JP2005258854A - Method and system for medical information management - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To solve a problem that operation such as inquiries, transfer of business matters, and issuing documents is troublesome for busy medical workers. <P>SOLUTION: A medical information management method comprises the steps of: inputting a plurality of pieces of medical information generated in the medical institutes into terminal means of a plurality of health examination centers 31 to 3n, pharmacies 41 to 4n, and other medical institutes 51 to 5n each located on different place; transmitting the plurality of pieces of inputted medical information from terminal means located on different places via a communication means; memorizing the plurality of pieces of transmitted medical information in a data center 2; comparing and determining the plurality of pieces of memorized medical information and specific medical information in the data center 2; and performing the role of a medical institute on the procedures of the medical institute having the specific medical information on the basis of compared and determined results. <P>COPYRIGHT: (C)2005,JPO&NCIPI

Description

  The present invention relates to a medical information management method and a medical information management system for managing various types of medical information obtained at a plurality of medical institutions.

As part of the conventional medical information management method, users and families, care managers, doctors, care service staff, care service providers, and local care insurance personnel as shown in Patent Document 1 are mutually connected via a network. By connecting, such as application agency, certification survey, opinion creation, care plan creation, 24 hour consultation, user information change notice, risk management care management, reporting consultation, care conference, service vacancy schedule / results, care record creation, etc. In the service, by sharing each information and enabling cooperation between multiple business operators performing various nursing care service operations, there is one server in the community, which allows close cooperation between multiple business operators, An integrated home care service support system that users and families can participate in is proposed. To have.
Japanese Patent Laid-Open No. 2002-215800

However, in the above-mentioned Patent Document 1, regarding information sharing cooperation, for example, when moving from one service provider's facility to another service provider's facility due to a transfer, etc., the history information up to that time is taken over. It was just something that uses this system as it can be used as it is.
Therefore, taking the transfer between medical institutions as an example, even if the above-mentioned Patent Document 1 is networked to share information, it is necessary to perform the following procedure through human intervention.
(1) Inquiry about whether there is a vacant room that can be accommodated in the hospital or facility of the transfer destination
(2) Report the patient's age, gender, pre-existing condition, etc.
(3) Inquiries about whether there is a facility suitable for treatment, rehabilitation, etc. for illnesses the patient has.
(4) Issuing a letter of introduction to the hospital.
The above is a list of typical items, but the above-mentioned manual procedures are carried out by busy nurses, doctors, and other healthcare professionals, so the operations such as inquiries, notifications, and document issuance are complicated. A service that performs these operations has been desired.

  The objective of this invention is providing the medical information management method and medical information management system which improve the workability | operativity of a medical worker.

  The medical information management method according to the present invention is characterized in that a plurality of pieces of medical information generated in the medical institutions are input to terminal means in the medical institutions at different locations, Transmitting medical information from terminal means at different locations via communication means, and storing the transmitted plurality of medical information in a database means, in the medical information management method comprising: Comparing and determining medical information and specific medical information, and substituting a procedure performed by a medical institution having the specific medical information based on the comparison and determination result.

The medical information management system according to the present invention is characterized in that the medical information management system is inputted to the terminal means in a plurality of medical institutions at different locations by the means for inputting a plurality of medical information generated in the medical institutions, and the input means. In the medical information management system comprising: means for transmitting a plurality of pieces of medical information from terminal means at different places via communication means; and means for storing the plurality of pieces of transmitted medical information in database means. Means for comparing and determining a plurality of pieces of medical information stored by the means and specific medical information, and means for performing a procedure performed by a medical institution having the specific medical information based on the result of comparison and determination by the comparison and determination means It is in having prepared.

