JP2009134424A - Medical inspection support system and medical inspection support method - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a medical inspection support system that reduces wait time for inspection, presents the order of inspection and wait time to patients, and is capable of performing notification when the order of inspection or wait time changes. <P>SOLUTION: The medical inspection support system includes: a plurality of pieces of medical inspection equipment connected via a network; a distribution section for distributing inspection by predicting time required for inspection in a plurality of pieces of inspection equipment and selecting inspection equipment having a small amount of wait time for a person to be inspected; and an information management section for setting the order of inspections and calculating time required for each inspection item, and generating transmission information including information on the order of inspection and wait time for each person to be inspected. The transmission information generated by the information management section can be displayed at a terminal device for providing information. <P>COPYRIGHT: (C)2009,JPO&INPIT

Description

  The present invention relates to a medical examination support system and a medical examination support method capable of reducing the waiting time for examination in a medical examination using a radiographic apparatus and the like and providing the examination order, waiting time, etc. to the subject. It is about.

 Generally, in medical institutions, diagnostic imaging apparatuses such as an X-ray CT apparatus (X-ray computed tomography apparatus), an MRI apparatus (magnetic resonance imaging apparatus), and an X-ray imaging apparatus are used. Also, image file communication storage systems such as HIS (Hospital Information System) that manages information in medical institutions, RIS (Radiology Information System) that manages information in radiology, or PACS (Picture Archiving Communication System) are built. As a result, online information transmission is being promoted. As a result, it is possible to manage the reservation reception of medical image photographing orders, the use status of medical devices, and the like.

  By the way, conventionally, when an imaging order reservation is received, an examination room is determined according to an examination pattern such as a head and a chest, and sorting is performed so that an examination is performed in one of a plurality of examination rooms. However, the conventional sorting method does not take into account the patient's waiting situation, and there is a problem that only a specific examination room is congested when similar examinations are continuously received.

  There are several examples of other factors that increase the waiting time. For example, there are cases where the number of examination items for a patient increases more than expected, or the examination room is occupied due to deterioration of the patient's physical condition. Further, since the proficiency level is different for each inspection engineer, it takes time when an inexperienced engineer performs the inspection. Furthermore, the waiting time also increases when the number of patients is too large compared to the number of laboratory technicians.

  For this reason, various systems have been proposed to reduce patient waiting time. For example, Patent Document 1 describes medical imaging that guides the imaging room with the least waiting time by calculating the average inspection time for each imaging technician, examination site, and imaging room, and calculating the waiting time for each imaging room. The system is described.

  However, the waiting time of the patient can be shortened by sorting the imaging rooms in the past, but there is no room for providing information on the examination order and waiting time for the patient, so there is still room for further improvement. Yes.

For example, the patient himself / herself does not know how long it will take to wait, so he / she waits in a waiting room or examination room in a medical institution. In particular, when a plurality of inspections are performed on the same day, after one inspection is completed, a waiting time is generated even in the next inspection. Also, if the previous patient's examination is prolonged, the waiting time also becomes long, and waiting for a long time at the same place becomes a factor that irritate the patient.
JP 2007-202678 A

  In the conventional examination support system, although a certain amount of contrivance has been made to shorten the waiting time of the patient, it is impossible to present how long the waiting time is for the patient. I often waited for a long time in the same place such as an examination room.

  The present invention has been made in view of the above circumstances, and reduces the waiting time for the examination, calculates the waiting time for the examination for each examination device, presents the examination order and the waiting time to the patient, and changes the examination order. When there is, it aims at providing the medical examination support system and medical examination support method which enabled notification of that.

  The medical examination support system of the present invention according to claim 1 predicts a plurality of medical examination devices connected via a network and time required for the examination with the plurality of examination devices, Selecting an inspection device with a low waiting time and sorting the inspection, and setting the order of the plurality of inspections when the inspected person requires a plurality of inspections including inspection by the selected inspection device An information management unit that calculates a required time for each inspection item and generates transmission information including information on the inspection order and waiting time for each person to be inspected, and transmits the transmission information generated by the information management unit It is possible to display on the terminal device for provision.

