”,“ result (definition for branching according to the processing result of the business procedure) ”and the like.

In the flow definition section 103 shown in FIG. 3, a business procedure definition 104 and a business procedure definition 105 are described. The business procedure definition 104 defines that the business procedure to which the ID “confirm examination material” is attached is executed by calling the medical business module “Getmaterial”. The medical service module “Getmaterial” is a medical service module for processing to determine the type of test material. If the test material is bone marrow fluid, it returns “bone marrow fluid” as the processing result, and the test material is blood. If there is, return the default value. Further, the business procedure definition 104 defines that when the medical business module “Getmaterial” returns the processing result “bone marrow fluid”, the business procedure transitions to the business procedure of “output guide card”. The medical business module “Getmaterial” It is defined that when the default value is returned, the clinical flow is terminated.
The business procedure definition 105 defines that a business procedure with an ID “output guide slip” is executed by calling a medical business module “OutputGuidance”. The medical service module “OutputGuidance” is a process of printing out a predetermined guide sheet by a printer (IP address 127.0.0.1) installed on the network 5. The business procedure definition 105 defines that the clinical flow is terminated when the medical business module “OutputGuidance” returns a default processing result.

  As described above, in the clinical flow system 1 to which the present invention is applied, the execution order of a plurality of medical service modules is defined by the order tray described in XML. Can be easily handled.

  Note that FIG. 3 is merely an example of an order tray, and the XML tags and parameters used in the clinical flow system 1 are not limited to those shown in FIG. 3, but in a medical institution that uses the clinical flow system 1. It can be arbitrarily changed according to the business procedure, the implementation form of the clinical flow system 1, and the like.

  The clinical flow execution request I / F 22 is an interface that accepts various requests input from the user by the operation of the terminal 6 or the mobile terminal 7, and performs control such as start of execution of the clinical flow in accordance with the input request. The clinical flow execution request I / F 22 acquires the order tray stored in the data entity storage unit 24 in response to the request by the operation of the terminal 6 or the mobile terminal 7, and combines the runtime information with the acquired order tray. An order tray instance is generated and stored in the data entity storage unit 24. Further, the clinical flow execution request I / F 22 generates an instance of the clinical flow control unit 23 for processing the order tray instance. In the clinical flow control unit 23, a plurality of instances can independently process an order tray instance. That is, the clinical flow control unit 23 can execute a plurality of order tray instances in parallel.

  The clinical flow control unit 23 reads the order tray instance stored in the data entity storage unit 24 in response to a request from the clinical flow execution request I / F 22 and executes the clinical flow. When executing the clinical flow, the clinical flow control unit 23 calls and executes the medical service module defined in the order tray from the medical service module execution unit 25. The clinical flow control unit 23 updates the execution state of the order tray instance and stores it in the data entity storage unit 24 according to the execution of the medical service module during the execution of the order tray instance.

Here, the operations of the clinical flow execution request I / F 22 and the clinical flow control unit 23 will be described in detail with reference to FIG.
FIG. 4 is a diagram showing in detail the operations of the clinical flow execution request I / F 22 and the clinical flow control unit 23. (a) shows the operation when starting the clinical flow, and (b) resumes the clinical flow. (C) shows the operation when the clinical flow is stopped.

  First, in FIG. 4A, when a clinical flow start request is input by operating the terminal 6 or the portable terminal 7, and the target patient and the order tray to be executed (here, the order tray 201) are designated (in the figure). P1), the clinical flow execution request I / F 22 acquires information on the designated target patient, and obtains the designated order tray 201 from the data entity storage unit 24 (P2 in the figure). Subsequently, the clinical flow execution request I / F 22 generates an order tray instance 202 by combining runtime information including information on the target patient and information indicating the execution state of the clinical flow with the order tray, and generates data Store in the entity storage unit 24 (P3 in the figure).

Then, the clinical flow execution request I / F 22 generates an instance of the clinical flow control unit 23 and designates the order tray instance 202 to be executed by the generated instance (P4 in the figure).
The clinical flow control unit 23 executes the clinical flow by reading the order tray instance 202 designated by the clinical flow execution request I / F 22 from the data entity storage unit 24 and executing it (P5 in the figure).

