JP2007213555A - Electronic medical chart preparation program and electronic medical chart preparation system - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an electronic medical chart program preparing an electronic medical chart automatically disposing and displaying examination data of a patient, and displaying information of a view or the like related to the patient together therewith. <P>SOLUTION: This electronic medical chart preparation program makes a computer function as: an examination data acquisition means 32 acquiring the examination data of the patient from a database 22 storing the examination data of the patient; an examination data imaging means 33 imaging the examination data into a prescribed size allowing display in a display area of the electronic medical chart in each examination item; an examination data image disposal means 34 managing position information for disposing the examination data image, and disposing the examination data image to a prescribed position on the basis of the position information to create an examination data list image; a handwritten image data input means 35 acquiring handwritten image data; and a display means 36 displaying the electronic medical chart prepared by superposing the examination data list image and the handwritten image data. <P>COPYRIGHT: (C)2007,JPO&INPIT

Description

  The present invention relates to an electronic medical record creation program and an electronic medical record creation system, and is particularly useful when applied to displaying an electronic medical record including a plurality of examination data.

  In recent years, information is also being advanced in medical institutions, and information communication devices and the like have been introduced to improve work efficiency. In such an information flow, the patient's medical records (diagnosis records) are also digitized and managed.

  Conventionally, doctors hand-drawn various measured values for patients measured using testing equipment, findings when examining patients, and schemas (graphic figures representing human body parts) that represent patients' diseased parts. The patient's medical record is expressed in the medical record. Therefore, when digitizing a medical chart, it is necessary to have a function capable of expressing such information, and a technique such as an electronic medical chart creation program having such a function has been proposed ( (See Patent Documents 1, 2, and 3).

  However, the appearance of electronic medical charts created by these techniques is different from the appearance of conventional paper medical charts because character information and the like are classified and displayed according to their types. For this reason, in particular, doctors who have become accustomed to paper charts for many years need a certain amount of time to become familiar with electronic charts, and thus may be hindered by the original medical work.

  By the way, in a specific medical field, it is not limited to only a doctor to input a medical record in an electronic medical record. For example, division of labor is progressing in ophthalmology, inspectors measure various examination data such as patient's visual acuity using various examination devices, and ophthalmologists perform examinations by referring to the measurement results .

  Therefore, in such a field, when providing an electronic medical chart having an appearance and operation feeling similar to the appearance of a conventional paper medical chart, a plurality of persons such as inspectors and doctors record patient examination data and the like. The inspector must consider the position of the inspection data in the electronic medical record or the size of the inspection data. That is, when an inspector describes inspection data in an electronic medical record, the inspector must consider how other inspectors describe the inspection data in the electronic medical record. There is a problem with it.

  Furthermore, if the examination data is described in the electronic medical record freely depending on the inspector, the doctor refers to an electronic medical chart with low readability that lacks a sense of unity, resulting in a problem that the medical examination cannot be performed smoothly.

JP 2000-325314 A JP 2001-43284 A JP 2005-250526 A

  In view of such circumstances, the present invention automatically arranges and displays various examination data, and also creates an electronic medical record program for creating an electronic medical record for displaying information such as findings at the time of treating a patient and electronic medical record creation The purpose is to provide a system.

In order to achieve the above object, the first aspect of the present invention provides:
Computer
Examination data acquisition means for acquiring examination data of a patient who is to create an electronic medical record from a database storing examination data of patients classified into a plurality of examination items;
Inspection data imaging means for forming an inspection data image by imaging the inspection data for each of the plurality of inspection items into a predetermined size that can be displayed in the display area of the electronic medical record of the display device of the computer;
The position information for arranging the examination data image in the display area of the electronic medical record of the display device is managed, and the examination data image is arranged at a predetermined position on the basis of the position information to display an examination data list image. Inspection data image arrangement means to be created;
Handwritten image data input means for acquiring handwritten image data via the input device of the computer;
An electronic medical record creation program that causes an electronic medical record created by superimposing the inspection data list image and the handwritten image data to function as display means for displaying on the display device.

  In the first aspect, since the input inspection data is imaged and automatically displayed in the display area of the electronic medical record of the display device, an input process considering the display position of the inspection data becomes unnecessary. Implementation of inspection data input means is facilitated. Further, since the inspection data is uniformly arranged at a predetermined position, the appearance of the electronic medical chart becomes consistent, and the convenience for the user can be improved.

According to a second aspect of the present invention, in the electronic medical record creation program described in the first aspect,
The position information is a flag indicating whether or not the inspection data image or the handwritten image data is arranged in a rectangular area obtained by dividing the display area of the electronic medical record into a grid pattern,
The predetermined position is an empty rectangular area where no other inspection data image or the handwritten image data is arranged,
The inspection data image arrangement means selects at least one empty rectangular area by determining whether or not the flag is set, and arranges the inspection data image in the empty rectangular area to list the inspection data An electronic medical record creation program characterized by creating an image.

  In the second aspect, the inspection data image is displayed in a grid pattern in the display area of the electronic medical record. This makes it possible to display an electronic medical record in which inspection data images are arranged in an orderly manner.

According to a third aspect of the present invention, in the electronic medical record creation program described in the first or second aspect,
The database stores an update flag indicating that new examination data has been added to the database, and stores examination data list images and handwritten image data in association with patients,
The inspection data acquisition means determines whether the update flag is set and acquires the inspection data,
The examination data image arrangement means stores the examination data list image created by arranging the examination data image imaged by the examination data imaging means at a predetermined position in association with a patient, and saves it in the database.
The display means acquires the inspection data list image and the handwritten image data stored in the database, and displays an electronic medical record created by superimposing the inspection data list image and the handwritten image data on the display device. This is an electronic medical record creation program characterized by this.

  In the third aspect, the inspection data list image once created is stored in the database, and when displaying the electronic medical chart, the inspection data list image is acquired from the database and displayed on the display device. An imaging process or the like for creating an image becomes unnecessary, and the processing load on the computer can be reduced.

According to a fourth aspect of the present invention, in the electronic medical record creation program described in any one of the first to third aspects,
In the electronic medical record creation program, the display means displays the examination data list image as a sketch on the display device and acquires the handwritten image data.

  In the fourth aspect, since the handwritten image data can be input by the user using the inspection data list image as a sketch, it is equivalent to the work of adding a finding such as that performed in a paper chart. It is possible to carry out intuitively even on an electronic medical record.

According to a fifth aspect of the present invention, in the electronic medical record creation program described in the first to fourth aspects,
The display means is an electronic medical record creation program that performs predetermined image processing so that the inspection data image is displayed with priority over the handwritten image data.

  In the fifth aspect, even if the handwritten image data is overwritten on the inspection data image, the inspection data image is displayed so as to be visually recognized.

According to a sixth aspect of the present invention, in the electronic medical record creation program according to any one of the first to fifth aspects,
The examination data imaging means obtains examination data of a patient for which an electronic medical record is to be created from the database, applies a prescribed format to the examination data, and has a predetermined size that can be displayed on the display device. An electronic medical record creation program is characterized in that the inspection data is imaged for each of the plurality of inspection items to create an inspection data image.

  In the sixth aspect, the inspection data is automatically converted into the customary notation used when describing the inspection data on the medical chart, and then the inspection data image is created.

According to a seventh aspect of the present invention, in the electronic medical record creation program according to any one of the first to sixth aspects,
The handwritten image data input means converts a part of a bit string constituting color information designated as a color for drawing the handwritten image data into a bit string constituting an entry identifier for identifying a person who has inputted the handwritten image data. The drawing color information is calculated by replacing
The display means displays handwritten image data on the display device with the drawing color information, and displays on the display device writer information related to the writer identified by the writer identifier included in the drawing color information. This is an electronic medical record creation program characterized by

  In the seventh aspect, the writer information regarding the writer is displayed together with the handwritten image data. This makes it obvious at a glance who is the person who entered the handwritten image data. Such display of the writer information is particularly useful in the case of inputting, as handwritten image data, findings and the like examined by a plurality of doctors with respect to an electronic medical record relating to one patient.