  In this invention, medical institutions are those that generate medical information related to individuals, such as health checkup centers, clinics, acute hospitals, medical hospitals, nursing care facilities, health insurance associations, telephone health consultation companies, etc. It is a broad concept including those that do not generate medical information related to individuals, such as home medical device companies and business trip care service companies. In this invention, in response to a request from one of such medical institutions, examination data (images, biopsy, other data) of patients and medical checkups, clinic observations, clinical paths (treatment, medication, rehabilitation, A database means for electronically backing up and storing medical information such as nursing care, health maintenance, disease prevention, etc.) It is installed in a facility geographically different from these medical institutions, for example, in a data center. Note that such a database means may be provided in one of these medical institutions. Further, the database means is not limited to one place, and may be provided at a plurality of places.

  In the data center, in response to the entrustment of these medical institutions, predetermined information is detected from the database means among the medical information and attribute information regarding the patient and the medical checkup recipient, and the detected predetermined information is entrusted to the data center. It is possible to refer to it by notification, posting, alarm notification, etc. to the medical institution that was present, another medical institution that cooperates in its business, related parties such as dispensing pharmacies, etc. It is transferred so that it can be used by other terminal devices, or predetermined medical information is provided. At this time, it is judged whether or not the detected predetermined information has obtained the consent of the individual who is the subject of the information. It is sent to persons other than the person concerned, such as medical institutions, pharmacies, telephone health binocular operators, care service providers, etc. In this way, the data center performs processes such as identification and authentication for confirming that the examinee himself / herself has requested the provision of information to others. In authenticating the request from the person himself / herself, an ID card issued by an insurance company, a health club, or the like may be used, or it may be performed by confirming the presentation of an insurance card.

  In addition, the data center provides a business intermediary agency service that issues a letter of introduction to a medical institution different from the medical institution that has been consulted at the request of the individual, and further, from the dispensing pharmacy at the request of the insurance subscriber. Access medical information, and perform inter-drug interference check services for individuals and dispensing guidance services by dispensing pharmacies. The information provision performed by the data center is to execute at least one service of making it possible to refer to stored information and transferring the information. This enables cooperation between patients and surrounding medical institutions, and patients and individuals can store their medical information safely and use them across multiple medical institutions, especially after post-surgical treatment. , You can increase the sense of security after leaving the hospital, it will be easier for other medical institutions to issue referral letters, and the medical examination data obtained in the past can be viewed at other medical institutions. This has the effect of making it easier to use the second opinion. In addition, the examinee can consult with other medical institutions and third parties other than medical institutions at any time about health. This is particularly effective for those who have left the health insurance association due to retirement or individuals who do not belong to the health insurance association.

  If the format and specifications of medical records recorded in the database means are different between medical institutions, the data center performs information processing such as format conversion that standardizes image data, medical records, clinical paths, etc. After that, store the data so that the data can be handled centrally. The information to be provided includes information on services of medical institutions such as vacant floors and modality reservation status. Data stored in the database means of the data center is frequently rewritten by a plurality of parties so that it is always up-to-date. In addition, when data is exchanged between medical institutions, confirmation between the sender and the receiver is necessary, and the data center plays a role of mediating the confirmation. It is preferable that the information stored in the data center is not attached with the first and last name information of the person but is assigned an ID number of 11 digits or more to identify the individual. This is because personal medical information can be used without adding the first and last name information of the person himself / herself.

  According to the present invention, there is an effect of improving the workability of medical workers.

  Hereinafter, an embodiment of a medical information management method and a medical information management system according to the present invention will be described in detail with reference to the accompanying drawings. FIG. 1 is a diagram showing an overall configuration of a medical information management system according to the present invention. This medical information management system is configured by connecting various medical institutions, various organizations / organizations, and individuals via the Internet 1. As medical institutions, health insurance associations 21 to 2n, medical examination centers 31 to 3n, pharmacies 41 to 4n, other medical institutions 51 to 5n (for example, clinics, acute hospitals, medical hospitals, nursing homes, telephone health consultations) Company, home medical device company, business trip care service company, etc.), interpretation doctor network 6, etc., as various organizations / organizations, companies / organizations 11-1n, local governments 71-7n, etc. Personal computers 81 to 8n possessed by individuals, mobile terminals 91 to 9n such as cellular phones possessed by individuals, and the like correspond to each other and are connected via the Internet 1. Some medical institutions, such as medical examination centers, clinics, acute hospitals, medical hospitals, nursing homes, etc., generate medical information about individuals, telephone health consultation companies, home medical equipment, etc. This includes those that do not generate medical information about individuals, such as companies and business trip service companies.

