JP2006004272A - Disease name inspection device, and disease name inspection method - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To resolve a problem wherein embodiment of disease name inspection also including analogical disease names as objects is needed. <P>SOLUTION: A disease name recording means is provided for recording a disease name of a patient, a medical care data recording means is provided for recording medical care data including data of drugs prescribed to the patient, an adaptable disease name recording means is provided for recording adaptable disease names of the drugs, a disease name inspection means is provided for referring to the adaptable disease name recording means in regard to a drug recorded in the medical care data recording means and determining whether the adaptable disease name is recorded in the disease name recording means as the disease name of the patient, and an analogized disease name recording means is provided for recording a basic disease name in coordination with a disease name wherein its development can be analogized by determining from the basic disease name. The disease name inspection means is composed so as to determine whether the analogized disease name matches with an adaptable disease name of the drugs recorded in the medical care data recording means by referring to the analogized disease name recording means in regard to the disease name recorded in the disease name recording means. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

  The present invention relates to a disease name inspection apparatus for examining whether or not a disease name corresponding to a prescribed medicine is registered in medical data of a patient described in a medical fee remuneration statement in a medical institution.

In a medical institution, an insurance medical action performed for a patient is described in a medical fee remuneration statement (hereinafter referred to as a receipt), which is submitted to the insurance institution to receive insurance benefits. At that time, the receipt is required to describe the name of the disease that is the basis for the medical practice. For example, when a medicine is prescribed, if the name of the applicable disease of the medicine is not described in the receipt, medical fees such as a medicine fee related to the prescription may not be covered by insurance benefits. Therefore, there is a device having a so-called disease name inspection function for inspecting whether or not an indication disease name of a prescription drug described in a receipt is described in the receipt, and such a device is disclosed in Patent Document 1. Here, a database in which a drug and the name of an applicable disease of the drug are registered is prepared, the name of an applicable disease of a prescribed medicine is searched from the database, and whether or not the name of the indicated disease is described in a receipt is inspected.
JP 2000-293583 A

  As for the administered drug, as described above, the name of the disease on which the prescription is based is basically described in the receipt. However, for a drug whose drug price per predetermined unit is less than or equal to a predetermined value, if it can be inferred from the other disease names described, it is not necessary to indicate the name of the applicable disease of the drug in the receipt. For example, when a gastrointestinal digestive agent is administered to a patient who has developed gastroenteritis to assist gastrointestinal digestion, the gastrointestinal It is only necessary to describe the name of the disease “flame”.

  However, since the conventional disease name inspection system refers to the database for the name of the applicable disease for each administered drug and checks whether it is described in the receipt, the above-mentioned case is treated as an omission error in the indication of the applicable disease. It was. For this reason, extra error information is output to the error list, which has been a burden for verification work by doctors and office staff.

  The present invention relates to a disease name recording means for recording a disease name of a patient, a medical data recording means for recording medical data including data of a medicine prescribed to the patient, and an adaptive disease name recording means for recording an adaptive disease name of the medicine. And a disease name inspection means for referring to the adaptive disease name recording means for the medicinal product recorded in the medical data recording means, and determining whether the applicable disease name is recorded in the disease name recording means as a patient's disease name, and a basic disease name And an analogy name recording unit that records an associated disease name that can be estimated from the basic disease name, and the disease name inspection unit further records an analogy name for the disease name recorded in the disease name recording unit. The above-mentioned problem is solved by determining whether the analogy name is matched with the applicable disease name of the medicine recorded in the medical data recording means. That.

  According to the disease name inspection apparatus of the present invention, when inspecting whether the prescribed disease name of a prescribed medicine is recorded, it is possible to inspect an analogy name that can be inferred from the recorded patient disease name. is there.

  FIG. 1 shows the configuration of a disease name inspection apparatus according to an embodiment of the present invention. The CPU 10 executes a pre-recorded program so that a patient data registration function for registering medical data such as a disease name, treatment, and medication for each patient, and a disease name corresponding to an administered drug are registered in the patient data file 16. It is a control means which implement | achieves the disease name test | inspection function etc. which test | inspect whether it exists. Reference numeral 11 denotes an input means for the user to input patient medical data, which comprises a keyboard and a mouse device. Reference numeral 12 denotes a display unit such as a CRT, and the control unit 10 outputs a data input window for the user to input medical data and a result of a disease name test. Reference numeral 13 denotes a printing unit that outputs an error list 14 as a result of performing the disease name inspection function.

  Reference numeral 15 denotes storage means constituted by a magnetic disk device or the like, which stores the following files. Reference numeral 16 denotes a patient data file for storing the patient's disease name and the data of the medical treatment performed for each patient. Reference numeral 20 denotes a medical care master database in which names of medical treatments such as treatments, examinations, administered drugs, and insurance scores are registered together with codes. Reference numeral 30 denotes a disease classification database in which disease classifications for each disease name are registered. Reference numeral 40 denotes a drug indication database in which drug indications are registered. Reference numeral 50 denotes an analogy name database in which a specific disease name and a disease name that can be inferred therefrom are registered in association with each other.

