JP2006164251A - Medical information system, medical information system program, and medical information processing method for performing information processing for management of medical practice - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide information allowing easy and sure verification of procedures for a medical practice. <P>SOLUTION: An information collection part 11 collects status information showing a status of a medical instrument and/or a status of a person in time series. A procedure analysis part 14 determines an operation procedure for a plurality of stages according to an event occurrence condition determined according to the status information, and also determines respective starting timing of the a plurality of stages according to the status information. The procedure analysis part 14 generates procedure information showing the operation procedure and the respective starting timing of a plurality of stages. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

  The present invention provides a medical information system that provides information that can be effectively used for post-analysis and verification of medical practice, a medical information system program that causes a computer to function as the medical information system, and information processing for medical practice management The present invention relates to a medical information processing method.

  In general, in medical practice, when a medical action such as surgery is performed, the details are recorded as a document by a doctor involved in the surgery. This record may be accompanied by charts, photographs and videos showing data output from various devices during the operation.

  However, in the above record, various kinds of data are often described regardless of the order of time. Therefore, it has been difficult even for specialists such as doctors to confirm and verify the medical procedure after the fact based on the above records.

In view of this, it is also conceivable to record the state of the medical practice with a video camera and to confirm and verify the procedure of the medical practice based on the recorded moving image. However, such verification has to keep watching a long-time moving image while analyzing the contents of the medical practice being performed, which is a very time-consuming work.
JP 2002-253545 A JP 2004-280455 A

  As described above, conventionally, information collection for confirming and verifying the procedure of medical practice that has already been performed has not been performed, and the above-described operation for confirmation and verification has been extremely difficult.

  The present invention has been made in view of such circumstances, and an object of the present invention is to provide information that enables easy confirmation and verification of a medical practice procedure.

  In order to achieve the above object, the first aspect of the present invention provides a medical information system for performing information processing for management of a medical practice including a plurality of stages achieved by a combination of a plurality of events. Collecting means for collecting state information indicating the state of the appliance and / or human in time series, and a first order for determining the execution order of the plurality of stages based on the occurrence state of the event determined based on the state information 1 determination means, second determination means for determining the start timing of each of the plurality of stages based on the state information, the sequence of execution, and the start timing of each of the plurality of stages Means for generating information.

  In order to achieve the above object, the second aspect of the present invention is a medical information system for performing information processing for management of a medical action including a plurality of stages achieved by a combination of a plurality of events. Collecting means for collecting state information indicating the medical instrument and / or human state relating to the medical action in time series, and performing the plurality of stages based on the occurrence state of the event determined based on the state information First determination means for determining the order, second determination means for determining the start timing of each of the plurality of stages based on the state information, the execution order, and the start timing of each of the plurality of stages The program is configured to function as a medical information system including means for generating procedure information indicating the above.

  In order to achieve the above object, the third aspect of the present invention provides a medical information processing method for performing information processing for managing a medical action including a plurality of stages achieved by a combination of a plurality of events, Collecting time-series state information indicating a medical instrument and / or human state regarding an action, determining an execution order of the plurality of stages based on an occurrence state of the event determined based on the state information, The start timing of each of the plurality of stages is determined based on the state information, and the procedure information indicating the execution order and the start timing of each of the plurality of stages is generated.

  ADVANTAGE OF THE INVENTION According to this invention, the information which makes it possible to confirm and verify the procedure of medical practice easily can be provided.

  Hereinafter, embodiments of the present invention will be described with reference to the drawings.

  FIG. 1 is a diagram illustrating an example of a usage state of the medical information system 1 according to the present embodiment. The medical information system 1 records medical information related to surgery in the operating room in a separate room. Tools used to perform the surgery in this example include BIS monitor 2, patient monitor 3, bipolar forceps 4, contrast agent administration device 5, aspiration catheter 6 and X-ray imaging device 7.

  The medical information system 1 records medical information related to almost all events that occur during a medical practice such as surgery, diagnosis, medication, treatment, rehabilitation, etc. in chronological order, and includes a plurality of medical information included in the medical practice. This system automatically determines the stage procedure. The medical information generated in the operation includes the operation of the medical staff and the accompanying operation, the position of the medical staff, the condition of the patient, the condition of the operating room, the operating condition of the medical device, the position of the medical instrument, the image during the operation, and Includes environmental conditions. In the present embodiment, the “medical device” refers to a medical machine such as an X-ray imaging apparatus. The “medical device” includes, in addition to a medical device, a medical tool such as a scalpel and a medical tool such as a gauze. That is, the “medical device” refers to various items used in medical practice. Further, in the present embodiment, “medical practice” refers to all of a series of processes for completing surgery, diagnosis, medication, treatment, rehabilitation, and the like. “Stage” refers to a medical procedure that constitutes a medical practice. “Event” refers to each of the operations of the staff and the devices during the medical practice. Specifically, for coronary angiography, which is a medical practice, femoral artery puncture, guide wire insertion, sheath insertion, catheter insertion into the artery, catheter insertion into the coronary artery, imaging, compression, etc. Including. Further, for example, the femoral artery puncture includes events such as skin incision and insertion of a puncture needle. Therefore, in general, a stage is formed by a combination of a plurality of events. A medical practice is formed by a combination of a plurality of stages.