The eighth aspect of the present invention is
An examination data input terminal for storing examination data of patients classified into a plurality of examination items in a database, and an electronic chart creation computer that creates an electronic chart based on the examination data acquired from the database, An electronic medical record creation system used when a doctor refers to an electronic medical record based on the examination data stored in the database by an employee,
The electronic medical record creation computer is:
Examination data acquisition means for acquiring examination data of a patient who is to create an electronic medical record from the database;
Inspection data imaging means for forming an inspection data image by imaging the inspection data for each of the plurality of inspection items into a predetermined size that can be displayed in a display area of an electronic medical record of a display device of the electronic medical record creation computer;
The position information for arranging the examination data image in the display area of the electronic medical record of the display device is managed, and the examination data image is arranged at a predetermined position on the basis of the position information to display an examination data list image. Inspection data image arrangement means to be created;
Handwritten image data input means for acquiring handwritten image data via an input device of the electronic medical record creation computer;
An electronic medical record creation system comprising: display means for displaying an electronic medical record created by superimposing the inspection data list image and the handwritten image data on the display device.

  In the eighth aspect, since the input inspection data is imaged and automatically displayed in the display area of the electronic medical record of the display device, an input process considering the display position of the inspection data becomes unnecessary. Implementation of inspection data input means is facilitated. Further, since the inspection data is uniformly arranged at a predetermined position, the appearance of the electronic medical record becomes consistent, and the convenience for the user can be improved.

According to a ninth aspect of the present invention, in the electronic medical record creation system according to the eighth aspect,
The position information is a flag indicating whether or not the inspection data image or the handwritten image data is arranged in a rectangular area obtained by dividing the display area of the electronic medical record into a grid pattern,
The predetermined position is an empty rectangular area where no other inspection data image or the handwritten image data is arranged,
The inspection data image arrangement means selects at least one empty rectangular area by determining whether or not the flag is set, and arranges the inspection data image in the empty rectangular area to list the inspection data An electronic medical record creation system characterized by creating an image.

  In the ninth aspect, the inspection data images are displayed in a grid pattern in the display area of the electronic medical record. This makes it possible to display an electronic medical record in which inspection data images are arranged in an orderly manner.

According to a tenth aspect of the present invention, in the electronic medical record creation system according to the eighth or ninth aspect,
The database stores an update flag indicating that new examination data has been added to the database, and stores examination data list images and handwritten image data in association with patients,
The inspection data acquisition means determines whether the update flag is set and acquires the inspection data,
The examination data image arrangement means stores the examination data list image created by arranging the examination data image imaged by the examination data imaging means at a predetermined position in association with a patient, and stores it in the database.
The display means acquires the inspection data list image and the handwritten image data stored in the database, and displays an electronic medical record created by superimposing the inspection data list image and the handwritten image data on the display device. This is an electronic medical record creation system characterized by this.

  In the tenth aspect, the inspection data list image once created is stored in the database, and when displaying the electronic medical chart, the inspection data list image is acquired from the database and displayed on the display device. An imaging process or the like for creating an image becomes unnecessary, and the processing load on the computer can be reduced.

According to an eleventh aspect of the present invention, in the electronic medical record creation system according to any one of the eighth to tenth aspects,
In the electronic medical record creation system, the display means displays the inspection data list image as a sketch on the display device and acquires the handwritten image data.

  In the eleventh aspect, since the user can input handwritten image data using the examination data list image as a sketch, it is equivalent to the work of adding additional findings or the like as is done in a paper chart. It is possible to carry out intuitively even on an electronic medical record.

According to a twelfth aspect of the present invention, in the electronic medical record creation system according to any one of the eighth to eleventh aspects,
In the electronic medical record creation system, the display means performs predetermined image processing so that the inspection data image is displayed with priority over the handwritten image data.

  In the twelfth aspect, even if the handwritten image data is overwritten on the inspection data image, the inspection data image is displayed so as to be visually recognized.

According to a thirteenth aspect of the present invention, in the electronic medical record creation system according to any one of the eighth to twelfth aspects,
The examination data imaging means obtains examination data of a patient for which an electronic medical record is to be created from the database, applies a prescribed format to the examination data, and has a predetermined size that can be displayed on the display device. In the electronic medical record creation system, the inspection data is imaged for each of the plurality of inspection items to create an inspection data image.

  In the thirteenth aspect, the inspection data is automatically converted into the customary notation used when describing the inspection data on the medical chart, and then the inspection data image is created.

In a fourteenth aspect of the present invention, in the electronic medical record creation system according to any one of the eighth to thirteenth aspects,
A web server that presents an input form for inputting the inspection data on the inspection data input terminal;
The web server includes an inspection data input unit that stores the inspection data acquired via the input form in the database.

  In the fourteenth aspect, since the inspection data can be stored in the database via the input form presented by the web server by introducing a general web browser to the inspection data input terminal, the inspection data input terminal There is an effect that a dedicated program for inputting inspection data is not required.

According to a fifteenth aspect of the present invention, in the electronic medical record creation system according to any one of the eighth to fourteenth aspects,
The handwritten image data input means converts a part of a bit string constituting color information designated as a color for drawing the handwritten image data into a bit string constituting an entry identifier for identifying a person who has inputted the handwritten image data. The drawing color information is calculated by replacing
The display means displays handwritten image data on the display device with the drawing color information, and displays on the display device writer information related to the writer identified by the writer identifier included in the drawing color information. It is in the electronic medical chart making system characterized by.

  In the fifteenth aspect, the writer information regarding the writer is displayed together with the handwritten image data. This makes it obvious at a glance who is the person who entered the handwritten image data. Such display of the writer information is particularly useful in the case of inputting, as handwritten image data, findings and the like examined by a plurality of doctors with respect to an electronic medical record relating to one patient.

  According to the present invention, since the input inspection data is imaged and automatically arranged at a predetermined position, the appearance of the electronic medical record becomes consistent, and the convenience for the user is improved. Can do. In addition, since doctors can add information such as findings when treating patients while referring to this imaged examination data, it is equivalent to the task of adding additional findings such as those performed on paper charts. This can be done intuitively on the electronic medical record.

  Hereinafter, the best mode for carrying out the present invention will be described. The description of the present embodiment is an exemplification, and the present invention is not limited to the following description.

<Embodiment 1>
FIG. 1 is a functional block diagram of an electronic medical record creation system including a computer in which the electronic medical record creation program according to the first embodiment is installed.

  In this embodiment, an electronic medical record creation process in ophthalmology is exemplified.

  The electronic medical record creation system 1 directly receives the examination data input terminal 20 for inputting the examination data obtained by examining the patient by the inspector 2 into the database 22 and the examination data of the patient obtained by the operation of the inspector 2. Are composed of an examination device 21 for inputting into the database, an electronic medical record creation computer 30 used by the ophthalmologist 3, a web server 23, and a database 22, which are connected to each other via a LAN 24 so as to communicate with each other. In addition, an electronic medical record creation program 31 is installed in the electronic medical record creation computer 30.

  On the premise of such a configuration, the inspector 2 stores the patient inspection data in the database 22 using the inspection data input terminal 20 or the inspection device 21, and the ophthalmologist 3 uses the electronic medical record creation computer 30 to An example in which an electronic medical record created based on these examination data is referred to or a finding when a patient is examined is added to the electronic medical record is shown.

  Here, the electronic medical record creation computer 30 includes, as main hardware, an input device such as a CPU, a ROM, a hard disk, a RAM, a keyboard mouse, and an output device such as a display (none of which are shown), for example. As an operating system (OS) that makes these hardware functions, for example, Windows (registered trademark) manufactured by Microsoft Corporation is provided, and the electronic medical record creation program 31 is executed on this OS. Note that the electronic medical record creation program 31 does not start on the OS of the electronic medical record creation computer 30 but may directly function on the hardware of the electronic medical record creation computer 30 via BIOS or the like.

