JP2006252305A - Prescription audit support system and prescription audit support method - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To contribute to audit for the amount of medicines having the same component to be prescribed to a patient, and audit whether a prescription order is suitable to the state of the patient or not. <P>SOLUTION: Medicine item data including administration units stored in a unit conversion master 107 is retrieved to specify administration units of medicine items, administration unit conversion data including conversion coefficients for converting medicine names shown in medicine data and the dosage of medicines shown in a prescription order to dosage of administration units shown in medicine item data stored in a medicine item master 108 is retrieved. Based on the specified administration units, the daily dosage of each medicine item is calculated to generate display data for the calculated daily dosage of every medicine item. The daily dosage is adjusted with a physical data coefficient based on the physical feature of the patient and a reference adjustment coefficient based on the clinical result of the patient to generate a final administration reference value. Further, a determination reference table for daily dosage is formed to determine whether the daily dosage of medicines are appropriate or not. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

  The present invention relates to a prescription audit support system and a prescription audit support method capable of supporting the audit when a prescription of a medicine to be administered to a patient ordered by a prescription or an injection is audited.

  This often occurs when a patient visits multiple departments in a medical institution such as a hospital. The medicine prescribed at that time may be administered with the same medicine, or there may be the same ingredients even if the medicine names are different. When a plurality of medicines having the same component is administered to the patient in this way, the patient has administered a medicine of a prescribed amount or more, and there is a possibility that the patient's health may be seriously impaired. Even if the conventional prescription audit support method has the function of performing audits between multiple orders such as prescriptions and injections issued in the department that the patient consulted, It was an audit system based on the premise that it is a medicine.

  In addition, for drugs such as anti-cancer drugs, it is necessary to determine whether to reduce the dosage or postpone the timing of administration depending on the physical characteristics and condition of the patient. There was no system corresponding to.

  As mentioned above, in conventional prescription audits, medicines with the same ingredients and different standards in the prescriptions and injections issued by the patient are only audited as separate medicines. There has been a problem that the amount of the medicine having the same component to be administered has not been audited, and the amount of the medicine to be administered to the patient exceeds the prescribed amount, which may seriously harm the patient's health.

  In addition, for drugs such as anti-cancer drugs, it is necessary to determine whether to reduce the dosage or postpone the timing of administration depending on the physical characteristics and condition of the patient. There was no system corresponding to.

  In view of the above problems, the present invention contributes to the audit when auditing the amount of the medicine having the same component prescribed to the patient, and further, in the administration of an anticancer agent, etc. It is an object of the present invention to provide a prescription audit support system and a prescription audit support method that can audit whether an order is received.

  The prescription audit support system according to the present invention provides an audit support for the daily dose of the medicine for the patient when there are a plurality of prescription orders for a specific patient and the medicines of the same component are indicated across the plurality of prescription orders. The prescription audit support system used in the above-mentioned prescription audit support system includes an order receiving unit that receives a prescription order indicating a medicine to be administered to a patient, a prescription amount of the medicine, and an administration date and time. A medicine item master that stores medicine items that describe medicines as the same group, and medicine item data that includes a notation unit of the medicine items, a medicine master that stores medicine data including correspondence between medicines and medicine items, and the order The prescription amount of the medicine indicated in the prescription order received by the receiving unit is indicated in the medicine item data stored in the medicine item master. A unit conversion master for storing unit conversion data including a conversion coefficient for converting to a daily dose of the notation unit, and the drug data stored in the drug master are searched and indicated in the prescription order. Based on the correspondence relationship in the medicine data of the medicine master and the medicine specifying part for specifying the medicine contained in the medicine data, the medicine item of the medicine specified by the medicine specifying part is specified. And a notation unit specifying unit for specifying the notation unit of the drug item specified by the drug item specifying unit from the notation unit indicated in the drug item data stored in the drug item master. And the unit conversion data stored in the unit conversion master for the conversion coefficient corresponding to the notation unit specified by the notation unit specifying unit. The conversion factor specifying unit to be specified, the prescription amount and the administration date and time of the drug indicated in the prescription order, and the conversion factor specified by the conversion factor specification unit, the drug indicated in the prescription order A unit conversion unit that calculates the daily dose of the drug item and converts it into the notation unit of the drug item, and a display data generation unit that generates display data of the daily dose for each drug item calculated by the unit conversion unit And a display unit for displaying the display data.

  By using the prescription inspection support system, it becomes easy to audit the amount of medicine having the same component prescribed to the patient. Moreover, the prescription inspection assistance server comprised in parts other than a display part in the said structure is also contained in this invention.

  In the above configuration, the drug item data stored in the drug item master includes a dosing standard indicating a daily dose of the notation unit to be administered to a standard patient for each drug item, and dosing to the patient. A determination criterion generation coefficient table for generating a determination criterion table used for determining the daily dose of the notation unit of the drug item may be further provided. At the same time, the prescription inspection support system further includes a patient data receiving unit that receives patient data having a body data coefficient based on the physical characteristics of the patient, and the body indicated in the patient data received by the patient data receiving unit. A dosage standard adjustment unit for adjusting the dosage standard indicated in the chemical item data stored in the chemical item master using a data coefficient, and an adjusted dosage standard adjusted by the dosage standard adjustment unit As a final administration criterion, based on the determination criterion generation coefficient table shown in the drug item data, a determination criterion table generation unit that generates the determination criterion table, and the determination criterion table generator Based on the determination criteria table, the unit of medicine item indicated in the prescription order received by the order receiving unit A dose determination unit for determining the calculated daily dose; and a determination result display data generation unit for generating display data indicating the determination result determined by the dose determination unit; and the display unit, The display data indicating the determination result can be displayed.