  The medical examination support method of the present invention according to claim 7 comprises a plurality of medical examination devices connected via a network, predicting the time required for examination with the plurality of examination devices, Select an inspection device with a low waiting time for the inspected person, sort the inspection, and when the inspected person requires a plurality of inspections including inspection by the selected inspection device, set the order of the plurality of inspections, Calculating a required time for each of the plurality of inspection items, generating transmission information including information on the inspection order and waiting time for each person to be inspected, and displaying the generated transmission information on a terminal device for providing information It is characterized by.

  According to an embodiment of the present invention, when a plurality of examinations are required, the person to be inspected can be allocated to an examination room with a short waiting time. In addition, the inspection order and the waiting time required for each inspection can be provided to the inspected person in real time, and even if the inspection order and the waiting time are changed, the inspected person can confirm it.

  Hereinafter, an embodiment of the present invention will be described in detail with reference to the drawings.

 FIG. 1 is a system diagram showing a configuration of a medical examination support system of the present invention.

 In FIG. 1, reference numeral 100 denotes an HIS (Hospital Information System) configured in a medical institution such as a hospital, and the network 110 is connected to terminal devices 121, 122. The department includes a reception department, a medical department, a medicine department, an accounting department, and the like. In the following description, a case where the reception department 121 and the medical department 122 are connected to the network 110 will be described as an example.

Further, for example, a physiological examination department 131, a specimen examination department 132, and the like are connected to the network 110 as examination departments. The physiological examination department 131 performs an electroencephalogram, an electrocardiogram examination and the like. The specimen testing department 132 performs blood tests, urine tests, etc. Reference numeral 200 denotes an RIS (Radiology Information System), which is an image diagnostic apparatus connected to the network 210, such as an X-ray CT apparatus 220, an MRI apparatus 230, It manages the X-ray imaging apparatus 240, the reception apparatus 250, and the like. These X-ray CT apparatus 220, MRI apparatus 230, X-ray imaging apparatus 240, etc. are each arranged in the examination room.

 A PACS (Picture Archiving Communication System) 260 is connected to the network 210, and an image database 270 is connected to the PACS 260. The RIS 200 and the PACS 260 are also connected to the network 110 of the HIS 100. Further, the information management terminal 10, the information terminal 11, and the communication device 12 are connected to the network 110, and the RIS server 20 is connected to the network 210.

 The information management terminal 10 is operated by a user (doctor, engineer, etc.) on the medical institution side, and constitutes an information management unit that manages patient waiting time and the like. The information terminal 11 is a terminal device for providing information that can be operated by the patient, and is used when the patient himself / herself confirms the order of examination, waiting time, and the like. The communication device 12 transmits information to a mobile terminal 13 managed by a medical institution or a mobile terminal (mobile phone or the like) 14 owned by an individual patient.

  On the other hand, the receiving device 250 has an input unit and a display unit, and can access the RIS server 20 via the network 210. When the patient needs to be imaged, the accepting device 250 inputs a radiographic imaging examination pattern (imaging type, examination site, etc.) according to the patient's condition and accepts a reservation for a medical image imaging order.

  In the following description, imaging of medical images by the image diagnostic apparatuses 220 to 240 and various types of examinations by the examination departments 131 and 132 may be collectively referred to as examinations. A patient to be examined is called an examinee. Furthermore, an image diagnostic apparatus that performs imaging and devices that perform various inspections may be collectively referred to as inspection devices.

 The RIS server 20 constitutes a distribution unit, receives an imaging order from the accepting device 250, checks the usage status of each examination room (imaging room), and calculates the waiting time of the patient for each examination room. A calculation process is performed to distribute the execution of the inspection to one of a plurality of inspection rooms. The RIS server 20 includes a database 30 including a plurality of tables and a calculation unit 40 that performs calculation processing, and determines an examination room with the smallest waiting time.

 The RIS server 20 has a configuration as shown in Patent Document 1, but the configuration and functions of the RIS server 20 will be briefly described below.

  FIG. 2 is a block diagram showing a configuration of various tables in the database 30 in the RIS server 20 and a calculation unit 40 for automatically allocating examination rooms.

  The database 30 includes an examination room master table 31, an engineer master table 32, a part master table 33, an executable examination room master table 34, an average examination time management table 35, and an execution result management table 36. The calculation unit 40 also calculates a first logic unit 41 that calculates an average examination time for a predetermined period (for example, the previous month) for each imaging technician, examination region, and examination room, and calculates a current waiting time for each examination room. It has the 2nd logic part 42 which determines an examination room.