  The inspection data input terminal 20 is a PDA terminal including, as main hardware, an input device such as a CPU, a ROM, a RAM, and a pen tablet and an output device such as a display (none of which are shown). As an operating system (OS) that makes these hardware functions, for example, a Windows (registered trademark) Mobile 2003 Second Edition software for Pocket PC manufactured by Microsoft Corporation is provided, and patient examination data is stored in the database 22 on this OS. Predetermined processing is performed.

  The inspection device 21 is a device for measuring intraocular pressure, for example. The inspection device 21 is connected to a control computer (not shown) for controlling the inspection device 21 via an interface such as RS-232C. In this control computer, processing for acquiring the inspection data of the inspection device 21 is performed via this interface, and predetermined processing for storing the inspection data in the database 22 is performed.

  In addition, the web server 23 presents an inspection data input form for inputting inspection data to the inspection data input terminal 20 and acquires inspection data via the inspection data input form and stores it in the database 22. A server computer having data input means.

  Further, the database 22 is an RDBMS (Relational DataBase Management System), and a control computer or an electronic medical record creation computer 30 connected to the inspection device 21 via an ODBC (Open DataBase Connectivity) or RDBMS original database connection driver. And data input / output.

  In addition, an electronic medical record creation program 31 is installed in the electronic medical record creation computer 30, and a test data acquisition unit 32 that acquires test data of a patient whose electronic medical record is to be created from the database 22, and the acquired test data Inspection data imaging means 33 for imaging each inspection item to create an inspection data image, inspection data image arrangement means 34 for arranging each inspection data image at a predetermined position to create an inspection data list image, and electronic medical chart The handwritten image data input means 35 for acquiring handwritten image data via the input device of the creation computer 30 and the display means 36 for superimposing the inspection data list image and the handwritten image data on the display device of the electronic medical record creation computer 30 Are provided.

  The examination data acquisition means 32 is used to acquire from the database 22 examination data of a patient for whom an electronic medical record is to be created. As a result, it is possible to specify the inspection data for which the electronic medical record is to be created. Further, the inspection data is acquired from the database 22 through a database connection driver such as ODBC. Here, the inspection data refers to an inspection value when an inspection item such as a patient's eyesight and intraocular pressure is inspected.

  The examination data imaging means 33 is used to create an examination data image by imaging patient examination data acquired by the examination data acquisition means 32 for each examination item. Thereby, examination data over a plurality of examination items of a patient is converted into an examination data image for each examination item, and a data format that can be displayed on the display area of the electronic chart of the display device of the electronic medical record creation computer 30 is obtained. The process of imaging the inspection data image will be described later.

  The inspection data image arrangement unit 34 is used to arrange the inspection data image at a predetermined position and create an inspection data list image. Thus, the inspection data image created for each inspection item is automatically aligned in the display area of the electronic medical record. As a result, the ophthalmologist 3 can list the examination data for all examination items of the patient. The process of creating the inspection data list image will be described later.

  The handwritten image data input means 35 is used for inputting handwritten image data. Here, the handwritten image data refers to image data that can be displayed on the display device of the electronic medical record creation computer 30 drawn using an input device such as a mouse. Thereby, the ophthalmologist 3 can express a finding, a schema, etc. with respect to the patient at the time of a medical examination. The process for inputting the handwritten image data will be described later.

  The display means 36 is used to create an electronic medical record by superimposing the inspection data list image and the handwritten image data, and display the electronic medical record on the display device of the electronic medical record creation computer 30. As a result, the examination data and the handwritten image data representing the findings and the like are integrally displayed, so that an electronic medical chart similar to the appearance of a conventional paper medical chart familiar to the ophthalmologist 3 can be displayed. When handwritten image data is not input, only the inspection data list image is displayed. This overlapping process will be described later.

  A series of processes for creating an electronic medical chart in the electronic medical chart creating system 1 configured as described above will be described. Here, a case where the patient ID for identifying the patient is “1000” and the examination data of the patient is stored in the database 22, while the ophthalmologist 3 refers to the electronic medical record of the patient and inputs findings and the like will be described. . The date of the examination is December 01, 2005.

  FIG. 2 is a diagram illustrating various data stored in the database 22. The structure of various data will be described with reference to this figure.

  The database 22 stores examination data, update flags, electronic medical record management data, and display position management data.

  FIG. 2A illustrates the visual acuity test data 100 that is inspection data related to a visual acuity test that is one of the inspection items. Other examination items include intraocular pressure, reflex, kerato, corneal diameter, deep vision, FLY, BET, and D15. The vision test data 100 includes, for example, patient ID, examination date, left and right, naked eye vision, correction vision, spherical power, astigmatism power, astigmatism axis direction, pinhole, patient glasses, prisms 1, 2, bases 1, 2, R / G and display position ID are comprised, and the test value (from "left and right" to "R / G") of the vision test performed on the patient is managed in association with each patient and each test date. That is, by specifying the patient ID and the examination date, it is possible to acquire the examination value of the eyesight examination. The display position ID is an identifier indicating a display position when the visual acuity test data 100 is displayed on the electronic medical record. If this display position ID is not set, the display position is not yet determined. Is shown. The display position ID will be described later.

  FIG. 2B illustrates an update flag 101 indicating that new examination data has been added to the database 22, for example, patient ID, examination date, update flag, eye examination, intraocular pressure, ref, It consists of kerato, corneal diameter, deep vision, FLY, BET and D15. The number of times the patient was examined is recorded in the column D15 from the vision test. The update flag is set to “1” when corresponding inspection data is input for any inspection item. The set of the number of inspections and the update flag can be implemented by a trigger function that is generally provided in the database 22.

  This makes it possible to determine the presence or absence of newly input inspection data. For example, for the data in the row where the patient ID in FIG. 2B is “1000” and the examination date is “20051201” (representing December 1, 2005), the update flag is “1”. Therefore, it can be determined that there is newly input inspection data. In addition, the value of the column of the eye test and the intraocular pressure of the data in the same row is 1, and the value of the column of the reflex is 2. That is, it is shown that there is one test data related to the visual acuity test and intraocular pressure, and two test data related to the reflex.

  FIG. 2C illustrates the examination data list image displayed as the patient's electronic medical record and the electronic medical record management data 102 for managing the handwritten image data. For example, patient ID, examination date, doctor in charge, examination data It consists of list images, handwritten image data, search keywords, pages, and plates. Thereby, an examination data list image, handwritten image data, etc. can be acquired by specifying patient ID and examination date. Note that a page is used to manage the number of electronic medical records when the electronic medical records cover a plurality of pages. The version is used for version management of electronic medical records. Details of pages and plates will be described later.

  FIG. 2D illustrates the display position management data 103 for managing the position where the examination data image and the handwritten image data are arranged in the display area of the electronic medical record. For example, the patient ID, the examination date, etc. , The image section and the display position ID. Thereby, by specifying the patient ID and the examination date, it is possible to acquire the display position ID indicating the position where the examination data image and the handwritten image data are arranged in the display area of the electronic medical record. As a result, when the inspection data image is arranged at a predetermined position and the inspection data list image is created, the inspection data image is arranged to overlap the position already used in the display area of the electronic medical record. It can be avoided.

  FIG. 3 is a schematic diagram showing an inspection data input screen. A process in which the inspector 2 inputs patient examination data will be described with reference to FIG.

  The inspector 2 uses the examination data input terminal 20 to input patient examination data into the database 22 via the web server 23. Specifically, the inspector 2 activates a web browser on the examination data input terminal 20 and operates the web browser so as to access a URL indicating the location of the input form 40 on the web server 23.

  Corresponding to this URL, the web server 23 presents the input form 40 to the inspection data input terminal 20. For example, when the inspector 2 inputs inspection data related to a visual acuity test, the input form 40 enables each inspection value as shown in the visual acuity inspection data 100 of FIG.