Similarly to the above, the drug item data stored in the drug item master includes a dosing standard indicating a daily dose of the notation unit to be administered to a standard patient for each drug item, and a patient In addition, a determination criterion generation coefficient table for generating a determination criterion table used for determining the daily dosage of the notation unit of the drug item to be administered can be provided. At the same time, the prescription inspection support system further includes a patient data receiving unit that receives patient data having a body data coefficient based on the physical characteristics of the patient, and the body indicated in the patient data received by the patient data receiving unit. A first dosing reference adjustment unit that adjusts the dosing criteria indicated in the medicinal item data stored in the medicinal item master using a data coefficient, and generates a first adjusted dosing reference; A clinical data receiving unit that receives clinical data including clinical items and clinical results of the patient data received in the patient data receiving unit;
Administration reference value adjustment coefficient master storing administration reference value adjustment coefficient data in which a reference adjustment coefficient required for generating the determination reference table and a threshold value for determining the reference adjustment coefficient are described, and the clinical data receiving unit A threshold value determination unit for determining the threshold value from the administration reference value adjustment coefficient data stored in the administration reference value adjustment coefficient master, based on the clinical result indicated in the clinical data received in step S; A reference adjustment coefficient specifying unit that specifies the reference adjustment coefficient corresponding to the threshold value determined by the unit, and the reference adjustment coefficient specified by the reference adjustment coefficient specifying unit, and A second dosage reference adjustment unit that generates a second adjusted dosage reference, and a second adjusted dosage base generated by the second dosage reference adjustment unit As a final administration criterion, based on the determination criterion generation coefficient table shown in the drug item data, a determination criterion table generation unit that generates the determination criterion table, and the determination criterion table generator Based on the determination criteria table, a dose determination unit for determining the daily dose of the drug item indicated in the prescription order received by the order receiving unit, and a display indicating the determination result determined by the dose determination unit A determination result display data generation unit that generates data, and the display unit displays display data indicating the determination result.

  In the above configuration, only the display unit can be configured from an independent client device. On the other hand, the order receiving unit, the drug item master, the drug master, the unit conversion master, the drug specifying unit, the drug item specifying unit, the notation unit specifying unit, and the conversion coefficient specifying The unit, the unit conversion unit, the display data generation unit, and the display unit may all be provided in the server / client integrated apparatus.

  Furthermore, the prescription audit support method of the present invention has a plurality of prescription orders for a specific patient, and when a medicine of the same component is indicated across the plurality of prescription orders, the daily dosage of the medicine for the patient is determined. A prescription audit support method used for audit support, wherein the prescription audit support method receives a prescription order indicating a medicine to be administered to a patient, a prescription amount of the medicine, and an administration date and time. The medicine item data described as the same group and the medicine item data including the notation unit of the medicine item are stored, the medicine data including the correspondence relationship between the medicine and the medicine item name is stored, and the medicine data indicated in the received prescription order is stored. Storing unit conversion data including a conversion coefficient for converting a prescription amount of a drug into a daily dose of the notation unit indicated in the stored drug item data; And the medicine indicated in the prescription order is specified as the medicine included in the medicine data, and the medicine item of the specified medicine is determined based on the correspondence relationship in the medicine data. And specifying a notation unit corresponding to the specified drug item in the drug item data, and specifying the conversion coefficient corresponding to the specified notation unit from the stored unit conversion data. And calculating the daily dose of the medicine shown in the prescription order using the prescribed amount and administration date and time of the medicine shown in the prescription order and the specified conversion factor, Is converted into the notation unit, display data for the calculated daily dose for each of the calculated drug items is generated, and the display data is displayed.

  By using the prescription inspection support method, it becomes easy to audit the amount of the medicine having the same component prescribed to the patient. Further, the present invention includes a program for causing a computer to execute each step of the method, a recording medium on which the program is recorded, a memory, and the like.

  In addition, an order receiving unit that receives a prescription order indicating a medicine to be administered to a patient, a medicine item master that stores medicine items that describe medicines of the same component as the same group, a medicine, and a medicine of the same component A medicine master that stores the correspondence of medicine items described as the same group, and a medicine that identifies the medicine item of the medicine shown in the prescription order based on the medicine item stored in the medicine item master and the correspondence. A prescription inspection support system including an item specifying unit and a display data generating unit that generates display data including the specified drug item is also included in the present invention.

  As described above, the present invention can provide a useful prescription audit support system, prescription audit support method, and the like when auditing the amount of a medicine having the same component prescribed to a patient.

  DESCRIPTION OF EXEMPLARY EMBODIMENTS Hereinafter, the best mode for carrying out the invention will be described with reference to the drawings.

  FIG. 1 is a block diagram showing a configuration of a prescription inspection support system according to an embodiment of the present invention. As shown in FIG. 1, the prescription audit support system of this embodiment includes a prescription audit support server 10, an order input device 20, a patient / clinical data input device 30, and a client device (display unit) 40. ing. However, the order input device 20 and the patient / clinical data input device 30 are not essential devices in the system, and both devices can be integrally formed. Therefore, the prescription audit support system can be configured only from the prescription audit support server 10 and the client device 40. In addition, the prescription inspection support server 10 and the client device 40 may be configured by a server / client integrated device. In this case, the client device 40 portion displays data to allow the user to perform prescription inspection. Part.

  The prescription inspection support server 10 includes an order receiving unit 101, a patient / clinical data receiving unit 102, an order data storage unit 103, a patient data storage unit 104, a clinical data storage unit 105, a medicine master 106, a unit conversion master 107, a medicine item master. 108, an administration reference value adjustment coefficient master 109, a prescription inspection engine unit 110, and a master editing unit 111. However, the master editing part 111 can also be comprised from the terminal independent of the prescription inspection assistance server 10 like the client apparatus 40. FIG. Also, order receiving unit 101, patient / clinical data receiving unit 102, order data storage unit 103, patient data storage unit 104, clinical data storage unit 105, medicine master 106, unit conversion master 107, medicine item master 108, administration reference value The adjustment coefficient master 109, the prescription inspection engine unit 110, and the master editing unit 111 may be distributed on the network and need not be included in the prescription inspection support server 10.

  When the order receiving unit 101 receives from the order input device 20 a prescription order (including a prescription and an injection note) indicating a medicine to be administered to a patient, a prescription amount of the medicine and a date and time of administration, the order receiving unit 101 receives the order. Order data (to be described later) to be stored in the order data storage unit 103 is generated, and this data is stored in the order data storage unit 103.