The clinical flow executed by the clinical flow system 1 includes, for example, processing related to operations involving humans, such as an approval operation by a doctor and treatment in a treatment room, but waiting for progress of operations involving humans. In the meantime, the progress of the clinical flow is temporarily stopped, and a so-called “standby state” is entered. Further, in the clinical flow server 2, while waiting for the processing result after requesting the processing to the external subsystem 41, the “standby state” is similarly entered.
When the currently executed order tray instance 202 enters a standby state, the clinical flow control unit 23 sets the execution state of the order tray instance 202 to the suspended state and stores it in the data entity storage unit 24. At this point, the instance of the clinical flow control unit 23 disappears.
The suspended order tray instance 202 is resumed or stopped as described below in response to a request for the clinical flow execution request I / F 22 from the terminal 6 or the portable terminal 7.

  As shown in FIG. 4 (b), when a clinical flow resumption request is input to the suspended order tray instance (here, the order tray instance 202) by the operation of the terminal 6 or the portable terminal 7 (P11 in the figure). The clinical flow execution request I / F 22 generates an instance of the clinical flow control unit 23 and designates the order tray instance 202 requested to be resumed (P12 in the figure). The clinical flow control unit 23 reads the order tray instance 202 designated by the clinical flow execution request I / F 22 from the data entity storage unit 24, and resumes the order tray instance (P13 in the figure).

  Further, as shown in FIG. 4C, when a clinical flow stop request for the suspended order tray instance is input by the operation of the terminal 6 or the portable terminal 7 (P21 in the figure), the clinical flow execution request I / F 22 Generates an instance of the clinical flow control unit 23 and designates the order tray instance 202 requested to be canceled (P22 in the figure). The clinical flow control unit 23 reads the order tray instance 202 designated by the clinical flow execution request I / F 22 from the data entity storage unit 24, sets the execution state of the order tray instance 202 to “cancel”, and updates it. Perform (P23 in the figure).

  Returning to FIG. 2, the data entity storage unit 24 stores various data entities processed by the clinical flow engine 21 such as an order tray and an order tray instance.

The medical service module execution unit 25 stores a medical service module for performing various business processes related to the medical service, and provides the medical service module in response to a call from the clinical flow control unit 23.
The medical service modules provided by the medical service module execution unit 25 include a common function module that can be used for general purposes in general medical services and a business function module related to a specific medical service. The common function module includes, for example, a function for transmitting a process queue, a function for accessing the rule control unit 27, a function for transmitting data to the media exchanger 29, and transferring data to the external subsystem 41 via the adapter 28. Functions to be included. The medical service module provided by the medical service module execution unit 25 takes the form of a plug-in and can be easily added. The added medical service module is called as necessary to provide the function, like the medical service module that has existed before.

Here, the process queue transmitted by the medical service module execution unit 25 will be described.
The process queue is a message with a specific destination set. For example, it is used for the purpose of requesting the treatment room to collect bone marrow fluid or notifying the doctor of abnormalities in test results. It is done. The user who is the destination of the process queue can perform processing such as browsing and approval of the process queue by the terminal 6 or the mobile terminal 7.
When the clinical flow is in the suspended state, the terminal 6 or the mobile terminal 7 performs processing such as browsing and approval for the process queue, thereby making a request for restarting the clinical flow in response to the clinical flow execution request I / F 22.

When the medical service module execution unit 25 executes a medical service module for transmitting a process queue, process queue information is generated and stored in the data entity storage unit 24. FIG. 5 is a diagram schematically showing the configuration of process queue information.
As shown in FIG. 5, the process queue information includes process queue control information, message information, and application control information.

The process queue control information includes “process queue ID” as identification information unique to each process queue, “destination” indicating the destination of the process queue, and “source” indicating the sender and the like regarding the clinical flow that originated the process queue. , "Date and time of sending" indicating the date and time of sending out the process queue, "Expiration date" showing the expiration date of the process queue, "Urgent level" showing the urgency level of the process queue, "Importance level" showing the importance level of the process queue Various information such as “status” indicating the processing state of the queue is included.
The message information includes each information of “subject” that is the title of the process queue and “message content” that is the content of the message.
The application control information includes “related application” indicating an application used when processing the process queue, “application information” that is information passed to the application to be used, and “order” that is information on the order tray instance that originated the process queue. Various information such as “tray instance” and “related event” that defines an event generated by processing of the process queue are included.
Note that the information included in the process queue can be arbitrarily changed in accordance with a business procedure or an organization form in a medical institution using the clinical flow system 1 or an implementation form of the clinical flow system 1.