  The web server 23 stores the visual examination data 100 transmitted by the inspector 2 in the database 22 in association with the patient ID and the examination date. This patient ID is given by the inspector 2 via the input form 40. The examination date is the date when the web server 23 stores the eyesight examination data 100 in the database 22. Note that no value is stored for the display position ID of the visual acuity test data 100 at this time.

  When the eyesight test data 100 is added by the trigger function of the database 22, the value of the update flag shown in FIG. 2B is set to “1” and the value of the eyesight test column is set to one. Incremented by one. Based on the values of these update flags, it can be determined that the vision test data of the patient whose patient ID is “1000” and whose examination date is “20051201” has been added.

  As described above, since the inspector 2 does not need to consider how the inspection data is displayed on the electronic medical record, the inspector 2 can concentrate on the work of inputting the inspection data and smoothly It is possible to carry out the inspection.

  FIG. 4 is a diagram showing a processing flow of the electronic medical record creation program. A series of processes for creating an electronic medical record from examination data stored in the database 22 will be described with reference to FIG.

  First, an update flag acquisition process with the patient ID “1000” and the examination date “20051201” is performed from the database 22 (S1), and it is determined whether or not the update flag is 1 (S2). When the update flag is 1, the acquisition process (S3), the examination data imaging process (S4), the examination data list image creation process (S5), the patient ID “1000”, and the examination date “20051201”, A graphic image input process (S6) and an electronic medical chart display process (S7) are performed. If the update flag is not 1, the process of S6 is performed after S2. Further, it is determined whether or not the end of the program is selected (S8), and the creation of the electronic medical record is ended based on the result.

  Each process will be described in detail below.

  First, the inspection data acquisition unit 32 mainly performs the inspection data acquisition processing (S1 to S3) to be an electronic medical record creation target.

  In the update flag acquisition process (S1), examination data is obtained from the database 22 using the patient ID “1000” and the examination date “20051201” given by the ophthalmologist 3 as search keys.

  As a result, the update flag 101 of the row whose patient ID is “1000” shown in FIG. 2B can be acquired. By determining the update flag of this record, it is determined whether or not the inspection data is imaged (S2). In this case, since the update flag is 1, examination data relating to visual acuity examination, intraocular pressure, and ref is acquired (S3). Therefore, for example, the vision test data 100 of the patient ID “1000” in FIG. 2A is acquired.

  On the other hand, if the update flag is not 1, it can be determined that there is no change in the inspection data. Therefore, the process of S3 to S5 is omitted, and the process shifts to the handwritten image data input process of S6.

  Next, a process for imaging the inspection data will be described (S4). Here, imaging processing will be described by taking, as an example, examination data related to a visual acuity examination among examination data with a patient ID “1000”.

First, each examination value of a record with a patient ID “1000” is acquired, and a predetermined format is applied. Here, the predetermined format is information for designating a display method of inspection data defined for each inspection item. By applying this predetermined format, it is possible to display the inspection data of only the inspection value on the electronic medical chart in the notation conventionally used. For example, RV =% f (% f% f × S% f D: Cyl% fD A ×% f) for the vision test
The format is defined. % F indicates a place for replacing the place with the inspection value of the inspection data. Therefore, when this format is applied to each test value of test data whose patient ID is “1000” in FIG. 2A, RV = 0.5 (1.50 p × S −4.25D: Cyl 0D A × 0 °)
Will be generated.

  FIG. 5 is a diagram illustrating an inspection data image obtained by imaging the inspection data. A character string to which a predetermined format is applied is imaged in a predetermined size that can be displayed on the display device of the electronic medical record creation computer 30. Specifically, this is performed using a GDI TextOut function or the like, which is a drawing API that is generally available in Windows (registered trademark). As another aspect of the predetermined format, a font, a character color, or a background color used when imaging the inspection data may be defined in advance for each inspection item. By using the TextOut function or the like according to these definitions, the inspection data can be imaged in a display manner that differs for each inspection item.

  In addition, the size of the inspection data image is imaged using a plurality of basic areas, for example, with an area having a pixel size of 70 × 140 as a basic area. For example, when imaging examination data relating to a visual acuity examination, two of the basic areas are arranged side by side. As a result, as shown in FIG. 5A, an inspection data image 200 in which the inspection data related to the visual acuity inspection is imaged in an area of 70 × 280 pixels is created.

  The number of basic areas used is defined for each inspection item. For example, for the intraocular pressure, one basic region (inspection data image 201 in FIG. 5B) is used. In addition, for kerato, there are two basic areas vertically (inspection data image 202 in FIG. 5B), and for BET, there are three basic areas vertically and two in the horizontal direction (inspection of FIG. 5B). Like the data image 203), it is defined according to the number of inspection values of each inspection item and the notation method.

  Further, the present invention is not limited to such an expression based on characters, and a graph may be drawn based on the inspection data as shown in the inspection data image 203 in FIG. In this case as well, a graph is drawn by drawing a rectangle or a straight line using the GDI LineTo or MoveTo function.

  Next, an inspection data list image creation process will be described (S4). In this process, the inspection data image is arranged at a predetermined position to create an inspection data list image. In arranging at a predetermined position, display position management data indicating in which part of the display area of the electronic medical record the examination data image is arranged is used.

  FIG. 6 is a diagram showing the relationship between the display area of the electronic medical record and the display management table. As shown in the drawing, the electronic medical record display area 50 is displayed on the output device 38 of the electronic medical record creation computer 30. Further, the display area is divided into 64 rectangular areas in a grid pattern, and display position IDs 1 to 64 correspond to the one rectangular area. This one rectangular area has a size of 70 × 140 pixels.

  The display position management data 103 in FIG. 2D indicates in which display position ID of these rectangular areas the inspection data image is arranged. In this example, it is shown that the examination data image with the patient ID “1000” and the examination date “20051201” is arranged at the position of the display position ID 1, 2, 3, 6, 7, 9, 10. Yes. That is, by referring to the display position management data 103, it is possible to determine at which position on the electronic medical record the inspection data image is arranged. Therefore, the inspection data image to be newly arranged can be compared with other inspection data images. It becomes possible to arrange without overlapping.

  FIG. 7A and FIG. 7B are diagrams sequentially illustrating processing for arranging inspection data images. The process of creating an inspection data list image with reference to the display position management data 103 will be described with reference to this figure. In addition, the part enclosed with the broken line of FIGS. 7-1 and FIGS. 7-2 shows a rectangular area | region, and the circled number has shown the display position ID.

  For patient ID “1000” and examination date “20051201”, examination data with one intraocular pressure (70 × 140), two reflexes (140 × 140 each), and one visual acuity (70 × 280) The process for arranging images is as follows.

  As illustrated in FIG. 7A, since the examination data image is not yet arranged in the display position management data 103, the examination data image 204 of examination data relating to intraocular pressure is arranged at the display position ID “1”. To do. At this time, the display position management data 103 is updated as shown in Table 1 below.

  Thereby, it can be determined that the rectangular area 1 in the display area of the electronic medical record is in use.

  Next, the position where the inspection data image 205 of the inspection data relating to one of the reflexes is arranged is determined. The size of the inspection data image 205 is 140 × 140, that is, the size of two rectangular regions arranged vertically. Therefore, a portion having two empty spaces in the vertical direction is searched for in the display area of the electronic medical record.

  Referring to the display position management data 103 shown in Table 1, since the display position ID “1” is in use, it is next checked whether or not the display position ID “2” is recorded in the display position management data 103. To do. As a result, since the display position ID “2” has not been recorded yet, it is determined whether “6”, which is the display position ID of the rectangular area under the display position ID “2”, is recorded in the display position management data 103. To check. As a result, since the display position ID “2, 6” is unused, the inspection data image 205 is arranged as shown in FIG.

  At this time, the display position management data 103 is updated as shown in Table 2 below.