  When the patient / clinical data receiving unit (patient data receiving unit) 102 receives input data indicating the physical characteristics of the patient from the patient / clinical data input device 30, the patient / clinical data receiving unit 102 stores the input data in the patient data storage unit 104. Patient data to be stored (described later) is generated, and this patient data is stored in the patient data storage unit 104. When the patient / clinical data receiving unit (clinical data receiving unit) 102 receives the input data indicating the clinical state of the patient from the patient / clinical data input device 30, the patient / clinical data receiving unit 102 stores the input data in the clinical data storage unit 105. Clinical data to be stored (described later) is generated, and this clinical data is stored in the clinical data storage unit. The patient / clinical data input device 30 can be divided into a patient data input device and a clinical data input device. Similarly, the patient / clinical data receiving unit 102 can be configured to be divided into a patient data receiving unit and a clinical data receiving unit. Furthermore, the order receiving unit may receive patient data together with the order and store it in the patient data storage unit 104.

  The order data storage unit 103 stores the order data generated by the order receiving unit 101. Although not shown, the order data includes a patient name, administration date and time, a code of a medicine to be administered, a medicine name, a unit (mg, ml) of a prescription amount of the medicine, a prescription amount, and the like.

  The patient data storage unit 104 stores the patient data generated by the patient / clinical data receiving unit 102. In the patient data, as shown in FIG. 2, the patient name, the patient's height, weight, and body surface area are described. The body surface area is a value calculated using the Fujimoto formula based on height and weight. Height, weight, body surface area, etc. each constitute body data coefficients based on the physical characteristics of the patient.

  The clinical data storage unit 105 stores the clinical data generated by the patient / clinical data receiving unit 102. As shown in FIG. 3, the clinical data describes the patient name, clinical items, measurement date (strictly speaking, sample collection date, not measurement date), and clinical results.

  The medicine master 106 stores medicine data describing the contents of the medicine to be administered to the patient generated by the master editing unit 111. As shown in FIG. 4, the medicine data describes a medicine item that describes a medicine identification code, a medicine name, a dosage unit (mg, ml), and a group name of medicines of the same component. For example, the medicine A1 of the code 1231, the medicine A1 of the code 1232, and the medicine A2 of the code 1233 have the item A as a medicine item. Here, the code 1231 chemical A1 (5 mg 25 ml) and the code 1232 chemical A1 (10 mg 50 ml) are chemicals of the same manufacturer, but indicate that they are different standards, and the chemical A1 and chemical A2 indicates that the manufacturer is a different chemical. Therefore, the medicine data describes the correspondence between medicines and medicine items.

  The unit conversion master 107 stores the unit conversion data generated by the master editing unit 111. The unit conversion data is data for converting the unit of medicine to be administered to the ordered patient. As shown in FIG. 5, the code for identifying the medicine, the medicine name, the unit before conversion, the unit after conversion, A conversion coefficient necessary for conversion from the unit before conversion to the unit after conversion is described. For example, when the medicine ordered in the prescription order received by the order receiving unit 101 is administered in the amount and unit of medicine A1 (5 mg 25 ml) of code 1231, 1 is multiplied by a coefficient 5. The obtained 5 mg is the amount and unit of the administered drug after conversion.

  The drug item master 108 stores the drug item data generated by the master editing unit 111. As shown in FIG. 6, the drug item data includes a drug item describing the drug of the same component as the same group, a notation unit of the drug item, availability information indicating whether or not adjustment of the administration standard is necessary, and standard information. Dosage criteria that indicate the amount of the drug to be administered to a patient in the unit of the drug item, a judgment target that indicates the judgment target when adjusting the dosage criteria, a small warning amount range that determines the suitability of the drug dosage, a normal amount Describes the small amount warning amount range rate, normal amount range rate, warning amount range rate, and limit amount range rate used when calculating the range, warning amount range, and limit amount range (which will be described later) . The determination criterion generation coefficient table is configured by the small amount warning amount range rate, the normal amount range rate, the warning amount range rate, and the limit amount range rate. The small warning amount range is a range indicating that the amount of the drug to be administered to the patient is insufficient, the normal amount range is a range indicating that the amount of the drug to be administered is appropriate, and the warning amount range is the dose The amount of medicine is not dangerous at the present time, but is a range indicating that it is too much, and the limit amount range is a range indicating that the amount of medicine to be administered exceeds the dangerous amount. The low warning amount range is the range obtained by multiplying the final dosage reference value finally obtained by the small warning quantity range rate, and the normal dosage range is the normal dosage to the final dosage reference value finally obtained. It is the range obtained by multiplying the range rate, the warning amount range is the range obtained by multiplying the final dose reference value finally obtained by the warning amount range rate, and the limit amount range is finally This is a range obtained by multiplying the determined final dose reference value by the limit amount range rate.

  The administration reference value adjustment coefficient master 109 stores the administration reference value adjustment coefficient data generated by the master editing unit 111. As shown in FIG. Multiply the clinical item such as Bil, AST, GFR, the threshold value indicating the determination of the clinical result, and the administration standard (administration standard after the first adjustment) and the final standard value (the administration standard after the second adjustment). A reference adjustment coefficient for generating is described.

  The prescription inspection engine unit 110 reads out the order data to be administered to the patient received from the order receiving unit 101 and stored in the order data storage unit 103, and stores it in the drug master 106, the drug item master 108, and the unit conversion master 107. Each of the data is retrieved and the daily dose for the same component drug is calculated.

  In addition, the prescription inspection engine unit 110 searches the respective data stored in the drug item master 108 and the patient data storage unit 104 for the drug items to be administered to the patient, and the body data coefficient (height of the patient data storage unit 104) , Body weight, body surface area, etc.) to adjust the administration criteria of the drug item master 108 to generate the first adjusted administration criteria (first adjustment). Further, the prescription inspection engine unit 110 searches the respective data stored in the clinical data storage unit 105 and the administration reference value adjustment coefficient master 109, and from the administration reference after the first adjustment, the administration reference value adjustment coefficient master. The second adjusted administration standard as the final administration standard value is created using the 109 standard adjustment coefficient (second adjustment). Further, the prescription inspection engine unit 110 determines the amount of medicine ordered based on the created determination criterion, creates display data indicating the determination result, and transmits the display data to the client device 40 that has requested the display data.

  The master editing unit 111 is stored in the medicine master 106, the unit conversion master 107, the medicine item master 108, and the administration reference value adjustment coefficient master 109 based on data input from a master data input device (not shown). The generated data is generated, and the generated data is stored in the corresponding master.

  Next, the operation of the prescription inspection support system will be described with reference to FIGS.

