JP2008197742A - Medical care information distribution device - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To allow a patient to control the disclosed range of medical care information, and to deliver the latest medical care information without exerting a large load on a server for distributing the medical care information. <P>SOLUTION: When patient introduction is performed between medical facilities 11 and 12, the medical care information is delivered from an introduction source to an introduction destination via a data center 10. A server computer 14, on receiving a medical care information distribution request of the introduced patient from a client terminal of the medical facility of the introduction destination, accesses a medical care information DB on the introduction source, acquires the medical care information of the introduced patient, and distributes it to the medical facility of the introduction destination. Set information where the disclosed range of the medical care information is set is registered for each patient in the server computer 14, and the server computer 14 distributes only medical care information whose disclosure is permitted by the patient to the introduction destination according to the registered information. <P>COPYRIGHT: (C)2008,JPO&INPIT

Description

  The present invention relates to a medical information distribution apparatus that distributes patient information of a referral source medical facility to a referral destination medical facility.

  In the medical field, an introduction act of introducing a patient between a plurality of medical facilities is performed according to the role of the medical facility. For such referrals, the medical information of referral patients obtained by the referral source medical facility is transferred to the referral destination medical facility. Here, the medical information includes medical chart data and examination data, and the examination data includes an examination result, an examination image, an interpretation report that records a result of interpretation of the examination image, and the like. By exchanging medical information in this way, it is possible to use test data that has already been performed at the referral medical facility, so that it is possible to smoothly proceed with medical care, which is beneficial for both the referral medical facility and the patient. There is.

  Patent Document 1 discloses a system for disclosing medical information to other medical facilities using a data center that is connected to a plurality of medical facilities via a communication network and stores and stores medical information held by each medical facility. Is described. The data center periodically uploads medical information held by each medical facility, and stores the medical information as backup data. When a patient is introduced, the data center extracts the medical information of the target patient from the backup data based on the patient ID in response to a request from the referral destination medical facility designated by the referral source. The extracted medical information is transmitted to the referral medical facility.

  Since medical information includes personal information, it is indispensable to take security measures such as prevention of information leakage when the information is disclosed. In this system, the referral source medical facility can designate the referral destination medical facility where the medical information is to be disclosed, so the disclosure destination is limited, and it is prevented from being disclosed to unspecified medical facilities. be able to.

In addition, the medical information is not directly transferred from the referral source medical facility to the referral destination medical facility, but the medical information backed up in the data center is transmitted to the referral destination medical facility. Security is also ensured. This is because, between data centers and medical facilities, for example, it is easy to develop a communication environment with information security measures such as laying a dedicated line or building a VPN (Virtual Private Network). It is difficult to establish such a communication environment between them because of the large cost obstacles.
Japanese Patent Laid-Open No. 11-143958

  As described above, since the patient's medical information includes a lot of information related to privacy, there are many patients who worry that the medical information will be disclosed more than necessary. In the conventional system, although the disclosure destination can be limited to the medical facility of the introduction destination, the medical information is extracted by searching the patient ID, and the extracted medical information is transmitted to the introduction destination. Will be released to the referral destination. Therefore, for example, there is a problem that the patient cannot control the disclosure range of the medical information, such as making only a part of the medical information private.

  In addition, in the conventional system, since data backed up regularly to the data center is transmitted to the referral destination, there is a concern that the referral medical facility cannot receive the latest medical information. When image data such as examination images as well as medical record data is backed up to the data center, it takes a lot of time to upload, and the load on the data center is also large, so it can be backed up in real time or the backup interval can be shortened. Thus, it is not practical to increase the backup frequency, so it is especially problematic in such cases.

  Of course, if the medical information held by the medical facility is directly transmitted and received between the medical facilities, the latest medical information can be delivered. However, as described above, there is a concern in terms of information security in this method.

  An object of the present invention is to allow a patient to control the disclosure range of medical information.

  Another object of the present invention is to deliver the latest medical information without imposing a heavy load on a server that distributes medical information.

  The medical information distribution apparatus of the present invention is connected to a plurality of medical facilities that hold medical information of patients including medical chart information and examination data through a communication network, and when a patient is introduced between the medical facilities, the introduction is performed. In response to a request from a medical facility, a medical information distribution apparatus that distributes the medical information of a patient to be referred to the referral medical facility, whether the medical information held by each medical facility is disclosed or undisclosed. The setting information registration table in which the setting information is registered, and the medical information that is the target of the distribution request with reference to the setting information registration table when the medical information distribution request is received from the introduction medical facility A setting information check unit for examining the range of disclosure or non-disclosure of the medical information, and acquiring the medical information from the referral source medical facility within a range permitted to be disclosed, and the medical information A medical information distribution unit for distributing to the introduction destination medical facilities, is characterized in that a history information recording unit for recording the distribution request history of the introduction destination medical facility.