  Similarly, the position where the inspection data image 206 of the inspection data relating to the other ref is to be arranged is determined. The size of the inspection data image 206 is 140 × 140, that is, the size of two rectangular regions arranged vertically. Therefore, a portion having two empty spaces in the vertical direction is searched for in the display area of the electronic medical record.

  Referring to the display position management data 103 shown in Table 2, since the display position ID “1, 2” is in use, whether or not the display position ID “3” is recorded in the display position management data 103 next is determined. Check. As a result, since the display position ID “3” has not yet been recorded, it is determined whether “7”, which is the display position ID of the rectangular area under the display position ID “3”, is recorded in the display position management data 103. To check. As a result, since the display position ID “3, 7” is unused, the inspection data image 206 is arranged as shown in FIG.

  At this time, the display position management data 103 is updated as shown in Table 3 below.

  Similarly, the position where the inspection data image 207 of the inspection data relating to visual acuity is arranged is determined. The size of the inspection data image 207 is 70 × 280, that is, the size of two rectangular regions arranged side by side. Therefore, a portion having two vacant spaces on the side is searched for in the display area of the electronic medical record.

  Referring to the display position management data 103 shown in Table 3, the display position ID “1, 2, 3, 6, 7” is in use and the display position ID “4, 5, 8” is unused. Since this inspection data image 207 requires two horizontal spaces, the display position ID “4, 5, 8” cannot be used. As a result, the display position ID “9, 10” is unused. It can be determined that the inspection data image 207 can be arranged. Therefore, the inspection data image 207 is arranged as shown in FIG.

  At this time, the display position management data 103 is updated as shown in Table 4 below.

  As described above, as a result of determining the positions to be arranged for all the inspection data images, the inspection data list image 60 shown in FIG. 8 is created.

  In this way, since the inspection data images are automatically arranged, the inspection data is displayed in a unified manner, and thus it is possible to provide an electronic medical chart screen that is easy for the ophthalmologist 3 to view. Further, since it is not necessary for the inspector 2 to input the inspection data in consideration of the display of the inspection data, it is possible to concentrate on the inspection data input work.

  The examination data list image created by the above process is stored in the electronic medical record management data 102 in association with the patient ID and the examination date.

  The stored examination data list image is a target of display processing described later only when the examination data of the patient is not updated when the same patient ID and examination date electronic medical record are referenced next time. Used. That is, when there is a request for the creation of an electronic medical record, since the created examination data list image is used, it is possible to omit the data acquisition process and the imaging process, and promptly send the electronic medical record to the ophthalmologist 3. Can be displayed, and the processing load on the database 22 and the electronic medical record creation computer 30 can be reduced.

  When the display area where the inspection data image is initially arranged is insufficient during the process of arranging the inspection data image, a display area consisting of 64 rectangular areas is newly provided, and the inspection data is provided in this display area. Arrange the images. At this time, the inspection data list image created by arranging the inspection data image first is “1” page, and the inspection data list image created by arranging the inspection data image in the new display area is “2” page. 5, each inspection data list image is stored (for example, stored in a predetermined file format such as PNG format).

  Table 5 shows a part of the electronic medical record management data 102 specified by the patient ID “1000” and the examination date “20051201”. As shown in Table 5, the specified electronic medical chart management data 102 indicates that there are two inspection data list images (PNG format image data B, B '). As a result, even when the number of inspection data is large and cannot be arranged in 64 rectangular areas, it is possible to store a large number of inspection data as images by storing the inspection data list image as a separate page. Become.

  Next, handwritten image data input processing (S6) will be described.

  FIG. 9 is a flowchart showing input processing of handwritten image data. First, handwritten image data is acquired, displayed, and stored via the input device of the electronic medical record creation computer 30 using the examination data list image as a sketch (S10). Thereby, the ophthalmologist 3 can list the inspection data input by the inspector 2. In addition, using this examination data list image as a sketch, it is possible to add findings and the like when a patient is treated.

  For example, when the ophthalmologist 3 inputs a schema, the schema can be input by drawing a free curve that is handwritten image data. When entering a free curve, you can obtain the coordinates of the trajectory that the pointer has passed between the point where you first clicked the mouse and the point you clicked next, and draw those coordinates in a predetermined color. Enter the curve.

  This free curve is stored in the electronic medical record management data 102 in association with the patient ID and the examination date as PNG format image data that can be displayed on the screen. The size of the image data is the same as the display area 50 of the electronic medical record.

  Note that character information may be acquired via a keyboard, and data obtained by imaging the character information may be used as handwritten image data. This is useful when it is difficult to draw characters with a free curve by mouse operation. In addition, for words that are frequently input in a fixed form, the character information of such words is registered in advance as a fixed phrase so that the fixed phrase to be input can be selected by operating the mouse, and the selected fixed phrase May be converted into an image and handwritten image data. Further, the character information may be imaged and the character information itself may be stored as a search keyword for the electronic medical record management data 102. As a result, the character information input as a finding by the ophthalmologist 3 is displayed on the electronic medical record as an image, while the electronic medical record can be searched using the character information input as the finding as a search target.

  Next, the display position management data 103 is updated in accordance with which part of the sketch inspection data list image the acquired handwritten image data corresponds to (S11).

  FIG. 10 is a diagram illustrating a relationship between handwritten image data input using the examination data list image as a background and the display area of the electronic medical record. As shown in the drawing, it is shown that the free curve 70 as handwritten image data is drawn in a rectangular area with display position IDs 1, 2, 5, 6, 9, and 10 in the display area 50 of the electronic medical record. Yes.

  When such handwritten image data is input, the display position management data 103 of the display management table is updated. For example, the patient ID is “1000”, the examination date is “20051201”, the image classification is “handwritten data image”, and the display position ID is 1, 2, 5, 6, 9, 10. As a result, the display position management data 103 is updated as shown in Table 6.

  By performing this processing, when the inspection data image arranging unit 34 creates the inspection data list image (S5), the position where the handwritten image data is drawn can be grasped. Arrangement can be performed.

  Further, the handwritten image data is converted into an image file such as PNG format and stored in the electronic medical record management data 102. In this storage, every time handwritten image data is input by the ophthalmologist 3, it may be stored in the electronic medical record management data 102 as a separate image file. This makes it possible to leave a history of handwritten image data. At this time, the first input handwritten image data is the “1” version, and the next input handwritten image data is the “2” version.

  Table 7 shows a part of the electronic medical record management data 102 specified by the patient ID “1000” and the examination date “20051201”. As shown in Table 7, the specified electronic medical record management data 102 indicates that there are two handwritten image data (PNG format image data B, B '). That is, each time handwritten image data is input by the ophthalmologist 3, the handwritten image data is saved as an image file. As a result, the ophthalmologist 3 can confirm the process in which information such as findings represented by these handwritten image data is added / edited, so that the change in the patient's condition can be grasped more appropriately. Become.

  As described above, by performing the processes of S10 and S11, the ophthalmologist 3 can input handwritten image data while using the examination data list image as a sketch.

  Next, the electronic medical record display process will be described (S7). In this display processing, examination data list images and handwritten image data stored in the electronic medical record management data 102 are acquired, and these images are superimposed to create an electronic medical record, which is displayed on the display device of the electronic medical record creation computer 30. To do.

  First, the electronic medical record management data 102 with the patient ID “1000” and the examination date “20051201” is acquired from the database 22. As a result, it is possible to acquire the inspection data list image and handwritten image data stored as PNG format image data.

  FIG. 11 is a diagram illustrating an examination data list image and handwritten image data, and an electronic medical record obtained by superimposing these images.

  When superimposing, handwritten image data 61 is superimposed with the inspection data list image 60 as a background. Specifically, the handwritten image data 61 is subjected to mask processing, the X coordinate and Y coordinate origin positions (0, 0) of each image are made coincident, and the bitmap is copied using a function such as a BitBlt function. In addition, an electronic medical chart image 62 is created.

