JP2005157560A - Hospital information system - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a hospital information system for unifying management of orders to each subsystem. <P>SOLUTION: The hospital information system for managing clinical path information composed of a plurality of items of medical practice information indicating a schedule for medical practice to each patient, acquires the clinical path information, converts the acquired path information into order information and transmits the converted order information to related medial departments. <P>COPYRIGHT: (C)2005,JPO&NCIPI

Description

  The present invention relates to a system for effectively using patient information in a medical field.

  In recent years, in hospitals, for example, various departmental systems (hereinafter also referred to as subsystems) such as an endoscopic examination system, a radiological examination system, and a nursing system. A system composed of such subsystems is called a “hospital information system”. ), IT (Information Technology) is progressing, and in each subsystem, examination results and patient information are converted into data and managed.

Conventionally, exchange of instruction information (hereinafter referred to as an order) of individual medical procedures for a patient between subsystems has been performed using a paper medium or the like, and a person in charge of each department inputs it to the subsystem. Such an operation was duplicated in each subsystem.
In addition, with the recent advancement of IT, it has been possible to transmit patient order information input at a predetermined terminal to a department subsystem that performs the medical practice.

  Now, in the medical field, a clinical path has been introduced in order to improve medical efficiency. The clinical path is a standardized hospitalization / treatment schedule for each disease. More specifically, the contents and timing of treatment, inspection, care, treatment, guidance, etc. for patients with certain diseases are summarized along the time axis.

In a medical field, a clinical path is printed on paper, and based on this, an order is input to each subsystem, thereby managing medical practices among a plurality of subsystems as a medical plan.
Moreover, the invention which introduces a clinical path and manages medical practice is also disclosed (for example, patent document 1, patent document 2).
JP-A-2001-1118014 JP 2003-108661 A

  However, there are various medical practices for patients, and it is necessary to place an order for each of a plurality of related medical practices. However, in the conventional hospital information system, an order for each medical practice is individually input, and the order issuance is repeated. Therefore, it takes time to input the order, and input errors and omissions are likely to occur. There was a problem. In addition, in order to ensure the consistency of patient information among the subsystems, a large amount of manual work has been a burden.

  Conventionally, it has been possible to change individual orders in a function for issuing orders in a hospital information system or the like. However, it was not possible to automatically change the order for the subsequent medical practice that is affected by the change of one order. For example, it has been impossible to communicate to the department subsystems changes such as a shift in the schedule of various medical practices occurring after surgery due to a shift in the schedule of surgery.

  In view of the above problems, the present invention provides a hospital information system capable of centrally managing orders for each subsystem. In addition, a hospital information system is provided for confirming whether or not a reservation is possible when setting a medical action for a clinical path. Furthermore, when there is a change in the clinical path, a hospital information system is provided that transmits the change information to a subsystem of a department in charge of medical practice or the like affected by the change.

  According to the first aspect of the present invention, in the hospital information system for managing clinical path information composed of a plurality of pieces of medical practice information indicating a schedule related to a medical practice for a patient, An acquisition means for acquiring clinical path information, and medical action notification information that is information for converting the clinical path information and notifying the medical department related to the medical action information related to the medical action information of the medical action information This can be achieved by providing a hospital information system comprising: a conversion unit configured as follows; and a transmission unit configured to transmit the medical practice notification information to the medical department.

With this configuration, the order information can be transmitted to the subsystems of a plurality of related departments with a single input of the clinical path, so that the clinical path can be centrally managed.
According to the second aspect of the present invention, the conversion means extracts the medical practice information from the clinical path information acquired by the acquisition means, and the extracted medical practice It can achieve by providing the hospital information system of Claim 1 characterized by adding the information regarding the said medical department to information.

By configuring in this way, each medical practice information included in the clinical path can be appropriately transmitted to a subsystem in a department related to the medical practice.
Moreover, according to the invention described in claim 3 of the claims, the above-described problem is a hospital information system that manages clinical path information composed of a plurality of medical practice information indicating a schedule related to a medical practice for a patient. Means for acquiring the clinical path information; determination means for determining whether or not the medical action schedule shown in the medical action information constituting the clinical path information is executable; and the determination By providing a hospital information system, comprising: a determination result change notifying means for notifying the change of the medical practice information constituting the clinical path information based on the determination result by the means; Can be achieved.

By configuring in this way, it is possible to confirm the reservation status of the medical practice in advance at the stage of setting the medical practice, and to make a reservation if there is an empty reservation frame.
Further, according to the invention described in claim 4 of the scope of the invention, the determination means is a medical practice included in the medical practice information constituting the clinical path information acquired by the acquisition means. 4. The hospital information system according to claim 3, wherein the scheduled date and time is compared with the date and time when the medical practice related to the medical practice can be performed or not. 5. it can.