  The process queue information generated when the process queue is transmitted is stored in a storage area (not shown) provided for each destination in the data entity storage unit 24. The terminal 6 or the portable terminal 7 used by the user set as the destination acquires the process queue destined for the user as needed by referring to the process queue information stored in the storage area corresponding to the user, Can browse.

  Note that the process of sending a process queue in the medical service module execution unit 25 is performed only when the process queue has only a function as a message and the process proceeds after the process queue is sent, and when the user responds to the sent process queue. Since there is a need to input an instruction from, there is a case where the process enters a standby state for the instruction input after the process queue is transmitted. When a transition is made to the standby state after the process queue is transmitted, when the order flow instance being executed is suspended by the clinical flow control unit 23 and an instruction is input in response to the transmitted process queue, the instruction input is The clinical flow execution request I / F 22 accepts it as a clinical flow resumption request, and execution of the order tray instance is resumed.

  FIG. 6 is a diagram showing a process queue browsing screen 61 displayed on the terminal 6 as an example of a screen when browsing the process queue information on the terminal 6 or the portable terminal 7. Note that the process queue browsing screen 61 in FIG. 6 is merely an example of a configuration for browsing the process queue, and the detailed configuration such as the type and order of display columns in the process queue browsing screen 61 is described. The type and number of information included in the process queue or the implementation form of the clinical flow system 1 can be arbitrarily changed.

The process queue browsing screen 61 shown in FIG.
“Queue Browser” is displayed, and the user name “doctor A” being viewed is displayed. That is, the process queue browsing screen 61 shown in FIG. 6 is a screen for browsing the process queue addressed to “doctor A”.

On the process queue browsing screen 61, for the three process queues destined for the doctor A, the title of the process queue is displayed together with information such as “unconfirmed” indicating the state of the process queue and “! Important” indicating the importance level. ing. The contents of the process queue can be browsed by selecting and specifying the titles of the process queues.
In addition, a confirmation button for instructing to confirm the contents of the process queue is arranged at the bottom of the process queue browsing screen 61. When the title of the process queue displayed on the process queue browsing screen 61 is selected and designated by operating the terminal 6 and the confirmation button is operated, confirmation (approval) processing for the process queue can be performed. When the process queue confirmation process is performed, the process queue state in the process queue browsing screen 61 is changed from “unconfirmed” to “confirmed”, and the process queue in the data entity storage unit 24 corresponding to the process queue is displayed. A process of updating the “status” in the information is performed.

  In the terminal 6, the confirmed process queue may be deleted from the process queue browsing screen 61. In this case, the process queue browsing screen 61 can be used as a kind of ToDo list.

  Further, when the confirmation button arranged on the process queue browsing screen 61 is operated on the terminal 6, the state of the process queue is changed from “unconfirmed” to “confirmed”, and an instruction to respond to the process queue is displayed in the clinical mode. It may be transmitted to the flow execution request I / F 22.

The destination of the process queue can be set by various methods based on information set in advance.
FIG. 7 is a diagram illustrating an example of a condition for designating a process queue destination. In the figure, (a) shows the conditions for direct designation, (b) shows the conditions for alias designation, and (c) shows the conditions for alias designation including a plurality of destinations. , (D) show conditions for specifying a role.

As a method for setting the destination of the process queue in units of each person, conditions as shown in FIG. 7A may be used. The condition shown in FIG. 7A is a condition in the case of performing direct designation for directly designating a destination. When doctor A is designated as a destination, a process queue destined for doctor A is transmitted, and pharmacist B When designated as a destination, a process queue destined for pharmacist B is transmitted.
Further, for example, as shown in FIGS. 7B and 7C, it is possible to specify a destination using an alias indicating a role in the medical institution. According to the condition of FIG. 7B, when “Teacher A” is designated as the destination, the doctor A is set as the destination of the actual process queue. Further, when “substitute doctor of teacher A” is designated as the destination, a process queue destined for doctor B is transmitted. If there is a doctor A who is a doctor, the doctor A and the doctor can view the process queue addressed to the doctor A if the doctor A and the doctor see the process queue.