  The health insurance associations 21 to 2n provide insurance benefits for employees and employees belonging to the companies and organizations 11 to 1n and local governments 71 to 7n that are members of the health insurance associations (supported persons who are insured persons and dependents). In the case of sickness, injury, childbirth, death, etc. of the elderly, we will pay medical expenses or provide various benefits, etc. and health services (to maintain and promote the health of the insured and their dependents) ), Belonging to a company, belonging to a community of companies, or belonging to each local government, and performing individual activities. The health insurance associations 21 to 2n include a reception database 211 that stores employee and employee reception information, a medical examination database 212 that stores medical examination results, a control server 213 that manages and controls these databases, and these databases from the outside. A web server 214 is provided for performing control when access is made.

  The medical examination centers 31 to 3n include a medical examination information system including a medical examination database 311 that stores medical examination data such as medical examination findings and various examination data. This medical examination information system is connected to the Internet 1 via the control server 312.

  The pharmacies 41 to 4n include a drug history management system including a drug history / drug database 411 stored such as a patient's drug history file and drug information. This drug history management system is connected to the Internet 1 via a control server 412.

  Other medical institutions 51 to 5n are medical institutions other than the medical examination centers 31 to 3n, and include clinics, acute-type hospitals, medical hospitals, nursing care facilities, etc., medical records, nursing records, various examination data, An electronic medical record system storing a clinical map, a care map and the like is connected to the Internet 1 via a control server. Other medical institutions 51-5n include telephone health consulting companies, home medical device companies, business trip care service companies, etc. related to various types of medical care. A stored database is provided, which is connected to the Internet 1 via a control server.

  The interpretation doctor network 6 is a network in which a plurality of interpretation sites constituted by specialized interpretation doctors capable of interpreting and interpreting medical images are connected via the network. The interpretation doctor network 6 has an interpretation doctor center (not shown) that performs scheduling on interpretation sites that can be interpreted, to which interpretation site medical image data is transmitted, and is transmitted from the interpretation site. Sorting processes such as sending interpretation reports to medical institutions and storing key images together with interpretation reports are performed.

  The data center 2 is a medical information archive center (CMA) that receives a request from a medical institution and acts as a proxy for handling, storing, analyzing, posting, and transferring personal medical information. ) And the function of the Health Concierge Center (HCC) that supports personal health and medical services on behalf of negotiating with medical and related service providers such as medical consultations and referral requests. .

  The CMA in the data center 2 is based on an open medical record, and stores information such as a backup copy of personal medical information at the request of a medical institution. The medical information stored in the data center 2 includes examination data (including health check data), medical records, care records, clinical paths (including care maps), medical maps that are extended concepts, reexamination plans, 2 There are secondary prevention and home care management plans, personal characteristics (allergy, immunity, genetic information), electronic medical records created by medical institutions, drug history files, and drug files. In the data center 2, these various types of medical information are stored in the medical database 201. Then, the control server 202 and the web server 203 in the data center 2 perform processing such as analysis, presentation, transfer, notification, generation of warnings, transfer between institutions, and the like of medical information in the medical database 201, Institutional collaboration is supported.

  The HCC in the data center 2 performs negotiations between the provider of the medical service and the medical related service and the person who receives the service and receives the request and credit of the receiver. The HCC includes a mining engine database 204 that performs medical analysis data analysis in addition to the medical database 201, and is realized by controlling these databases 201 and 204 by the control server 202 and the web server 203. HCC's services include medical consultation, medication advice, referral request issuance, disease risk analysis, etc., and comprehensively supports the extension of healthy life expectancy and overcoming lifestyle-related diseases.

