JP2005182506A - Medical prescription downloading system - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an efficient input method for prescription data of a pharmacy and a system supporting it, and methods of coupling with an automatic packaging device and protecting personal information of a patient while keeping the current laws. <P>SOLUTION: A prescription downloading system in which an outside pharmacy downloads an electronic prescription that a doctor creates at medical facilities and prepares medicines according to the prescription is equipped with (1) a means in which the doctor creates the prescription based upon clinical consultation results and examination results of a patient at respective medical departments and registers the prescription as the electronic prescription in an electronic clinical card database and (2) in which the patient brings the prescription created by the means or access information on the electronic clinical card database at the medical facilities instead of the prescription to a pharmacy and shows the access information and then the pharmacy downloads the prescription in the electronic clinical card database at the medical facilities based upon the access information and prepares medicines based upon the prescription. <P>COPYRIGHT: (C)2005,JPO&NCIPI

Description

  The present invention relates to a method and system for efficiently processing medicine preparation and packaging by downloading an electronic prescription created by a medical institution from a pharmacy terminal.

  Currently, some large hospitals are also preparing medicines in the same hospital, but in general hospitals and clinics, outpatients have separate examinations and medical treatments and drug prescriptions. In the latter case, the patient brings a prescription created at a medical institution to the pharmacy, and the pharmacy sees the prescription and prepares the medicine. Recently, some prescriptions have been entered into a personal computer (receipt computer), and automatic packaging of medicines and automatic packaging machines have been carried out. For example, some automatic powder monitoring devices use bar codes to determine how many grams are measured when packaging powder medicine. In the automatic tablet packaging machine, there is a machine for packaging a medicine in a medicine bag and printing a patient name and how to drink at the same time.

In pharmacies, the contents of prescriptions brought by patients are entered manually into a personal computer for automatic preparation and automatic packaging. Manual data entry is not only time consuming but also has problems such as input mistakes. To solve this problem, the “Out-of-hospital prescription management system” (Patent Document 1) converts the prescription into a two-dimensional barcode, and the pharmacy reads the two-dimensional barcode prescription brought by the patient with a barcode reader. Yes. In order to convert the prescription recorded in the two-dimensional barcode into character information, the out-of-hospital prescription management system (external pharmacy) is provided with software for converting the two-dimensional barcode into character information. The “Support System for Easily and Efficiently Performing Dispensing Operations” (Patent Document 2) creates a database of patient information, medical product information, inventory information, doctor information, etc., from drug dispensing design to automatic drug collection, tablets An integrated system for dispensing operations has been proposed. Among them, the prescription is converted into a two-dimensional barcode, and it is touched on the efficient transmission of information.
JP2003-186999 JP2001-043279

  In medical institutions, computerization is being promoted to improve the efficiency of medical services. A representative example is the digitization of medical records. Electronic medical records make it possible to speed up searches, reduce documents, and share information between departments or hospitals by digitizing medical records. On the other hand, mechanization and computerization are also progressing in pharmacies, and as described in the prior art, automatic preparation of medicines, automatic packaging and the like have been performed.

  However, there is no exchange of information between the medical institution and the pharmacy by electronic communication. This is because the Pharmaceutical Affairs Law prohibits medical institutions from assigning specific pharmacies to patients. In the future, this law may be replaced, but at least at this time patients choose their pharmacies voluntarily.

  As mentioned in the prior art, although the work efficiency has been improved by mechanization and computerization, the input part of the prescription content is still manually input. Manual input not only requires input time but also has a serious problem of input error. In the patent application case mentioned in the prior art, the prescription data is input by printing the prescription contents using a two-dimensional barcode and reading the two-dimensional barcode at an external pharmacy. This method is also one of the measures to maintain the independence of the external pharmacy and the medical institution while improving the efficiency of data input at the pharmacy. However, there is a partition between the medical institution and the external pharmacy.

  In view of the above points, the present invention is to develop an efficient method for inputting prescription data in a pharmacy and a system that supports the method while complying with current laws. Another object of the present invention is to connect to an automatic packaging device and protect a patient's personal information.