  Furthermore, the condition shown in FIG. 7C is a condition for performing alias designation including a plurality of destinations. According to the condition of FIG. 7C, when “internal doctor” is designated as the destination, a process queue destined for doctor A who is a medical doctor and a process queue destined for doctor B are transmitted. When “examination room” is designated as the destination, a process queue destined for engineer C belonging to the examination room and a process queue destined for engineer D are transmitted, and “surgical reception” is designated as the destination. Then, a process queue destined for staff E who is a staff member belonging to the surgical reception, a process queue destined for staff F, and a process queue destined for staff G are transmitted.

  In addition, as shown in FIG. 7D, it is possible to set a destination based on the role in the medical institution. In accordance with the condition of FIG. 7D, when “reservation allocation staff” is designated as the destination, a process queue addressed to the reservation allocation staff is transmitted. The engineer C and engineer D who are in charge of the reservation allocation can share the process queue, and both the engineer C and the engineer D can receive the process queue addressed to the reservation allocation engineer. Similarly, when “medicine guidance manager” is designated as the destination, a process queue addressed to the medication guidance manager is transmitted. The pharmacist H, the pharmacist J, and the pharmacist K who are in charge of taking medication can share the process queue, and all three can receive the process queue whose destination is the person in charge of reservation allocation.

  As described above, conditions as shown in FIGS. 7A to 7D are set in advance and stored in, for example, the data entity storage unit 24, so that the destination of the process queue can be assigned to the organizational authority in the medical institution. Because it can be specified by direct designation, alias designation, role designation based on responsibilities, roles, group structure, etc., it facilitates the smooth progress of medical work and supports medical work according to the situation of medical institutions can do.

  When a plurality of users are set as process queue destinations, a process queue for each set destination may be transmitted, or one process queue having a plurality of destinations may be sent to a plurality of destinations. It is good also as a structure transmitted. In addition, when a plurality of users are set as process queue destinations and when a process queue is shared, only a user who can perform processing such as confirmation (approval) of the process queue can be viewed. Of course, it is possible to set the user separately.

  Further, as a method for receiving, browsing, and processing the process queue stored in the data entity storage unit 24, not only the method of accessing the clinical flow engine 21 from the terminal 6 and the portable terminal 7, but also the media from the clinical flow engine 21 A method may be adopted in which the process queue information is transmitted to the e-mail creation unit 46 via the exchanger 29 and is transmitted from the e-mail creation unit 46 to various devices as an e-mail. A method of transmitting process queue information to 42 or FAX 43 may be used.

  Returning to FIG. 2, the management tool 26 performs a process for managing the data entities stored in the data entity storage unit 24. Specifically, the management tool 26 installs a clinical flow engine, registers / changes / deletes a destination of a process queue, manages plug-in information of a use business module, defines an order tray, monitors an order tray instance state, processes Processes such as queue status monitoring, log referencing for various processes, deletion of completed order tray instances, cleanup of completed process queues, detection and recovery of order tray instances that have entered an illegal state are performed.

  The rule control unit 27 holds various medical business rules related to medical work and an evaluation engine that performs an evaluation process according to the medical work rules. When called by the clinical flow engine 21, the rule control unit 27 evaluates data passed from the clinical flow engine 21 by the evaluation engine, and returns the evaluation result to the clinical flow engine 21.

  The adapter 28 is an interface for transmitting / receiving various data to / from the external subsystem 41 via the network 5.

The media exchanger 29 is connected to various external devices such as a mobile phone 42, a FAX 43, a label printer 44, and a printer 45, and an e-mail creation unit 46, and receives common data input from the clinical flow engine 21. Process and output for the various external devices or e-mail creation unit 46. For example, the media exchanger 29 sends a call to the mobile phone 42 based on data input from the clinical flow engine 21 and transmits voice to the mobile phone 42. In addition, for example, the media exchanger 29 transmits a fax by calling a fax 43 and executing a predetermined protocol. Further, the media exchanger 29 generates print data based on the data input from the clinical flow engine 21 and transmits the print data to the label printer 44 or the printer 45 to print out a label or a form.
Further, the media exchanger 29 controls the e-mail creating unit 46 based on the data input from the clinical flow engine 21 and causes the e-mail creating unit 46 to create and send an e-mail.

  The e-mail creation unit 46 creates an e-mail according to the control of the media exchanger 29 and transmits the e-mail via the network 5 (FIG. 1) or the local / public telephone line 40 (FIG. 1).

  As an example of executing the clinical flow by the clinical flow system 1 configured as described above, a case of executing the clinical flow of the inspection work will be described as an example.