  Each master table 31 to 33 stores various data for each examination room, imaging technician, and examination site. The master table 34 stores various data for designating examination rooms that can be imaged for each examination pattern. As the storage data, for example, data of a laboratory that can perform imaging according to an inspection pattern such as an imaging type, an inspection site, an imaging method, an imaging direction, and the presence / absence of a contrast medium is stored. When there are a plurality of examination rooms where imaging can be performed, all are stored.

  Further, the table 35 stores inspection time data for each imaging technician, inspection region, and inspection room, and the data is updated every predetermined period (for example, one month). This examination time data is used when calculating the waiting time for each examination room. In the execution result table 36, data of an imaging start time and an imaging end time are stored as examination time data required for examination imaging for each examination room, engineer, and part.

  FIG. 3A is a flowchart for explaining the operation of the first logic unit 41 for calculating the average inspection time. In FIG. 3A, in step S1, a record in the table 36 is searched to determine whether it is data of the previous month. If it is the determination data (YES) of the previous month, the process proceeds to the next step S2, and the examination time for each imaging technician, examination site, and examination room is calculated.

  This inspection time is calculated by subtracting the inspection start time from the inspection end time to determine the inspection time. If there are multiple inspections for the previous month, add the inspection times for the previous month to obtain the total inspection time for the previous month. Σ is obtained and divided by the number of examinations, and the examination time per previous month is calculated for each imaging technician, examination site, and examination room. In step S3, the result calculated in step S2 is registered in the table 35. Thus, the average inspection time is automatically calculated periodically.

  FIG. 3B is a flowchart for explaining the operation of the second logic unit 42 that determines the examination room by predicting the current waiting time for each examination room. In this flow, the current waiting time of an examination room where imaging can be performed is calculated at the time of reception.

  In FIG.3 (b), in step S11, the presence or absence of the laboratory which can implement imaging | photography is discriminate | determined. Here, a determination is made as to whether the examination room is ready or a radiographer is present, and candidate examination rooms that can perform imaging are selected. That is, referring to the table 34, an examination room where the acceptance order can be photographed is extracted. In step S12, the waiting time is calculated for each examination room that can be photographed from the examination contents of the current waiting patient with reference to the examination time (table 35) obtained previously for each examination room selected. In step S13, the examination room with the shortest waiting time is determined.

The calculation result is displayed on the display unit of the accepting device 250 and guides the patient to the examination room. Thereby, the execution of the examination can be distributed to the examination room with the smallest patient waiting time. In each laboratory, when imaging is completed, an engineer inputs an end and transmits it to the RIS server 20 via the network 210.
In this way, when assigning examination rooms, the waiting time for each examination room is calculated based on the examination pattern of the patient's imaging type, examination site, etc., and the examination time for each examination site and examination room by the imaging technician. Therefore, the patient can be guided to the laboratory with the least waiting time. In addition, since the imaging | photography condition in each laboratory is sent to the RIS server 20 via the network 210, when imaging | photography deviates from a plan, a laboratory can be changed according to it.

  Even an inexperienced engineer is expected to shorten the inspection time as he gains experience, but by updating the total data of the inspection time every predetermined period, for example, every month, the latest Since the inspection time can be calculated based on the data, the waiting time can be calculated appropriately.

  As described above, the RIS server 20 can automatically distribute examination rooms even when the same examination is continuously received. In addition, since the average examination time is managed by the imaging technician, the examination site, and the examination room, it is possible to calculate the waiting time according to the examination characteristics and the technician's ability.

  Next, functions of the information management terminal 10 will be described.

  The information management terminal 10 is connected to the reception department 121, the medical department 122, and the examination departments 131 and 132 via the network 110, and is further connected to the RIS server 20 via the RIS 200 and the network 210. As a result, the waiting time information calculated by the RIS server 20 is taken into the information management terminal 10.

 In the medical department 122, the doctor determines what kind of specimen test is necessary and what kind of image photographing is necessary according to the condition of the patient, and notifies the related department. In addition, information on inspection items is sent to the information management terminal 10.

  In addition, the physiological examination department 131 performs an electroencephalogram, an electrocardiogram examination, and the like, and for these examinations, it is possible to perform laboratory distribution and calculation of examination waiting time by using the same method as the RIS server 20. The calculated information is taken into the information management terminal 10.