  While services such as medical care, nursing care, and insurance that protect individual health have traditionally been “provider-centered”, CMA and HCC, which are components of the medical information management system according to the present invention, used the Internet. It is a new service business that provides various services based on IT infrastructure and transforms it into “customer-centered”. It is a network collaboration of various services such as medical care, nursing care, insurance, home medical equipment provision, etc. IT infrastructure indispensable.

  The medical information management method and the medical information management system according to the present invention provide necessary parties (medical providers) when personal medical information is necessary for the maintenance of personal health, disease prevention, and recovery treatment from illness. , Safe storage and appropriate processing so that it can be provided to the care provider and the person). All operations are conducted under strict information security and privacy protection. Only the related medical institutions can access the personal medical information stored in the data center 2, and are limited to administrative corporations, medical institutions, health consultation companies, and dispensing pharmacies, for example.

FIG. 2 is a functional block diagram of the medical information management method and medical information management system of FIG.
The health center 31 has a medical examination information system, which includes examination data such as height, weight, blood pressure, chest X-ray image, medical examination findings such as interviews and image diagnosis, and reservation status of the facility. It is remembered. Other medical institutions 51 to 5n include a specialized hospital 51, an acute hospital 52, a medical hospital 53, a nursing facility 54, and the like. Specialized hospital 51, acute type hospital 52, and recuperation type hospital 53 have an electronic medical chart system, which includes blood pressure, examination data such as X-ray CT images, electronic medical chart (medical record), and patient treatment. The clinical map that is the plan and the reservation status of the facility are stored. The care facility 54 has an electronic care record system, which includes examination data such as the progress of rehabilitation, a care record that records the progress of the examination data, a care map that is a care plan for the patient, and the facility The reservation status is memorized. The data center 2 is a medical examination center 31, a specialized hospital 51, an acute hospital 52, a medical hospital 53, a nursing facility 54, and other examination data, medical records / care records, clinical care maps and beds, and device reservation status. The database of medical appointment status. The data center 2 has CMA and HCC functions. CMA is a service center that offers introduction and application between medical institutions, and HCC introduces medical institutions for health check-up recipients and individual individuals 81 (including individuals who work for companies belonging to the health insurance association 21). This is a service center that acts as an application agent. CMA can also share information in community medicine through networks of municipalities, public health centers, and medical associations. In the present embodiment, since the CMA service is described, the configuration necessary for the HCC service can be omitted.

FIG. 3 is a flowchart for explaining each processing procedure of CMA service reservation, application, and application result display, FIG. 4 is a flowchart showing processing handled by the data center of FIG. 3, and FIG. 5 is processing handled by the medical institution of FIG. FIG. 6 is a diagram for explaining a mode of hospital conformity comparison in the data center of FIG. 3, and FIG. 7 is a display example showing the completion of reservation / application.
In this example, “Hitachi Taro,” who was admitted to the acute hospital for cerebral infarction, explained the substitution service and application for a transfer to a recuperative hospital for recovery from the acute phase and rehabilitation aiming to return to society. To do,

(Step S31)
Step S31 is a facility reservation process. First, the condition of “Hitachi Taro” as shown in the column “A hospital” of FIG. 6 is transmitted to the data center 2 from the terminal of the acute type hospital (A hospital) 52. “Hitachi Taro” suffers from cerebral infarction and needs blood flow promoters and gait rehabilitation, so he looks for a ward, ward, and a recuperation type hospital where the conditions of the facility are complete. In this example, it is assumed that a plurality of hospitals are connected to the data center 2 such as medical treatment hospitals B1 to Bn.

First, the processing of the data center in FIG. 4 is executed.
In step S41 of FIG. 4, the terminal of the data center 2 receives the condition of the condition “Taro Hitachi”. In step S42, since the condition of “Hitachi Taro” is received, it is determined that the reservation is made, and the process proceeds to step S43. Step 43 transmits the condition of “Hitachi Taro” to the B1 hospital connected to the data center 2 over the network.