FIG. 8 is a flowchart showing a clinical flow of inspection work as an example of the clinical flow executed by the clinical flow system of FIG.
The examination work shown in FIG. 8 is started when a doctor issues an examination order (step S11). When an examination order is issued, the name of the patient to be examined and the type of examination are specified.
When the doctor issues a test order, the test material is confirmed, and it is determined whether the test is a bone marrow fluid test or a blood test (step S12).
When examining the bone marrow fluid, the bone marrow fluid is collected in the treatment room, so a guide sheet to the patient is given to the patient (step S13), and the bone marrow fluid is collected in the treatment room (step S14). ). In the case of a blood test, blood is collected immediately, and the blood test label is printed out by the label printer (step S15).
Thereafter, an inspection request is issued to the inspection system (step S16). When the inspection result is returned, the inspection result is evaluated (step S17).
If the test result is a normal value, the doctor is notified that the test has ended (step S18), and the clinical flow ends. If the test result is an abnormal value, the doctor is notified that the test result is abnormal (step S19), and the clinical flow ends.

FIG. 9 is a functional block diagram showing a detailed configuration of the clinical flow server 2 in the present embodiment. The clinical flow server 2 shown in FIG. 9 is basically the same as the configuration shown in FIG.
In this embodiment, an inspection system 47 is connected as an external subsystem 41 to the clinical flow server 2. The inspection system 47 is assigned an IP address “192.168.1.200” and accepts an inspection request in response to access to the port with the port number “5678”.
Further, in the clinical flow server 2, the rule control unit 27 holds a medical service rule related to the test result, and has an evaluation engine “Evaluate Test Result” that evaluates the test result by the test system 47 according to the medical service rule. . “Evaluate Test Result” is a specification that returns the processing result “normal” when the inspection result is a normal value, and returns the processing result “abnormal” when the inspection result is an abnormal value.
Further, in the clinical flow server 2, the IP address “192.168.1.100” is assigned to the media exchanger 29. In addition, when data including the identifier “Guidance” is input from the clinical flow engine 21, the media exchanger 29 causes the printer 45 to print out a form based on the guide form format created in advance, and the identifier “BloodTestLabel” ”Is input, the label printer 44 prints out a label based on a blood test label format created in advance.

  FIG. 10 is a diagram showing an order tray for executing the clinical flow in the present embodiment. The order tray shown in FIG. 10 is described in XML.

  The order tray shown in FIG. 10 includes “confirmation of examination material”, “handing out a guide sheet to the patient to the treatment room”, “collecting bone marrow fluid in the treatment room”, “requesting examination from the examination system”, “examination” The following processes are defined: “Evaluation of results”, “Notify doctor of completion of test”, “Notify doctor of abnormal test result”, and “Output blood test label”.

  In the “check of test material” process, the medical service module “CheckTestMaterial” of the medical service module execution unit 25 is called. When the medical service module “CheckTestMaterial” returns the processing result “bone marrow fluid”, the process proceeds to the “Give patient guide card to treatment room” process, and when “CheckTestMaterial” returns the processing result “blood”, Move to “Output blood test label” process.

  In the process of “passing the patient a guide sheet to the treatment room”, the medical service module “MediaExchanger” of the medical service module execution unit 25 is called and “192.168.1.100 | Guidance” is passed as a parameter. The medical service module “MediaExchanger” is a program for controlling the media exchanger 29 (FIG. 9) to perform various processes. By executing the medical service module “MediaExchanger”, data is output to the media exchanger 29 based on the IP address “192.168.1.100”. The media exchanger 29 causes the printer 45 to print a guide sheet according to the identifier “Guidance”. After running “MediaExchanger”, move to “Collecting bone marrow fluid in the treatment room” process.

  In the “collect bone marrow fluid in the treatment room” process, the medical work module “ProcessQueue” of the medical work module execution unit 25 is called, and the parameter “treatment room | please collect bone marrow fluid | normal” is passed. Therefore, by executing the medical process module “ProcessQueue”, a process queue having the content “please collect bone marrow fluid” and the urgency level “normal” is transmitted to the “treatment room”. After executing “ProcessQueue”, move to “Request inspection from inspection system” process.