  A position sensor group 8 and a plurality of collection devices 9 for collecting medical information to be recorded are arranged in the operating room. The position sensor group 8 includes a plurality of position sensors arranged in the operating room. These position sensors read identification information from, for example, adjacent IC tags. The position sensor outputs the read identification information to the medical information system 1. Thus, the medical information system 1 can recognize that the IC tag whose identification information has been read by the position sensor is located in the vicinity of the position sensor. The IC tag is attached to a surgeon, an assistant, an anesthesiologist, or a surgeon such as a nurse or a movable medical instrument as necessary.

  The collection device 9 collects medical information other than the position detection information. This collector machine 9 can be classified into a plurality of categories according to the installation location, usage and the like. These categories include first to seventh categories. The first category includes sensors installed in the medical device or its peripheral part in order to check the operation status of the medical device. The second category includes cameras that capture multiple locations such as operating rooms and surgical sites. The third category includes sensors that detect vitals of surgical staff such as doctors. The fourth category includes microphones that detect sound (including sound of objects) exchanged in the operating room. The fifth category includes sensors for keeping track of staff entering and leaving the operating room. The sixth category includes sensors for detecting patient biometric information. The seventh category includes sensors for obtaining patient identification information.

  Specific examples of the collection device 9 included in each of these categories are listed for each category along with the use of the output signal for some of them.

(1) First category
・ Drip drip monitor sensor: The drip drip state measures how wet, pressure, flow meter, drip, etc. Moreover, you may make it measure a dripping state from the decreasing condition of the weight of an infusion bag.
-Bed angle sensor: An angle meter or pressure gauge is used to measure the angle of the patient bed.
-Suction machine sensor: The suction status of the suction machine is detected by the sound, pressure, flow rate, etc. of the suction machine.
-Electric knife sensor: The driving state of the electric knife is estimated from the current and voltage consumed by the electric knife.
-Bed warmer temperature sensor: A thermometer is used to measure the temperature of the bed warmer.
Anesthesia system sensor: detects the concentration and amount of anesthetic gas.
-Navigator sensor: The output of the X-ray CT scanner is measured.
Earth current sensor: Measures the operating room earth current to monitor the current flowing into the room.
-Sensor for checking the power supply of medical equipment: The light quantity of the pilot lamp is measured with an optical sensor, and this confirms whether the power supply is normally turned on. The light on the monitor screen may be measured by an optical sensor, or the current of the power cable may be measured.
-Medical device dials and switch setting confirmation sensors: Appropriate configurations such as attaching an angle monitor to the dial, shooting with a camera (coloring the dial), attaching a contact switch, attaching a magnet, or measuring with an optical sensor Can be adopted.

(2) Second category
・ Instrument table camera: An instrument such as a scalpel is installed near the instrument table, and the instrument taken from the instrument table is photographed.
・ Wide-angle camera: Captures the entire field of view inside the operating room.
Surgery camera: Takes a picture of the patient's surgical site and its surroundings (attached to the microscope). This operative field camera also includes an endoscopic image.
Anesthesiologist camera: Take pictures of emergency medicine shelves (preferably only when there is movement). Or take a picture of the monitor the anesthesiologist is looking at. A camera attached to a penlight used by an anesthesiologist may be used.
Shadowless camera: A camera that is configured by combining a plurality of cameras, and automatically selects and outputs the output of a camera that has successfully taken a picture from the plurality of cameras. Standards for this automatic selection include image brightness, abnormal focal length when using an autofocus camera, the color of hats worn by medical staff, measurement results of distance sensors such as markers and ultrasound, and whether halation is occurring. Or a color code that appears in the image when the identification color code is attached to the doctor's hat.
・ Head-mounted camera: Attached to doctor's protective glasses and protective clothing for orthopedic imaging, it captures the field of view according to the direction of the doctor.

(3) Third category
Sensors that detect heart rate, adrenaline (stress hormone) in saliva, brain waves, body temperature, blood pressure, etc.
-Sensor for detecting blinking: Measured by detecting the position of eyelashes with an optical sensor, detecting the state of eyeball reflection, using an electromyograph, or looking up at the operator with a camera.
・ Acceleration sensor: Attached to the doctor's arm. This acceleration sensor is also used as an inclinometer. For example, sensor wiring is applied to the surgical clothes.
-Sensor for detecting sweating: An electrode is attached to socks to measure sweating.
-Sensors such as pressure and humidity: Respiratory sensors and the like are incorporated in a mask of a doctor or the like.

