JP2005196369A - Medical information management system - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a medical information management system for writing medical information in a computer-readable portable storage medium for delivering it to a patient. <P>SOLUTION: This medical information management system is provided with a data input terminal 10 for enabling an identified first operator to input medical information by associating patient information and authenticity information with it, a medical data storage device 20 for storing the medical information by associating the patient information and the authenticity information with it, a medical business terminal 13 for enabling an identified second operator to input the patient information and a use purpose, and to extract the medical information to be delivered from the data storage device based on the patient information and the authenticity information and a media writing device 23 for writing the medical information extracted from the medical business terminal 13 in a portable storage medium 24 such as CD-R. <P>COPYRIGHT: (C)2005,JPO&NCIPI

Description

  The present invention relates to a medical information management system, and more particularly, to an improvement of an information processing system capable of inputting and browsing medical information, in which medical information can be stored in a portable storage medium and delivered. Information management system.

  In general, medical information in a medical facility is described in a paper medium called a medical record and managed for each patient. A medical information management system that manages such medical information using a computer system is known as an electronic medical record system. At present, this type of electronic medical chart system is spreading mainly in large-scale medical facilities, and is expected to spread in small-scale medical facilities in the future.

  The electronic medical record system records medical information such as examinations, diagnoses, and medications in a data storage device such as a hard disk, and displays them on a display as needed, or allows them to be viewed by printing them out on paper. System. The input of medical information is performed by a doctor who performed a medical examination or medical treatment, an inspection engineer who performed an inspection, and the like, and medical information for each patient is accumulated and managed. In many cases, such medical information has a function of not only displaying input information as it is, but also displaying a series of examination results in a graph, as in the case of a paper-based medical record.

  In addition, the input medical information is shared among the departments in the medical facility. In other words, medical information in the electronic medical record system is managed for each patient, and can be viewed by a plurality of doctors, laboratory technicians, pharmacists, office staff, etc. related to the patient, and shared by the parties in the medical facility Is done.

  The electronic medical record system has special characteristics resulting from handling medical information compared to other data management systems. In other words, since medical information is information related to a patient's individual privacy, it is necessary to pay close attention to data management. For example, an operator who can access medical information is registered in advance, and access is permitted after identity verification is performed using a password or the like. Further, it is normal that medical information is not provided to an external system.

  Since medical information is personal information, it should be disclosed to the patient. However, the medical information may include information that is inappropriate to be disclosed to the patient. For example, in the case where the name of the disease is not announced, not only the description of the disease name but also the medication information associated with the name of the disease cannot be disclosed to the patient.

  Recently, an increasing number of patients are seeking views from doctors other than the attending physician, so-called second opinions. When trying to obtain a second opinion, the patient's medical history and examination data are required, so it is necessary to disclose this information to the doctor who gives the second opinion, and it would be convenient if it could be provided as electronic data. . However, in this case, it is necessary to disclose all information to the doctor even if the disease name has not been announced to the patient.

  For this reason, computerized medical information is only used within the electronic medical record system, and if it is necessary to disclose the medical information to the patient, it is printed out and provided on paper. It had been. That is, it was not provided to the patient in a form (electronic data) that can be used by the computer.

  The present invention has been made in view of the above circumstances, and an object thereof is to provide a medical information management system capable of writing medical information in a computer-readable storage medium and delivering it to a patient.

  In the medical information management system according to the present invention, the authenticated first operator stores the data input means for inputting the patient information and the authenticity information in association with the medical information, and stores the patient information and the authenticity information in association with the medical information. Medical data storage means, data delivery means for an authenticated second operator to input patient information and purpose of use, and extract medical information to be delivered based on the patient information and authenticity information from the data storage device, and data delivery Media writing means for writing medical information extracted by the terminal into a computer-readable portable storage medium.

  Further, in the medical information management system according to the present invention, the data input means allows the authenticated first operator to display the medical information in the medical data storage means, and graph data in which designated data is visualized The data delivery means generates graph data based on the extracted medical information, and the media writing means generates the medical information extracted by the data delivery means and the data delivery means The written graph data is configured to be written into the portable storage medium.

  In the medical information management system according to the present invention, the medical information includes date information on which the medical information is input, and the media writing unit divides the medical information into two or more portable storage media. And storing the medical information of the same date in the same portable storage medium.