By configuring in this way, it is possible to confirm the reservation frame on a date / time basis.
Further, according to the invention described in claim 5 of the claim, the above-mentioned problem is a hospital information system that manages clinical path information composed of a plurality of medical practice information indicating a schedule related to a medical practice for a patient. An acquisition unit that acquires the clinical path information, a storage unit that stores association information that associates the medical practice information, and a change instruction for predetermined medical practice information among the clinical path information acquired by the acquisition unit When receiving the information, the clinical path information is configured based on search means for searching for the medical practice information related to the predetermined medical practice information from the association information, and a search result by the search means. Search result change notification means for notifying the medical practice information to be changed, and a hospital information system comprising: It can be achieved by providing a.

With this configuration, order information can be transmitted to subsystems of a plurality of related departments with a single input operation when changing the clinical path.
Further, according to the invention described in claim 6, the association information includes information indicating an interval time of the scheduled date and time indicated by the associated medical practice information, The search result change notification means performs the notification including a change example of the medical practice information generated based on the interval time corresponding to the medical practice information searched by the search means. This can be achieved by providing the hospital information system described in 5.

By configuring in this way, it is possible to indicate how much time (or number of days) should be changed with respect to a change in medical practice associated with a change in one piece of medical practice information.
In addition, according to the invention described in claim 7, the hospital information system further includes the clinical path related to the medical practice information changed after the notification by the search result change notifying unit. Conversion means for acquiring information, converting the clinical path information, and converting the clinical path information into medical action notification information that is information for notifying the medical department related to the medical action related to the medical action information; It can be achieved by providing a hospital information system according to claim 6, further comprising: a transmission unit that transmits the medical action notification information to the medical department.

By configuring in this way, when changing medical practice information, it is possible to search for medical practices that are affected by this change, and to be notified when affected.
Further, according to the invention described in claim 8, the conversion unit extracts the medical practice information from the clinical path information acquired by the acquisition unit, and the extracted medical practice It can achieve by providing the hospital information system of Claim 7 characterized by adding the information regarding the said medical department to information.

  With this configuration, order information can be transmitted to subsystems of a plurality of related departments with a single input operation when changing the clinical path.

  By using the present invention, it becomes possible to centrally manage a series of medical actions for a patient based on a clinical path, and to easily reflect the change of the order in the system of each department by a single input. Can do. That is, as a result, the time required for order input work can be reduced. In addition, since duplicate input work does not occur, order input mistakes and input omissions are reduced.

  FIG. 1 shows the overall configuration of a hospital information system. The hospital information system 1 includes a hospital information system terminal 2 (2a, 2b, 2c, 2d, 2e,...), A clinical path database server 3, an order management server 4, and a department subsystem 5 (5a, 5b, 5c, 5d, 5e,...) And a LAN connecting them. The server group of the clinical path database server 3 and the order management server 4 can be physically integrated or distributed.

  The hospital information system terminal 2 (2a, 2b, 2c, 2d, 2e,...) Performs planning, display, order input, execution content / result display, patient information input, and display of the patient's clinical path. be able to. The information input to the hospital information system terminal 2 is transmitted to the clinical path database server 3.

  The clinical path database server 3 stores the clinical path plan and implementation contents / results for each patient transmitted from the hospital information system terminal 2. Also, clinical path template data for each disease name / disease is registered, which serves as reference data for making a hospitalization / treatment plan for each patient.

  The clinical path template data is configured as a schedule that combines medical practices such as treatment, examination, and medication, and medical practices from the start to the end of the schedule, for example, from hospitalization to discharge are input. Since there is a relationship between each medical practice and there is a connection that this nursing action is necessary for a certain treatment, data indicating such association is also registered. In addition, the stored clinical path plan and implementation contents / results for each patient are transmitted to the order management server 4.

  The order management server 4 includes order conversion means 4a and order transmission means 4b. The order conversion means 4a extracts each medical practice information from the received clinical path for each patient, and converts it into order information. The order transmitting means 4b transmits the order information to the department subsystem corresponding to this order.

  The department subsystem 5 includes, for example, a nursing system, a surgical system, a meal system, a medicine system, and each examination department system. Each subsystem 5 (5a, 5b, 5c, 5d, 5e,...) Is composed of a PC terminal, a server, a portable terminal, and the like, and each is connected by a LAN. In each department subsystem, a medical practice is performed based on the order information transmitted from the order management server 4, and an implementation record (implementation content, result, etc.) of the implemented medical practice is stored. Thereafter, a part (necessary information) of the execution record is transmitted to the clinical path database server 3 or the order management server 4.