  The prescription download system of the present invention aims at improving the efficiency of prescription data input processing at an external pharmacy and preventing input errors that occur when an input occurs. Moreover, in order to avoid medical institutions regulated by the current Pharmaceutical Affairs Law from specifying pharmacies, the system allows patients (general customers when viewed from pharmacies) to freely select pharmacies. In the present invention, by giving access information that can access only prescription data of a medical institution to the patient, the pharmacy has a system that downloads prescription data based on the access information carried by the patient. For this reason, when using a bar code, it may be a one-dimensional bar code that has been widely used, and is easy to handle in a pharmacy terminal (of course, a two-dimensional bar code is also acceptable). In addition to the barcode printed on prescription paper, it can be in the form of a magnetic examination ticket or an examination ticket with RFID attached on the back of a mobile phone, and the access information of the present invention can be created with a small amount of data. Has advantages. In particular, since mobile phones are common and are always carried, they are the most suitable tools for patients as examination tickets and prescriptions that are convenient for patients.

  In the present invention, from the viewpoint of protecting the personal information of the patient, since the access information is encrypted and only the prescription table is accessed by the management server, there is a risk that personal information such as the patient's medical history will be leaked to a third party. Absent.

  In order to effectively use the prescription download system of the present invention, the pharmacy needs to be equipped with a barcode reader, RFID reader, magnetic examination ticket reader, or the like. One-dimensional barcode readers and the like have become commonplace in stores that have already introduced a post system, so there is no handicap that new equipment must be introduced. For this reason, the present invention can be utilized immediately even when it becomes possible to sell drugs in a combination that is not currently approved. However, in order to utilize the present invention more efficiently, a more efficient usage is possible by close cooperation between the medical institution and the pharmacy. For example, in the present invention, a pharmacy is established as an independent entity from a medical institution in a sense, but by registering a list or quantity of medicines prepared at the pharmacy in the medical institution's database, the medical institution can also be referred to. And can be used to treat patients later.

  In the present invention, since the pharmacy can directly obtain the prescription data by using computer communication, it can be used as data of an automatic compounding machine or an automatic packaging machine based on the prescription data, and automatic drug mixing / packaging can be performed. For this reason, not only the efficiency of manual data entry, but also the time-consuming work of compounding and packaging can be greatly reduced, and the entire process from data entry to packaging is automated and speeded up. It becomes possible to do. Increasing the efficiency and speed of data entry, formulation, and packaging not only avoids mistakes at pharmacies and reduces costs, but also improves customer service.

In order to solve the problem to be solved by the invention, the present invention adopts a method of accessing an electronic medical record database of a medical institution from a pharmacy using computer communication. First, an electronic prescription is created at a medical institution, and access information for accessing the electronic prescription is passed to the patient. The patient brings the access information to the pharmacy. In the pharmacy, the electronic prescription of the medical institution is read from the terminal based on the access information brought by the patient, and the prescription is downloaded by computer communication. Medicines are formulated based on the downloaded prescription.
The above is the outline of the present invention.

Electronic prescription access information that the patient brings to the pharmacy is recorded on the following medium.
-A barcode printed on a prescription.
・ Recorded access information on a magnetic examination ticket.
・ A card with RFID attached to a mobile phone is used as an examination ticket, and access information is recorded on the RFID.

An electronic prescription created by a medical institution is a table in an electronic medical record database. In this electronic medical record database, a lot of information related to the medical treatment of patients such as an electronic medical record table and a test result table is recorded. The Internet is generally used for computer communication. For this reason, when the electronic medical record database is freely accessed from the outside, not only the prescription but also other patient information may be accessed. Therefore, the access information is encrypted when it is recorded on the above medium in the medical institution, and when there is an access request, the encrypted information is decrypted and only the prescription table is transmitted to the pharmacy. For example, as access information
URL + (Prescription table access information)
The information in parentheses is encrypted. Avoiding anyone's free access by encrypting the prescription table, i.e. not publishing the raw access information. The access target is limited to only the prescription table. The URL is an Internet homepage address disclosed by a medical institution. Details will be described in the embodiment. Hereinafter, the database may be described as “DB” and the homepage may be described as “HP”.

