JP2008077314A - Program making information processor perform treatment plans to a plurality of patients, information processor and treatment planning method - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To minimize a burden on a patient him/herself and a family, to adjust treatment plans for a plurality of patients, and to efficiently perform hospital management. <P>SOLUTION: This program makes an information processor perform the treatment plans to the plurality of patients. The program makes the information processor execute a treatment plan stage for performing the treatment plans within a prescribed number of days by acquiring a treatment procedure corresponding to a disease name of a target patient from a treatment procedure master table wherein a medical examination/treatment procedure is associated to each disease name on the basis of the disease name and a treatment start day of the target patient input by a doctor, and adjusting reservation days of medical practice needing reservation between the plurality of patients. <P>COPYRIGHT: (C)2008,JPO&INPIT

Description

  The present invention minimizes the burden on the patient and the family, enables adjustment of a treatment plan for a plurality of patients, and allows a computer to efficiently operate a hospital, an information processing apparatus, The present invention relates to a treatment planning method.

  A treatment plan for a patient is called a clinical path, and a single clinical path often includes a plurality of medical actions such as examinations and operations. A system that supports the creation of this clinical path has been proposed.

For example, Patent Document 1 discloses a technique in which a series of medical actions corresponding to a disease name or the like is automatically scheduled based on a predetermined rule when a disease name or the like is designated by a doctor who is a user. Yes.
JP 2000-48109 A

  When a large number of patients are handled as in a large-scale hospital, when scheduling as described above, there is a situation where the appointment for the medical action to be scheduled (for example, examination) is full and it is not possible to get a close date and time. To do. As a result, even a clinical path that should be completed in about one week is likely to be prolonged because a reservation cannot be made. By prolonging the treatment period, not only the patient but also the patient family is forced to bear a mental and economic burden.

  In recent years, the introduction of a comprehensive medical procedure fee (DPC) has started. This DPC is a new medical fee system that replaces the conventional pay-for-care medical fee system, which is highly criticized for inviting excessive medical care. In the DPC, a medical treatment pattern is determined according to a disease type, a patient attribute, or the like, and a daily medical fee is determined for each pattern. And this score is set so that the score of the medical fee per day gradually decreases as the hospitalization period becomes longer. In other words, from the standpoint of the hospital, as the hospitalization period of the patient becomes longer, the profit is gradually reduced.

  For this reason, if a clinical path that is prolonged as described above is set, there is a problem that the profit of the hospital is gradually reduced.

  Therefore, an object of the present invention is to minimize the burden on the patient and his / her family, enable adjustment of treatment plans for a plurality of patients, and to efficiently perform hospital operation, an information processing apparatus thereof, and The present invention relates to a treatment planning method. Is to provide.

  In order to solve the above-described problems, the present invention is a program for causing an information processing apparatus to perform a treatment plan for a plurality of patients. The information processing apparatus includes a disease name and a treatment start date of a target patient input by a doctor. Based on the treatment procedure master table corresponding to the medical procedure for each disease name, the treatment procedure corresponding to the disease name of the target patient is acquired, and the appointment date of the medical action requiring appointment is obtained among the plurality of patients. By adjusting, the treatment planning stage of performing the treatment planning within a predetermined number of days is executed.

  With such a program, the information processing apparatus can minimize the burden on the patient and the family, can adjust the treatment plan for a plurality of patients, and can support efficient hospital management. it can.

  As means for solving the above-mentioned problems, the present invention provides an information processing apparatus provided with means for carrying out the treatment plan, a treatment planning method in the information processing apparatus, and a storage medium storing the program. You can also.

  The present invention minimizes the burden on the patient and the family, enables adjustment of treatment plans for a plurality of patients, and can support efficient hospital management.

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

  FIG. 1 is a diagram illustrating a functional configuration of a clinical path adaptation support apparatus. In FIG. 1, a clinical path adaptation support apparatus 100 is constructed in a hospital, for example. The clinical path adaptation support apparatus 100 is a computer server controlled by a CPU (Central Processing Unit), and is connected to a plurality of doctor terminals 3 via the network 2. The clinical path adaptation support apparatus 100 functions as an ASP (Application Service Provider).

  The clinical path adaptation support apparatus 100 provides a process for adapting an optimal clinical path to a plurality of doctor terminals 3 via the network 2, and inputs a patient's disease name and hospitalization date by a doctor using the doctor terminal 3. In response, the doctor terminal 3 is provided with a schedule adapted to the optimal clinical path.

  The clinical path adaptation support apparatus 100 includes an output control unit 13, an input control unit 14, a display control unit 15, a communication control unit 18, an installer 19, a disease name / hospital date acquisition unit 31, and a rescheduling processing unit 32a. A scheduling processing unit 32 and a confirmation processing unit 33.

  Furthermore, the clinical path adaptation support apparatus 100 stores a patient master table 51, a DPC path master table 52, a DPC (Diagnosis Procedure Combination) path specification master table 53, a path application table 54, and a reservation in a storage area such as a hard disk. The frame table 55, the reservation details table 56, the path development work area 57, and the hospitalization days calculation work area 58 are stored and managed.