Thereafter, the clinical path database server 3 receives the implementation record transmitted from the department subsystem 5 and stores the implementation record.
FIG. 2 shows a conceptual configuration inside each device of the hospital information system terminal 2, clinical path database server 3, order management server 4, or department subsystem 5. In the figure, a control unit (CPU) 12 that performs processing and calculation by a program, a storage unit 11 that stores necessary data, and a command, data, or the like are input from an input device such as a mouse, a keyboard, or a portable terminal. An input interface (hereinafter referred to as I / F) 13 for connecting these devices, an output I / F 14 for connecting these devices to output data to devices such as a printer and a display, and a LAN It comprises a communication I / F (interface) 10 that is an interface for connection to a network, and a bus 15 that connects them.

  FIG. 3 shows a flow of clinical path plan input at the hospital information system terminal 2. The patient's clinical path is input on the hospital information system terminal 2 by the operator. The operator activates the program of FIG. 3 according to the present embodiment installed in the hospital information system terminal 2 using an input device such as a mouse.

  Upon receiving the activation command from the above, the control unit 12 reads the program stored in the storage unit 11 and activates the program shown in the flow of FIG. When this program is started, the menu screen of the clinical path setting system is displayed on the display. In this menu screen, there are multiple buttons for processing screens according to the processing of each job, and when you select the “Clinical Path Selection” button, a patient selection list is displayed. When selected, the screen transitions to the screen of FIG. In the following, the screen of each figure will be described with reference to the flow of FIG.

  FIG. 4 shows a clinical path selection screen 20. Here, a description will be given of a case where a patient's disease name / disease is clear and a clinical path for the disease name / disease is defined in advance. In the figure, a clinical path selection screen 20 includes a “clinical path selection” list 21, a “cancel” button 22 for canceling the clinical path selection screen 20 and returning to the transition source screen, and a “clinical path selection” list 21. The “OK” button 23 is used to determine the clinical path selected in.

  The “clinical path selection” list 21 includes predetermined disease names and diseases such as “XX disease clinical path”, “□□ disease clinical path”, “XX surgery clinical path”, “□□ surgery clinical path”, etc. The clinical path corresponding to is displayed and can be selected. Each clinical path name displayed in the “clinical path selection” list 21 is information acquired from the clinical path database server 3 at the time of transition to the clinical path selection screen 20.

  First, the operator selects a clinical path for the patient at the hospital information system terminal 2 (step S1, hereinafter, step is abbreviated as S). That is, a list of clinical paths for each disease / disease registered in the clinical path database server 3 is displayed. From the list, a path suitable for the patient's disease / disease is selected, and an “OK” button 23 is displayed. Press.

  After pressing the “OK” button 23, the screen transitions to a screen (not shown), and on that screen, the scheduled start date of clinical path setting, for example, the hospitalization date is selected or entered (S 2), and “OK” "" Button is pressed, the screen transitions to the screen of FIG. Then, for example, if the selected clinical path is set for 10 days from hospitalization to discharge, and if the hospitalization date is September 1, then from September 1 to 10 as shown in FIG. The schedule of medical practice up to the day is displayed on the screen.

  FIG. 5 shows a clinical path display screen 30. The clinical path display screen 30 displays basic information of a patient, a selected clinical path name, and a plan table from the start date to the end date. Specifically, the clinical display screen 30 includes a “patient basic information” display field 31, a “clinical path basic information” display field 32, a “clinical path detailed information” field 33, and exits this screen and returns to the transition source screen. A “Cancel” button 38 and an “OK” button 39 for registering information set on this screen in the clinical database server 3 are configured.

  The “patient basic information” display field 31 displays the patient ID, name, sex, and date of birth of the patient whose clinical path is to be set. Further, in the “clinical path basic information” display field, names of diseases and diseases selected in the “clinical path selection” list 21 of FIG. 4 and the application start date-application end date of the clinical path are displayed.

  The “clinical path detailed information” column 33 includes a horizontal axis 34 representing the date, event information 35 for displaying an event corresponding to this date, “medical practice” such as treatment / treatment, examination, medicine, nutrition / meal, nursing, etc. ”Item 36, and a bar display area 37 for displaying a bar (shaded portion in FIG. 5) representing the number of days corresponding to each“ medical practice ”name display area 36. As described above, the number of days corresponding to each medical practice from September 1 to 10 is displayed as a bar. In the following, clinical path components such as treatment / treatment, examination, medicine, nutrition / meal, and nursing are referred to as medical practice.

  The items displayed on the above-described clinical display screen 30 acquire information corresponding to each item from the clinical path database server 3 when transitioning to the clinical display screen 30. At this time, the clinical path database server 3 makes an inquiry to the order management server 4 to check whether a reservation frame is available for a medical activity with a reservation frame among the medical activities included in the displayed clinical path. (S3). This will be described later.