  According to the present invention, in a medical information management system for storing patient information and authenticity information in association with medical information, medical information to be delivered based on patient information and authenticity information can be obtained by inputting the patient information and purpose of use. It can be extracted and written to a computer readable portable storage medium. Therefore, medical information can be written in a computer-readable storage medium and delivered to a patient according to the purpose of use.

Embodiment 1 FIG.
FIG. 1 is a block diagram showing a configuration example of a medical information management system according to the present invention. The network N is a LAN in a medical facility to which the medical information management server 10 and the terminal devices 11 to 14 are connected. A medical data storage device 20 for storing medical information is connected to the medical information management server 10, and each of the terminal devices 11 to 14 can access the medical information via the medical information management server 10. it can. That is, the medical information in the medical facility is centrally managed by the medical information management server 10 and is shared by the medical personnel who are permitted to use the terminal devices 11 to 14.

  In the medical data storage device 20, a user table 201, a patient table 202, and medical data 203 are held as medical information. The user table 201 includes data related to medical personnel (users) who can access medical information. The patient table 202 includes patient data for specifying each patient. The medical data 203 is composed of various data, so-called medical chart information, which has been described or attached to a conventional medical chart by a doctor.

  The doctor terminal 11 is a terminal device that is installed in the examination room and allows a doctor to input and browse medical information. The nurse terminal 12 is installed in the nurse's office and the medical office terminal 13 is installed in the office. The nurse and medical office staff are terminal devices for browsing medical information. The image processing terminal 14 is a terminal device that is arranged in the examination room and converts image data output from the examination apparatus into a predetermined format and registers it in the medical information management server 10. Here, the X-ray imaging apparatus 21 and the image data storage apparatus 22 are connected.

  Image data captured by the X-ray imaging apparatus 21 is output in a dedicated high-quality format called DICOM (Digital Imaging and Communication in Medicine). For this reason, the X-ray image is temporarily stored in the image data storage device 22 and then converted into a general-purpose image format such as JPEG or GIF in the image processing terminal 14, and medical treatment in the medical data storage device 20 is performed. It is registered as part of the data 203. This conversion process is performed based on instructions from a laboratory technician or doctor who operates the image processing terminal 14. For example, the range or accuracy of the image data to be converted is designated by an inspection engineer or the like.

  Each terminal device 11-14 includes a browser for displaying medical information, and the medical information management server 10 provides the browser data to each terminal device 11-14. Here, each terminal device 11-14 is provided with a WEB browser for displaying a WEB page, and the medical information management server 10 converts the WEB page made up of medical information into HTML based on a request from the terminal devices 11-14. It is assumed that an HTML file described using (Hyper Text Makeup Language) is generated and transmitted to the request source.

  A media writing device 23 for writing medical information to an external storage medium is connected to the medical office terminal 13. The medical information provided to the patient is written to the external storage medium 24 by the media writing device 23, and this storage medium is delivered to the patient or his / her agent. Therefore, the medical clerk who operates the medical office terminal 13 can not only view the medical information for paperwork, but also disclose the medical information to the patient or his / her agent if requested by the patient or doctor. can do.

  The external storage medium 24 is a data-writable, computer-readable, and portable storage medium, and a semiconductor memory, a magnetic storage medium, a magneto-optical storage medium, or the like can be used. However, since a storage medium for medical information is required to be easy to falsify after delivery, rewriting cannot be performed and a highly versatile CD-R (Compact Disc Recordable) is externally stored. It is desirable to use as the medium 24.

  The medical office terminal 13 generates disclosure data to be written to the external storage medium 24 based on an instruction from a medical office worker. The disclosed data includes medical information regarding the patient extracted from the medical data storage device 20. The disclosed data also includes data obtained by processing medical information, for example, graph data visualizing numerical data included in the medical information.

  FIG. 2 is a diagram illustrating an example of the user table 201. The user table 201 includes user data registered for each user. Each user data consists of a user ID, name, class, description availability information, and password. The user ID is user identification information in the medical information management system. The class is qualification information indicating the qualification as a user such as a doctor, nurse, laboratory technician, or office worker. Further, the description availability information is authority information indicating authority to write to medical information (particularly, medical data 203).