  It is preferable that the medical information includes medical record data and examination data as individual items, and the setting information registration table can be set to be public or private for each individual item. Setting is easy because each item is divided in advance.

  It is preferable to include a setting information update unit that receives an update request for the setting information registration table via the communication network and updates the setting information registration table. This makes it possible to change the disclosure range flexibly and easily.

  The history information recording unit preferably records the delivery request date and time, the request source and request destination medical facility IDs, and the delivered medical information. More preferably, the history information includes an introduction history that is reported from the referral medical facility and indicates that the patient has been introduced. By recording such a history, unauthorized access is suppressed. In addition, it is preferable to include a history information distribution unit that receives the history information inquiry request via the communication network and distributes the history information.

  The setting information registration table is preferably stored by integrating a plurality of setting information corresponding to medical information of the same patient held at a plurality of medical facilities.

  The present invention provides a setting in which public or non-public setting information is registered with respect to the medical information held by each medical facility when distributing the medical information of the patient held by the medical facility of the referral to the medical facility of the referral destination By referring to the information registration table, medical information in the permitted range of disclosure is acquired and distributed to the referral medical facility, so that the patient can control the disclosure range of medical information. it can. In addition, the latest medical information can be transferred without imposing a heavy load on the server that distributes the medical information.

  Since the setting information update unit that receives the update request for the setting information registration table via the communication network and updates the setting information registration table is provided, the patient's intention can be easily reflected in the setting of the disclosure range.

  By recording the history information including the distribution history, it is possible to prevent the medical information from being disclosed to the public. In addition, since the history information can be referred to via a communication network, the suppression effect can be further improved.

  The setting information registration table integrates and manages a plurality of setting information corresponding to medical information of the same patient held in a plurality of medical facilities, so that the disclosure range can be easily set.

  FIG. 1 is an explanatory diagram of a medical network connecting a data center 10 and medical facilities 11 and 12. The medical facilities 11 and 12 are, for example, small-scale medical facilities such as clinics, and the data center 10 provides medical application support to the medical facilities 11 and 12 by providing various application services.

  The application service includes, for example, a data backup service that stores patient medical information held by each of the medical facilities 11 and 12, and an examination reservation service that supports examination reservations of a large-scale medical facility having advanced examination equipment. In addition to these services, the data center 10 distributes medical information of a patient (referred patient) 13 to be referred to when a patient is introduced between the medical facilities 11 and 12. Provide service. Such an application service is provided to a medical facility that has a service use contract with the data center 10 in advance. In this example, for convenience, the number of medical facilities is described as two, but the number of medical facilities may be three or more.

  A server computer 14 is installed in the data center 10, and the server computer 14 is communicably connected to client terminals 11 a and 12 a installed in the medical facilities 11 and 12 via the communication network 15. The server computer 14 is installed with various programs for executing processing corresponding to the application service and data necessary for executing the processing. The processing is performed according to requests from the client terminals 11a and 12a. Execute.

  The storage unit 16 stores medical facility information such as the ID, address, contact information, and address of each of the medical facilities 11 and 12, and also serves as backup data for medical information, schedule data for examination reservations, and medical information distribution services. Various data necessary for executing each application service, such as necessary data, are stored.

  Each medical facility 11 and 12 has medical information of each patient, and the medical information is stored in each medical information DB 11b and 12b connected to each client terminal 11a and 12a. When the data backup service is used, for example, the data of the medical information DBs 11 b and 12 b are uploaded through the communication network 15 and stored in the data center 10.

  The communication network 15 is, for example, the Internet or a public IP (Internet Protocol) network provided uniquely by a communication carrier. A VPN (Virtual Private Network) using encryption technology such as IPsec (Internet Protocol Security) is constructed between the data center 10 and each of the medical facilities 11 and 12 based on the communication network 15. By constructing the VPN, a logical dedicated communication channel 15a is established between the server computer 14 and each of the client terminals 11a and 12a, and data communication is performed through each communication channel 15a.