  FIG. 6 shows a message display prompting the user to change the schedule on the clinical display screen 30. When the clinical display screen 30 is opened, there may be no reservation frame for the scheduled date and time automatically set by default. When the operator wants to change the scheduled date and time automatically set by default in the clinical path for each medical practice, the scheduled date and time of the medical practice can be manually input. At this time, it is necessary to confirm the availability of the reservation frame for the medical practice with the reservation frame. Depending on the contents of the medical practice, the reservation frame is managed as a reservation frame because the number of times and the time zone that can be carried out per day are determined due to restrictions on the number of inspection devices, examination rooms, and the like.

  When the clinical display screen 30 is opened (see FIG. 5), if a medical action for which a reservation frame is set is included in the clinical path, it is determined in S3 whether reservation is possible. Here, S3 will be described in detail. When a transition to the clinical display screen 30 is made, a search for the presence or absence of a specific reservation frame is performed by acquiring information necessary for displaying the clinical display screen 30 from the clinical database server 3. Yes.

  At this time, the clinical database server 3 acquires the reservation information of each subsystem managed by the order management server 4 and stores the date and time of the medical practice included in the target clinical path to be displayed on the clinical display screen 30. It is determined whether or not a reservation is possible by comparing with the reservation information of the subsystem (for example, reservation date and time information). The reservation information may be acquired directly from the server of each subsystem.

  As a result of the determination in the clinical database server 3, if there is no vacancy in the reservation frame at the default date and time of any medical practice included in the target clinical path displayed on the clinical display screen 30, information to that effect is displayed. It is transmitted to the hospital information system terminal 2. It is displayed on the screen of the hospital information system terminal 2 that it is necessary to change the scheduled date and time of the examination (see FIG. 6). For example, if the examination schedule for the morning of hospitalization on the 6th day is set as a clinical pass, but there is no vacancy in the appointment schedule for that examination at that date and time, the need to change the date and time can be seen by emphasizing colors and letters. It is displayed (S4).

In the present embodiment, as shown in FIG. 6, a message 40 of “Reservation frame is full. Please change the schedule.” Is displayed. Therefore, when the “reservation frame” button 41 in the message 40 is clicked, the screen of FIG. 7 is displayed.
FIG. 7 shows an examination reservation screen 50. In the figure, an examination reservation screen 50 has a reservation frame setting area 51 in which the horizontal axis is date and the vertical axis is time, a “cancel” button 52 for canceling the processing on this screen, and the processing on this screen is confirmed. The “OK” button 53 is configured. In the inspection reservation screen 50, the inspection schedule can be changed.

  In the reservation frame setting area 51, the reservation frame is represented as “reservation impossible” (shaded display) and “reservation possible” (thick frame display). In the present embodiment, as described above, since the reservation for the morning of 6th is already filled, the “reservation impossible” display 54 is displayed. Further, since the “reservation impossible” display 57 is also displayed on the afternoon of the 7th, the reservation cannot be made. Therefore, it is necessary to select from the “reservable” displays 55, 56, and 58. In this embodiment, the afternoon of 6th is selected (the selected reservation frame is displayed with a double frame).

When the “OK” button 53 is pressed after selecting the reservation frame from the above, the examination reservation screen 50 is closed and the clinical path display screen 30 is displayed, and the scheduled date of the changed medical practice is displayed in the “clinical path detailed information” column 33. Updated.
Next, when it is necessary to individually input detailed order information for the medical action determined by the clinical path template or when the order contents are changed (proceed to "Yes" in S5) Then, the order input screen of FIG. 8 is opened (S6), and detailed information or change information is input. If there is no change in S5, the process proceeds to “No”, and the process of S8 described later is performed.

  FIG. 8 shows an order input screen 61. For example, if you want to change the contents of the examination for the 4th day medical practice “examination”, right-click on the 4th day examination bar in the “clinical path detailed information” field 33 with the mouse to display the menu 60. When “Change” is selected, an order input screen 61 is displayed. The order input screen 61 includes a “scheduled date” indicating a scheduled date of the medical practice “examination”, an “examination type”, and an “examination item (examination 1, examination 2, examination 3, examination 4, examination 5, examination 6)”. ”, A“ cancel ”button 62 for canceling the process on this screen, and an“ OK ”button 63 for confirming the process on this screen.

  The “scheduled date”, “inspection type”, and “inspection item” can be input / changed, respectively. Here, the change of the inspection item will be described. For example, in the default setting of the clinical path, the inspection 3 is used. However, when the inspection 1 and the inspection 4 are performed by changing this, the check box of the inspection 1 is unchecked on the order input screen 61 and the inspection 1 is performed. When the check box of the inspection 4 is checked and the “OK” button 63 is pressed, the order input screen 61 is closed. At this time, the changed clinical path information is updated on the clinical path display screen 30.

  Examples of cases in which the examination contents are changed using the order input screen 61 include reasons such as individual factors for each patient, medical conditions, allergic symptoms, and infectious diseases. Further, when it is necessary to shift the schedule, the “scheduled date” for performing the medical practice is changed on the schedule, which will be described later.