  When there is an access from each of the terminal devices 11 to 14, the medical information management server 10 first performs user authentication. User authentication is performed by collating the user ID and password transmitted from each terminal device 11 to 14 with the user table 201. Only when this authentication is successful, the requested medical information is read from the medical data storage device 20 and returned to the requesting terminal devices 11 to 14. In addition, based on the user table 201, writing to the medical data storage device 20 is performed only when there is a request from a user who has authority to write. The class is used as a part of display information constituting the WEB page when creating the HTML file.

  FIG. 3 is a diagram illustrating an example of the patient table 202. The patient table 202 includes patient data registered for each patient. Each patient data includes a patient code, a patient name, a date of birth, and a delivery approval flag. The patient code is patient identification information in the medical information management system. The name and date of birth are data used for identity verification. The delivery approval flag indicates that the doctor has approved the delivery of medical information related to the patient.

  FIG. 4 is a diagram illustrating an example of the medical data 203. The medical data 203 is composed of a large number of medical records. Each medical record corresponds to one line in the figure, and includes a recording date / time, a writer ID, a patient code, a medical number, a correction date / time, a corrector ID, a deletion flag, a true / false flag, and medical contents.

  The recording date and time is a time stamp given when the medical information management server 10 writes a medical record with data in the medical data storage device 20. The reporter ID is the user ID of the doctor who created the medical record. The medical number is a serial number given for each medical examination. When a plurality of medical records are created in one medical examination, the same medical care number is assigned to each medical record. The authenticity flag indicates whether or not the medical record is genuine data. The medical treatment contents include various medical information described by the doctor, for example, subjective symptoms appealing to the patient, physical findings, laboratory findings, evaluation and analysis of these findings, future medical treatment plans and guidelines.

  When the registered medical record is corrected, the time stamp at the time of correction is recorded as the correction date and time, and the user ID of the doctor who made the correction is recorded as the corrector ID. When the medical record is deleted, the deletion flag is turned on. From the viewpoint of preventing falsification, once registered medical records are not deleted regardless of part or all, only data is added if the doctor performs a correction operation, and the doctor performs the deletion operation. If done, only the deletion flag is changed.

  FIG. 5 is a diagram showing a display example of medical information on the doctor terminal 11. In many cases, browsing and input of medical information by the doctor terminal 11 is performed during examination of a patient. For this reason, the display information can be browsed by the patient, and the disease name before the notification and information related thereto cannot be displayed. For this reason, the doctor terminal 11 can select which of fake data and genuine data is displayed.

  (A) in the drawing shows a display example of fake data. If there is a medical record in which the true / false flag is “false” in the medical data of the specific patient, the corresponding true / false flag is displayed instead of the “true” medical record. On the other hand, (b) in the figure shows a display example of authentic data. In this case, only the medical record whose true / false flag is “true” is displayed, and the medical record whose true / false flag is “false” is not displayed. Whether the fake data or the authentic data is being displayed is displayed so that only the doctor can determine the display color or symbol.

  FIG. 6 is a diagram showing another display example of the medical information on the doctor terminal 11. The medical information includes numerical data such as test results. The numerical data can be displayed as a graph if necessary. The type and range of data to be graphed are specified by a doctor. For example, in (a) in the figure, the result of the blood test is displayed. If the doctor selects “GPT” which is one of the items and instructs the graphing, the GPT in the previous blood test is displayed. Data transitions are displayed in a graph. The graph data (graphed image data) is not created in advance and stored in the medical data storage device 20, but is generated as needed.

  Steps S101 to S107 in FIG. 7 are flowcharts illustrating an example of medical information delivery processing. Delivery of medical information is performed by a medical office worker operating the medical office terminal 13.

  First, an authentication process is performed for the operator of the medical office terminal 13 (step S101). When the medical clerk inputs the user ID and password to the medical office terminal 13, these pieces of information are sent to the medical information management server 10, and authentication processing is performed by collating with the user table 201 in the medical data storage device 20. . If the authentication result is returned to the medical office terminal 13 and the authentication fails, the processing after step S102 is not performed (step S102).