  Since the data passing through the communication channel 15a is encrypted, the medical information is not leaked to the outside. Since VPN uses a public network that is open to an unspecified number of users, there is an advantage that information security can be secured at a lower cost than a dedicated network that uses a physical dedicated line. Although the cost is higher than that of VPN, instead of using VPN, a dedicated line may be laid between the data center 10 and each of the medical facilities 11 and 12 to ensure information security.

  As described above, a communication environment in which information security measures are taken is established between the data center 10 and each of the medical facilities 11 and 12, but as described above, between the medical facilities 11 and 12, the medical facility 11, It is difficult to maintain such a communication environment between the twelve. Therefore, the medical facilities 11 and 12 deliver the referral patient's medical information via the data center 10 using the medical information distribution service. Thereby, safe medical information can be exchanged between the medical facilities 11 and 12.

  About the medical information handed over by the medical information distribution service, the introduction patient 13 can control the disclosure range. For example, assume that the referral source medical facility 11 is A orthopedic surgery and the referral destination medical facility 12 is B General Hospital. The medical chart included in the medical information of A orthopedic surgery describes the orthopedic part of the referral patient 13, etc. For the referral patient 13, the disclosure range of the medical information is kept to the minimum necessary and more information than necessary. There is a strong desire to prevent being released. Also, if you have acquired test data such as electrocardiograms, CR (Computed Radiography) test images, and sample test results in A orthopedic practice, B General Hospital will be able to consult you if you can acquire such test data. There is a possibility that it can proceed efficiently, which is preferable.

  The storage unit 16 of the data center 10 stores setting information for determining the disclosure range of such medical information, and the data center 10 distributes the medical information to the referral destination within the permitted range according to the contents. To do. For example, the setting of the open range can be changed by connecting to the data center 10 through the medical facility where the referral patient 13 consulted, and the data center 10 directly from the mobile terminal of the referral patient 13 or a terminal device 17 such as a PC. Can be connected and changed. As a result, since the minimum necessary medical information is disclosed to the referral destination in accordance with the intention of the referral patient 13, a desirable result can be obtained for both the referral patient 13 and the referral destination medical facility.

  FIG. 2 is an explanatory diagram of the server computer 14 and the storage unit 16. The server computer 14 is connected to a communication I / F (interface) 18 that is connected to the communication network 15 and performs communication control. The communication I / F 18 is, for example, a router, and performs communication control using the VPN with the client terminals 11a and 12a and communication control with the terminal device 17 of the referral patient 13.

  The storage unit 16 is provided with a common information DB 22, a setting information registration table 22, and a history information storage unit 24. The common information DB 22 includes medical facility information related to medical facilities and patient information of each medical facility, and these are information commonly used in a plurality of application services. Patient information consists of patient ID, patient name, age, and sex. Patient information and medical facility information are registered when the service of the data center 10 is used.

  The setting information registration table 23 and the history information storage unit 24 store information used in the medical information distribution service. The setting information registration table 23 is a storage unit that stores preliminarily registered setting information of the disclosure range of medical information. The setting information registration table 23 stores setting information for each patient. The setting information for each patient is managed by an integrated ID. The integrated ID is a combination of a medical facility ID and a patient ID assigned to each medical facility. For example, the medical facility ID is “009”, and the patient ID assigned to the medical facility is “1000”. Then, “009-1000” is obtained by combining these.

  When one patient is examined at a plurality of medical facilities, patient IDs are issued at the respective medical facilities, so that an integrated ID can be generated for each patient. With the registered integrated ID as a representative ID, the medical information of other medical facilities is also managed by the representative ID. For example, as shown in FIG. 2, for the patient whose representative ID is “009-1000”, the medical information of A orthopedic surgery and the medical information of B General Hospital are managed under the representative ID.

  The setting information registration table 23 stores a representative ID and an integrated ID for each medical facility in association with each other. The representative ID is searched from the integrated ID, or the representative ID is associated with the representative ID. It is also possible to search for a plurality of integrated IDs. The setting information registration table 23 can accept access from the terminal device 17 and change its contents. At that time, the patient ID is transmitted from the terminal device 17, but even if the patient ID is not the representative ID, the integrated ID and the representative ID are associated with each other, so that the setting for updating or browsing is desired. It is possible to access information.

  When the data center 10 receives the medical information of a patient with the same surname, for example, the operator of the data center 10 inquires of the patient through the medical facility whether the medical information belongs to the same person. To confirm. In addition, when identification information that can identify each individual is assigned in the future, the identity of the patient may be automatically determined based on the identification information.