  The best mode for carrying out the present invention will be described with reference to the drawings. FIG. 1 is a hardware configuration diagram for realizing the present invention. Reference numeral 1 is a medical management center, 2 is a diagnosis room, a reception, an examination room, etc., which are basically each processing department / treatment facility in the same hospital. The management server 100 of the medical management center 1 and the terminal 200 of each department 2 are LAN-connected. The management server of the medical management center manages various databases. The electronic medical record DB 101 plays an important role in the present invention.

An example of the structure of the electronic medical chart DB is shown in FIG. This structure indicates that a plurality of patient information tables TK10 are created under the attending physician information table TK00, and a plurality of chart information tables TK110 are created under the patient information table. A prescription is made based on the medical record, but generally the medical record information table and the prescription table TK111 have a one-to-one relationship. Various examinations and treatments (treatments) are performed in each department 2 based on the medical record, and the result is input from the terminal 200 and added to the medical record information table of the electronic medical record DB. Detailed personal information about the patient is registered in the patient DB (one of the other DBs 103). Therefore, access information (patient code) to the patient DB is registered in the patient information table, and detailed patient information can be extracted from the patient DB.

FIG. 3 shows an example of an electronic medical record code system. The medical doctor code in a broad sense is composed of a medical department code and a medical doctor code (a medical doctor code in a narrow sense: a code assigned to the attending physician <primary physician>) and serves as a search key for the attending physician information table. The patient code is also a search key for the patient information table and at the same time a search key for the patient DB. The medical chart information table is basically a serial number and is numbered in the order of creation. Therefore,
Medical doctor code in the broad sense + patient code + serial number −− → chart code in the broad sense
It is. That is, the medical record code in a broad sense serves as a search key when accessing the target electronic medical record. When accessing the patient information table from the patient DB, the patient information table is searched from the patient code. In this case, a plurality of patient information tables are searched. There is usually a one-to-one relationship between one doctor and one patient, but if the patient is consulted across multiple departments such as internal medicine and ophthalmology, the patient information table for the same patient under a different charge information table May be created (n-to-1 relationship).

  However, it is not always preferable to have a plurality of patient tables for the same patient from the viewpoint of centralized data management. In order to solve such a problem, it is possible to manage the data so that the main doctor is determined and the patient information table is always created under the main doctor (responsible doctor information table). That is, it is preferable that this main doctor is the attending physician and one attending physician is assigned to one patient (usually this is adopted in hospitals). In this case, if the attending physician (in charge doctor code) is registered in the patient DB, the patient information table in the electronic medical record DB can be directly accessed (searched).

  Returning to FIG. 1 again, a procedure for downloading a prescription (electronic prescription) from a pharmacy terminal will be described. The prescription is created by the attending physician at the terminal 200 in the examination room 2. The created prescription is transmitted to the medical management server 100 via LAN1 and registered in the prescription table TK111. After completion of the examination and treatment, the prescription in the prescription table is printed at the examination room or at the reception. At the same time, the access information output device 210 outputs prescription access information 220 that can be accessed by the prescription table from the pharmacy. This access information output device differs depending on the medium to which the information is output. In the case of a barcode, it is a printer.

  FIG. 4 is an example in which access information is printed on a prescription (paper). The prescription access information in the figure is printed separately from the URL that is the homepage address of the Internet and the prescription access information. As will be described later, the prescription sheet 220 with access information is handed over to the patient 4. The patient brings it to pharmacy 3. In the pharmacy, the access information 220 is read by the access information input device 310 connected to the terminal 300, and the prescription (data in the prescription table of the electronic medical record DB) is downloaded via the Internet i. The pharmacy medical clerk prepares the medicine from the downloaded prescription, wraps it, and delivers it to the customer (patient). At this time, if the automatic blending / automatic packaging device 320 is installed, the blending / packaging is performed directly from the downloaded prescription data by the device. If the access information is a barcode, the access information input device 310 is a barcode reader. However, at present, there is no such thing as a complete medicine automatic compounding device. To some extent, the selection of medicine and the introduction of medicine into the device are manual.