Subsequently, the process proceeds to B1 hospital in FIG.
Step S51 of FIG. 5 receives the condition of “Taro Hitachi” transmitted from the terminal of the B1 hospital to the data center 2. In Step 52, since the hospital B1 receives the condition of “Hitachi Taro”, it is determined that the reservation is made, and the process proceeds to Step S53. In step S53, the data of the condition item “Hitachi Taro” is extracted. This extraction is performed in order of priority in the order of the location of the hospital, vacancy information in the hospital room, inventory information of drugs requiring medication, and facility information. That is, the extraction stops at items that do not match under the condition of “Hitachi Taro” according to the priority order. For example, as shown in FIG. 6, the B1 hospital has a location (condition matching) and a ward (condition mismatch), so these two conditions are the search results for the B1 hospital. In this way, if the search process is terminated when the conditions do not match, the execution time of the terminal (personal computer) of the medical institution can be minimized, and the search can be performed without any trouble in the work of the B1 hospital. In this example, the B2 hospital next to the B1 hospital is an optimal hospital for “Hitachi Taro”. When an optimal hospital is found in this way, an application is assumed, so the order number and the condition of “Hitachi Taro” are stored in the terminal of the B2 hospital. In step S54, the search result and order number of this B1 hospital are transmitted to the data center 2. Similarly, steps S51 to S54 are repeated up to B2 hospital,... Bn hospital.

Again, the processing returns to the data center processing of FIG.
In step S44 of FIG. 4, the data center 2 sequentially receives the conditions of the B1 to Bn hospitals transmitted in step S54.
As shown in FIG. 6, the data center 2 has a memory 600 for storing patient data from the hospital A, a memory 611 for storing hospital data from the hospital B1, a memory 612 for storing hospital data from the hospital B2,. , A memory 61n for storing hospital data from the Bn hospital, a switch 620 connected to the memories 611 to 61n,
A switch 620, a comparator 630 connected to the memory 600, a data generation unit 640 connected to the comparator 630, and a transmission unit 650 connected to the data generation unit 640. The switch 620 switches the output from the memories 611 to 61n. The comparator 630 compares the output of the switch 620 and the output of the memory 600. The data generation unit 630 generates data of the transfer destination optimal for “Hitachi Taro”, here, B2 hospital from the output of the comparator 630. The transmission unit 650 outputs the order number of the B2 hospital generated by the data generation unit 630 to the network, and sends the order number to the terminal of the A hospital, for example, so that the medical staff in charge of the A hospital can view it.
In step S45, the B1-Bn hospital conditions obtained sequentially in the memories 611-61n of the data center 2 are stored, and the B1-Bn hospital conditions stored in the memory 600 and the "Hitachi Taro" patient stored in the memory 600, respectively. Compare the data. In step S46, for example, the comparison result in step S45 is transmitted to the network so that the terminal of hospital A can output it.

(Step S32)
Step S32 is a facility application process. In this example, it is assumed that B2 hospital among the medical treatment type hospitals is selected for the data center 2.

First, the processing of the data center in FIG. 4 is executed.
In step S41 of FIG. 4, the terminal of the data center 2 receives the hospital name B2 and the order number. In step S42, since the hospital name B2 is received, it is determined that the application is made, and the process proceeds to step S47. Next, step S47 transmits application information to the application medical institution (in this case, B2 hospital).

Subsequently, the processing proceeds to the application medical institution (B2 hospital) in FIG.
In step S51 of FIG. 5, the terminal of the B1 hospital receives the hospital name B2 and the order number transmitted to the data center 2. In step 52, since the hospital name B2 is received by the hospital B2, it is determined that the application is made, and the process proceeds to step S55. In step S55, the condition of “Hitachi Taro” stored in the reservation step is read based on the order number, and the transfer procedure of the B2 hospital is performed. A step S56 outputs / transmits that the transfer procedure of the B2 hospital has been completed.