  Medical information is registered for each individual item of medical record, examination data 1 (electrocardiogram), examination data 2 (CR examination), examination data 3 (specimen examination), and the disclosure range is disclosed for each individual item. It is set as “Yes” or “No”. In this example, for example, regarding medical information on A orthopedic surgery, the medical record is not disclosed and the other examination data 1 to 3 are disclosed.

  The history information storage unit 24 stores an introduction history 24a and a distribution history 24b. When the referral medical facility introduces the medical facility to the patient, the referral source reports to the data center 10 through the client terminal that the referral act has been performed. The introduction history 24a records such a report, and one record includes an introduction source, an introduction destination, an introduction patient name, and the like. The introduction history 24a is a proof that the referral medical facility has a legitimate access authority to the referral source medical information DB when viewed from the referral source medical facility. This is the basis for having a legitimate access authority. By granting access authority in this way, unauthorized access is prevented.

  When performing an introduction act, it is normal to send an introduction letter from the introduction source to the introduction destination. However, the data center 10 acts as a proxy for sending the introduction letter to the introduction destination based on the report. It may be. In this way, the referral source does not need to send a referral letter to the referral destination separately from the report to the data center 10.

  The distribution history 24b is a history of medical information distribution requests (medical information distribution requests) transmitted from the referral medical facility to the data center 10, and contents distributed to the referral destination by the data center 10 based on the distribution requests. It is a record of (what kind of medical information). Each record includes a delivery request date and time, a delivery date and time, a requesting medical facility ID, a medical facility ID from which medical information is acquired (patient referral source), and the like. Such distribution history 24b is distributed based on an inquiry request from a medical facility. By recording the distribution history in this way, unauthorized access is suppressed.

  When executing the medical information distribution service, the CPU 26 of the server computer 14 functions as an introduction history check unit 26a, a medical information distribution unit 26b, a history information management unit 26c, and a setting information management unit 26d. When receiving the medical information distribution request, the introduction history check unit 26a checks the introduction history 24a to check whether there is an introduction act. Thereby, it is checked whether or not the request source has a legitimate access authority, and unauthorized access is prevented.

  Based on the medical information distribution request, the medical information distribution unit 26b acquires the medical information of the target patient to be introduced by accessing the medical information DB of the referral source, and distributes the acquired medical information to the referral destination. As a result, the medical information is transferred from the referral source to the referral destination. The medical information distribution unit 26b refers to the setting information registration table 23, checks the setting information of the medical information of the introduced patient, and examines the range of disclosure or non-disclosure. Then, the medical information is acquired from the referral source within a range permitted to be disclosed and distributed to the referral destination.

  The history information management unit 26c records the introduction history 24a and the distribution history 24b, accepts such a history inquiry request, and distributes the history information to the request source. The history inquiry request includes the request source ID, and the history information management unit 26c extracts the history information corresponding to the request source ID from the history information storage unit 24 and distributes it. Such history information can be used by medical facilities for various purposes, such as management of expenses and the like that accompany patient introduction.

  The setting information update unit 26d updates the setting information registration table 23. As illustrated in the flowchart of FIG. 3, the setting information update unit 26 d transmits a setting screen to the terminal device 17 when receiving a setting information update request from the patient terminal device 17 or the like. The setting information update request includes a patient ID, and the setting information update unit 26d responds to the terminal device 17 with a setting screen corresponding to the patient ID based on the patient ID.

  Through the setting screen, the patient checks the information that is permitted to be disclosed and the information that is not permitted to be disclosed (not disclosed), and inputs the update information. The update information thus input is transmitted to the server computer 14. When the setting information update unit 26d receives the update information, the setting information update unit 26d updates the setting information registration table 23 based on the information.

  Thereby, the patient can control the disclosure range of his medical information. Further, since the setting information registration table 23 manages and manages the medical information held in a plurality of medical facilities, the setting information of the plurality of medical facilities can be updated collectively on the setting screen. Yes. For this reason, there is no need to re-login and change each medical facility, and the setting information can be easily updated.

  Moreover, since the setting information update unit 26d can directly receive an update request from the terminal device 17 without going through a medical facility, it can be easily accessed from a patient. If the setting information can be updated only through the medical facility, it is necessary to go to the medical facility only to update the setting information, which greatly reduces the convenience for the patient. By doing so, such concerns are eliminated.

  For example, such setting information is transmitted after being encrypted, but the security level is lowered as compared with the communication between the client terminal and the server computer 14. However, since the setting information is not medical information itself, there is a low demand for increasing the security level. Of course, the security environment is appropriately set as necessary, such as data communication using a telephone line with a higher security level than the Internet, and communication using encryption technology with a higher security level. May be maintained.