  The order receiving unit 101 receives, for example, the patient name “Taro Matsushita”, the administration date “October 17” from the order input device 20, the code “1231” of the drug to be administered, the drug name “medicine A1”, Ingredient amount (mg, ml) ”(5 mg, 25 ml)”, prescription amount “1”, code “1321”, drug name “drug B1”, ingredient amount of this drug ”(50 mg, 100 ml)”, When the prescription order (hereinafter referred to as the first order) with the prescription amount “50 mg” is received from the order input device 20, order data to be stored in the order data storage unit 103 is generated, and this order data is stored in the order data storage unit 103. Remember. Similarly, the order receiving unit 101 has the patient name “Taro Matsushita”, the administration date “October 17”, the code “1232” of the drug to be administered, the drug name “medicine A1”, the component amount of this drug ”(10 mg , 50 ml), and a prescription amount “100 ml”, a code “1402”, a drug name “drug C2”, a component amount of this drug ”(30 mg, 15 ml), and a prescription amount“ 1 ” 2nd order), patient name “Taro Matsushita”, administration date “October 17”, drug code “1233”, drug name “Drug A2”, component amount of this drug ”(10 mg, 50 ml) ) And prescription amount “10 mg”, code “1401”, drug name “drug C1”, component amount of this drug ”(30 mg, 150 ml), and prescription amount“ 30 ml ”(hereinafter referred to as third order) ) Then, each order data is generated, and the generated order data is stored in the order data storage unit 103. The generated order data is, for example, the patient name “Taro Matsushita” in the first order data. , Date of administration “October 17”, code of drug to be administered “1231”, drug name “drug A1”, amount of this drug component (mg, ml) ”(5 mg, 25 ml)”, and prescription amount “1” “, And a code“ 1321 ”, a medicine name“ medicine B1 ”, a component amount of this medicine“ (50 mg, 100 ml) ”, and a prescription amount“ 50 ml ”are described.

  The prescription inspection engine unit 110 reads the order data of the first order from the order data storage unit 103 and calculates the dose for the code “1231 drug name” drug A1. That is, the prescription inspection engine unit 110 searches the medicine master 106 using the code “1231” as a key, and reads out the medicine item “medicine A” having the group name having the same component. Here, the prescription inspection engine unit 110 searches the drug data stored in the drug master 106, specifies the drug indicated in the prescription order to the drug included in the drug data, and It functions as a drug item specifying unit that specifies the drug item of the specified drug based on the correspondence between the drug and the drug item in the drug data. Next, the prescription inspection engine unit 110 searches the drug item master 108 using the drug item “item A” as a key, and reads the notation unit “mg”. Here, the prescription inspection engine unit 110 functions as a notation unit specifying unit that specifies the notation unit of the specified medicine item from the notation unit indicated in the medicine item data of the medicine item master 108. Thereafter, the prescription inspection engine unit 110 searches the unit conversion master 107 using the code “1231” as a key, reads “5” as the coefficient in the unit conversion data in which the unit “mg” after conversion is described, “5” obtained by multiplying the read coefficient “5” by 1 of the prescription amount “1” is calculated as the dose “5 mg” of this medicine. Here, the prescription inspection engine unit 110 specifies the conversion coefficient corresponding to the specified notation unit from the unit conversion data of the unit conversion master 107, and the prescription amount of the medicine indicated in the prescription order Further, it functions as a unit conversion unit that calculates the daily dose of the medicine indicated in the prescription order by using the conversion coefficient specified by the administration date and time and the conversion coefficient specifying unit, and converts it into the notation unit of the drug item. Next, the prescription inspection engine unit 110 stores data including a code “1231”, a medicine item “item A”, and a prescription amount “5 mg” in a work memory (not shown). Similarly, the prescription inspection engine unit 110 calculates the dosage for the drug “code“ 1321 ”,“ medicine B1, ”and works with the data including the code“ 1321 ”, the drug item“ item B ”, and the calculated dose. Store in memory.

  Next, the prescription inspection engine unit 110 reads the order data of the second order from the order data storage unit 103, calculates the dose “20 mg” of the drug name “A1” of the code “1232” in the same manner as described above, Data consisting of code “1321”, drug item “item A”, and dose “20 mg” is stored in the work memory. Similarly, the prescription inspection engine unit 110 calculates a dose for the code “1402 drug name” drug C2, and includes the code “1402”, the drug item “item C”, and the calculated dose “30 mg”. Store data in work memory. Thereafter, the prescription inspection engine unit 110 reads the order data of the third order from the order data storage unit 103, calculates the dose “10 mg” of the drug name “A2” of the code “1233” in the same manner as described above, Data including “1233”, drug item “item A”, and dose “10 mg” is stored in the work memory. Similarly, the prescription inspection engine unit 110 calculates the dose for the drug name “drug C2” with the code “1401”, the code “1401”, the drug item “item C”, and the calculated dose “60 mg”. The data consisting of is stored in the work memory.

  Next, the prescription inspection engine unit 110 reads the data stored in the work memory, adds up the doses of the same drug item, and stores the data describing the dosed drug items and the added dose in the work memory. To do. Next, the prescription inspection engine unit 110 includes the code “1231”, the drug item “item A”, the data describing the dose “5 mg”, the code “1232”, the drug item “item A”, and the dose. The data describing “20 mg”, the code “1233”, the drug item “item A”, and the data describing the dose “10 mg” are read out, and the dose for the drug item “item A” is added together. 35 mg "is calculated as a daily dose of medicine to be administered to the patient name" Taro Matsushita ". Thereafter, in the same manner, the prescription inspection engine unit 110 reads out the data describing the code “1321”, the drug item “item B”, and the data describing the dose, and the administration for the drug item “item B”. The total dose is calculated as the daily dose of the drug to be administered to the patient name “Taro Matsushita”. Thereafter, in the same manner, the prescription inspection engine unit 110 reads the code “1402”, the drug item “item C”, the data describing the dose, the code “1401”, the drug item “item C”, and the dose. Is calculated, and the value of the dose for the drug item “item C” as the dose of the drug for one day to be administered to the patient name “Taro Matsushita” is calculated (step 101).