  In addition, medical practices can be added to the clinical path. For example, when the mouse pointer is moved to the “medical practice” name display area 36 and right-clicked, a menu is displayed. When “add medical practice” is selected from the menu, a medical practice information list is displayed. A medical practice may be selected from among them. At this time, after the selection, the selected medical practice is added to the “clinical path detailed information” column.

Thereafter, the operator determines whether or not to make another change, and if there is a change (goes to “Yes” in S7), repeats the process of S6. If there is no change in S7, the process proceeds to "No", and the process of S8 described later is performed.
After the above processing, after inputting and setting the necessary medical action from the start date to the end date of the clinical path schedule, the clinical path set on the clinical path display screen 30 is stored in the clinical path database 3. Register (S8). That is, when the “OK” button 39 is pressed, for example, the information changed in S4 and S6 is transmitted to the clinical path database server 3, and the clinical path information is registered in the clinical path database server 3.

  FIG. 9 shows an example of clinical path information 65 transmitted from the hospital information system terminal 2 to the clinical path database server 3. In the figure, clinical path information 65 has a header information portion and a detailed information portion. The header information portion mainly includes information on the “patient basic information” display field 31 and the “clinical path basic information” display field 32 on the clinical path display screen. For example, “patient ID” 65a, “clinical path” "Code" 65b, "Clinical pass start date" 65c, "Clinical pass end date" 65d, and other field groups 65e. The “clinical pass code” is a code set for each clinical pass.

  The detailed information portion mainly includes information in the “clinical path detailed information” column 33, for example, “medical practice code” 65f, “medical practice index” 65g. It consists of “scheduled start date and time” 65 h, “scheduled end date and time” 65 i, other field groups 65 j, and the like, and stores as many records as the number of bars displayed in the “clinical path detailed information” column 33.

  The “medical practice code” is a code set for each medical practice, and the medical practice index is a code for identifying a duplicate medical practice code. For example, the record corresponding to the medical practice code = 500101 in FIG. 9 corresponds to the medical practice “treatment / processing” in the “clinical path detailed information” column 33 in FIG. Since there is only one medical practice “treatment / processing” on September 3, 1 is stored in the “medical practice index” of the record.

  Further, the record of the medical practice code = 510201 in FIG. 9 corresponds to the medical practice “inspection” in the “clinical path detailed information” column 33 of FIG. Since there are five medical actions “treatment / processing” on September 3, there are also five records, and “medical action index” stores 1 to 5 in order.

In the above, the management of reservation slots has been managed by the order management server in the above, but is not limited to this, and it is possible to adopt a configuration in which the reservation slots of each department are individually managed by each department subsystem. .
Next, a case where the clinical path information 65 registered in the clinical path database server 3 is issued to each subsystem will be described.

  FIG. 10 shows a flow in which an order is issued to each subsystem based on the clinical path information 65 registered in the clinical path database server 3. As described above, the clinical path information 65 is stored in the clinical path database server 3 (S10). This is the process of S8 described above. Thereafter, the clinical path information stored in the clinical path database server 3 is transmitted to the order management server 4.

  Next, the order management server 4 starts the following order process (S11). The order management server 4 extracts each medical practice from the received clinical path information 65 (S12), and converts it into order information transmitted to the department subsystem in charge of each medical practice (S13). Information on which department subsystem is sent the order is managed by the order management subsystem for each order type.

  Further details of S13 will be described based on the master tables of FIGS. On the database of the clinical path database server 3, there are a medical practice master 70 (FIG. 11), a subsystem master 80 (FIG. 12), and a medical practice-subsystem related master 90 (FIG. 13).

  The medical practice master 70 in FIG. 11 is a table that manages medical practices that can be set as components of clinical paths such as correspondence measurement and blood pressure measurement. One record includes a “medical practice code” 71, a “medical practice name” 72, and a plurality of field groups 73 that store other necessary information.

  The subsystem master 80 in FIG. 12 is a table that manages information related to subsystems used in each department such as a drug system and an endoscopy system. One record includes a “subsystem code” 81, a “subsystem name” 82, and a plurality of field groups 83 for storing other necessary information.

  When the medical practice-subsystem association master 90 in FIG. 13 issues an order to a subsystem related to the medical practice based on the medical practice, which medical practice order should be issued to which subsystem? Is a table for managing the association information. One record includes a “medical practice code” 91, an “order index” 92, a “subsystem code” 93, and a field 94 for storing other necessary information. A plurality of subsystems can be associated with one type of medical practice. This is because the possibility of transmitting orders to a plurality of subsystems for one medical practice is considered.

  The “order index” 92 is an item used when a plurality of subsystem codes are associated with one medical practice code. When only one subsystem code is associated with one medical practice code, “1” is stored in the “order index” 92.