  The output control unit 13 controls output data and outputs it to a printer or the like in accordance with an instruction from the CPU. The input control unit 14 controls input data input by a keyboard, a mouse, or the like. The display control unit 15 controls display data to control display on a monitor or the like.

  The communication control unit 18 controls transmission / reception of data with an external terminal via a network such as the Internet or a LAN (Local Area Network) according to a predetermined communication protocol.

  When the storage medium 20 storing the program for realizing the processing in the clinical path adaptation support apparatus 100 is set in the driver, the installer 19 reads the program from the storage medium 20 and stores it in a predetermined storage area such as a hard disk. install. The execution of the processing in the clinical path adaptation support apparatus 100 is realized by the CPU performing it according to a program installed in a predetermined storage area such as a hard disk. The storage medium 20 may be any medium that can read a program by a computer. For example, it is a CD-ROM (Compact Disc Read-Only Memory). Alternatively, it may be downloaded via a network and installed in a predetermined storage area such as a hard disk.

  The disease name / hospital date acquisition unit 31 is a processing unit that displays a DPC path input screen for inputting the patient's disease name and hospitalization date on the doctor terminal 3 and the patient's disease name and hospitalization date input by the doctor.

  The scheduling processing unit 32 determines the treatment plan and hospitalization period by the clinical path based on the disease name and hospitalization date in consideration of comprehensive medical fee accuracy (DPC). The rescheduling processing unit 32a adjusts the schedules such as examinations and operations specified in the clinical path of the other patient when the clinical path based on the disease name and the hospitalization date is prolonged due to the clinical path of the other patient. This is a processing unit for rescheduling.

  The confirmation processing unit 33 is a processing unit that confirms a schedule based on a patient's clinical path.

  In DPC, there is a period called a 25th percentile value as a numerical value indicating a threshold of revenue such as a breakeven point in the manufacturing industry. In other words, if a clinical pass is placed within the period, the profit of the medical fee will increase.

  In this embodiment, when creating a schedule for a patient (patient A), if the schedule is such that the DPC exceeds the 25th percentile value due to a balance with the schedule of another patient, the other patient ( The patient's DPC is adjusted to fall within the 25th percentile value by adjusting the schedule of the medical practice of patient B).

  Each table 51 to 56 and each work area 57 to 58 shown in FIG. 1 will be described with reference to FIGS.

  FIG. 2 is a diagram illustrating an example of a patient master table. In FIG. 2, the patient master table 51 includes items such as a patient ID and a patient name. For example, the patient name of the patient ID “0000000001” is “patient A”, the patient name of the patient ID “0000000002” is “patient B”, and the patient name of the patient ID “0000000003” is “patient C”. Is shown.

  FIG. 3 is a diagram illustrating an example of the DPC path master table. In FIG. 3, a DPC pass master table 52 is a table for managing the score for each hospitalization period for each DPC passcode corresponding to the disease name. The DPC passcode, disease name, disease name code, hospitalization period, hospitalization score, hospitalization It consists of items such as period 1, hospitalization period 1 score, hospitalization period 2 and hospitalization period 2 score.

  For example, in the DPC passcode “1001” corresponding to the disease name “stomach cancer” identified by the disease name code “65001”, if the hospitalization period is “7” days, the hospitalization period score is “2900”. If the hospitalization period is “14” days, the score of the hospitalization period is “1800” points, and if the hospitalization period is “18” days, the score of the hospitalization period is “1200” points.

  In the DPC pass code “1002” corresponding to the disease name “cecum” identified by the disease name code “65002”, if the hospitalization period is “4” days, the hospitalization period score is “2000” and the hospitalization period is “ If the hospitalization period is 12 days, the score of the hospitalization period is “1500”, and if the hospitalization period is “19” days, the score of the hospitalization period is “900”.

  In the DPC passcode “1003” corresponding to the disease name “lung cancer” identified by the disease name code “65003”, if the hospitalization period is “7” days, the hospitalization period score is “1300” and the hospitalization period is “ If it is 18 ”, the score for the hospitalization period is“ 900 ”, and if the hospitalization period is“ 26 ”, the score for the hospitalization period is“ 500 ”.

  FIG. 4 is a diagram illustrating an example of the DPC path detail master table. In FIG. 4, a DPC path detail master table 53 is a table showing procedures of a plurality of medical practices such as examinations and operations, and items such as DPC passcode, path name, detail order, reservation code, order name, and required number of days. Consists of.

  For example, in the path name “pass 1” identified by the DPC pass code “1001”, “blood test” for the required number of days “1” is performed in the detailed order “1”, and the required number of days “in the detailed order“ 2 ”. Perform “counter shock” on day 1; perform “MRI” on required day “1” in detailed order “3”; perform “injection” on required day “1” in specified order “4” To perform “injection” for the required number of days “1” in the detailed order “5”, to “prescribe” the required number of days “1” in the detailed order “6”, etc. It is shown that it is a procedure.