  Next, the prescription inspection engine unit 110 includes the patient name “Taro Matsushita”, the administration date “October 17”, the drug item “item A” to be administered, and the daily dose (hereinafter referred to as “daily dose”). Create data describing “35 mg”, item name “item B”, daily dose “50 mg”, item name “item C”, daily dose “90 mg” (hereinafter referred to as individual dose data). This data is stored in the work memory. Thereafter, the prescription inspection engine unit 110 reads the dose data for each item from the work memory, and first searches the drug item master 108 for the drug item “item A” using “item A” as a key, and the corresponding drug item data. Is read (step 102), and it is determined whether or not an adjustment of the administration standard (first adjustment) indicating the amount of medicine to be administered to a patient having standard body characteristics is required. (Step 103). That is, the prescription inspection engine unit 110, when it is described that the adjustment is made in the availability information, the administration standard value “20 mg” described in the read medicine item data and the “body surface area” that is the determination target of the adjustment. Is read.

Next, the prescription inspection engine unit 110 searches the patient data stored in the patient data storage unit 104 and reads the body surface area “1.1862” described in the patient data of the patient name “Taro Matsushita”. Thereafter, the formulation audit engine 110, previously administered reference "20 mg / ^{m 2"} body surface area "1.1862M ^2" by multiplying the read, first administration criteria adjusted to suit the physical characteristics of the patient " 23.724 mg "is calculated (step 104). Here, the prescription inspection engine unit 110 uses the body data coefficient (body surface area) indicated in the patient data to adjust the administration standard indicated in the drug item data of the drug item master 108 and perform the first adjustment. It functions as a first administration reference adjustment unit that generates later administration criteria. Thereafter, the prescription inspection engine unit 110 searches the clinical data stored in the clinical data storage unit 105 and determines whether there is clinical data of the patient name “Taro Matsushita” (step 105). When it is determined that there is clinical data of the patient name “Taro Matsushita” (step 105; YES), the prescription inspection engine unit 110 matches the first adjusted administration standard “23.724 mg” with the clinical data. Clinical items described in the clinical data of patient name “Taro Matsushita” when it is determined that adjustment (second adjustment) to generate the second adjusted dose standard as the final dose standard value is necessary “T.Bil” and clinical result “2.5”, clinical item “AST” and clinical result “55”, clinical item “GFR” and clinical result “65” are read out.

  Thereafter, the prescription inspection engine unit 110 searches the administration reference value adjustment coefficient data stored in the administration reference value adjustment coefficient master 109, and stores the medicine item “item A” and the clinical item “T.Bil”. The reference adjustment coefficient “50%” of the administration reference value adjustment coefficient data in which the result threshold satisfies the clinical result “2.5” is read. Next, the prescription inspection engine unit 110 similarly searches the administration standard value adjustment coefficient data stored in the administration standard value adjustment coefficient master 109, and in the medicine item “item A” and the clinical item “AST”, Further, the reference adjustment coefficient “100%” of the administration reference value adjustment coefficient data whose clinical result threshold satisfies the clinical result “55” is read out. The administration reference value adjustment coefficient data does not include administration reference value adjustment coefficient data satisfying the clinical result “65” for the drug item “item A” and the clinical item “GFR” and the clinical result threshold is “65”. Here, the prescription inspection engine 110 corresponds to the threshold value determination unit that determines the threshold value from the administration reference value adjustment coefficient data stored in the administration reference value adjustment coefficient master 109 based on the clinical result of the clinical data, and the threshold value. It functions as a reference adjustment coefficient specifying unit that specifies the reference adjustment coefficient to be performed.

  Next, the prescription inspection engine unit 110 considers the safety of the drug dosage among the read standard adjustment factors “50%” and “100%”, and finally “50%” having a small standard adjustment factor is finally administered. A reference adjustment coefficient for calculating a reference value is specified. Thereafter, the prescription inspection engine unit 110 multiplies the previously-calculated administration standard “23.724 mg” by the determined standard adjustment coefficient “50%” and obtains “11.862 mg” as the final administration standard value (second The final administration standard value “11.862 mg” is stored in the work area (step 106). Here, the prescription inspection engine 110 adjusts the first adjusted dosage standard (23.724 mg) using the specified standard adjustment coefficient, and obtains the final dosage standard value (second adjusted dosage standard). It functions as the 2nd administration standard adjustment part to generate.

  Thereafter, the prescription inspection engine unit 110 retrieves the medicine item data stored in the medicine item master 108, and the small amount warning amount rate of the medicine item “item A” described in the medicine item data is 80 (%). “Normal dose rate” 110 (%), warning dose rate “130 (%), and limit dose rate“ 130 (%) ”are read, and the read final rates and final administration reference values stored in the work area” Multiply by 11.862 mg ”, small amount warning amount range“ 0 mg to less than 9.4896 mg, normal amount range “9.4896 mg or more, and 13.0882 mg or less”, greater than warning amount range “13.0482, and , Less than 15.4206 mg ”is created (step 107). Here, based on the final administration reference value (11.862 mg) and the determination reference generation coefficient table shown in the medicine item data, it functions as a determination reference table generation unit that generates a determination reference table. Next, the prescription inspection engine unit 110 determines that the daily dose “35 mg” of the previously calculated medicine item “item A” is the small amount warning amount range, the normal amount range, the warning amount indicated in the created administration criterion. Of the range and the limited amount range, it is determined that it belongs to the limited amount range. Similarly, the prescription inspection engine unit 110 determines that the daily dose of 50 mg of the drug item “item B” is the small amount warning amount range, normal amount indicated in the administration criteria for the created drug item “item B”. In addition, the prescription inspection engine unit 110 determines that the daily dose 90 mg of the drug item “item C” is in the range of the range, the warning amount range, and the limit amount range. It is determined that the medicine item “item C” belongs to any of the small amount warning amount range, normal amount range, warning amount range, and limit amount range indicated in the administration criteria. Here, the prescription inspection engine unit 110 functions as a dose determination unit.

  The prescription inspection engine unit 110 includes a small amount warning amount range, a normal amount range, and a warning amount range indicated in the administration criterion values for the drug item “item A”, the drug item “item B”, and the drug item “item C”. When it is determined that any one of the limits is included, audit result data indicating the audit result is created and output to the client device 40 that requested the audit result (step 108), and the process is terminated. The client device 40 displays the input audit result data on the display unit.