(4) Fourth category
-Surgeon microphone: Inputs voices uttered by the surgeon and ambient sounds of the surgeon.
-Assistant microphone: Inputs voices uttered by assistants and ambient sounds of assistants.
Anesthesiologist's microphone: Inputs voices uttered by anesthesiologists and ambient sounds of anesthesiologists.
・ Nurse microphone: Inputs voices uttered by nurses and ambient sounds of nurses.

(5) Fifth category
-Sensors that monitor the opening and closing of operating room doors: Use open / close switches and cameras to detect the opening and closing of doors.
ID card reader: Reads the ID card of the staff who enters and exits the operating room.

(6) Sixth category
Anesthesia monitor sensor: monitors heart rate, oxygen partial pressure, body temperature, etc.
-BIS monitor: A BIS value (Bispectral Index), which is the depth of anesthesia during anesthetic administration, is detected.
-Cranial nerve monitor: detects brain waves.

(7) Seventh category
・ Fingerprint sensor: Reads the patient's fingerprint.
-Iris sensor: Reads the patient's eye iris.
-Electronic medical record system: Patient information is acquired from the electronic medical record system.
Wristband: Reads the identification information of the wristband previously attached to the patient list.

  In the example of FIG. 1, 16 collection devices 9 are arranged. In the following, when it is necessary to distinguish these 16 collection devices 9, they are referred to as collection devices 9-1, 9-2,.

  The collection device 9-1 is a sensor that monitors the power supply of the BIS monitor 2. The collection device 9-2 is a sensor that monitors the power source of the patient monitor 3. The collection devices 9-3, 9-15, and 9-16 are cameras that photograph the operating room at a wide angle. The collection device 9-4 is a microphone for inputting anesthesiologist's voice. The collection device 9-5 is a microphone that inputs the sound of the surgeon. The collection device 9-6 is a microphone that inputs a patient's voice. The collection device 9-7 is a camera that photographs the operative field. The collection devices 9-8, 9-9, 9-14 are microphones that input sound in the operating room. The collection device 9-10 is a sensor that monitors the power supply of the bipolar forceps 4. The collection device 9-11 is a camera that takes an overhead view of the operative field from the ceiling. The collection device 9-12 is a sensor that detects the dose of the contrast medium in the contrast medium administration device 5. The collection device 9-13 is a sensor that detects the operating state of the suction catheter 6.

  These collection devices 9 are connected to the identification device 10, respectively. Accordingly, in the example of FIG. 1, 16 identification devices 10 are arranged. In the following, when it is necessary to distinguish these 16 identification devices 10, they will be referred to as identification devices 10-1, 10-2,. The identification devices 10-1, 10-2,..., 10-16 are all connected to the medical information system 1.

  The identification device 10 sends the medical information transmitted from the connected collection device 9 to the medical information system 1. The identification device 10 notifies the medical information system 1 of identification information representing the type of the connected collection device 9. The identification device 10 stores medical information collection conditions notified from the medical information system 1 and notifies the collection device 9 of the conditions.

  The X-ray image apparatus 7 acquires a medical image related to a patient using X-rays. The X-ray imaging apparatus 7 has a function of outputting tag information in addition to the medical image. The tag information is, for example, tag information output from the X-ray imaging apparatus 7 is information indicating the state of the apparatus such as X-ray irradiation dose, arm angle (X axis, Y axis), or examination site name. Therefore, this tag information is also a part of medical information.

  FIG. 2 is a block diagram showing the configuration of the medical information system 1.

  As shown in FIG. 2, the medical information system 1 includes an information collection unit 11, a medical information storage unit 12, a stage table storage unit 13, a procedure analysis unit 14, a procedure information storage unit 15, and a display data generation unit 16.

  The medical information system 1 can use, for example, a general-purpose server device or computer device as basic hardware. The information collecting unit 11, the procedure analyzing unit 14, and the display data generating unit 16 can be realized by causing a processor mounted on the server device or the computer device to execute a program. At this time, the medical information system 1 may be realized by installing the above-described program in the server device or the computer device in advance, or a removable recording such as a magnetic disk, a magneto-optical disk, an optical disk, or a semiconductor memory. It may be realized by recording the program on a medium or distributing the program through a network and installing the program in a server device or a computer device as appropriate. Note that part or all of the above-described units can be realized by hardware such as a logic circuit. Each of the above-described units can also be realized by combining hardware and software control. The medical information storage unit 12, the stage table storage unit 13, and the procedure information storage unit 15 are externally attached to a storage device such as a memory or a hard disk device built in the server device or computer device, or the server device or computer device. Further, it can be realized by appropriately using a storage device such as a memory or a hard disk device, or a removable recording medium such as a magnetic disk, a magneto-optical disk, or an optical disk.