  The handwritten image data can be input at any position regardless of whether or not the inspection data is displayed in the sketch. For example, as a result of inputting a free curve as the handwritten image data, the inspection data list In some cases, the image is overwritten and it becomes impossible to visually recognize what inspection data is displayed.

  In such a case, an electronic medical chart image can be created so that the inspection data can be visually recognized by using the Bi-Linear method, which is a known technique, as the predetermined image processing. FIG. 12 is a diagram illustrating an example of superposition of handwritten image data and inspection data list image before and after using this Bi-Linear method. FIG. 12A shows a diagram in which a free curve 70 is input as handwritten image data to the inspection data image 208 in the inspection data image list. As shown in FIG. 12A, the inspection data image 208 cannot be visually recognized at a location where the free curve 70 is displayed overlapping the inspection data image 208.

  In such a case, the Bi-Linear method is applied to the inspection data image 208 to perform image processing, and the inspection data image 208 subjected to such image processing is superimposed on the free curve 70 and displayed on the display device. FIG. 12B shows the result of superimposing the free curve 70 on the inspection data image 208 after applying the Bi-Linear method. As shown in the figure, the inspection data image 208 can be visually recognized even when the free curves 70 overlap as a result of applying the Bi-Lineaer method.

  FIG. 13 is a diagram illustrating an electronic medical record display / edit screen. The ophthalmologist 3 designates a patient ID and designates an arbitrary examination date from the examination date selection menu 90, whereby examination data list images in which examination data images 209 to 212 are arranged are displayed in the display area 50 of the electronic medical record. Is displayed.

  The ophthalmologist 3 inputs findings and the like as necessary while referring to this screen. When inputting a finding or the like, after selecting a button for switching to a mode for inputting a straight line, a curved line, a rectangle or the like in the handwritten image data menu 91, handwritten image data such as a finding data 92 is drawn by drawing a free curve, for example. To the electronic medical record.

  The electronic medical chart created from the examination data list image and the handwritten image stored in the database 22 is not limited to the one displayed on the electronic medical chart creating computer 30 used by the ophthalmologist 3. For example, in order to confirm the inspection data input by the inspector 2, the inspection data input terminal 20 may be configured to refer to the electronic medical record.

  As described above, in this embodiment, since the inspection data is arranged at a predetermined position and displayed as an electronic medical record, the inspector 2 can concentrate on the input of the inspection data and the ophthalmologist. 3 makes it possible to list the inspection data and add findings and the like.

<Embodiment 2>
In the first embodiment, the person who input the handwritten image data 61 is not recorded. In the present embodiment, a case where handwritten image data 61 and an input person thereof are recorded will be described. In addition, the same code | symbol is attached | subjected to the same thing as the electronic medical record preparation system 1 which concerns on Embodiment 1, and the overlapping description is abbreviate | omitted.

  First, in the database 22, information on the entrant about the person who uses the electronic medical record creation system 1 is stored. Here, the entry information includes at least the name of the person who uses the electronic medical record creation system 1 and the entry identifier that identifies the person. In addition, when the user of the electronic medical record creation system 1 uses it, it is specified which writer identifier the user has. For example, the electronic medical record creation program 31 is provided with a function for allowing the user to input the writer identifier, thereby obtaining the writer identifier.

  When the handwritten image data input means 35 obtains the handwritten image data 61 and renders it, for example, the handwritten image data input means 35 embeds the writer identifier in color information representing a predetermined color designated by the person who has input the handwritten image data. Color information is calculated, and handwritten image data 61 is displayed on the display based on the drawing color information.

  When the handwritten image data 61 drawn with the drawing color information as described above is displayed on the display, if the mouse pointer is over the handwritten image data 61, the entry embedded in the drawing color information The user identifier may be extracted and the user information corresponding to the user identifier may be displayed near the mouse pointer, for example.

  Hereinafter, the process of embedding the writer identifier in the color information of the handwritten image data 61 will be specifically described. FIG. 14 is a diagram showing a flow of processing for drawing handwritten image data with drawing color information.

  First, using the electronic medical record creation computer 30, an entrant identifier relating to a person who creates and browses an electronic medical record is acquired (S20). This is performed via an input means such as a keyboard connected to the electronic medical record creation computer 30, for example.

  Next, color information is acquired (S21). For example, a sample of a plurality of colors is presented on the screen of the electronic medical record creation computer 30, and the sample designated by the mouse pointer is acquired as color information. In the present embodiment, the color information designated by the person who has input the handwritten image data 61 has a total of 24 bits including 8 bits for the red (R) component, 8 bits for the green (G) component, and 8 bits for the blue (B) component. It consists of bits. This is the so-called RGB format.

  Based on the writer identifier and color information acquired as described above, actual color information used for drawing the handwritten image data 61 (hereinafter referred to as “drawing color information”) is calculated (S22). . In this embodiment, the writer identifier is represented by 9 bits. In this case, the writer identifier is divided into three parts of every 3 bits, and each is the lower 3 bits of each color component of the color information. Hereinafter, a case where Aqua (light blue) is selected as the color information and “102” is input as the writer identifier will be described in detail.

In the specification, d ₉ d ₈ d ₇ d ₆ d ₅ d ₄ d ₃ d ₂ d _{1 (2)} is a binary identifier for the writer identifier, and d _i {0,1 | i = 1 to 9} indicates that the i-th bit is 1 or 0. Similarly, r ₈ r ₇ r ₆ r ₅ r ₄ r ₃ r ₂ r _{1 (2)} (r _k {0,1 | k = 1 to 8}) is the red component of the color information, g ₈ g ₇ g ₆ g ₅ g ₄ g ₃ g ₂ g _{1 (2)} (g _k {0,1 | k = 1-8}) is the green component, b ₈ b ₇ b ₆ b ₅ b ₄ b ₃ b ₂ b _{1 (2)} (b _k {0, 1 | k = 1 to 8}) represents a blue component.

First, the logical product (AND operation) of the writer identification information and a predetermined bit string is calculated (in the following formula, “&” is an operator that calculates the logical product for each bit of the value on the left side and the value on the right side. is there.).
(1) D ₁ = d ₉ d ₈ d ₇ d ₆ d ₅ d ₄ d ₃ d ₂ d _{1 (2)} & 00000011 _{(2)
= 000000d 3 d 2 d 1 (} 2)
_{(2) D 2 = d 9} d 8 d 7 d 6 d 5 d 4 d 3 d 2 d 1 (2) & 000111000 (2)
_{= 000d 6 d 5 d 4 000} (2)
_{(3) D 3 = d 9} d 8 d 7 d 6 d 5 d 4 d 3 d 2 d 1 (2) & 111000000 (2)
_{= D 9 d 8 d 7 000000} (2)
Then, the 3-bit logical shift _{D 2} to the right of the (2), to 6-bit logical right shift the _{D 3} (3). This is shown in (2 ′) and (3 ′) (where “>>” is an operator that logically shifts the value on the left side to the right by the number on the right side).
(2 ′) G _y = D ₂ >> 3 = 000000d ₆ d ₅ d _{4 (2)
(3 ') B y = D} 3 >> 6 = 000000d 9 d 8 d 7 (2)
If the writer identification information is “102 (decimal number)”, its binary representation is 00100110 ₍₂₎ , and R _y (= D ₁ ), G _y , and B _y are 000000110 ₍₂₎ and 000000100 _{( 2)} 000000001 ₍₂₎

On the other hand, the lower 3 bits are set to 0 for the red, green, and blue components of the color information.
(4) R _i = r ₈ r ₇ r ₆ r ₅ r ₄ r ₃ r ₂ r _{1 (2)} & 11111000 _{(2)
= R 8 r 7 r 6 r} 5 r 4 000 (2)
(5) G _i = g ₈ g ₇ g ₆ g ₅ g ₄ g ₃ g ₂ g _{1 (2)} & 11111000 _{(2)
= G 8 g 7 g 6 g} 5 g 4 000 (2)
(6) B _i = b ₈ b ₇ b ₆ b ₅ b ₄ b ₃ b ₂ b _{1 (2)} & 11111000 _{(2)
= B 8 b 7 b 6 b} 5 b 4 000 (2)
If the color information is light blue, red component of light blue 00000000 _(2), the green component 11111111 _(2), because the blue component is _{11111111 (2), R i,} G i, B i respectively 00000000 ₍₂₎ The green component is 11111000 ₍₂₎ and the blue component is 11111000 ₍₂₎ .