  In the “Request Test to Test System” process, the medical service module “TestSystemAdapter” is called and the parameter “192.168.1.200” is passed. By executing the medical service module “TestSystemAdapter”, data is transmitted to the test system 47 via the adapter 28 based on the IP address “192.168.1.200”, and the process proceeds to the “test result evaluation” process.

  In the “test result evaluation” process, the medical service module “RuleEngine” is called and the parameter “EvaluateTestResult” is passed. When the medical service module “RuleEngine” is executed, the evaluation engine “EvaluateTestResult” of the rule control unit 27 is called, and the inspection result is evaluated by the inspection system 47. If the processing result returned by the evaluation engine “EvaluateTestResult” of the rule control unit 27 is “normal”, the process proceeds to the “notify the doctor to end the examination” process, and the processing result returned by “EvaluateTestResult” is “abnormal”. If there is, the process proceeds to “notify doctor that test result is abnormal” process.

  In the “notify the doctor of the end of examination” process, the medical work module “ProcessQueue” of the medical work module execution unit 25 is called, and the parameter “doctor | test result is given | normal” is passed. Therefore, by executing the medical service module “ProcessQueue”, a process queue having the contents “examination result has been issued” and the urgency level “normal” is transmitted to the “doctor”. After executing “ProcessQueue”, the clinical flow ends.

  In the “notify the doctor that the test result is abnormal” process, the medical service module “ProcessQueue” of the medical service module execution unit 25 is called, and the parameter “doctor | test result was abnormal | immediate” is passed. Therefore, by executing the medical service module “ProcessQueue”, a process queue having the content “The examination result was abnormal” and the urgency level “Urgent” is transmitted to “Doctor”. After executing “ProcessQueue”, the clinical flow ends.

  In the “output blood test label” process, the medical service module “MediaExchanger” of the medical service module execution unit 25 is called, and “192.168.1.100 | BloodTestLabel” is passed as a parameter. By executing the medical service module “MediaExchanger”, data is output to the media exchanger 29 based on the IP address “192.168.1.100”. The media exchanger 29 causes the label printer 44 to print the blood test label according to the identifier “BloodTestLabel”. After executing “MediaExchanger”, move to “Request inspection by inspection system” process.

  FIG. 11 is a flowchart showing the operation of the clinical flow system 1 when executing the clinical flow according to the order tray shown in FIG.

In step S21, the medical service module “CheckTestMaterial” is executed in order to check the test material (step S21).
Here, when the medical service module “CheckTestMaterial” returns the processing result “bone marrow fluid”, the clinical flow proceeds to step S22, and the medical service module “MediaExchanger” executes to pass the information sheet to the treatment room to the patient. The guide sheet is output by the printer 45, and the clinical flow proceeds to step S23.
In step S23, in order to collect bone marrow fluid in the treatment room, the medical service module “ProcessQueue” is executed, and a process queue having the destination “treatment room” is transmitted. Here, the clinical flow shifts to the suspended state, is restarted by the clinical flow restart request, and shifts to step S25.

  On the other hand, if “CheckTestMaterial” returns the processing result “blood” in step S21, the clinical flow proceeds to step S24, the medical service module “MediaExchanger” is executed to print the blood test label, and the label printer 44 The guidance slip is output by and the clinical flow moves to step S25.

  In step S25, the medical service module “TestSystemAdapter” is executed in order to request the inspection system 47 to perform an inspection. Here, the clinical flow shifts to the suspend state, and after the inspection in the inspection system is completed, for example, when a clinical flow resumption request is generated by an input from the terminal 6 installed in the inspection room, the clinical flow is resumed and step S26 is performed. Migrate to

In step S26, the medical service module “RuleEngine” is executed in order to evaluate the test result. When the medical service module “RuleEngine” returns the processing result “normal”, the clinical flow proceeds to step S27, and the medical service module “ProcessQueue” is executed to notify the doctor of the end of the examination. Is sent. Here, the clinical flow shifts to the suspend state, is resumed by the clinical flow resumption request, and the clinical flow ends.
On the other hand, when the medical service module “RuleEngine” returns the processing result “abnormal” in step S26, the clinical flow proceeds to step S28 to notify the doctor that the test result is abnormal. "ProcessQueue" is executed, and a process queue with the destination "doctor" is transmitted. Here, the clinical flow shifts to the suspended state, is resumed by the clinical flow resumption request, and the clinical flow ends.