  The information collecting unit 11 collects the outputs of the X-ray image device 7, the position sensor group 8, and the plurality of collecting devices 9 as medical information. The information collection unit 11 writes the collected individual medical information in the medical information storage unit 12 in association with the time when the medical information is acquired.

  The medical information storage unit 12 stores medical information written by the information collection unit 11.

  The stage table storage unit 13 stores a stage table. The stage table is a data table describing conditions for stage determination.

  The procedure analysis unit 14 determines in what procedure the performed medical action is based on the tag information of the medical information accumulated in the medical information storage unit 12 and the stage table stored in the stage table storage unit 13. It analyzes whether it has been performed and generates procedure information indicating the procedure.

  The procedure information storage unit 15 stores the procedure information.

  The display data generation unit 16 uses the medical information and procedure information stored in the medical information storage unit 12 to display display data for displaying on the display device 5 a presentation screen showing the procedure of the medical practice that has been performed. Is generated.

  The above is the basic configuration of the medical information system according to the present embodiment. In the following, more detailed embodiments will be described.

(First embodiment)
In the first embodiment, the stage table is a data table as shown in FIG. 3, for example. This stage table describes the state of each medical device used in the above medical practice in association with the stage classification names of a plurality of stages. In the example of FIG. 3, the irradiation dose in the X-ray image device 7, the arm angle (X axis, Y axis), the examination site name, and the contrast agent dose in the contrast agent administration device 5 are described.

  Next, the operation of the medical information system 1 in the first embodiment will be described.

  When the medical practice is performed, the information collecting unit 11 collects all the outputs of the X-ray imaging apparatus 7, the position sensor group 8, and the plurality of collecting devices 9 as medical information, and the medical information storage unit 12 is written. Specifically, the information collection unit 11 starts collecting medical information in response to, for example, lighting of a light in the operating room, and continues collecting medical information until the light in the operating room is turned off. At this time, the information collection unit 11 collects at least the tag information of the X-ray image apparatus 7 and the amount of contrast agent at regular time intervals. The collection interval may be arbitrary, but in the present embodiment, the collection interval is 1 minute.

  In this way, various types of medical information corresponding to various events that occur during the execution of medical practice are accumulated in the medical information storage unit 12. These pieces of medical information are stored in the medical information storage unit 12 in association with the time when each was acquired. In the medical information storage unit 12, the medical information is managed as a file in which items related to a single medical practice are collected.

  Now, the procedure analysis unit 14 creates procedure information relating to a medical practice that has been performed in the procedure as shown in FIG. This process is executed with one of the files stored in the medical information storage unit 12 as a processing target. The procedure analysis unit 14 may create procedure information for all the files created in the medical information storage unit 12, or may create the procedure information only for files specified by the operator. good.

  In step Sa1, the procedure analysis unit 14 substitutes “Null” for the variable having the variable name “detected name”. In step Sa2, the procedure analysis unit 14 substitutes the start time of the medical action to be analyzed into the variable having the variable name “time of interest”.

  In step Sa <b> 3, the procedure analysis unit 14 reads out tag information associated with the time of interest from the medical information storage unit 12. In the present embodiment, the medical information includes information indicating the irradiation dose, the arm angle (X axis), the arm angle (Y axis), the amount of the contrast agent, and the examination site name. Read information. In step Sa4, the procedure analysis unit 14 searches the stage table for a data record including the combination of the read information. In step Sa5, the procedure analysis unit 14 checks whether there is a matching data record.

  If it is determined YES in step Sa5, the procedure analysis unit 14 proceeds to step Sa6. In step Sa6, the procedure analysis unit 14 reads out the stage classification name included in the data record matched in the search in step Sa4. For example, the information read out in step Sa3 includes irradiation dose = “1 (High)”, arm angle (X axis) = “0”, arm angle (Y axis) = “30”, and contrast agent amount = “2. If “00-4.00” and the examination part name = “LVA” are indicated, the procedure analysis unit 14 reads “Cardio-001” as the stage classification name in step Sa6. Thereby, the stage performed at the time of interest is specified.

  In step Sa7, the procedure analysis unit 14 confirms whether or not the detected name is “Null”. Since the detected name is set to “Null” in step Sa1, the procedure analysis unit 14 determines YES when it first reaches step Sa7. As will be described later, when the stage is not specified one minute before the target time, the detected name is set to “Null”. For this reason, when the stage is newly specified from the state where the stage is not specified, the procedure analysis unit 14 determines YES in Step Sa7. And when it determines with YES in step Sa7, the procedure analysis part 14 progresses to step Sa10. In step Sa10, the procedure analysis unit 14 updates the detected name to the stage classification name read in step Sa6. Subsequently, in step Sa11, the procedure analysis unit 14 substitutes the time of interest into a variable having a variable name “stage start time”.