  Here, the reservation code “R01” is designated in the detail order “3”. This indicates that “MRI” performed in the detail order “3” requires that a specific treatment room be reserved.

  In the path name “pass 2” identified by the DPC pass code “1002”, the “urine test” for the required number of days “1” is performed in the detailed order “1”, and the required number of days “1” in the detailed order “2”. Performing “MRI” for the day, performing “prescription” for the required number of days “1” in the detailed order “3”, performing “prescription” for the required number of days “1” in the detailed order “4”,・ ・ Etc. are shown to be procedures for medical practice.

  Here, the reservation code “R01” is specified in the detail order “2”. “MRI” performed in the detail order “2” indicates that a reservation for a specific treatment room is necessary.

  FIG. 5 is a diagram illustrating an example of a path application master table. In FIG. 5, a path application master table 54 is a table showing a schedule based on the currently applied clinical path. The DPC pass code, path name, patient ID, application start date, application end date, detailed order, and reservation acquisition It consists of days. The appointment acquisition date indicates the appointment date of a specific treatment room.

  For example, the schedule based on the clinical path adapted to the patient ID “0000000001” (that is, the path name “path 1”) starts to be applied in accordance with the detailed order of “pass 1” in the DPC path detailed master table shown in FIG. If you are admitted on the day “2006/5/2”, the detail order “1” will be executed on the application end date “2006/5/2” and the detail order “2” will be displayed on the end date “2006/5/3”. The detail order “3” is performed on the application end date “2006/5/5”, the detail order “4” is performed on the application end date “2006/5/6”, and the application end date “2006/5” / 7 ”indicates that the detail order“ 5 ”is performed, and the detail order“ 6 ”is performed on the application end date“ 2006/5/8 ”.

  In the schedule of this patient ID “0000000001”, a reservation for a specific treatment room for “MRI” is made after 3 days based on the required number of days required for the detailed order 1 and 2 of pass 1 shown in FIG. 4 ”is not possible, and“ 2006/5/5 14:00:00 ”, which is one day off, is the reservation date that can be acquired. This adjustment will be described later.

  In addition, the schedule based on the clinical path adapted to the patient ID “0000000002” (that is, the path name “path 2”) starts to be applied in accordance with the detailed order of “pass 2” in the DPC path detailed master table shown in FIG. If you are admitted on the day “2006/5/3”, the detail order “1” is performed on the application end date “2006/5/3” and the detail order “2” is displayed on the end date “2006/5/4”. It is shown that the detail order “3” is performed on the application end date “2006/5/5” and the detail order “4” is performed on the application end date “2006/5/6”.

  In the schedule of this patient ID “0000000002”, a reservation for a specific treatment room for “MRI” is made at “2006/5/4 10:00:00”.

  FIG. 6 is a diagram illustrating an example of a reservation frame table. In FIG. 6, a reservation frame table 55 is reservation items such as examination items or treatment rooms specified by the reservation code, and includes items such as a reservation code, a department code, and a reservation name.

  For example, for the reservation code “R01”, the department code is “01”, which indicates a reservation with the reservation name “MRI”. Regarding the reservation code “R01”, the department code is “01”, which indicates a reservation of the reservation name “CT examination room 1”. Regarding the reservation code “R02”, the clinical department code is “01”, which indicates the reservation of the reservation name “CT examination room 1”. Regarding the reservation code “R03”, the department code is “01”, which indicates a reservation for the reservation name “CT examination room 2”.

  Regarding the reservation code “R04”, the clinical department code is “01”, which indicates reservation of the reservation name “endoscope”. Regarding the reservation code “R05”, the clinical department code is “01”, which indicates a reservation with the reservation name “electrocardiogram”.

  FIG. 7 is a diagram illustrating an example of a reservation details table. In FIG. 7, the reservation details table 56 is a table for managing the reservation status, and includes items such as a reservation code, reservation name, year, month, date, reservation order, start time, end time, patient ID, and disease name code. Is done. In the reservation details table 56, a start time and an end time that can be reserved in a reservation frame unit are registered, and a patient ID and a disease name code of a patient that needs to be reserved by a clinical pass are set. When the patient ID and the disease name code are “NULL”, this indicates that the time zone is vacant (reservation is possible).

  For example, for the reservation status of May 4, 2006 with the reservation code “R01”, the end time “1100” (11:00) from the start time “1000” (10:00) is the patient ID “0000000002”. It is reserved with the disease name code “65002”, and the end time “1200” (12:00) from the start time “1100” (11:00) is reserved with the disease name code “38281” of the patient ID “0000000007”, and the start time The end time “1400” (14:00) from “1300” (13:00) is reserved with the disease name code “43021” of the patient ID “0000000006”, and the start time “1400” (14:00) The end time “1500” (15:00) is reserved with the disease name code “49521” of the patient ID “0000000004”.