  FIG. 2 shows a record configuration of the medical care master database 20. Here, an example of a medicine is shown, and an official name 22 such as Jias [pure student], a master code 23 assigned by a database provider, a classification 24 of medical practice, a drug price as a basis for calculating medical fees, that is, an insurance score And the unit of measurement are registered together with the user code 21. The user code 21 is used when inputting a medical practice, and is composed of four-digit kana characters derived from the reading of the name so that the user can easily remember it. Each record is sorted and arranged in the order of the user code 21.

  FIG. 3 shows the record structure of the disease classification database 30. A name 32 such as bacterial enteritis, a master code 33 assigned by a database provider, and a disease classification 34 based on the international disease classification ICD 10 are registered together with the user code 31. Similarly to the previous medical master database 20, this user code 31 is also composed of 4-digit kana characters derived from the reading 32 of the name 32, and the records are sorted and arranged in the order of the user code 31. The disease classification 34 is a classification of all disease names into 17 major classifications, each of which is divided into quasi-classifications and represented by 4-digit numbers, and is also called a disease group classification. In the present embodiment, the association between the patient's disease name and the drug's indication disease name is performed by this disease classification.

  FIG. 4 shows the record structure of the drug indication database 40. Correspondences between medicines and indications (groups) for which the medicines are effective are registered in the master code. Here, an example of indications of the drug Dias [pure raw] and albumin tannate illustrated in FIG. 2 is shown. As described above, there may be one or more names of indications.

  FIG. 5 shows the record structure of the analogy name database 50. The relationship between a certain disease name 51 and its analogy name 52 is registered with a user code. The analogy disease name 52 is a wound disease whose onset can be estimated by judging from the name of a primary injury or a secondary injury described in the receipt. One or more analogy names 52 are registered for a specific disease name 51.

Next, the operation of the disease name test in this embodiment will be described with reference to the flowchart of FIG. The disease name test is to determine whether at least one of an indication name or an indication specified for each drug administered to a patient is registered as the disease name of the patient. That is, it is inspected whether or not a medicine suitable for the patient's disease is prescribed. When the name of the applicable disease of the medicine and the name of the patient's disease do not match, the medicine is output to the error list 14.

  FIG. 7 shows patient data when a patient visits once in May. The figure shows a patient data registration window 60. Reference numeral 61 indicates the number and frequency of internal medicine prescriptions. As shown in FIG. 8, the data relating to the disease name examination of this patient registered in the patient data file 16 is that the given disease name is bacterial enteritis, and the administered drug is Dias [pure raw] and albumin tannate. And the insurance score was 2 points.

  Therefore, when the user instructs a disease name test, the control means 10 first acquires the disease classification of the prescribed medicine (step S01). Specifically, the user code of Diaz [Junsei], which is the first medicine registered in the patient data file 16, is read out, and the clinical master database 20 is searched to obtain the master code. The master code 9233325320 is obtained from FIG. Next, the drug indication database 40 is searched with the master code, and the master code of the indication disease name (group) is acquired. Here, master codes 0153668025, 0153669015, and 015799003 are obtained from FIG. Next, the disease classification database 30 is searched with the master code, and the corresponding four-digit disease classification is acquired. In this case, from FIG. 3, the same disease classification 1112 is obtained for dyspepsia (symptoms), digestive dysfunction, and digestive absorption disorders. This is the disease classification corresponding to the drug Dias [Junsei].

  Next, the control means 10 acquires one patient's disease name (step S02), and acquires the disease classification of the disease name (S04). Specifically, the user code and the saiyo of the disease name registered in the patient data file 16 are read out, and the disease classification database 30 is searched to acquire the corresponding disease classification 0101. This disease classification is compared with the disease classification (group) of the medicine acquired in step S01 (S05). If there is a match, it means that the applicable disease name of the drug is registered, and it will be described in the receipt. Therefore, the disease name test for the drug is successful here. And the control means 10 repeats a disease name test similarly about all the prescription drugs.

  On the other hand, since there is a mismatch in this example, the process proceeds to S06, and it is determined whether the prescription score of the target drug is equal to or less than a predetermined score. In this embodiment, it is determined whether there are 17 points or less. This is the determination for pharmaceuticals with a predetermined score or less, since the applicable disease name is not described in the receipt as long as it can be inferred from other disease names described in the receptor. If the score is not less than the predetermined score, it is unnecessary to check the analogy name, so the process returns to step S02 to compare with the next disease name.

  As can be seen from FIG. 7 and FIG. 8, since the current prescription score is 2, the process proceeds to S07, and it is determined whether or not the bacterial enteritis that is the patient's disease name is registered in the heading of the analogy name database 50. If it is not registered, there is no analogy name to be examined, and the process returns to step S02.