  In step Sa12, the procedure analysis unit 14 substitutes the time of interest into a variable having a variable name “stage completion time”. The stage completion time is a variable indicating the time when one stage is completed. Here, the completion of the stage has not been detected yet, but it is known that the currently specified stage has been performed up to the current attention time, so the attention time is provisionally set as the stage completion time. . In step Sa13, the procedure analysis unit 14 advances the time of interest by one minute. In step Sa14, the procedure analysis unit 14 confirms whether or not the updated attention time exceeds the end time of the medical practice. If it is determined NO in step Sa14, the procedure analysis unit 14 returns the process to step Sa3.

  Now, after the stage classification name is assigned to the detected name in step Sa10 and then the process reaches step Sa7 again, the procedure analysis unit 14 determines NO. If it is determined NO in step Sa7, the procedure analysis unit 14 proceeds to step Sa8. In step Sa8, the procedure analysis unit 14 checks whether or not the stage classification name newly read in step Sa6 matches the detected name.

  If the stage category name newly read in step Sa6 is different from the detected name, the stage specified for one minute before the target time is completed, and the stage specified for the target time is started instead. . Therefore, when it is determined NO in step Sa8, the procedure analysis unit 14 proceeds to step Sa9 and writes a new data record regarding the completed stage in the procedure information storage unit 15. This data record is generated by describing the contents of the stage start time, stage completion time, and detected name in association with the serial stage number in the order of writing to the procedure information storage unit 15. On this basis, the procedure analysis unit 14 sets the stage classification name of the newly started stage as the already detected name, and proceeds to step Sa10 in order to set the current attention time as the stage start time. Perform as described above.

  If the stage category name newly read in step Sa6 matches the detected name, the stage specified for one minute before the target time is continued at the target time. Therefore, when it is determined YES in Step Sa8, the procedure analysis unit 14 passes Step Sa9 to Step Sa11, proceeds to Step Sa12, and performs the subsequent processing as described above.

  If no matching record is found by the search in step Sa4, no stage is performed at the time of interest. Therefore, when it is determined NO in step Sa5, the procedure analysis unit 14 proceeds to step Sa16. In step Sa <b> 16, the procedure analysis unit 14 confirms whether or not the detected name is “Null”. When a certain stage has been specified one minute before the target time, the detected name is not “Null”. That is, if the detected name is not “Null”, the stage specified for one minute before the target time is completed, and another stage is not started. Therefore, if it is determined NO in step Sa16, the procedure analysis unit 14 proceeds to step Sa17, and writes a new data record regarding the completed stage in the procedure information storage unit 15 in the same manner as in step Sa9.

  In step Sa18, the procedure analyzing unit 14 cannot identify the stage for the time of interest, and substitutes “Null” for the detected name. After this, the procedure analysis unit 14 proceeds to step Sa19.

  If the detected name is “Null” in step Sa16, the stage is not specified. Therefore, when it is determined YES in Step Sa16, the procedure analysis unit 14 passes Step Sa17 and Step Sa18 and proceeds to Step Sa19.

  In step Sa19, the procedure analysis unit 14 advances the time of interest by one minute. In step Sa20, the procedure analysis unit 14 confirms whether or not the updated attention time exceeds the end time of the medical practice. If it is determined NO in step Sa20, the procedure analysis unit 14 returns the process to step Sa3.

  In step Sa13 or step Sa19, if the time of interest exceeds the end time of the medical practice by advancing the time of interest by 1 minute, stage identification based on all tag information collected in one medical practice is completed. Become. Therefore, if YES is determined in step Sa14, the procedure analysis unit 14 proceeds to step Sa15, and writes a new data record relating to the completed stage in the procedure information storage unit 15 in the same manner as in step Sa9. Then, the process of FIG. 4 is finished. If it is determined as YES in step Sa20, there is no specified stage, and there is no information to be written in the procedure information storage unit 15. Therefore, the procedure analysis unit 14 does not perform the process of step Sa15, but in FIG. The process ends.

  Thus, in the procedure information storage unit 15, data records indicating the stage classification names of the plurality of stages performed in the medical practice, the time when each stage was started, and the time when each stage was completed are arranged in the order of execution. For example, procedure information as shown in FIG. 5 is generated.

  The display data generation unit 16 generates display data indicating a presentation screen that enables confirmation of the contents of a medical practice that has been performed. This display data is given to the display device 5. The display device 5 displays the presentation screen based on the display data.

  If the presentation screen shows the procedure information as shown in FIG. 5, the procedure of medical practice can be easily grasped.

  The presentation screen may be a screen that displays the medical information stored in the medical information storage unit 12 or the procedure information stored in the procedure information storage unit 15 as it is, but the medical information is associated with the procedure information. When the screen is displayed, it is easier to grasp the contents of the medical practice.