  In step 103, when it is described that the prescription inspection engine unit 110 does not adjust the availability information (step 103; not), the administration criteria described in the corresponding drug item data in the drug item master 108 " 20 ″ is used as the administration reference after the first adjustment (although not adjusted), the process proceeds to step 105 and the same process as described above is performed.

  In step 105, when the prescription inspection engine unit 110 determines that there is no clinical data of the patient name “Taro Matsushita” (step 105; NO), the pre-adjusted administration standard is the final administration standard value described above. The same processing as described above is performed. That is, in the above-described embodiment, after the first adjustment (step 103), the second adjustment (step 105) is performed, and the determination criterion table (FIG. 10) is generated. However, the second adjustment is not essential. For example, when clinical data of a predetermined patient is not received, the determination criterion table shown in FIG. 10 is directly created from the administration criteria adjusted only by the body data coefficient (FIG. 9: administration criteria after the first adjustment). (Creation criteria table creation). In this case, the prescription inspection engine unit 110 functions as a determination criterion table generation unit that generates a determination criterion table based on the first adjusted administration criterion and the determination criterion generation coefficient table indicated in the drug item data. To do. That is, the “first adjusted administration standard” used here is directly used to create the determination standard table, and thus functions as the “final administration standard value” in the above-described embodiment.

  According to the prescription inspection support system of the embodiment, the prescription inspection engine unit 110 includes the medicine item master 108, the unit conversion master 107, and the medicine master 106, and the small amount warning amount range and the normal amount range shown in the determination criterion table. Since it is determined to belong to any of the warning amount range and the limit amount range, the amount of the medicine having the same component prescribed to the patient can be audited.

  The prescription audit support system of the present invention can be used for all medical conditions, all drugs, and pharmaceutical items, but it is particularly useful for auditing prescription orders including anticancer drugs when treating cancer using anticancer drugs. It can be suitably used. In cancer treatment, a regimen of a prescription plan that functions as a basic template for so-called administration check is created, and administration of an anticancer drug is generally advanced according to the regimen. In the regimen, the schedule and dose of drug administration are generally shown, and the schedule and dose for each drug item in the prescription plan are shown as “drug item in regimen”. Therefore, by using this drug item in the regimen together with the audit support, it is possible to determine whether each item itself such as the administration criteria in the drug item data of the drug item master 108 is in line with the patient's regimen to be treated. Can be confirmed. Even under such usage, the audit support system and audit support method of the present invention can be applied. Accordingly, the drug item master in the present invention includes those already checked by the regimen.

  In the above-described embodiment, the present system is used for auditing the daily dose of a specific drug item. However, the subject of the dose audit is not limited to one day, and the present system can be used for auditing a dose for any period such as a single dose or a cumulative dose.

  This often occurs when a patient visits multiple departments in a medical institution such as a hospital. The medicine prescribed at that time may be administered with the same medicine, or there may be the same ingredients even if the medicine names are different. According to the present invention, even if an order including a plurality of medicines having the same component is prescribed to a specific patient, the daily dose of the medicine having the same component can be calculated. A support system and a prescription audit support method are provided.

  In particular, for drugs such as anticancer drugs, it is necessary to determine the dose reduction or postponement of the administration period according to the physical characteristics and condition of the patient. Can adjust the administration standard according to the physical characteristics and condition of each patient, and can prescribe administration according to each patient.

  Although various embodiments of the present invention have been described above, the present invention is not limited to the matters shown in the above-described embodiments, and those skilled in the art can make modifications and applications based on the description and well-known techniques. This is also the scope of the present invention, and is included in the scope of seeking protection.

  According to the present invention, when auditing the amount of a medicine having the same component prescribed to a patient, whether or not the prescription order is in accordance with the patient's condition in the administration of an anticancer agent, etc. A prescription audit support system, a prescription audit support method, and the like are provided.

The block diagram which shows the structure of the prescription inspection assistance system which concerns on embodiment of this invention. The figure which shows the patient data memorize | stored in the patient data memory | storage part in FIG. The figure which shows the clinical data memorize | stored in the clinical data memory | storage part in FIG. The figure which shows the chemical | medical agent data memorize | stored in the chemical | medical agent master in FIG. The figure which shows the unit conversion data memorize | stored in the unit conversion master in FIG. The figure which shows the chemical item data memorize | stored in the chemical item master in FIG. The figure which shows the administration reference value adjustment coefficient data memorize | stored in the administration reference value adjustment coefficient master in FIG. The figure explaining the process until calculating the dosage administered to a patient The figure explaining the process which calculates final administration reference value (administration reference after the 2nd adjustment) The figure explaining the process after determining a reference | standard criterion table from the last dosage reference value until it performs a 1-day administration determination The flowchart explaining operation | movement of the prescription inspection assistance system of embodiment

Explanation of symbols

DESCRIPTION OF SYMBOLS 10 Prescription inspection support server 101 Order receiving part 102 Patient / clinical data receiving part 103 Order data storage part 104 Patient data storage part 105 Clinical data storage part 106 Drug master 107 Unit conversion master 108 Drug item master 109 Administration reference value adjustment coefficient master 110 Prescription inspection engine unit 111 Master editing unit 20 Order input device 30 Patient / clinical data input device 40 Client device

Claims (12)