  Regarding the reservation status of the reservation code “R01” on May 5, 2006, the start time “1300” (13:00) to the end time “1400” (14:00) and the start time “1400” (14:00) The end time “1500” (15:00) from “00 minutes” indicates that reservation is possible in an empty state.

  FIG. 8 is a diagram illustrating an example of a path development work area. In FIG. 8, a path development work area 57 is a work area for recalculating a schedule based on a patient's clinical path in which reservation dates and times by the same reservation code overlap in order to adapt an optimal clinical path to a patient. It consists of items such as code, path name, patient ID, application start date, application end date, detailed order, and reservation acquisition date.

  FIG. 9 is a diagram illustrating an example of the hospitalization days calculation work area. In FIG. 9, the hospitalization days calculation work area 58 calculates the number of hospitalization days of each patient when a specific examination or treatment room is adjusted, and scores the DPC passcode that becomes the 25th percentile value based on the hospitalization days. Is a table that associates.

  Next, the overall processing flow will be described. FIG. 10 is a flowchart for explaining the entire process. In FIG. 10, the clinical path adaptation support apparatus 100 displays a medical chart description screen (step S1), and displays the DPC path screen in response to the user clicking the DPC path button (step S2). The disease name / hospital date acquisition unit 31 is activated.

  In response to the user clicking a disease name button for selecting a disease name on the DPC pass screen, the disease name / hospital date acquisition unit 31 displays a disease name input screen (step S3). When the user selects the target disease name and clicks the confirm button, the disease name / hospital date acquisition unit 31 ends the disease name input screen and displays the disease name on the DPC pass screen (step S4).

  The doctor inputs the hospitalization date on the DPC pass input screen (step S5), and schedules with the optimal clinical path according to the click of the pass button by the doctor (step S6). The scheduling processing unit 32 is activated and the scheduling process is executed. The medical reward score based on the scheduled DPC pass is displayed on the DPC pass screen.

  When the doctor clicks the confirmation button on the DPC pass screen, the confirmation processing unit 33 performs a confirmation process for confirming the schedule (step S7). Then, the DPC pass screen ends and the screen returns to the medical record description screen (step S8).

  Screens operated by the doctor in the overall processing flow described above will be described with reference to FIGS. FIG. 11 is a diagram showing an initial display state of the DPC path screen. In FIG. 11, the DPC pass screen G60 displays a disease name input area 61 for inputting a main disease name, an admission date input area 62 for inputting an admission date, an discharge date display area 63 for displaying the discharge date, and path information. A path display area 64, a score display area 65 for displaying the medical reward score, a disease name button 66 for displaying a disease name input screen for selecting a main disease name, and a path button for creating a schedule adapted to a clinical path 67 and a confirm button 68 for confirming the path.

  When the doctor clicks on the disease name button 66 to select the main disease name of the patient A, a disease name input screen 70 as shown in FIG. 12 is displayed on the doctor terminal 3. FIG. 12 is a diagram illustrating an example of a disease name input screen. In FIG. 12, the disease name input screen 70 has a disease name display field 71 indicating a patient's disease name list extracted from the patient's medical record information, and a confirm button 72 for confirming the disease name selected by the doctor.

  For example, when the doctor selects “stomach cancer” and clicks the confirm button 72, “stomach cancer” is entered in the disease name input area 61 of the DPC pass screen 60 as shown in FIG. 13. When the doctor inputs the hospitalization date into the hospitalization date input area 62 and clicks the pass button 67, a DPC pass screen 60 as shown in FIG. 14 or FIG. 15 is displayed on the doctor terminal 3.

  FIG. 14 is a diagram illustrating an example of a DPC pass screen when a patient can be scheduled in the shortest hospitalization period. In FIG. 14, “2006/5/7” is displayed in the discharge date display area 63, “Pass 1” is displayed in the path information display area 64, and “ “2,900” points are displayed, and “up to 7 days” is displayed in the display area 65-2 as the number of hospitalization days to which “2,900” points are applied. When the doctor confirms the schedule based on this processing result, the confirm button 68 is clicked.

  FIG. 15 is a diagram illustrating an example of the DPC path screen when the schedule is adjusted by the rescheduling processing unit. The DPC path screen 60 shown in FIG. 15 adjusts the basic path display area 60a for displaying the result of the schedule based on the clinical path adapted to the patient A when the schedule of the other patient is not adjusted, and the schedule of the other patient. Thus, the shortest path display area 60b for displaying the result of the schedule based on the shortest path shorter than the basic path and the changed patient path display area 60c for displaying the result of the schedule of the other adjusted patient are configured.

  The basic path display area 60a includes a disease name display area 61a for displaying the main disease name, an hospitalization date display area 62a for displaying the hospitalization date, a discharge date display area 63a for displaying the discharge date, and a path display area for displaying path information. 64a, a score display area 65a for displaying the medical reward score, a days display area 65a-2 for displaying the number of days to which the path is applied, and a check for validating the schedule displayed in the basic path display area 60a And a box 69a.