  For example, when displaying an image taken by a camera, if the image of the field of view in which an important event can be reflected at each stage is automatically selected and displayed, the contents of the medical practice can be easily confirmed.

  If the screen counts the number of shakes of the doctor determined based on the vital data of the doctor (the number of so-called “near hat” and “queue”) for each stage, and displays it in association with the stage classification name, Useful for determining the stage at which there is a high risk of mistakes.

  In addition, it is effective for grasping the contents of medical practice by presenting the dose of contrast medium, the time required for catheter operation, the number of dangerous catheter operations, etc. in association with the stage. The time required for the catheter operation and the number of dangerous catheter operations can be obtained by image processing from the image taken by the camera.

(Second Embodiment)
In the second embodiment, the stage table describes appearance determination conditions, start determination conditions, and end determination conditions of the stages in association with the stage classification names of a plurality of stages. These conditions represent the state of one or more events. The events included in each condition include not only the operating state of the medical device but also those related to the position of the surgical operator and the position of the medical instrument.

  In the case of the hemostasis stage, each condition is determined as follows, for example.

  Appearance determination condition: The surgeon holds the bipolar forceps 4 and the bipolar forceps 4 is energized in the coagulation mode.

  Start determination condition: From the leading edge of the period in which the coagulation mode energization of the bipolar forceps 4 is continuously used at intervals of 30 seconds or less, the suction operation of the suction catheter 6 or the presence or absence of gauze insertion into the patient is traced back for a maximum of 1 minute. Search for. If they are present, start from there for a maximum of 1 minute and search for the presence of suction or gauze insertion. This is repeated, and the time when the suction operation or gauze insertion is detected last is set as the start time of the hemostasis stage.

  Termination judging condition: Whether or not the suction operation of the suction catheter 6 or the insertion of the gauze into the patient is performed within 1 minute backward from the trailing edge of the period in which the coagulation mode energization of the bipolar forceps 4 is continuously used at intervals of 30 seconds or less. Search for. If there are any, search for the presence or absence of suction or gauze insertion within 1 minute again from that point. This is repeated, and the time when the suction operation or gauze insertion is detected last is set as the end point of the hemostasis stage.

  Now, the procedure analysis unit 14 creates procedure information relating to a medical practice that has been performed in the procedure as shown in FIG. This process is executed with one of the files stored in the medical information storage unit 12 as a processing target. The procedure analysis unit 14 may create procedure information for all the files created in the medical information storage unit 12, or may create the procedure information only for files specified by the operator. good.

  In step Sb1, the procedure analysis unit 14 selects one of the recorded events as the event of interest. As will be described later, step Sb1 is repeated, but the procedure analysis unit 14 selects the event of interest in order of time.

  In step Sb2, the procedure analysis unit 14 determines whether or not the event of interest is included in any of the appearance determination conditions described in the stage table. If it determines with NO here, the procedure analysis part 14 will return to step Sb1, change an attention event, and will repeat subsequent processing. If it determines with YES, the procedure analysis part 14 will progress to step Sb3 from step Sb2. For example, if the event of interest is the movement of the bipolar forceps 4, the surgeon may have grasped the bipolar forceps 4, so the event of interest is included in the condition for determining the appearance of the hemostasis stage. It determines with YES.

  In step Sb3, the procedure analysis unit 14 checks whether or not an appearance determination condition including the event of interest is satisfied. If it determines with NO here, the procedure analysis part 14 will return to step Sb1, change an attention event, and will repeat the subsequent process. If it determines with YES, the procedure analysis part 14 will progress to step Sb4 from step Sb3. For example, in the case of the hemostasis stage, the position of the bipolar forceps 4 matches the position of the surgeon's hand, and the operation state of the bipolar forceps 4 is confirmed in consideration of other events in the coagulation mode. If possible, the procedure analysis unit 14 determines YES in step Sb3.

  In step Sb4, the procedure analysis unit 14 selects a stage corresponding to the established appearance determination condition as a candidate stage. When a plurality of appearance determination conditions are satisfied, the procedure analysis unit 14 selects stages corresponding to all of the plurality of appearance determination conditions as candidate stages. In step Sb5, the procedure analysis unit 14 selects an unselected one of the candidate stages as the stage of interest. In step Sb6, the procedure analysis unit 14 tries to determine the start time and the end time based on the start determination condition and the end determination condition for the stage of interest.

  For example, in the situation shown in FIG. 7, the appearance of the hemostatic stage is determined at time TA. Then, the time point TB can be determined as the start point of the hemostasis stage by going back from the leading edge of the period PA in which the coagulation mode energization of the bipolar forceps 4 is continuously used at intervals of 30 seconds or less. Further, the time point TC can be determined as the end point of the hemostasis stage by following the trailing edge of the period PA.