A prescription audit support system used to support auditing of the daily dosage of the medicine for the patient when there are a plurality of prescription orders for a specific patient and the medicines of the same component are indicated across the plurality of prescription orders. The prescription audit support system
An order receiving unit for receiving a prescription order indicating a medicine to be administered to a patient, a prescription amount of the medicine and an administration date;
A medicine item master that stores medicine item data including medicine items that describe medicines of the same component as the same group, and a notation unit of the medicine item;
A medicine master that stores medicine data including correspondence between medicines and medicine items;
For converting the prescription amount of the medicine shown in the prescription order received by the order receiving unit into a daily dose of the notation unit shown in the medicine item data stored in the medicine item master A unit conversion master that stores unit conversion data including conversion factors;
Searching for the medicine data stored in the medicine master, and specifying the medicine shown in the prescription order to the medicine contained in the medicine data;
Based on the correspondence in the drug data of the drug master, a drug item specifying unit that specifies the drug item of the drug specified by the drug specifying unit;
A notation unit specifying unit for specifying the notation unit of the drug item specified by the drug item specifying unit from the notation unit indicated in the drug item data stored in the drug item master; and
A conversion coefficient specifying unit for specifying the conversion coefficient corresponding to the notation unit specified by the notation unit specifying unit from the unit conversion data stored in the unit conversion master;
Using the prescription amount and the administration date and time of the medicine shown in the prescription order, and the conversion coefficient specified by the conversion coefficient specifying unit, calculate the daily dose of the medicine shown in the prescription order, A unit conversion unit for converting into the above described unit of the chemical item;
A display data generation unit that generates display data of a daily dose for each of the drug items calculated by the unit conversion unit;
A prescription inspection support system comprising: a display unit that displays the display data. A prescription audit support system according to claim 1,
The medicinal item data stored in the medicinal item master includes a dosage criterion indicating a daily dose of the notation unit to be administered to a standard patient for each medicinal item, and the notation of the medicinal item to be administered to a patient. A determination criterion generation coefficient table for generating a determination criterion table used for determining the daily dosage of the unit;
The prescription audit support system
A patient data receiver for receiving patient data having body data coefficients based on the physical characteristics of the patient;
The administration standard adjustment for adjusting the administration standard indicated in the medicine item data stored in the medicine item master using the body data coefficient indicated in the patient data received by the patient data receiving unit. And
Determination criterion table generation for generating the determination criterion table based on the determination criterion generation coefficient table indicated in the drug item data, with the adjusted administration criterion adjusted by the administration criterion adjustment unit as the final administration criterion And
Based on the determination criterion table generated by the determination criterion table generation unit, a dose determination for determining a daily dose converted into a notation unit of a drug item indicated in the prescription order received in the order receiving unit And
A determination result display data generation unit that generates display data indicating the determination result determined by the dose determination unit;
Comprising
The prescription inspection support system, wherein the display unit displays display data indicating the determination result. A prescription audit support system according to claim 1,
The medicinal item data stored in the medicinal item master includes a dosage criterion indicating a daily dose of the notation unit to be administered to a standard patient for each medicinal item, and the notation of the medicinal item to be administered to a patient. A determination criterion generation coefficient table for generating a determination criterion table used for determining the daily dosage of the unit;
The prescription audit support system
A patient data receiver for receiving patient data having body data coefficients based on the physical characteristics of the patient;
Using the body data coefficient indicated in the patient data received by the patient data receiving unit, the administration criteria indicated in the drug item data stored in the drug item master are adjusted, and the first A first administration standard adjustment unit for generating an administration standard after adjustment;
A clinical data receiving unit for receiving clinical data including clinical items and clinical results of the patient data received in the patient data receiving unit;
A dosing reference value adjustment coefficient master that stores dosing reference value adjustment coefficient data in which a reference adjustment coefficient required for generating the determination reference table and a threshold value for determining the reference adjustment coefficient are described;
A threshold value determination unit that determines the threshold value from the administration reference value adjustment coefficient data stored in the administration reference value adjustment coefficient master based on the clinical result indicated in the clinical data received by the clinical data reception unit. When,
A reference adjustment coefficient specifying unit that specifies the reference adjustment coefficient corresponding to the threshold value determined by the threshold value determination unit;
A second dosing reference adjusting unit that adjusts the first adjusted dosing standard and generates a second adjusted dosing reference using the reference adjusting coefficient specified by the reference adjusting coefficient specifying unit; ,
Based on the determination criterion generation coefficient table indicated in the drug item data, with the second adjusted administration criterion generated by the second administration criterion adjustment unit as the final administration criterion, the determination criterion table is A determination criterion table generation unit to generate;
Based on the determination criterion table generated by the determination criterion table generation unit, a dose determination unit that determines a daily dose of the drug item indicated in the prescription order received in the order receiving unit;
A determination result display data generation unit that generates display data indicating the determination result determined by the dose determination unit;
Comprising
The display unit displays display data indicating the determination result.
, Prescription audit support system. A prescription audit support system according to claim 1,
A prescription inspection support system in which only the display unit is configured by an independent client device. A prescription audit support system according to claim 1,
The order receiving unit, the drug item master, the drug master, the unit conversion master, the drug specifying unit, the drug item specifying unit, the notation unit specifying unit, and the conversion coefficient specifying unit, The unit conversion unit, the display data generation unit, and the display unit are prescription inspection support systems configured by a server / client integrated device. This is a prescription audit support method used for audit support of the daily dose of the medicine for the patient when there are multiple prescription orders for a specific patient and the medicines of the same component are indicated across the plurality of prescription orders. The prescription audit support method is:
Receive a prescription order that shows the drug to be administered to the patient, the prescription amount of the drug, and the date and time of administration,
Memorizing medicinal item data including medicinal items that describe medicinal products of the same component as the same group and the unit of the medicinal item;
Stores drug data including correspondence between drugs and drug item names,
Stores unit conversion data including a conversion coefficient for converting the prescription amount of the medicine shown in the received prescription order into a daily dose of the notation unit shown in the stored medicine item data. And
Search the stored medicine data, specify the medicine shown in the prescription order as the medicine contained in the medicine data,
Based on the correspondence relationship in the drug data, specify the drug item of the specified drug,
Specify the notation unit corresponding to the specified chemical item in the chemical item data,
The conversion coefficient corresponding to the specified notation unit is specified from the stored unit conversion data,
Using the prescription amount and administration date and time of administration of the medicine indicated in the prescription order and the specified conversion factor, the daily dose of the medicine indicated in the prescription order is calculated, and the drug item Convert to notation unit,
Generating display data of the calculated daily dose for each of the calculated drug items;
A prescription audit support method for displaying the display data. This is a prescription audit support server used for audit support of the daily dose of the medicine for the patient when there are a plurality of prescription orders for a specific patient and medicines of the same component are indicated across the plurality of prescription orders. The prescription audit support server