Again, the processing returns to the data center processing of FIG.
In step S48, the data center 2 receives the completion of the transfer procedure for the B2 hospital transmitted in step S56. In step S49, the data center 2 outputs / transmits the completion of the transfer procedure for the B2 hospital so that it can be viewed on the display screen of the terminal of the A hospital.
In addition, a letter of introduction addressed to the B2 hospital as the transfer destination can be electronically transmitted from the A hospital to the B2 hospital. If a letter of introduction is required, it can be output by a printer connected to the terminal of Hospital A and issued by a doctor's signature or seal.

(Step S33)
Step S33 is an application result display process.
A display example of the output and transmission of the terminal of hospital A by step 46 is shown in FIG. For example, the display screen 700 displays “Taro Hitachi's transfer destination applied for B2 hospital”.

  According to the medical information management method and the medical information management system according to the present embodiment, when the patient is transferred, various inquiries and notification items of the patient are determined to search for an optimal transfer destination, and introduction at the time of the transfer. Can support various medical information services such as electronically creating and providing documents that require issuance,

Moreover, in this embodiment, the transfer from the acute type hospital to the medical treatment type hospital was taken as an example. In the present invention, a medical examination center that conducts a medical examination, a specialized hospital that conducts a detailed examination as a result of the medical examination, a medical treatment type hospital, and a care facility can mutually make a reservation and apply.
In addition, CMA services are not limited to reservations and applications, but analysis, presentation, transfer, notification, warning generation, and processing of medical information in the medical database are executed to support medical institution operations and medical institution cooperation. It may be a thing.
When combined with HCC, medical consultation, medication advice, referral issuance request, disease risk analysis, etc. may be provided to comprehensively support the extension of healthy life expectancy of individuals and overcoming lifestyle-related diseases.

It is a figure showing the whole medical information management system composition concerning the present invention. It is a functional block diagram of the medical information management method and medical information management system of FIG. It is a flowchart explaining each processing procedure of CMA service reservation, application, and application result report. It is a flowchart figure which shows the process which the data center of FIG. 3 takes charge. It is a flowchart figure which shows the process which the medical institution of FIG. 3 takes charge. It is a figure explaining the aspect of the hospital compatibility comparison in the data center of FIG. It is a figure of the example of a display which shows completion of reservation and application.

Explanation of symbols

11 to 1n ... companies and organizations 21 to 2n ... health insurance associations 31 to 3n ... medical examination centers 41 to 4n ... pharmacies 51 to 5n ... other medical institutions 6 ... interpretation doctor networks 71 to 7n ... municipalities 81 to 8n ... individuals 91 to 9n ... Mobile terminal

Claims (4)

Inputting a plurality of medical information generated in the medical institutions into terminal means in the medical institutions at different locations,
Transmitting a plurality of inputted medical information from terminal means at different locations via communication means, and storing the transmitted plurality of medical information in database means, in a medical information management method comprising:
Comparing and determining the plurality of stored medical information and specific medical information;
Substituting a procedure performed by a medical institution having the specific medical information based on the result of the comparison and determination;
A medical information management method comprising:   The medical information management method according to claim 1, wherein the proxy step performs a mutual reservation or application between the plurality of medical institutions. Means for inputting a plurality of medical information generated in each medical institution into terminal means in a plurality of medical institutions in different places;
Means for transmitting a plurality of pieces of medical information inputted by the input means from terminal means at different locations via communication means, and storing the plurality of pieces of sent medical information in a database means. In the management system,
Means for comparing and determining a plurality of pieces of medical information stored in the storage means and specific medical information;
Means for acting on behalf of a procedure performed by a medical institution having the specific medical information based on the result of the comparison determination by the comparison determination means;
A medical information management system characterized by comprising:   The medical information management system according to claim 3, wherein the proxy means performs a mutual reservation or application between the plurality of medical institutions.

Images