  In step Sb7, the procedure analysis unit 14 confirms whether the start time and the end time have been successfully determined. If it determines with YES here, the procedure analysis part 14 will progress to step Sb8 from step Sb7. In step Sb8, the procedure analysis unit 14 determines the stage of interest as the stage that has generated, and writes a new data record relating to this stage in the procedure information storage unit 15. This data record is generated by describing the contents of the stage start time, stage completion time, and stage classification name in association with the serial stage number in the order of writing to the procedure information storage unit 15. The stage start time and stage completion time are the time corresponding to the start time and end time determined in step Sb6. The stage classification name is a classification name related to the stage of interest at this point. After this, the procedure analysis unit 14 proceeds to step Sb10.

  By the way, when it determines with NO in step Sb7, the procedure analysis part 14 progresses to step Sb9 from step Sb7. In step Sb9, the procedure analysis unit 14 checks whether there is a stage that is not selected as the stage of interest among the candidate stages selected in step Sb4. When it determines with YES here, the procedure analysis part 14 returns to step Sb5, changes the stage of interest, and repeats said process. However, when it is determined NO, the procedure analysis unit 14 proceeds from step Sb9 to step Sb10.

  In step Sb10, the procedure analysis unit 14 confirms whether or not the analysis for one file to be processed has been completed. If it is determined NO here, the procedure analysis unit 14 returns to step Sb1, changes the event of interest, and repeats the subsequent processing. When it determines with YES, the procedure analysis part 14 complete | finishes the process of FIG.

  In the second embodiment, the display data generation unit 16 generates display data representing a presentation screen as shown in FIG. 8, for example. If it is such a presentation screen, the procedure of medical practice can be easily grasped. The presentation screen shown in FIG. 8 includes a play button represented by “>”. In response to the click of the playback button, the display data generation unit 16 reads out video image data for the corresponding stage period from the medical information storage unit 12 and generates display data for playback of the data. . At this time, the display data generation unit 16 generates display data so that the stage classification name corresponding to the video image being reproduced is displayed at the same time. FIG. 9 shows an example of an image displayed on the display device 5 based on the display data. In the image shown in FIG. 9, four video images 91 to 94 are displayed simultaneously. The video image 91 is taken by a camera installed at the bottom of the surgical light. The video image 92 is taken by a camera installed beside the surgical microscope. The video image 93 is taken with a camera installed in a medical device. The video image 94 is taken with a camera installed on the ceiling of the operating room. The image shown in FIG. 9 includes an image 95 representing the stage classification name together with these video images. If the video image is reproduced in such a form, it is possible to easily grasp which stage is the operation being reproduced.

  Thus, according to the second embodiment, the procedure is analyzed in consideration of not only the operating state of the medical device but also the position of the operator and the position of the medical instrument. As a result, the stage can be determined in consideration of events that cannot be determined by the operating state of the medical device, such as the surgeon holding the bipolar forceps 4 or the gauze being inserted into the patient. The stage can be distinguished.

  This embodiment can be variously modified as follows.

  In the first embodiment, an example in which the X-ray imaging device 7 and the contrast medium administration device 5 are used as medical devices is shown. However, even when various other medical devices are used, characteristics of the medical devices are shown. This can be implemented by preparing a stage table according to the above.

  In each embodiment, the procedure analysis unit 14 may create procedure information in real time based on information input by the information collection unit 11 when a medical practice is performed.

  In each embodiment, it is not necessary to determine only the start time and determine the end time.

  In each embodiment, the time at which medical information is acquired is acquired as the time at which an event related to the medical information has occurred, but the time information is acquired from the X-ray image device 7, the position sensor group 8, or the collection device 9 together with the medical information. You may do it.

  Note that the present invention is not limited to the above-described embodiment as it is, and can be embodied by modifying the constituent elements without departing from the scope of the invention in the implementation stage. In addition, various inventions can be formed by appropriately combining a plurality of components disclosed in the embodiment. For example, some components may be deleted from all the components shown in the embodiment.

The figure which shows an example of the use condition of the medical information system which concerns on embodiment of this invention. The block diagram of the medical information system in FIG. The figure which shows an example of the stage table memorize | stored in the stage table memory | storage part in FIG. 2 in 1st Embodiment. The flowchart which shows the procedure which produces the procedure information regarding the medical practice which the procedure analysis part in FIG. 2 performed in 1st Embodiment. The figure which shows an example of the procedure information produced | generated by the procedure analysis part in FIG. 2 in 1st Embodiment. The flowchart which shows the procedure which produces the procedure information regarding the medical practice which the procedure analysis part in FIG. 2 performed in 2nd Embodiment. The figure which shows an example of the generation | occurrence | production condition of the event in a hemostatic stage. The figure which shows an example of the procedure information produced | generated by the procedure analysis part in FIG. 2 in 2nd Embodiment. The figure which shows an example of the image displayed with the display apparatus in FIG. 2 in 2nd Embodiment.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Medical information system, 2 ... BIS monitor, 3 ... Patient monitor, 4 ... Bipolar forceps, 5 ... Contrast agent administration apparatus, 5 ... Display apparatus, 6 ... Aspiration catheter, 7 ... X-ray image apparatus, 8 ... Position sensor group , 9 (9-1 to 9-16) ... collecting device, 10 (10-1 to 10-16) ... identifying device, 11 ... information collecting unit, 12 ... medical information storage unit, 13 ... stage table storage unit, 14 ... procedure analysis unit, 15 ... procedure information storage unit, 16 ... display data generation unit.