An order receiving unit for receiving a prescription order indicating a medicine to be administered to a patient, a prescription amount of the medicine and an administration date;
A medicine item master that stores medicine item data including medicine items that describe medicines of the same component as the same group, and a notation unit of the medicine item;
A medicine master that stores medicine data including correspondence between medicines and medicine items;
For converting the prescription amount of the medicine shown in the prescription order received by the order receiving unit into a daily dose of the notation unit shown in the medicine item data stored in the medicine item master A unit conversion master that stores unit conversion data including conversion factors;
Searching for the medicine data stored in the medicine master, and specifying the medicine shown in the prescription order to the medicine contained in the medicine data;
Based on the correspondence in the drug data of the drug master, a drug item specifying unit that specifies the drug item of the drug specified by the drug specifying unit;
A notation unit specifying unit for specifying the notation unit of the drug item specified by the drug item specifying unit from the notation unit indicated in the drug item data stored in the drug item master; and
A conversion coefficient specifying unit for specifying the conversion coefficient corresponding to the notation unit specified by the notation unit specifying unit from the unit conversion data stored in the unit conversion master;
Using the prescription amount and the administration date and time of the medicine shown in the prescription order, and the conversion coefficient specified by the conversion coefficient specifying unit, calculate the daily dose of the medicine shown in the prescription order, A unit conversion unit for converting into the above described unit of the chemical item;
A prescription inspection support server comprising: a display data generation unit that generates display data of a dosage of the notation unit for each medicine item calculated by the unit conversion unit. When there are multiple prescription orders for a specific patient and the same drug component is indicated across multiple prescription orders, the prescription audit support used for auditing the daily dose of the drug for the patient is stored in the computer. A program to be executed, the program being
A procedure for receiving a prescription order indicating a drug to be administered to a patient, a prescription amount of the drug, and a date and time of administration;
A procedure for storing medicinal item data including medicinal items of the same component as the same group and a notation unit of the medicinal item;
A procedure for storing medicine data including correspondence between medicines and medicine items;
Stores unit conversion data including a conversion coefficient for converting the prescription amount of the medicine shown in the received prescription order into a daily dose of the notation unit shown in the stored medicine item data. And the steps to
Searching the stored medicine data and identifying the medicine shown in the prescription order as the medicine contained in the medicine data;
A procedure for identifying a drug item of the identified drug based on the correspondence relationship in the drug data;
A procedure for specifying a notation unit corresponding to the specified drug item in the drug item data;
A procedure for specifying the conversion coefficient corresponding to the specified notation unit from the stored unit conversion data;
Using the prescription amount and administration date and time of administration of the medicine indicated in the prescription order and the specified conversion factor, the daily dose of the medicine indicated in the prescription order is calculated, and the drug item Procedure to convert to notation unit,
Generating display data of a daily dose of the notation unit for each of the calculated drug items;
A program for causing a computer to execute a procedure for displaying the display data. When there are multiple prescription orders for a specific patient and the same drug component is indicated across multiple prescription orders, the prescription audit support used for auditing the daily dose of the drug for the patient is stored in the computer. A program to be executed and controlled by the computer
A medicine item master that stores medicine item data including medicine items that describe medicines of the same component as the same group, and a notation unit of the medicine item;
A medicine master that stores medicine data including correspondence between medicines and medicine items;
Unit conversion data including a conversion coefficient for converting the prescription amount of the medicine shown in the prescription order into the daily dose of the notation unit shown in the medicine item data stored in the medicine item master. Including a unit conversion master for storing
The program is
Receiving the prescription order;
Searching the medicine data stored in the medicine master, and specifying the medicine shown in the prescription order as the medicine contained in the medicine data;
A procedure for specifying a drug item of the specified drug based on the correspondence relationship in the drug data of the drug master;
A procedure for specifying a notation unit corresponding to the specified drug item in the drug item data;
A procedure for specifying the conversion coefficient corresponding to the specified notation unit from the unit conversion data stored in the unit conversion master;
Using the prescription amount and administration date and time of administration of the medicine indicated in the prescription order and the specified conversion factor, the daily dose of the medicine indicated in the prescription order is calculated, and the drug item Procedure to convert to notation unit,
A program for causing a computer to execute a procedure for generating display data of the calculated dosage of the notation unit for each medicine item. An order receiving unit for receiving a prescription order indicating a medicine to be administered to a patient;
A medicine item master for storing medicine items that describe medicines of the same component as the same group;
A medicine master that stores the correspondence between medicines and medicine items that describe medicines of the same component as the same group;
A drug item specifying unit for specifying a drug item of the drug indicated in the prescription order based on the drug item stored in the drug item master and the correspondence relationship;
A prescription inspection support system comprising: a display data generation unit that generates display data including the specified medicine item. A prescription audit support system according to claim 10,
The prescription audit support system further includes:
Drug items that describe drugs of the same component as the same group, notation units of the drug items, dosing criteria indicating the daily dose of the notation units to be administered to a standard patient for each drug item, and daily doses A drug item master for storing a determination criterion generation coefficient table for generating a determination criterion table used for the determination of
A patient data receiver for receiving patient data having body data coefficients based on the physical characteristics of the patient;
An administration standard adjustment unit that adjusts the administration standard stored in the drug item master using the body data coefficient indicated in the patient data received by the patient data reception unit;
A prescription audit support system comprising: a determination criterion table generation unit that generates the determination criterion table based on the determination criterion generation coefficient table using the adjusted administration criterion adjusted by the administration criterion adjustment unit as a final administration criterion. . A prescription audit support system according to claim 10,
The prescription audit support system further includes:
Drug items describing drugs of the same component as the same group, notation units of the drug items, dosing criteria for the notation units to be administered to standard patients for each drug item, and determinations used for determining the daily dose A medicine item master for storing a criterion generation coefficient table for generating a criterion table;
A patient data receiver for receiving patient data having body data coefficients based on the physical characteristics of the patient;
Using the body data coefficient indicated in the patient data received by the patient data receiving unit, the administration standard stored in the medicine item master is adjusted, and a first adjusted administration standard is generated. A first administration standard adjustment unit;
A clinical data receiving unit for receiving clinical data including clinical items and clinical results of the patient data received in the patient data receiving unit;
An administration reference value adjustment coefficient master in which a reference adjustment coefficient required for generating the determination reference table is stored;
Using the reference adjustment factor to adjust the first adjusted administration standard, and to generate a second adjusted administration standard;
A determination criterion table generation unit that generates the determination criterion table based on the determination criterion generation coefficient table, with the second adjusted administration criterion generated by the second administration criterion adjustment unit as a final administration criterion; Prescription audit support system provided.

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