  In the basic path display area 60a, for example, “stomach cancer” in the disease name display area 61a, “2006/5/2” in the hospitalization day display area 62a, “2006/5/7” in the discharge date display area 63a, and the path display area 64a. “Pass 1”, “1,800” in the score display area 65a, and “up to 14 days” in the day display area 65a-2.

  Similarly, in the shortest path display area 60b, a disease name display area 61b for displaying the main disease name, an hospitalization date display area 62b for displaying the hospitalization date, a discharge date display area 63b for displaying the discharge date, and a path for displaying path information. In order to validate the schedule displayed in the display area 64b, the score display area 65b for displaying the medical reward score, the day display area 65b-2 for displaying the number of days to which the path is applied, and the basic path display area 60b. Check box 69b.

  In the shortest path display area 60b, for example, "stomach cancer" in the disease name display area 61b, "2006/5/2" in the hospitalization date display area 62b, "2006/5/8" in the discharge date display area 63b, and the path display area 64b "Shortest path", "2,900" is displayed in the score display area 65b, and "Up to 7 days" is displayed in the day display area 65b-2.

  The changed patient path display area 60c includes a disease name display area 61c for displaying the main disease name, an hospitalization date display area 62c for displaying the hospitalization date, a discharge date display area 63c for displaying the discharge date, and a path display for displaying path information. An area 64c, a score display area 65c for displaying the number of medical rewards, a day display area 65c-2 for displaying the number of days to which the path is applied, and a display area 69c for displaying change information including the changed patient name Have

  In the changed patient path display area 60c, for example, “stomach cancer” in the disease name display area 61c, “2006/5/3” in the hospitalization date display area 62c, “2006/5/6” in the discharge date display area 63c, path display area “Shortest path” is displayed in 64c, “2,000” is displayed in the score display area 65c, and “Up to 4 days” is displayed in the day display area 65c-2.

  After confirming the applicable path, schedule of hospitalization period, adjusted patient schedule, etc., for example, the doctor checks the check box 69b and clicks the confirm button 68 to confirm the schedule of the shortest path display area 60b. The patient's schedule is then confirmed.

  The processing outline has been described using the overall processing flow shown in FIG. 10 and the screen examples shown in FIGS. 11 to 15. However, the schedule shown in the screen examples shown in FIGS. 11 to 15 is the patient ID “0000000001”. As the patient A to be identified, the scheduling process executed in step S6 will be described in detail below.

  FIG. 16 is a flowchart for explaining the scheduling process. In FIG. 16, the scheduling processing unit 32 applies a clinical path (hereinafter referred to as a basic path) corresponding to the disease name “stomach cancer” of the patient A input by the doctor on the DPC path screen 60 (step S <b> 11). A record corresponding to the DPC pass code specifying the disease name in the DPC path master table 52 (FIG. 3) is acquired from the DPC path detail master table 53 (FIG. 4).

  When the basic path of the patient A acquired from the DPC path details master table 53 is applied, the reservation code “R01” included in the basic path and the hospitalization date “2006/5/2” input by the doctor on the DPC path screen 60 If the shortest reservation available date is identified from the hospitalization date based on the reservation details table 56 (FIG. 7), it is determined whether or not there is a change in the pass application period (step S12).

  In this case, the “MRI” designated by the reservation code “R01” of the detail order “3” is the third shortest from the detail order of the basic path of the patient A acquired from the DPC path detail master table 53 and the required number of days. Necessary on the day. That is, since the hospitalization date is “2006/5/2”, “MRI” is reserved after “2006/5/4”. In the reservation details table 56, it is confirmed in the reservation details table 56 whether or not there is a vacancy (NULL) of the reservation code “R01” at “2006/5/4”. When the reservation details table 56 is “2006/5/4” and there is no vacancy (NULL), it is determined that a change is necessary.

  It is checked whether or not the determination result indicates a change (step S13). If not changed, the basic path of the patient A is displayed in the basic path display area 60a of the DPC path screen 60 (step S13-2). For example, the DPC path screen shown in FIG. 14 is displayed. In this case, since there is a vacancy (NULL) at “2006/5/4” in the reservation details table 56, “MRI” is reserved at “2006/5/4”, and the details and order of basic path are required. From the number of days, the discharge date will be “May 7, 2006”. The hospitalization period from the hospitalization date “2006/5/2” to the discharge date “2006/5/7” is 5 days, and the hospitalization period of “stomach cancer” in the DPC pass master table 52 (FIG. 3) is “5” days. As applied, the length of hospital stay is "2,900".

  On the other hand, when changing the reservation of patient A, a reservation influence investigation is performed. From the reservation details table 56, patient IDs that are reserved on the shortest reservation date “2006/5/4” based on the detailed order of the basic path of the patient A and the required number of days are acquired as a patient ID list (step S14). In this case, patient IDs “0000000002”, “0000000007”, “0000000006”, and “0000000004” reserved for “2006/5/4” of the reservation code “R01” in the reservation details table 56 are extracted.