Claims (18)

A medical information system that performs information processing for managing a medical practice including a plurality of stages achieved by a combination of a plurality of events,
A collecting means for collecting state information indicating a medical device and / or a human state relating to the medical action in a time series;
First determination means for determining an execution order of the plurality of stages based on an occurrence state of the event determined based on the state information;
Second determination means for determining the start timing of each of the plurality of stages based on the state information;
A medical information system comprising: means for generating procedure information indicating the execution order and the start timing of each of the plurality of stages.   The collecting means includes at least information indicating a state of a medical instrument used in the medical practice, information indicating a position of a person related to the medical practice, and information indicating a position of the medical instrument used in the medical practice. The medical information system according to claim 1, wherein any one kind is acquired as the state information.   The medical information system according to claim 2, wherein the collection unit inputs information indicating an exposure dose as information indicating a state of the medical device.   The first determination unit determines the occurrence state of the event based on at least one of a change in the state of the medical device, a change in the position of the human, and a change in the position of the medical instrument, The medical information system according to claim 2, wherein the execution order is determined in consideration of relevance of the plurality of events.   The first determination unit determines that the stage associated with the matching state has started when the state of the medical device matches a preset state. Item 5. The medical information system according to Item 4.   The first determination means determines that the stage associated with the matching condition has started in response to occurrence conditions of a plurality of the events meeting a preset condition; The medical information system according to claim 4.   The medical information system according to claim 1, wherein the second determination unit also determines the end timing of each of the plurality of stages based on the state information.   The medical information system according to claim 1, further comprising a generation unit configured to generate presentation information for presenting the execution order based on the procedure information. The medical information system is capable of accessing a storage medium that stores medical information related to the performed medical practice together with timing information,
The generating means determines which of the plurality of stages the medical information relates to based on the start timing of each stage indicated in the procedure information and the timing information, and determines the relationship between the medical information and the stage. The medical information system according to claim 8, wherein the presentation information for presentation is generated.   The medical information includes at least one of an image photographed by the medical device, a dose of a contrast medium, a time required for catheter operation, the number of inappropriate catheter operations, and the number of times the person performing the medical action was shaken. The medical information system according to claim 9, comprising: Computer
A medical information system that performs information processing for managing a medical practice including a plurality of stages achieved by a combination of a plurality of events,
A collecting means for collecting state information indicating a medical device and / or a human state relating to the medical action in a time series;
First determination means for determining an execution order of the plurality of stages based on an occurrence state of the event determined based on the state information;
Second determination means for determining the start timing of each of the plurality of stages based on the state information;
A program which functions as a medical information system comprising means for generating procedure information indicating the execution order and the start timing of each of the plurality of stages.   The program according to claim 11, wherein the second determination unit determines the end timing of each of the plurality of stages based on the state information.   The program according to claim 11, further causing the computer to function as a generation unit that generates presentation information for presenting the execution order based on the procedure information. The computer is accessible to a storage medium that stores medical information related to the performed medical practice together with timing information,
The generation means determines whether the medical information relates to the plurality of stages based on the start timing of each stage indicated in the procedure information and the timing information, and determines the relationship between the medical information and the stage. The program according to claim 13, wherein the presentation information for presentation is generated. A medical information processing method for performing information processing for managing a medical practice including a plurality of stages achieved by a combination of a plurality of events,
Collecting time-series medical equipment and / or state information indicating the state of the person related to the medical action;
Determining the execution order of the plurality of stages based on the occurrence status of the event determined based on the state information;
Determining a start timing of each of the plurality of stages based on the state information;
Procedural information indicating the execution order and the start timing of each of the plurality of stages is generated.   The program according to claim 15, wherein the end timing of each of the plurality of stages is determined based on the state information together with the start timing.   The medical information processing method according to claim 15, further comprising: generating presentation information for presenting the execution order based on the procedure information. Accessing a storage medium that stores medical information about the medical practice that has already been performed together with timing information;
For determining which of the plurality of stages the medical information relates to based on the start timing of each stage indicated in the procedure information and the timing information, and presenting a relationship between the medical information and the stage The medical information processing method according to claim 17, wherein the presentation information is generated.

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