  Furthermore, in the specimen test department 132, blood tests, urine tests, and the like are performed. Since these tests generally do not take much time, the test time can be set based on statistical data. Therefore, the waiting time can be calculated by multiplying the number of people to be inspected and the inspection time. These pieces of information are also taken into the information management terminal 10.

 The information management terminal 10 determines the inspection items of the person to be inspected and the order of inspection based on the acquired information. For example, when a plurality of examinations such as photographing by an image diagnostic apparatus and blood examination are required, the order of each examination is set. In this case, the order of inspection can be changed by analyzing the time required for each inspection.

 For example, when an X-ray imaging test and a blood test are necessary, if X-ray imaging takes a long time, it is possible to schedule such that the blood test is interrupted between the waiting times. Of course, when there are a plurality of inspections and the order of the inspections cannot be changed, the inspections are performed according to the order.

 In this way, the information management terminal 10 sets the order of the inspection for the person to be inspected, and generates transmission information including information on the order of the inspection and the waiting time of each inspection. In addition, when there is a change in the inspection order, waiting time, examination room, etc., the transmission information is changed. Thus, transmission information is generated for each person to be inspected and transmitted from the information management terminal 10 to the information terminal device.

  As a means for notifying the inspected person of the transmission information, there is a method of displaying on the bulletin board in the waiting room. In the embodiment of the present invention, for providing information as described in the following (1) to (3) Notification is made using a terminal device.

  (1) Information is provided to the examinee using the information terminal 11 installed in the medical institution. In this case, the person to be inspected inputs patient identification information, for example, a patient name and a patient ID, and the information management terminal 10 provides only information on the person to be inspected, such as the order of examination and waiting time. Alternatively, by inserting an ID card (an identification medium such as a magnetic card or an IC card) 15 provided to the patient by the medical institution side into the information terminal 11, information is provided only to the subject. Also good. By arranging the information terminal 11 in various places in the medical institution, the patient can obtain information at an arbitrary place.

  In addition, when the examination order or the waiting time is changed, the information management terminal 10 generates transmission information in a format that can display an alert. This facilitates confirmation on the display unit. In addition, information for guiding the examination room may be included in the transmission information.

  (2) The portable terminal 13 managed by the medical institution side is given to the examinee, and the examinee inputs the terminal-specific number and the patient identification number (ID), so that only the examinee has the information management terminal 10 Providing communication information from In this case, the communication device 12 is used. The communication device 12 transmits information between the information management terminal 10 and the mobile terminal 14 by wireless communication.

  Then, when the examinee inputs the patient identification number (ID), the information management terminal 10 is accessed via the communication device 12, and the information from the information management terminal 10 is displayed on the display unit of the portable terminal 13 as The inspection order of the subject and the waiting time for each inspection are displayed. When the inspection order or waiting time is changed, the alert function is used to display the change. In addition, guidance for the examination room may be displayed. In (1) and (2), the patient ID may be set by the reception department 121 and registered in the management information terminal 10.

  (3) Information is provided using a portable terminal 14 (for example, a cellular phone) owned by the examinee. Also in this case, the communication device 12 is used. The communication device 12 includes, for example, a server capable of mail communication with the mobile terminal 14, stores information such as the inspection order and the waiting time of each inspection in the server, and stores the information in the server using the mobile terminal 14. It is intended to take out the data.

  In this case, the medical institution side provides the patient with information (for example, URL and ID and password necessary for information disclosure) that can be accessed with security maintained, and the examinee himself / herself provides the access information to the portable terminal 14. By inputting, information is provided.

  In this way, the inspected person is notified of the inspection order, information on the waiting time for each inspection, and information on changes in the inspection order and waiting time.

  Next, the operation | movement of the principal part of the medical examination assistance system of this invention is demonstrated with reference to the flowchart of FIG.

  FIG. 4 shows an operation flow when an examination is performed using the image diagnostic apparatuses 220 to 240. In step S21, the reception apparatus 250 performs reception processing and registers image inspection reservation information. For example, a radiographic imaging examination pattern (imaging type, examination site, etc.) is input according to the patient's condition, and a reservation for a medical image imaging order is received.