  Then, the rescheduling processing unit 32a executes rescheduling processing to reschedule the patient identified by the patient A and the patient IDs “0000000002”, “0000000007”, “0000000006”, and “0000000004” ( Step S15).

  The basic path of the patient when the schedules of other patients are not adjusted is displayed in the basic path display area 60a of the DPC path screen 60 (step S16). In this case, for example, “MRI” is reserved on “May 5th, 2006” and the hospitalization period from hospitalization date “May 2” to discharge date “May 8” is 6 days. The master table 52 displays “14” days of hospitalization period 1 and “1,800” of hospitalization period 1 in the basic path display area 60a of the DPC pass screen 60 as shown in FIG.

  Further, based on the result of the rescheduling process, a schedule that can make patient A shorter than the schedule displayed in the basic path display area 60a is displayed in the shortest path display area 60b of the DPC path screen 60 as shown in FIG. Step S17). For example, by adjusting the appointments of other patients, the discharge date will be “2006/5/7” and the hospital stay will be 5 days. Are displayed in the shortest path display area 60b of the DPC path screen 60 as shown in FIG.

  Further, based on the result of the rescheduling process, the path of the patient that is changed to enable the shortest path of patient A is displayed in the changed patient path display area 60c of the DPC path screen 60 as shown in FIG. (Step S18). For example, if the schedule of the patient B is adjusted, a schedule based on the path applied to the patient B is displayed in the changed patient path display area 60 c of the DPC path screen 60. Then, the scheduling process ends.

  Next, the rescheduling process executed by the rescheduling processing unit 32a in step S15 of FIG. 16 will be described in detail.

  FIG. 17 is a flowchart for explaining the rescheduling process. In FIG. 17, the path when the reservation is given to the patient A is redeployed in the path development work area 57 (step S151). From the patient ID list acquired in step S14 of FIG. 16, the schedule is developed for each patient ID according to the path development work area 57 and the detailed procedure of the path. At this time, the most recent reservation without a reservation in the reservation details table 56 is acquired based on the reservation code.

  A processing example of step S151 will be described with reference to FIG. 18 for patient B with patient ID “0000000002”. FIG. 18 is a diagram illustrating a processing example of step S151 in FIG. In FIG. 18, the DPC passcode or path name applied to the patient ID “0000000002” in the patient ID list is acquired from the path application master table 54 (step S151-2).

  Then, based on the DPC pass code or the path name, while referring to each record from the DPC path detail master table 53 to the detail order “1” to the detail order “5” (step S151-4), the patient ID “0000000002” Recalculate the path one day at a time. At this time, in the detail order “2”, referring to the reservation detail table 56, it is assumed that the reservation with the reservation code “R01” is provisionally reserved at the start time “1300” of the latest “2006/5/5” without reservation. (Step S151-6), the application end date “2006/5/5”, the detailed procedure “2”, and the reservation acquisition date “2006/5/5 13:00:00” are written in the path development work area 57 (Step S151). -8).

  The same processing is performed for other patient IDs in the patient ID list, and a schedule based on the recalculated path is written in the path development work area 57. Finally, for the patient A with the patient ID “0000000001”, a schedule based on the path is written in the path development work area 57 by the same process. In the case of patient A, the reservation code “R01” required for the detailed order “3” of the path name “pass 1” is temporarily reserved from the reservation details table 56 at the start time “1400”, and the path expansion work area 57 is entered. The application end date “2006/5/5”, the detailed procedure “3”, and the reservation acquisition date “2006/5/5 14:00:00” are written.

  In FIG. 17, the number of days of hospitalization is calculated for each patient ID (step S152). The path development work area 57 is used to calculate the number of hospitalization days using the application start date and the application end date of the last record for each patient ID, and the hospitalization period calculated from the DPC path master table 52 is the shortest hospitalization period. If it is within the range, the score for the hospitalization period is acquired and written in the hospitalization days calculation work area 58.

  The process of step S152 will be described in detail using FIG. FIG. 19 is a diagram for explaining the process of step S152 of FIG. In FIG. 19, a DPC passcode is obtained for each patient ID from the path development work area 57 (step S152-2), and the hospitalization days are calculated from the application start date and application end date for each patient ID from the path development work area 57. (Step S152-4).

  Based on the calculated number of days of hospitalization, the DPC pass master table 52 is referred to identify the hospitalization period from the DPC passcode and the number of days of hospitalization. If the hospitalization period is the shortest (that is, the 25th percentile value range), The score of the hospitalization period corresponding to the period is acquired, and the patient ID, the DPC passcode, the number of hospitalization days, and the score are written to the hospitalization day calculation work area 58 (step S152-6).

  In this example, the patient IDs “0000000002” and “0000000004” are in the 25th percentile range, and the points are “2000” and “1800”, respectively.

  In FIG. 17, a patient whose schedule is changed for the patient A is selected (step S153). The highest patient ID among the points written in the hospitalization days calculation work area 58 is acquired. In the case of the example of FIG. 19, the patient B is identified by the patient ID “0000000002” (FIG. 2).