  If the authentication is successful, the medical clerk inputs the patient code and the usage information and instructs the data to be written to the external storage medium 24 (step S103). Use information refers to the purpose of using the medical information issued.For example, (1) materials for obtaining a second opinion, (2) materials as medical records at the time of transfer, and (3) patients themselves in the medical care. Consists of materials to convince. When the usage information is (1) and (2), the external storage medium on which the medical information is written is sealed and delivered to the patient or his / her agent, but when the usage information is (3) Will be delivered without being sealed.

  If there is a request including the patient code and usage information from the medical office terminal 13, the medical information management server 10 extracts predetermined medical information from the medical data storage device 20 and returns it to the medical office terminal 13 (steps S104 to S104). S106). When the usage information is (1) or (2), since the patient does not browse the issued medical information, all medical records related to the patient specified by the patient code are extracted from the medical data 203 ( Steps S104 and S106). In this case, in step S106, the medical record is extracted regardless of the state of the true / false flag, but the deleted medical record in which the deletion flag is set may not be extracted.

  When the usage information is (3), that is, when the patient himself / herself views the delivered medical information, the medical information management server 10 refers to the patient table 202 and sets the delivery approval flag of the target patient data. It is confirmed whether it has been performed (step S105). At this time, if the delivery approval flag is not set, the medical information is not extracted and the delivery process ends.

  On the other hand, if the approval flag is set, the medical record of the patient is extracted from the medical data 203 (step S106). However, in this case, if there is a medical record whose true / false flag is “false”, a medical record whose corresponding true / false flag is “true” is not extracted. In the case of a patient who has not announced the name of the disease, the doctor creates fake data, confirms that no true data is extracted, and sets a delivery approval flag. For this reason, in the case of the purpose of use (3), an unannounced disease name and information that easily associates it are not erroneously extracted and delivered.

  The medical office terminal 13 creates graph data based on the extracted medical record (step S107). While the graph data viewed on the doctor terminal shown in FIG. 6 is created according to a doctor's instruction, the delivery graph data is created based on the latest numerical data for predetermined numerical data. Is done.

  The medical record and graph data extracted in this way are recorded as delivery data in the external storage medium (step S110). However, if the delivery data exceeds the storage capacity of the external storage medium, it is divided and recorded on two or more external storage media. During this division, the medical records having the same medical date and time are divided so that they are not written to different external storage media (steps S108 and S109). For example, medical records having the same medical number may not be written to different external storage media.

  The medical record and graph data are stored as data that can be browsed by a general-purpose browser. In particular, medical information can be browsed without using a special browsing device by storing it as an HTML file that can be browsed by a general-purpose WEB browser that is already widely used.

It is the block diagram which showed the example of 1 structure of the medical information management system by this invention. 6 is a diagram illustrating an example of a user table 201. FIG. It is the figure which showed an example of the patient table. 6 is a diagram illustrating an example of medical data 203. FIG. It is the figure which showed the example of a display of the medical information in the doctor terminal. It is the figure which showed the other example of a medical information display in the doctor terminal. It is the flowchart which showed an example of the delivery process of medical information.

Explanation of symbols

DESCRIPTION OF SYMBOLS 10 Medical information management server 11 Doctor terminal 12 Nurse terminal 13 Medical office terminal 14 Image processing terminal 20 Medical data storage device 21 X-ray imaging device 22 Image data storage device 23 Media writing device 24 External storage medium 201 User table 202 Patient table 203 Medical Data N Network

Claims (3)

A data input means in which an authenticated first operator inputs patient information and authenticity information in association with medical information;
Medical data storage means for storing patient information and authenticity information in association with medical information;
A data delivery means for the authenticated second operator to input patient information and purpose of use, and to extract medical information to be delivered based on the patient information and authenticity information from the data storage device;
A medical information management system comprising media writing means for writing medical information extracted by a data delivery terminal to a computer-readable portable storage medium. The data input means allows the authenticated first operator to display the medical information in the medical data storage means and display the graph data visualizing the specified data.
The data delivery means generates graph data based on the extracted medical information,
The medical information management system according to claim 1, wherein the media writing means writes the medical information extracted by the data delivery means and the graph data generated by the data delivery means to the portable storage medium. . The medical information includes date information on which the medical information is input,
The said media writing means stores medical information of the same date in the same portable storage medium, when medical information is divided into two or more portable storage media and stored. Medical information management system.

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