  When a plurality of subsystem codes are associated with one medical practice code, the order index code is counted up for each subsystem code and stored. That is, as shown in FIG. 13, “subsystem code: 1001” and “subsystem code: 7001” are associated with “medical practice code: 300101”. In this case, “order index” 92 Stores “1” for “subsystem code: 1001” and “2” for “subsystem code: 7001”.

For each medical practice extracted from the clinical path information 65, to which subsystem the order information should be transmitted is referred to the medical practice-subsystem-related master (FIG. 13). Refer to the corresponding subsystem code.
Here, there may be a plurality of target department subsystems. When one or more subsystems are associated with each other, the subsystem master (FIG. 12) is referred to, information necessary for order transmission to the subsystem is acquired, an order message is generated, and the subsystem is sent to the subsystem. The order is transmitted (S14). Information necessary for order transmission includes information such as the IP address and port number of the server of the department subsystem if socket communication is used as a communication means. An order message is generated by adding these pieces of information.

  Returning to the description of the flow of FIG. 10 again. The order management server 4 transmits the order to one or more department subsystems (S15). An example in which an order needs to be transmitted to a plurality of department systems for one medical practice is, for example, an injection order. The following operations are required for the injection order, and the order is transmitted to each department subsystem (for example, a drug system, a nursing portable terminal system, etc.) necessary for performing these operations.

1) Instruction reception work in the ward 2) Dispensing work of medicine in the pharmacy section 3) Mixed injection work of medicine in the ward (mixing work)
4) Injection start work to patient in ward 5) End injection work to patient in ward As mentioned above, when there is the following related department for the medical practice (proceed to "Yes" in S16), The processes of S14 and S15 are repeated. If there is no related department for the medical practice (proceed to “No” in S16), it is determined whether or not there is a next medical practice in the clinical path information 65 (S17).

  If there is the next medical practice in the clinical path information 65 (proceed to "Yes" in S17), the process of S12-S17 is executed, and the process of S12-S17 is executed for all the medical practices included in the clinical path information 65 To do. When the processing of S12-S17 is completed for all medical practices (the process proceeds to “No” in S17), the order processing is completed (S18).

  In the above, the main stream of the plan input of the clinical path-registration to the server-order issue to the subsystem has been described. Next, although touched a little in the above, the case where the scheduled date which implements the medical practice set by the clinical path is changed is explained in full detail below.

  FIG. 14 shows a clinical path change flow. The clinical path set for the patient may be changed according to changes in the situation such as the course of treatment. At this time, the clinical path already set on the hospital information system terminal 2 can be changed. Further, according to the change of the clinical path, it is possible to transmit the order content change information to each department subsystem. The details will be described below with reference to FIG.

  First, the above-mentioned clinical path display screen 30 is opened (S20). Next, as shown in FIG. 15, a medical practice that needs to be changed is selected on the clinical path screen (S21). This is the same as described in FIG. Then, since the details of the medical practice are displayed, change input is performed. For example, consider a case where the medical practice “inspection” is delayed by one day. At this time, the “scheduled date” 64 is changed from September 4 to September 5 (S22).

  Next, it is determined whether or not there is an influence on a medical practice plan after the scheduled date before the change due to the change in S22 (S23). Among these, some of the medical practices are affected and some are not affected, but since the association between medical practices is registered in the clinical path database, it can be seen where they are affected. This will be described later. If there is no change in the plan of the subsequent medical practice due to the change (the process proceeds to “No” in S23), the process of S24 is performed.

  Next, when it is determined in S23 that a change is necessary (proceeding to "Yes" in S23), the affected medical practice is displayed by emphasizing colors and characters. At this time, the contents of delaying or advancing the schedule of the affected medical practice are automatically displayed based on the changed “scheduled date” 64 (S25). This will be described with reference to FIG.

  FIG. 16 shows a display state of a medical practice affected by the change of the “scheduled date” 64 in FIG. In the figure, “treatment / treatment” and “examination” are affected in the medical practice. Looking at “Treatment / Treatment”, the scheduled date was set on September 5 before the “scheduled date” 64 was changed (see FIG. 15), but after the change, the date was shifted to one day by September 6. The scheduled date is displayed in the part (100) and further highlighted (S26). Here, the change to September 6 has not yet been confirmed, and here, the user is prompted that the change to September 6 is the smallest change. The same applies to “inspection”, and the user is prompted to change the scheduled date from September 6 to September 7 (101).