Then, a logical sum (OR operation) for each bit is calculated for R _y and R _i , G _y and G _i , and B _y and B _i . This is shown in (7), (8), and (9) (in the following formula, “+” is an operator that calculates a logical sum for each bit of the value on the left side and the value on the right side).
_{(7) R o = R y} + R i = 00000d 3 d 2 d 1 (2) + r 8 r 7 r 6 r 5 r 4 000 (2)
_{= R 8 r 7 r 6 r} 5 r 4 d 3 d 2 d 1 (2)
_{(8) G o = G y} + G i = 00000d 6 d 5 d 4 (2) + g 8 g 7 g 6 g 5 g 4 000 (2)
_{= G 8 g 7 g 6 g} 5 g 4 d 6 d 5 d 4 (2)
_{(9) B o = B y} + B i = 00000d 9 d 8 d 7 (2) + b 8 b 7 b 6 b 5 b 4 000 (2)
_{= B 8 b 7 b 6 b} 5 b 4 d 9 d 8 d 7 (2)
As a result, the drawing color information calculated by embedding the writer identification information (102) in the color information (light blue) has a red component of 00000110 ₍₂₎ , a green component of 11111100 ₍₂₎ , and a blue component of 11111001 ₍₂₎ It becomes.

The handwritten image data is drawn on the display with the drawing color information composed of R _o , G _o and B _o calculated as described above (S23). The handwritten image data is stored in the database 22 in a predetermined format such as PNG format.

  On the other hand, in order to extract the writer identifier from the handwritten image data 61 drawn with the drawing color information calculated as described above, the following calculation is performed. FIG. 15 is a diagram showing a flow of processing for extracting the writer identifier from the drawing color information and displaying the writer information related to the writer identifier.

As described in the first embodiment, when the examination data list image and the handwritten image data are displayed on the display of the electronic medical record creation computer 30, the coordinates when the mouse pointer moves to a position overlapping the handwritten image data And the color corresponding to the coordinates is acquired (S30). Then, a logical product for each bit of each of the red (R _o ), green (G _o ), and blue (B _o ) components of the acquired color and a predetermined bit string for extracting the lower 3 bits is calculated. This is shown in (10), (11), and (12).
(10) R _i = R _o & 00000111 _{(2)
= R 8 r 7 r 6 r} 5 r 4 d 3 d 2 d 1 (2) & 00000111 (2)
= 00000d ₃ d ₂ d _{1 (2)}
(11) G _i = G _o & 00000111 ₍₂₎
= G ₈ g ₇ g ₆ g ₅ g ₄ d ₆ d ₅ d _{4 (2)} & 00000111 ₍₂₎
= 00000d ₆ d ₅ d _{4 (2)}
(12) B _i = B _o & 00000111 _{(2)
= B 8 b 7 b 6 b} 5 b 4 d 9 d 8 d 7 (2) & 00000111 (2)
= 00000d ₉ d ₈ d _{7 (2)}
For example, if the acquired color has a red component of 00000110 ₍₂₎ , a green component of 11111100 ₍₂₎ , and a blue component of 11111001 ₍₂₎ , R _i is 00000110 ₍₂₎ , G _i is 00000100 ₍₂₎ , B _i becomes 00000001 ₍₂₎ .

Then, (11) 3-bit logical shift _{G i} to the left, to 6-bit logical shift _{B i} on the left (12). This is shown in (11 ′) and (12 ′) (where “<<” indicates an operator that logically shifts the value of the left side to the left by the number on the right side).
_{(11 ') G y = G} i << 3 = 000d 6 d 5 d 4 000 (2)
_{(12 ') B y = B} i << 6 = d 9 d 8 d 7 000000 (2)
The writer identifier is obtained by calculating the logical sum of the three R _y (= R _i ), G _y , and B _y calculated as described above (S31). This is shown in (13).
(13) D = R _y + G _y + B _y = 000000d ₃ d ₂ d <sub>1 (2)
+ 000d 6 d 5 d 4 000</sub> (2)
_{+ D 9 d 8 d 7 000000} (2)
_{= D 9 d 8 d 7 d} 6 d 5 d 4 d 3 d 2 d 1 (2)
In the case of the above example, 00100110 ₍₂₎ (decimal number 102) can be obtained as the writer identifier.

  Next, the writer information corresponding to the writer identifier extracted as described above is acquired from the database 22 (S32). For example, as shown in Table 8, it is assumed that entry information for two persons (for example, doctors) is registered in the database 22 as persons who use the electronic medical record creation system 1.

  One writer information whose writer identifier is 102 is extracted from the plurality of writer information. As a result, in the example of Table 8, the writer information whose name is “B river B child” is extracted. Based on the writer information, the name of the writer is displayed near the mouse pointer (S33).

  FIG. 16 shows an image in which handwritten image data and the name of the writer are displayed. As shown in the drawing, the name 301 of the writer is displayed near the handwritten image data 300. Thereby, it is obvious at a glance who the person who entered the handwritten image data 300 is. Such display of the name of the writer is particularly useful when inputting the findings and the like examined by a plurality of doctors on the electronic medical record relating to one patient as handwritten image data.

  The handwritten image data is displayed on the display with drawing color information including the writer identifier relating to the person who entered the handwritten image data, or saved as a file in PNG format or the like. That is, the handwritten image data and the writer identifier are integrated. This makes it easy to manage the correspondence between the handwritten image data and the person who entered it.

  If the correspondence is managed in another form, for example, a form in which the correspondence between the coordinates of each point of the handwritten image data and the writer when the handwritten image data is displayed on the display is stored in a database or the like is considered. It is done. However, in such a form, for example, when handwritten image data is deleted or edited, the correspondence in the database must be updated each time. In addition, the coordinates at which the handwritten image data is displayed are not always constant for reasons such as changing the resolution of the display. As a result, there is a difference between the coordinates of the handwritten image data managed on the database and the coordinates where the handwritten image data is actually displayed, and there is a problem that an appropriate correspondence relationship is not maintained. Since the correspondence relationship between the handwritten image data as described in the present embodiment and the writer thereof is integrated as described above, there is an advantage that such a problem does not occur.

  In this embodiment, 9 bits are used to represent the writer identifier, but the present invention is not limited to this. At least it must be shorter than the bit length of the color information in which the writer identifier is embedded, but the color displayed on the display displayed by the color information and the color displayed by the drawing color information are viewed from the human eye. What is necessary is just to select the bit length of an entry identifier so that it may not change so much. Further, although the RGB format is used as a format for expressing color information and the like, the present invention is not limited to this, and the present invention can be applied even when, for example, the CMYK format is used. This is because it is only necessary that the writer identification information can be embedded in a part of the color information used when drawing the handwritten image data.

  The present invention can be used in medical institutions that digitize and manage patient charts.