  In order to use the prescription download system of the present invention in a pharmacy, it is necessary to be connected to an access information input device, a download program, and the Internet. In the above example, the access information input device is a bar code reader. The download program has functions such as launching a web browser, connecting to the hospital management server from the browser with the URL read from the barcode, accessing the homepage, downloading prescriptions, displaying the screen, and saving to the terminal recording medium. ing. This download program can also be obtained through the Internet.

  FIG. 5 shows the main homepage (top page) displayed on the terminal screen when the homepage is accessed by connecting to the management server of the hospital medical management center. In this menu, “Install prescription download program” is selected (for example, mouse If you click), the download program will be installed on the pharmacy terminal. If the barcode of the prescription access information is read while the download program is running, the prescription is automatically downloaded. In the first stage (when the download program is not installed), even if the URL barcode is read with a barcode reader, the browser cannot be started or the homepage search by URL cannot be performed. It becomes input. After obtaining the download program, it can be automatically activated and searched by the download program.

FIG. 6 summarizes the above processing in HIPO. Hereinafter, a brief description will be given along the flow.
1. The doctor in charge creates a medical record and prescription based on the examination and test results. The creation result is registered in the electronic medical record DB 101.
2. The prescription registered in the electronic medical record DB is read and printed at the terminal in the reception or examination room. At this time, the prescription access information is converted into a barcode and printed on the prescription paper, but the access information is encrypted by the management server 100.
3. The patient goes to the pharmacy and presents the prescription to the pharmacy.
4). The pharmacy starts the download program on the terminal 200, reads the URL barcode printed on the prescription form 220 with a barcode reader, connects to the hospital management server 100 from the browser, and accesses the homepage from the homepage DB (HPDB) 102 Receive and display on screen. If the download program is not installed, the URL is manually entered by the browser to connect to the management server, and the home page (main home page) is accessed.
5). The prescription access information bar code printed on the prescription sheet 220 is read by a bar code reader and transmitted to the management server.
6). The management server that has obtained the prescription access information decrypts the information to obtain the original format chart code, searches the prescription table in the patient information DB 101, and transmits the read prescription information to the terminal of the pharmacy.
7). The prescription is displayed on the screen and stored in a recording medium of the terminal. At the same time, the medicine is prepared and packaged from the contents of the prescription.
8). The prepared and packaged medicine is given to the patient (customer).

  Although a series of processing is completed as described above, in general, medicine preparation / packaging is usually performed manually by a pharmacist at a pharmacy. However, when an automatic blending device or an automatic packaging device is connected to the terminal, automatic blending / automatic packaging can be performed in accordance with a prescription data command. In this case, the prescription data and the command (command code) to be issued to the automatic compounding machine / automatic packaging machine must match. Such an interface must be predetermined between the pharmacy and the hospital or covered by software.

  In the above example, a barcode printed on the prescription is used as prescription access information. However, in the present invention, since the prescription is transmitted from the hospital management server, the barcode is not necessarily required. Absent. Instead, as a medium on which the access information is recorded, a magnetic medical examination ticket or a readable / writable recording medium which is a medical examination ticket by attaching an RFID to a mobile phone can be used. FIG. 7 shows an example in which RFID is pasted on the back surface of the mobile phone 5 to replace the examination ticket. The data recorded here includes prescription access information, etc. in addition to information relating to the individual patient such as the date of issuance of the examination ticket, expiration date, patient code, and patient name. The prescription access information is recorded in a data format as shown in FIG.

The recorded data has a type at the beginning and represents the type of data recorded after the type. The issuance date includes a date when the prescription is issued (date when data is written to the RFID), an expiration date (a period or date when this prescription can be used), a URL, a medical record code in a broad sense, and the like. Since data must be read by an RFID reader, a pharmacy needs an RFID reader and software for analyzing the data in order to use an RFID mobile phone.