  The operation of the above configuration will be described below based on the flowchart shown in FIG. When the medical facility (A orthopedic surgery) 11 introduces the medical facility (B General Hospital) 12 to the patient, the medical facility (A orthopedic surgery) 11 reports to the data center 10 that the patient has been introduced. Upon receiving this report, the server computer 14 updates the introduction history 24a. When the referral patient's medical information (referred to as a referral medical facility) owned by the referral source is necessary, the referral medical facility (B General Hospital) 12 transmits a medical information distribution request to the data center 10 through the client terminal 12a.

  When the server computer 14 receives the medical information distribution request, first, the introduction history check unit 26a checks the introduction history 24a with reference to the introduction history 24a. If there is no introduction history, the request source is notified that there is no introduction history, and distribution is rejected. When there is an introduction history, the medical care information distribution unit 26b refers to the setting information registration table 23 and checks the setting information of the introduced patient. As a result, the disclosure range of the referral patient's medical information held by the referral source medical facility 11 is confirmed. Thereafter, the medical care information distribution unit 26b accesses the medical care information DB 11b of the referral source medical facility 11, acquires the referral patient's medical information that can be disclosed, and distributes it to the referral destination medical facility 12.

  Since the medical information is disclosed within a range set by the patient, there is no possibility that medical information unintended by the patient is disclosed to the public and leaked to the outside. In addition, since the medical information is not transferred directly between the medical facilities, but passed through the data center 10 through the communication channel 15a, information security is ensured.

  Moreover, since the medical information is acquired by accessing the medical information DB of the medical facility when the distribution request is received, the latest medical information can be delivered. In addition, this eliminates the need to constantly update the medical information (backup data) held by the data center 10 so that the load on the server computer 14 and the load on the communication environment can be greatly reduced. .

  In the above embodiment, the example of the medical information distribution apparatus has been described. However, the scope of the present invention naturally includes not only the apparatus but also a method and a program.

It is explanatory drawing of a medical network system. It is explanatory drawing of a server computer. It is a flowchart which shows a setting information update procedure. It is a flowchart which shows a medical treatment information delivery procedure.

Explanation of symbols

10 Data Center 11, 12 Medical Facility 11a, 12a Client Terminal 11b, 12b Medical Information DB
14 server computer 15 communication network 15a communication channel 16 storage unit 18 communication I / F
22 Common information DB
23 Setting Information Registration Table 24 History Information Storage Unit 24a Introduction History 24b Distribution History 26 CPU
26a Introduction history check part 26b Medical information distribution part (Medical information distribution part, setting information check part)
26c Setting information update unit 26d History information management unit (history information recording unit, history information distribution unit)

Claims (7)

In response to a request from a referral medical facility when a patient is introduced between each of the medical facilities connected to a plurality of medical facilities that hold patient medical information including medical chart information and examination data. In the medical information distribution apparatus for distributing the medical information of the patient to be referred to the referral medical facility,
A setting information registration table in which public or non-public setting information is registered with respect to the medical information held by each medical facility;
Setting information check for examining the disclosure range or non-disclosure range of the medical information that is the target of the distribution request with reference to the setting information registration table when the distribution request for the medical information is received from the referral medical facility And
A medical information distribution unit that acquires the medical information from the referral source medical facility within a range permitted to be disclosed, and distributes the medical information to the referral medical facility;
A medical information distribution apparatus comprising: a history information recording unit that records a distribution request history of the referral destination medical facility.   The medical information includes medical record data and examination data as individual items, and the setting information registration table can be set to be public or private for each individual item. Medical information distribution device.   3. The medical information distribution apparatus according to claim 1, further comprising a setting information update unit that receives an update request for the setting information registration table via the communication network and updates the setting information registration table.   The medical information distribution apparatus according to any one of claims 1 to 3, wherein the history information recording unit records a distribution request date and time, a medical facility ID of the request source and a request destination, and contents of the distributed medical information. .   The medical information distribution apparatus according to any one of claims 1 to 4, wherein the history information further includes an introduction history that is reported from a referral source medical facility and indicates that a patient has been introduced.   6. The medical information distribution apparatus according to claim 4, further comprising a history information distribution unit that receives an inquiry request for the history information via the communication network and distributes the history information.   The said setting information registration table integrates and stores several setting information corresponding to the medical information of the same patient held in several medical facilities, The medical information delivery in any one of Claims 1-6 characterized by the above-mentioned. apparatus.

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