It is a functional block diagram of an electronic medical record creation system including a computer in which an electronic medical record creation program according to an embodiment of the present invention is installed. It is a figure which illustrates the various data stored in a database. It is the schematic showing the input screen of test | inspection data. It is a figure which shows the flow of a process of an electronic medical record preparation program. It is a figure which illustrates the inspection data image which imaged inspection data. It is a figure which shows the relationship between the display area of an electronic medical record, and a display management table. It is the figure which represented sequentially the process which arrange | positions a test | inspection data image. It is the figure which represented sequentially the process which arrange | positions a test | inspection data image. It is a figure which illustrates an inspection data list image. It is a flow which shows the input process of handwritten image data. It is a figure which shows the relationship between the handwritten image data input as a background image by the test | inspection data list image, and the display area | region of an electronic medical record. It is a figure which illustrates the electronic medical record which overlap | superposed these images and inspection data list image and handwritten image data. It is a figure which illustrates the image of the superimposition of handwritten image data and an inspection data list image before and after using Bi-Linear method. It is a figure which illustrates the display and edit screen of an electronic medical record. It is a figure which shows the flow of a process which draws handwritten image data with drawing color information. It is a figure which shows the flow of the process which extracts writer identifier from drawing color information and displays writer information regarding this writer identifier. This is an image in which handwritten image data and the name of the writer are displayed.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Electronic medical record preparation system 2 Inspector 3 Ophthalmologist 20 Inspection data input terminal 21 Inspection equipment 22 Database 23 Web server 24 LAN
DESCRIPTION OF SYMBOLS 30 Electronic medical record preparation computer 31 Electronic medical record preparation program 32 Inspection data acquisition means 33 Inspection data imaging means 34 Inspection data image arrangement means 35 Handwritten image data input means 36 Display means 38 Output device 40 Input form 50 Electronic medical record display area 60 Inspection Data list image 70 Free curve 90 Inspection date selection menu 91 Handwritten image data menu 92 Observation data 100 Inspection data 101 Update flag 102 Electronic medical record management data 103 Display position management data 200 to 212 Inspection data image

Claims (15)

Computer
Examination data acquisition means for acquiring examination data of a patient who is to create an electronic medical record from a database storing examination data of patients classified into a plurality of examination items;
Inspection data imaging means for forming an inspection data image by imaging the inspection data for each of the plurality of inspection items into a predetermined size that can be displayed in the display area of the electronic medical record of the display device of the computer;
The position information for arranging the examination data image in the display area of the electronic medical record of the display device is managed, and the examination data image is arranged at a predetermined position on the basis of the position information to display an examination data list image. Inspection data image arrangement means to be created;
Handwritten image data input means for acquiring handwritten image data via the input device of the computer;
An electronic medical record creation program that causes an electronic medical record created by superimposing the inspection data list image and the handwritten image data to be displayed on the display device. In the electronic medical record creation program according to claim 1,
The position information is a flag indicating whether or not the inspection data image or the handwritten image data is arranged in a rectangular area obtained by dividing the display area of the electronic medical record into a grid pattern,
The predetermined position is an empty rectangular area where no other inspection data image or the handwritten image data is arranged,
The inspection data image arrangement means selects at least one empty rectangular area by determining whether or not the flag is set, and arranges the inspection data image in the empty rectangular area to list the inspection data An electronic medical record creation program characterized by creating images. In the electronic medical record creation program according to claim 1 or 2,
The database stores an update flag indicating that new examination data has been added to the database, and stores examination data list images and handwritten image data in association with patients,
The inspection data acquisition means determines whether the update flag is set and acquires the inspection data,
The examination data image arrangement means stores the examination data list image created by arranging the examination data image imaged by the examination data imaging means at a predetermined position in association with a patient, and saves it in the database.
The display means acquires the inspection data list image and the handwritten image data stored in the database, and displays an electronic medical record created by superimposing the inspection data list image and the handwritten image data on the display device. This is an electronic medical record creation program. In the electronic medical chart preparation program in any one of Claims 1-3,
The display means displays the inspection data list image as a sketch on the display device, and acquires the handwritten image data. In the electronic medical chart preparation program of Claims 1-4,
The electronic medical record creation program, wherein the display means performs predetermined image processing so that the inspection data image is displayed with priority over the handwritten image data. In the electronic medical record creation program according to any one of claims 1 to 5,
The examination data imaging means obtains examination data of a patient for which an electronic medical record is to be created from the database, applies a prescribed format to the examination data, and has a predetermined size that can be displayed on the display device. An electronic medical record creation program characterized by creating an inspection data image by imaging the inspection data for each of the plurality of inspection items. In the electronic medical record creation program according to any one of claims 1 to 6,
The handwritten image data input means converts a part of a bit string constituting color information designated as a color for drawing the handwritten image data into a bit string constituting an entry identifier for identifying a person who has inputted the handwritten image data. The drawing color information is calculated by replacing
The display means displays handwritten image data on the display device with the drawing color information, and displays on the display device writer information related to the writer identified by the writer identifier included in the drawing color information. An electronic medical record creation program characterized by An examination data input terminal for storing examination data of patients classified into a plurality of examination items in a database, and an electronic chart creation computer that creates an electronic chart based on the examination data acquired from the database, An electronic medical record creation system used when a doctor refers to an electronic medical record based on the examination data stored in the database by an employee,
The electronic medical record creation computer is:
Examination data acquisition means for acquiring examination data of a patient who is to create an electronic medical record from the database;
Inspection data imaging means for forming an inspection data image by imaging the inspection data for each of the plurality of inspection items into a predetermined size that can be displayed in a display area of an electronic medical record of a display device of the electronic medical record creation computer;
The position information for arranging the examination data image in the display area of the electronic medical record of the display device is managed, and the examination data image is arranged at a predetermined position on the basis of the position information to display an examination data list image. Inspection data image arrangement means to be created;
Handwritten image data input means for acquiring handwritten image data via an input device of the electronic medical record creation computer;
An electronic medical chart creation system comprising: display means for displaying an electronic medical chart created by superimposing the inspection data list image and the handwritten image data on the display device. The electronic medical record creation system according to claim 8,
The position information is a flag indicating whether or not the inspection data image or the handwritten image data is arranged in a rectangular area obtained by dividing the display area of the electronic medical record into a grid pattern,
The predetermined position is an empty rectangular area where no other inspection data image or the handwritten image data is arranged,
The inspection data image arrangement means selects at least one empty rectangular area by determining whether or not the flag is set, and arranges the inspection data image in the empty rectangular area to list the inspection data An electronic medical record creation system characterized by creating images. The electronic medical record creation system according to claim 8 or 9,
The database stores an update flag indicating that new examination data has been added to the database, and stores examination data list images and handwritten image data in association with patients,
The inspection data acquisition means determines whether the update flag is set and acquires the inspection data,
The examination data image arrangement means stores the examination data list image created by arranging the examination data image imaged by the examination data imaging means at a predetermined position in association with a patient, and saves it in the database.
The display means acquires the inspection data list image and the handwritten image data stored in the database, and displays an electronic medical record created by superimposing the inspection data list image and the handwritten image data on the display device. This is an electronic medical record creation system. In the electronic medical chart preparation system in any one of Claims 8-10,
The display means displays the examination data list image as a sketch on the display device and acquires the handwritten image data. In the electronic medical chart preparation system of Claims 8-11,
The electronic medical record creation system, wherein the display means performs predetermined image processing so that the inspection data image is displayed with priority over the handwritten image data. In the electronic medical chart preparation system in any one of Claims 8-12,
The examination data imaging means obtains examination data of a patient for which an electronic medical record is to be created from the database, applies a prescribed format to the examination data, and has a predetermined size that can be displayed on the display device. An electronic medical record creation system, wherein the examination data is imaged for each of the plurality of examination items to create an examination data image. In the electronic medical record preparation system in any one of Claims 8-13,
A web server that presents an input form for inputting the inspection data on the inspection data input terminal;
The web server includes an examination data input means for storing the examination data acquired via the input form in the database. In the electronic medical record preparation system in any one of Claims 8-14,
The handwritten image data input means converts a part of a bit string constituting color information designated as a color for drawing the handwritten image data into a bit string constituting an entry identifier for identifying a person who has inputted the handwritten image data. The drawing color information is calculated by replacing
The display means displays handwritten image data on the display device with the drawing color information, and displays on the display device information on the writer identified by the writer identifier included in the drawing color information. An electronic medical record creation system characterized by

Images