  Then, the reservation date and start time for the patient ID acquired in step S153 are acquired from the reservation details table 56, and the path developed as the reservation acquisition date for patient A in the path development work area 57 is rewritten (step S154).

  The process of step S154 will be described in detail using FIG. FIG. 20 is a diagram for explaining the process of step S154 of FIG. In FIG. 20, the patient ID “0000000002” with the highest score is acquired from the hospitalization days calculation work area 58, and “2006” of the reservation code “R01” which is about to make a reservation for the patient A in step S12 of FIG. The patient ID “0000000002” of “/ 5/4” is searched from the reservation details table 56 (step S154-2).

  Then, the start time “1000” (10 o'clock) of the patient ID “0000000002” is acquired from the reservation details table 56, and the detailed procedure “requires reservation of the patient ID“ 0000000001 ”indicating the patient A in the path expansion work area 57. 3 ”has been changed from“ 2006/5/5 ”to“ 2006/5/4 ”, and the reservation acquisition date has been changed from“ 2006/5/5 14:00:00 ”to“ 2006/5 / 4 10:00:00 "(step S154-4).

  In FIG. 17, the schedule to which the path is applied in the path development work area 57 is adjusted in this way, and only the adjusted record of the patient B identified by the patient A and the patient ID “0000000002” is left, and the path development work area is left. The record of the other patient is deleted from 57 (step S155). Then, the path expansion work area 57 is set as a processing result by the rescheduling process (step S156).

  In the scheduling process of FIG. 16 based on such a processing result, the schedule based on the shortest path of the patient A is shown in FIG. 15 by the record “0000000001” for identifying the patient A in the path development work area 57 in step S17. The schedule based on the shortest path of the patient B is changed in the DPC path screen 60 shown in FIG. 15 by the record “0000000002” for identifying the patient B in the shortest path display area 60b of the DPC path screen 60 shown in FIG. The information is displayed in the patient path display area 60c.

  When the doctor checks the check box 69b of the DPC path screen 60 in FIG. 15 and presses the confirm button 68, a confirm process for rewriting the path application master table 54 is performed based on the data in the path development work area 57 as a process result. Is called.

  As described above, the present invention minimizes the burden on the patient and the family due to long-term hospitalization of the patient by performing the hospitalization plan so that the DPC is within the 25th percentile value range, By making it possible to support the adjustment of the hospitalization plan, the hospitalization plan can be facilitated and the hospital can be operated efficiently.

Regarding the above description, the following items are further disclosed.
(Appendix 1)
A program for causing an information processing apparatus to perform a treatment plan for a plurality of patients.
Based on the disease name and treatment start date of the target patient input by the doctor, the treatment procedure corresponding to the disease name of the target patient is acquired from the treatment procedure master table corresponding to the medical procedure for each disease name, and reservation is made. A program for executing a treatment plan stage of performing the treatment plan within a predetermined number of days by adjusting a reservation date of a required medical practice among the plurality of patients.
(Appendix 2)
In the treatment planning stage, the information processing apparatus
An applied treatment plan storage step for storing treatment plan information indicating the treatment plan of the target patient to which the treatment procedure is applied when the medical procedure reserved for the plurality of patients is not changed in an application table. When,
A first display step of displaying the treatment plan information and first information indicating the points by referring to a score table in which the predetermined days and the medical reward points corresponding to the predetermined days are associated with each treatment procedure; The program according to appendix 1, wherein the program is executed.
(Appendix 3)
In the treatment planning stage, the information processing apparatus
Treatment plan information related to the treatment plan of the target patient when the reservation of the medical practice reserved for another patient to change the treatment plan of the target patient within the predetermined number of days is changed. A target patient treatment plan storage stage stored in the application work area;
The program according to claim 2, wherein a second display step for displaying second information indicating the treatment plan and a score of a medical fee corresponding to the treatment plan is executed by referring to the score table. .
(Appendix 4)
In the treatment planning stage, the information processing apparatus
In order to perform the treatment plan for the target patient within the range of the predetermined number of days, the treatment plan information related to the treatment plan of the other patient is applied by referring to the treatment procedure master table based on the disease name of the other patient. The other elephant patient treatment plan memorizing stage,
Other patient treatment plan selection step of selecting the treatment plan of the patient with the highest score among other patients whose reservation has been changed by referring to the score table;
By referring to the score table, a third display step of displaying third information indicating the treatment plan of the patient with the highest score and the medical reward score corresponding to the treatment plan is executed. The program according to Supplementary Note 2 or 3.
(Appendix 5)
When the doctor selects the treatment plan shown in the second information displayed in the second display step, the treatment plan of the target patient stored in the application work area and the highest score of the patient The program according to claim 3 or 4, further comprising a confirmation stage for performing a confirmation process by updating the application table as a treatment plan.
(Appendix 6)
An information processing apparatus for performing treatment planning for a plurality of patients,
A treatment procedure master table corresponding to a medical procedure for each disease name;
Based on the disease name and treatment start date of the target patient input by a doctor, the treatment procedure corresponding to the disease name is acquired from the treatment procedure master table, and a plurality of appointment dates for medical activities requiring appointment are obtained. An information processing apparatus comprising: treatment planning means for performing the treatment planning within a predetermined number of days by adjusting between patients.
(Appendix 7)
A treatment planning method for performing treatment planning for a plurality of patients, wherein a computer comprises:
Based on the disease name and treatment start date of the target patient input by the doctor, the treatment procedure corresponding to the disease name is acquired from the treatment procedure master table corresponding to the treatment procedure for each disease name, and reservation is required. A treatment planning method for executing a treatment planning procedure for performing the treatment planning within a predetermined number of days by adjusting a reservation date of a medical practice among the plurality of patients.