 In the next step S22, image examination reservation information is acquired by the RIS server 20, and an image diagnostic apparatus capable of handling a patient examination is selected based on the imaging order. In the next step S23, the usage status of the apparatus (examination room) is checked. Here, the RIS server 20 calculates the waiting time of the patient for each examination room according to the flowchart of FIG. 3B described above, determines the examination room with the smallest waiting time, and distributes the execution of the examination.

 In the next step S24, the receiving device 250 transmits reservation information to the assigned examination room (device waiting for imaging). On the other hand, in parallel with this, the information management terminal 10 obtains the waiting time information calculated by the RIS server 20, and provides the examination order and the congestion degree information (waiting time information) to the examinee in step S25. .

 Further, when examinations in the examination departments 131 and 132 are required, the examination rooms are allocated by the same method, and information such as the examination order and waiting time is provided to the patient.

 On the other hand, as a method for providing information to the patient, it is preferable to confirm the patient's desire at the time of reception at the reception department 120 and select the methods (1) to (3) described above. Since the examinee may not have the mobile phone 14, in general, a method of using equipment on the medical institution side such as the information terminal 11 or the mobile terminal 13 is suitable. In this case, the reception department 120 sets an ID and a password for each patient and passes the ID card 15 to the patient or teaches the patient the ID and password, so that the patient can set the waiting time and the order of examination at an arbitrary place. It becomes possible to know.

 The waiting time and the examination order are sequentially updated when the examination of the previous patient is completed. Therefore, when the waiting time of the patient is reduced, the information is checked again using the information terminal 11 and the portable terminals 13 and 14. For example, you can confirm that the time for examination is approaching, and you can go to the laboratory. Therefore, there is no need to wait in a specific place such as a waiting room. Further, even when the examination of the previous patient is extended and the waiting time is changed, it can be known in advance by checking the change information. In this way, when it is time for its own inspection, inspection / imaging is performed in step S26.

  FIG. 5 is a flowchart showing the operation of the medical examination support system when the examinee performs a plurality of examinations such as “simple X-ray imaging examination” and “blood examination”.

 In FIG. 5, in step S <b> 31, the examination item of the examinee is input in the medical department 122. For example, if “simple X-ray examination” and “blood test” are necessary, these items are input.

 In the next step S32, the time required for inspection is calculated for each inspection apparatus such as an image diagnostic apparatus. That is, here, for example, the examination room with the shortest waiting time is determined by the RIS server 20 and the examination rooms are sorted. At this time, information on the required time and waiting time for the examination is calculated for each person to be examined. If another test, such as a blood test, is necessary, the specimen test department 132 calculates the required time. If there are many persons to be inspected, the waiting time is determined accordingly.

 In step S33, the required time information and the waiting time information are sent to the information management terminal 10, and the information management terminal 10 determines the inspection order for each person to be inspected in consideration of the waiting time. Register each waiting time.

 In the next step S34, the inspected person confirms the inspection order and the waiting time. Here, for example, the person to be inspected logs in by inputting his / her ID using the information terminal 11 or inserting the ID card 15 and confirms his / her inspection order and waiting time displayed on the information terminal 11. It will be.

  After that, in step S35, the person to be inspected goes to the examination room when his / her examination or photographing time comes, and the examination is performed. In step S36, the inspection is terminated.

  The above operations are described in the case where the inspections are performed in the order set at the beginning and there is no change in the waiting time. See FIG. 6 for the operation when the waiting time is changed in the middle. To explain. The change in the waiting time occurs when an emergency patient imaging is incorporated or the previous subject's imaging is prolonged.

  In FIG. 6, Steps S41 to S45 are the same as Steps S31 to S35 in FIG. 5. However, for example, if the inspection is prolonged more than planned in Step S45, the waiting time is changed in Step S46.

  When there is a change in the waiting time, the inspection departments 131 and 132, the RIS server 20, and the like return to step S42 and recalculate the required time and waiting time for the inspection for each person to be inspected. Further, when the imaging time of the previous patient is prolonged in imaging by the diagnostic imaging apparatus, the examination order may be changed so that another examination is interrupted in the meantime, and in step S43, the corrected examination order and The waiting time is newly registered.

  The inspection order and waiting time thus changed can be notified to the subject. In this case, the alert function may notify that there has been a change. As a result, the subject can easily confirm that there has been a change.