  In the above embodiments and examples, the XML tag used to describe the order tray is merely an example, and can be arbitrarily changed according to the environment and conditions to which the present invention is applied. Further, the detailed configuration such as the installation location of the terminal 6 in the medical institution can be changed as appropriate. In the above embodiment, the clinical flow of the inspection work has been described. However, the present invention is not limited to this, and by preparing the necessary order tray, the clinical flow of almost all the work in the medical institution. It is possible to execute a flow.

It is a figure which shows schematic structure of the clinical flow system in the best embodiment of this invention. It is a block diagram which shows the functional structure of the clinical flow server shown in FIG. It is a figure which shows an example of the order tray processed by the clinical flow engine shown in FIG. It is a figure which shows typically operation | movement of the clinical flow engine shown in FIG. It is a figure which shows typically the structure of the process queue information transmitted by the clinical flow engine shown in FIG. It is a figure which shows the example of the process queue browsing screen displayed on the terminal shown in FIG. FIG. 3 is a diagram showing conditions for specifying a destination of a process queue by the clinical flow engine shown in FIG. 2, (a) showing conditions for direct designation, (b) showing conditions for performing alias designation, (C) shows conditions for performing alias designation including a plurality of destinations, and (d) shows conditions for performing role designation. It is a flowchart which shows the clinical flow of a test | inspection operation | work as an example of the clinical flow performed by the clinical flow system of FIG. It is a block diagram which shows the functional structure of the clinical flow server in the Example of this invention. It is a figure which shows the example of the order tray used in the Example of this invention. It is a flowchart which shows the clinical flow performed in the Example of this invention.

Explanation of symbols

1 Clinical Flow System 2 Clinical Flow Server 21 Clinical Flow Engine 22 Clinical Flow Execution Request I / F
DESCRIPTION OF SYMBOLS 23 Clinical flow control part 24 Data entity storage part 25 Medical service module execution part 26 Management tool 27 Rule control part 28 Adapter 29 Media exchanger 3 Database server 5 Network 6 Terminal 7 Portable terminal

Claims (6)

A method of executing a clinical flow that supports the performance of work including medical practice in a medical institution,
A plurality of order tray information that defines the execution order of the medical operation modules and the medical operation modules constituting the clinical flow are stored,
When any one of the plurality of order tray information is specified, and when processing target data to be processed is specified based on the order tray information, the specified order tray information and the processing An order tray instance is generated by combining the target data and information indicating the clinical flow execution status,
An order tray instance is executed by calling a medical service module based on the generated order tray instance, and information indicating an execution state of the order tray instance is updated according to the execution of the medical service module. Clinical flow execution method. When the order tray instance being executed is in a state of waiting for an input instruction from a user or information input from another device, the order tray instance is shifted to a suspended state,
Execution of the order tray instance is resumed when there is a restart request for the order tray instance in the suspended state, and execution of the order tray instance is stopped when there is a cancellation request for the order tray instance in the suspended state. The clinical flow execution method according to claim 1, wherein:   3. The clinical flow execution method according to claim 1, wherein the order tray information is described in XML (eXtensible Markup Language).   The clinical queue according to any one of claims 1 to 3, wherein a process queue transmission module for transmitting a process queue to a specified destination is executed when a notification is made to a user during execution of the order tray instance. Flow execution method.   When a process queue destination is specified when the process queue is transmitted by the process queue transmission module, any one of organizational authority, responsibility, role, and group configuration in the medical institution is associated with the specified destination. 5. The clinical flow execution method according to claim 4, wherein a process queue is transmitted to a predetermined destination based on one or more of the above. A clinical flow execution system that supports the execution of work including medical practice in a medical institution,
Order tray information storage means for storing a plurality of order tray information that defines the execution order of the medical operation modules and the medical operation modules constituting the clinical flow;
Designated when one of the plurality of order tray information stored in the order tray information storage means is designated, and further processing target data to be processed is designated based on the order tray information. A clinical flow execution request receiving unit that generates an order tray instance by combining the order tray information, the processing target data, and information indicating the execution state of the clinical flow,
The order tray instance generated by the clinical flow execution request accepting unit is acquired, the order tray instance is executed by calling the medical operation module based on the acquired order tray instance, and according to the execution of the medical operation module Flow execution control means for updating information indicating the execution state of the order tray instance;
Module execution means for executing the medical service module in response to a call by the flow execution control means;
A clinical flow execution system comprising:

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