  In this case, the access information input device 310 of FIG. 1 is an RFID reader or an RFID reader / writer. In the case of having a writing function, it is possible to code and write the sales date and type of medicine. FIG. 9 shows input, processing, and output when the information is read from the medium in which the prescription access information of FIG. 8 is recorded. Although not shown in the figure, the type and amount of medicine prepared from the terminal of the pharmacy, the sales date (formulation date), etc. are transmitted to the hospital management server, and the information is registered as one piece of prescription table data in the electronic medical record DB You can also take a method.

It is a block diagram for demonstrating the structure of the prescription download system of this invention. It is structure explanatory drawing of electronic medical chart DB used with the prescription download system of this invention. It is code system explanatory drawing of electronic medical chart DB used with the prescription download system of this invention. It is a prescription explanatory drawing containing prescription access information. It is explanatory drawing of the homepage (top page) which a management server transmits to the terminal of a pharmacy. It is a HIPO figure for demonstrating the flow of a process from preparation of prescription in the prescription download system of this invention to download and delivery of the medicine to a patient. It is explanatory drawing of the examination ticket (cell-phone examination ticket with RFID) which affixed RFID on the mobile phone. It is explanatory drawing of the code | cord | chord system of prescription access information recorded on a magnetic examination ticket or a mobile telephone examination ticket with RFID. It is explanatory drawing of the function of the prescription download program of this invention.

Explanation of symbols

1 Medical management center 100 Management server 101 Electronic medical record database 102 Homepage database 103 Other various databases (patient DB, doctor DB, prescription master DB, examination item master DB, etc.)
2 Examination room, reception desk, each department (examination room, operating room, etc.)
200 terminals (receipt computer)
210 Prescription access information output device (printer, magnetic examination ticket input / output device, RFID reader / writer)
220 Prescription access information (Prescription paper, magnetic examination ticket, mobile phone with RFID)
3 pharmacies (external pharmacies, pharmacies independent of medical institutions)
300 terminals (receipt computer)
310 Access information input device (Barcode reader, magnetic examination ticket input device, RFID reader)
320 Compounding / Packaging Device 330 Journalized Medicine Bag 4 Patient (Customer)
5 Mobile phone l LAN
i Internet

Claims (6)

In a system where an external pharmacy downloads an electronic prescription created by a doctor at a medical institution from a medical institution and prepares a drug based on the prescription,
(1) Means in which a doctor at a medical institution creates a prescription based on patient examinations and test results in each medical department and registers the prescription as an electronic prescription in an electronic medical record database;
(2) The patient has the prescription created by the above means or the access information of the electronic medical record database of the medical institution instead of the prescription at an external pharmacy, and the pharmacy presents the access information by presenting the access information. A means for downloading a prescription in a medical institution's electronic medical record database to a terminal based on the prescription and preparing a medicine based on the prescription;
A prescription download system characterized by having A prescription download comprising: means for printing a barcode on a prescription sheet as access information of the prescription download system according to claim 1, reading the barcode at a pharmacy terminal, and accessing an electronic database of a medical institution system. A prescription download system comprising means for recording access information on a magnetic recording surface of a magnetic examination ticket instead of the bar code according to claim 2. A prescription download system comprising means for recording access information that allows access to prescription information by attaching an RFID to a mobile phone instead of the magnetic examination ticket according to claim 3. . The electronic medical system according to claim 1,
A prescription download system comprising means for automatically prescribing and packaging medicine by transmitting prescription data downloaded by a pharmacy management server to an automatic compounding machine and an automatic packaging machine. The electronic medical system according to claim 1,
(1) The address (search code) of the prescription table of the database is used as information for accessing the prescription table of the electronic medical record database of the medical institution. At that time, the address is encrypted and recorded on the recording medium, and the recording Means to record additional information such as date and time and validity period at the same time,
(2) The management server of the medical institution that received the download request from the pharmacy terminal decrypts the encrypted address, restricts the access to only the prescription table, and keeps it confidential so that other information is not leaked. A means of protection,
An access method comprising:

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