  As described above, according to an embodiment of the present invention, when there are a plurality of inspection items, the inspection rooms can be allocated with the shortest waiting time based on the degree of congestion of the inspection equipment and the skill of the inspection engineer. In addition, since the inspection order and the waiting time required for each inspection can be provided to the inspected person in real time, the inspected person can know his / her inspection order and waiting time at an arbitrary place. Further, even if there is a change in the inspection order or waiting time, the inspected person can confirm it, and the inspected person can efficiently receive the inspection.

 The present invention is not limited to the above description, and various modifications can be made without departing from the scope of the claims.

1 is a system diagram showing a medical examination support system according to an embodiment of the present invention. The block diagram which shows the structure of the distribution part in one Embodiment of this invention. The flowchart explaining operation | movement of the distribution part in the embodiment. The flowchart explaining operation | movement of the principal part of the medical examination assistance system which concerns on one Embodiment of this invention. The flowchart explaining the whole operation | movement of the medical examination assistance system which concerns on one Embodiment of this invention. The flowchart explaining operation | movement when there exists a change of waiting time in the same embodiment.

Explanation of symbols

DESCRIPTION OF SYMBOLS 10 ... Information management terminal 11 ... Information terminal 12 ... Communication apparatus 13, 14 ... Portable terminal 15 ... Identification medium 20 ... RIS server (sorting part)
30 ... Database 40 ... Calculation unit 100 ... HIS
110 ... Network 121, 122 ... Terminal devices 131, 132 of each department ... Inspection department 200 ... RIS
210 ... Network 220 to 240 ... Diagnostic imaging device (inspection equipment)
250. Reception device

Claims (10)

A plurality of medical testing devices connected via a network;
Predicting the time required for the inspection with the plurality of inspection devices, selecting a test device with a low waiting time of the person to be inspected, and a distribution unit for distributing the inspection,
When the person to be inspected requires a plurality of inspections including an inspection by the selected inspection device, the order of the plurality of inspections is set and the required time is calculated for each inspection item, and the inspection order and waiting time information An information management unit that generates communication information including for each subject,
A medical examination support system, characterized in that the transmission information generated by the information management unit can be displayed on a terminal device for providing information.   The sorting unit is an inspection engineer in a plurality of inspection rooms equipped with the inspection device, a database storing average inspection time data for each inspection region, and an inspection waiting time based on the average inspection time data stored in the database. The medical examination support system according to claim 1, further comprising: an arithmetic unit that calculates and selects an examination device with a short time.   The medical examination support system according to claim 1, wherein the information management unit generates the changed transmission information when at least the examination order and the waiting time of the subject are changed.   4. The medical care according to claim 3, wherein the information management unit generates the changed transmission information in a form capable of displaying an alert when at least the examination order and the waiting time of the subject are changed. Inspection support system.   The information providing terminal device is an information terminal connected to the network, and the examinee inputs identification information to the information terminal or accesses the information management terminal by inserting an identification medium. The medical examination support system according to claim 1, wherein the transmission information can be acquired. A communication device that wirelessly communicates the transmission information generated by the information management unit to the information providing terminal device;
The medical examination support system according to claim 1, wherein the communication device transmits the transmission information for each patient using identification information set for each patient. A plurality of medical testing devices connected via a network;
Predicting the time required for the inspection with the plurality of inspection devices, selecting the inspection device with a low waiting time for the person to be inspected, and distributing the inspection,
When the person to be inspected requires a plurality of inspections including inspection by the selected inspection device, set the order of the plurality of inspections,
Calculate the required time for each of the plurality of inspection items and generate transmission information including information on the inspection order and waiting time for each person to be inspected,
A medical examination support method, wherein the generated transmission information is displayed on a terminal device for providing information.   The inspection distribution is performed by an inspection engineer in a plurality of inspection rooms equipped with the inspection device, calculating an inspection waiting time based on the average inspection time data for each inspection region, and inspecting the inspection device with a short holding time. The medical examination support method according to claim 7, wherein:   When at least the examination order and the waiting time of the person to be inspected are changed, changed transmission information is generated and the changed transmission information is displayed on the information providing terminal device. The medical examination support method according to claim 7.   8. The medical examination support method according to claim 7, wherein the transmission information is transmitted to the information providing terminal device using identification information set for each subject.

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