  According to FIG. 5, since the user code of bacterial enteritis, Saitoyo, which is the disease name of this patient, is registered in the analogy name database 50, the process proceeds to S08 and the user code of the analogy name is acquired. In this example, Shifriyo and Shikiyushi are acquired. Next, the disease classification database 30 is searched with the user code of this analogy name, and the disease classification 1112 is obtained together. Then, as in step S05, the disease classification is compared with the disease classification of the pharmaceutical obtained in step S01 (same as S10). If there is a match, the disease name test is successful. In this example, there is no error because the disease classification 1112 matches. And the control means 10 repeats a disease name test similarly about all the prescription drugs.

On the other hand, if there is no match, the process returns to step S02 to compare with the next disease name. Since the name of the disease can be described in the receipt, including the main injury and the minor injury, any one of them should match the name of the indication for the target drug. It only has to match.

  If there is no match compared with all the disease names registered in the patient data file 16 (step S03; Yes), an error list 14 indicating that there is no applicable disease name for the drug is output. FIG. 10 shows an example of the print output. The disease name registered in the patient data file 16 and described in the receipt is shown as the disease disease name, and the name of the medicine having no indication disease name is shown as the confirmation item. Furthermore, the name of the applicable disease of the drug is exemplified below. In addition, about the medicine below a predetermined score, while attaching the star mark which shows that it is below a predetermined score, it outputs the score together. An example is shown in FIG. Thus, it can be seen that a drug having an applicable disease name that does not match the disease name that can be inferred from the disease name described in the receipt is administered. The error list is not only printed by the printing unit 13 but also displayed on the display unit 12.

It is a block diagram which shows the structure of embodiment. It is a figure which shows the record structure of a medical treatment master database. It is a figure which shows the record structure of a disease classification database. It is a figure which shows the record structure of a medicine indication database. It is a figure which shows the record structure of an analogy disease name database. It is a flowchart which shows the operation | movement of the disease name test | inspection of embodiment. It is a figure which shows the example of a display of the input window of patient data. It is a figure which shows the data of the patient who concerns on a disease name test | inspection. It is a figure which shows the example of an output of an error list. It is a figure which shows the example of an output of an error list.

Explanation of symbols

DESCRIPTION OF SYMBOLS 10 Control means 11 Input means 12 Display means 13 Printing means 14 Error list 15 Storage means 16 Patient data file 20 Medical care master database 30 Disease classification database 40 Drug indication database 50 Analogy name database

Claims (6)

A disease name recording means for recording a patient's disease name;
Medical data recording means for recording medical data including data of pharmaceuticals prescribed to patients;
An adaptive disease name recording means for recording the name of an applicable disease of a medicine;
A disease name inspection device comprising: a disease name inspection unit that refers to an adaptive disease name recording unit for a medicinal product recorded in the medical data recording unit and determines whether the applicable disease name is recorded in the disease name recording unit as a patient's disease name. And
It further comprises an analogy name recording unit that records a basic disease name and a disease name that can be estimated from the basic disease name in association with each other,
The disease name inspection means refers to the analogy name recording means for the disease name recorded in the disease name recording means, and further determines whether the analogy name matches the adaptive disease name of the medicine recorded in the medical data recording means Characterized disease name inspection device.   2. The disease name test according to claim 1, wherein the disease name test unit tests the coincidence with the analogy name only when the number of medical treatment points recorded in the medical data recording unit is equal to or less than a predetermined score. apparatus.   The disease name inspection means outputs the drug to an error list when it is determined that the applicable disease name of the drug is not recorded in the disease name recording means as a result of the determination. In this case, the medical score of the drug is predetermined. 3. The disease name inspection apparatus according to claim 2, wherein when the score is less than or equal to the score, the disease list is output to the error list in such a manner that it is understood that the drug is equal to or less than the predetermined score. A disease name recording process for recording a patient's disease name;
A medical data recording process for recording medical data including data of pharmaceuticals prescribed to patients;
An adaptive disease name recording process for pre-recording the names of indications for pharmaceutical products;
A disease name test that reads out the name of an adaptive disease recorded in the medical data recording process from the name of the adaptive disease recorded in the adaptive disease name recording process and determines whether the adaptive disease name is recorded in the disease name recording process as the patient's disease name A disease name inspection method comprising:
There is further provided an analogy name recording process that records in advance an association between a basic disease name and a disease name that can be estimated from the basic disease name,
The disease name inspection step reads out the analogy name recorded in the analogy name recording step for the disease name recorded in the clinical disease name recording step, and the analogy disease name recorded in the medical data recording step A disease name inspection method comprising an analogy name check process for determining whether or not they match.   5. The disease name inspection method according to claim 4, wherein the disease name inspection step performs the analogy name check process only when the medical treatment score of the medicine recorded in the medical data recording step is equal to or less than a predetermined score. .   The disease name inspection step includes a step of outputting the medicinal product to an error list when it is determined that the adaptive disease name of the medicinal product is not recorded in the disease name recording step as a result of the determination. 6. The disease name test method according to claim 5, wherein when the medical score is equal to or less than a predetermined score, the medical score is output to the error list in such a manner that the medical score is equal to or lower than the predetermined score.

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