Next, it is necessary to perform processing for determining the scheduled date of these unconfirmed medical practices. Therefore, for example, when “inspection” (101) is selected with the mouse and right-clicked, a message shown in FIG. 17 is displayed.
FIG. 17 shows a message screen 110 for determining the change contents of the medical practice affected by the change. The message screen includes a “planned date change” indicating a planned date before the change and a planned date after the change (unconfirmed), a “change decision” button 112, and a “detailed display” button 111. If the automatically changed content / schedule is acceptable (the process proceeds to “Yes” in S27), the “change determination” button 112 is pressed to determine the change as it is. If it is necessary to confirm or change the details of the change (proceed to “No” in S27), the “detail display” button 111 is pressed to open the order input screen 61 to confirm or change the details of the change (S28). ).

The processes of S26, S27, and S28 are repeated, and after confirming all the changes, the process proceeds to S24.
Next, the operator determines whether there is any other change (S24). If there is a change, the operator returns to S21 and repeats the above processing. If there is no other change, the operator presses an “OK” button 39. Then, the set clinical path information 65 is transmitted to the clinical path database server 3, and the clinical path information 65 is registered in the clinical path database server 3.

Thereafter, as described in the flow of FIG. 10, the order management server 4 transmits the changed order to the related department system for all the changed medical practices.
Now, in S23 of FIG. 14, a method for checking whether or not a change in one medical practice will change the subsequent medical practice will be described in detail with reference to FIGS.

  FIG. 18 shows only the information related to the association of medical practice by extracting the part of the clinical path. Here, medical practices “0001”, “0002”, “0003”, and “0004” are recorded in the clinical path / medical practice information table 130 shown in FIG.

  FIG. 19 shows a clinical path / medical practice information table 130. The clinical path / medical practice information table 130 is a table stored in the clinical path database server, and is created based on the clinical path information 65 transmitted from the hospital information system terminal 2. The clinical path / medical practice information table 130 stores information on medical practices included in the clinical path.

Each record of the clinical path medical practice information table 130 is a field for recording a medical practice “index” 131, “medical practice code” 132, “scheduled start date / time” 133, “scheduled end date / time” 134, and other information. The group 135 is constituted.
On the other hand, the link information 0001 and 0002 in FIG. 18 is recorded in the clinical path / link information table 140 shown in FIG.

  FIG. 20 shows a clinical path / link information table 140. The clinical path link information table 140 includes a “link index” 141 that associates medical practices, a “medical practice index 1” 142 that indicates two medical practices associated by the “link index” 141, and “medical practice”. The action index 2 “143” and the “interval days (or interval time)” 144 required between the two medical actions are recorded.

  In FIG. 18, the medical action 0001 scheduled for September 1 at 9:00, the medical action 0003 scheduled for September 2 at 9:00, and the medical action 0004 scheduled for 12:00 at the same time are linked. They are related as indexes “0001” and “0002”. However, the medical practices 0002 and 0005 are not associated with other medical practices. That is, it does not depend on other medical practices and is independent and can be freely changed.

  Here, when the start date and time of the medical practice 0001 is to be delayed by one day, the following processing is performed. First, the start date and time of the medical practice 0001 is changed to 9:00 on September 2 by the operator. Then, the control unit of the hospital information system terminal 2 inquires the clinical database server 3 about the change. The control unit of the clinical database server 3 that has received this change inquiry information (for example, data including a changed index, a medical practice code, a scheduled start date and time after the change, etc.), the clinical path / link information table 140 The search process is executed to determine whether there is a medical practice corresponding to “medical practice index 1” 142, that is, medical practice index 1 = “0001”.

  In this case, when the medical practice index 1 = “0001”, two records of the link indexes 0001 and 0002 correspond, and the contents of the medical practice of “medical practice index 2” 143 of each record are examined. Then, the medical practice index 2 = 0003,0004. Here, when the contents of the medical practices 0003 and 0004 are examined from the clinical path / medical practice information table 130, each “scheduled start date / time” 133 is “September 2”, and “interval days” 144 is “1 day” (The next day) ".

  Since the scheduled start date and time of medical practice 0001 has been changed on September 2, the interval days recorded in the clinical path link information table 140 and the actual medical practice ("medical practice 0001-medical practice 0003") And the number of days between “medical practice 0001 and medical practice 0004”, the result is that the required interval is not available.

Therefore, the control unit of the clinical database server 3 executes a process of shifting the scheduled start date / time and the scheduled end date / time of each medical practice backward by the “interval days” 144.
In this case, the scheduled start date and time and the scheduled end date and time of the medical practice 0003 and the medical practice 0004 are both shifted by one day, and for the medical practice 0003, “scheduled start date = 2003/9/3 9:00”, “scheduled end date / time = 2003/9/3 12:00 ”, and for the medical practice 0004,“ scheduled start date and time = 2003/9/3 12:00 ”and“ scheduled end date and time = 2003/9/3 13:00 ”. The scheduled end dates and times are similarly changed, and these are temporarily stored in the work area in the storage unit of the clinical database server 3. Then, the temporarily stored information is returned to the hospital information system terminal 2 as change inquiry result information.