  The present invention is not limited to the specifically disclosed embodiments, and various modifications and changes can be made without departing from the scope of the claims.

It is a figure which shows the function structure of a clinical path adaptation assistance apparatus. It is a figure which shows the example of a patient master table. It is a figure which shows the example of a DPC path master table. It is a figure which shows the example of a DPC path detailed master table. It is a figure which shows the example of a path | pass application master table. It is a figure which shows the example of a reservation frame table. It is a figure which shows the example of a reservation details table. It is a figure which shows the example of a path | pass expansion work area. It is a figure which shows the example of a hospitalization days calculation work area. It is a flowchart for demonstrating whole processing. It is a figure which shows the initial display state of a DPC pass screen. It is a figure which shows the example of a disease name input screen. It is a figure which shows the display state of the DPC pass screen into which the disease name and the hospitalization date were input. It is a figure which shows the example of a DPC pass screen when a patient can schedule with the shortest hospitalization period. It is a figure which shows the example of a DPC path | pass screen when a schedule is adjusted by the rescheduling process part. It is a flowchart figure for demonstrating a scheduling process. It is a flowchart for demonstrating rescheduling processing. It is a figure which shows the process example of step S151 of FIG. It is a figure for demonstrating the process of step S152 of FIG. It is a figure for demonstrating the process of step S154 of FIG.

Explanation of symbols

DESCRIPTION OF SYMBOLS 2 Network 3 Doctor terminal 13 Output control part 14 Input control part 15 Display control part 18 Communication control part 19 Installer 20 Storage medium 31 Disease name and hospitalization date acquisition part 32 Scheduling process part 32a Rescheduling process part 33 Finalization process part 51 Patient master table 52 DPC path master table 53 DPC path details master table 54 path application table 55 reservation frame table 56 reservation details table 57 path development work area 58 hospitalization days calculation work area 100 clinical path adaptation support device

Claims (5)

A program for causing an information processing apparatus to perform a treatment plan for a plurality of patients.
Based on the disease name and treatment start date of the target patient input by the doctor, the treatment procedure corresponding to the disease name of the target patient is acquired from the treatment procedure master table corresponding to the medical procedure for each disease name, and reservation is made. A program for executing a treatment plan stage of performing the treatment plan within a predetermined number of days by adjusting a reservation date of a required medical practice among the plurality of patients. In the treatment planning stage, the information processing apparatus
An applied treatment plan storage step for storing treatment plan information indicating the treatment plan of the target patient to which the treatment procedure is applied when the medical procedure reserved for the plurality of patients is not changed in an application table. When,
A first display step of displaying first information indicating the treatment plan information and the score by referring to a score table in which the predetermined days and the medical reward score corresponding to the predetermined days are associated with each treatment procedure; The program according to claim 1, wherein the program is executed. In the treatment planning stage, the information processing apparatus
Treatment plan information related to the treatment plan of the target patient when the reservation of the medical practice reserved for another patient to change the treatment plan of the target patient within the predetermined number of days is changed. A target patient treatment plan storage stage stored in the application work area;
3. The second display step of displaying second information indicating the treatment plan and a medical reward score corresponding to the treatment plan by referring to the score table. program. An information processing apparatus for performing treatment planning for a plurality of patients,
A treatment procedure master table corresponding to a medical procedure for each disease name;
Based on the disease name and treatment start date of the target patient input by a doctor, the treatment procedure corresponding to the disease name is acquired from the treatment procedure master table, and a plurality of appointment dates for medical activities requiring appointment are obtained. An information processing apparatus comprising: treatment planning means for performing the treatment planning within a predetermined number of days by adjusting between patients. A treatment planning method for performing treatment planning for a plurality of patients, wherein a computer comprises:
Based on the disease name and treatment start date of the target patient input by the doctor, the treatment procedure corresponding to the disease name is acquired from the treatment procedure master table corresponding to the treatment procedure for each disease name, and reservation is required. A treatment planning method for executing a treatment planning procedure for performing the treatment planning within a predetermined number of days by adjusting a reservation date of a medical practice among the plurality of patients.

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