The control unit of the hospital information system terminal 2 that has received the change inquiry result information reflects the information and displays it in the “clinical path detailed information” column 33 of the clinical path display screen 30 (see FIG. 16).
Based on the above, a series of medical actions for patients can be planned based on the clinical path, and when this plan is entered, orders can be sent to the department in charge of each medical action. It is possible to reduce the order input work as much as possible, and to reduce the time for order input work.

  In addition, since a plan is made based on a clinical path as a template and a series of medical practice plans can be referred to in time series, order input mistakes and omissions are reduced. In addition, since the change of the clinical path can be easily reflected in each department system, there is no omission of passing of the changed items. In addition, based on the clinical path, it is possible to perform unified management for one patient's medical practice.

It is a figure which shows the whole structure of a hospital information system. It is a figure which shows the internal structure of each apparatus used with a hospital information system. It is a figure which shows the flow of the plan input of the clinical path | pass in the hospital information system terminal 2. FIG. It is a figure which shows the selection screen of a clinical path. It is a figure which shows a clinical path display screen. It is a figure which shows the message display which prompts the change of the schedule on a clinical display screen. It is a figure which shows a test | inspection reservation screen. It is a figure which shows an order input screen. It is a figure which shows an example of clinical path information. It is a figure which shows the flow by which an order is issued to each subsystem based on the clinical path information 65 registered into the clinical path database server. It is a figure which shows a medical practice master table. It is a figure which shows a subsystem master table. It is a figure which shows a medical practice-subsystem relevant master table. It is a figure which shows the change flow of a clinical path. It is a figure which shows the change of the scheduled date in an order input screen. It is a figure which shows the display state of the medical practice influenced by the change of the "scheduled date" 64 of FIG. It is a figure which shows the message screen which determines the change content of the medical practice affected by the change. It is a figure which extracts the part of a clinical path | pass, and shows the information regarding the correlation of medical practice. It is a figure which shows a clinical path and medical practice information table. It is a figure which shows a clinical path link information table.

Explanation of symbols

1 Hospital Information System 1
2 Hospital Information System Terminal 3 Clinical Path Database Server 4 Order Management Server 5 Department Subsystem 10 Communication I / F
11 Storage Unit 12 Control Unit 13 Input I / F
14 Output I / F
15 bus

Claims (8)

In a hospital information system that manages clinical path information consisting of multiple medical practice information indicating a schedule for medical practice for a patient,
Obtaining means for obtaining said clinical path information;
Conversion means for converting the clinical path information into medical action notification information which is information for notifying the medical department related to the medical action related to the medical action information of the medical action information;
Transmitting means for transmitting the medical practice notification information to the medical department;
A hospital information system characterized by comprising:   The said conversion means extracts the said medical practice information from the said clinical path information acquired by the said acquisition means, The information regarding the said medical department is added to this extracted medical practice information. Hospital information system. In a hospital information system that manages clinical path information consisting of multiple medical practice information indicating a schedule for medical practice for a patient,
Means for obtaining said clinical path information;
A determination means for determining whether or not the schedule of the medical practice shown in the medical practice information constituting the clinical path information is executable;
Based on the determination result by the determination means, a determination result change notification means for notifying the change of the medical practice information constituting the clinical path information;
A hospital information system characterized by comprising: The determination unit includes a scheduled date and time of the medical practice included in the medical practice information constituting the clinical path information acquired by the acquisition unit, and a feasible date and time of the medical practice of the medical department related to the medical practice Alternatively, the hospital information system according to claim 3, wherein the date and time cannot be collated. In a hospital information system that manages clinical path information consisting of multiple medical practice information indicating a schedule for medical practice for a patient,
Obtaining means for obtaining said clinical path information;
Storage means for storing association information relating the medical practice information;
Retrieval for searching for the medical practice information related to the predetermined medical practice information from the association information when receiving change instruction information about the predetermined medical practice information among the clinical path information acquired by the acquisition means Means,
Search result change notification means for notifying the change of the medical practice information constituting the clinical path information based on the search result by the search means;
A hospital information system characterized by comprising: The association information includes information indicating an interval time of the scheduled date and time indicated by the associated medical practice information,
The search result change notification means performs the notification including a change example of the medical practice information generated based on the interval time corresponding to the medical practice information searched by the search means. 5. The hospital information system according to 5. The hospital information system further includes:
Obtaining the clinical path information related to the medical practice information changed after the notification by the search result change notification means, converting the clinical path information, to the medical department related to the medical practice related to the medical practice information A conversion means for providing medical practice notification information which is information for notifying the medical practice information;
Transmitting means for transmitting the medical practice notification information to the medical department;
The hospital information system according to claim 6, further comprising: The said conversion means extracts the said medical practice information from the said clinical path information acquired by the said acquisition means, The information regarding the said medical department is added to this extracted medical practice information. Hospital information system.

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