JP2009176173A - Inspection data management device and method, and medical network system - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To support sorting of important inspection data. <P>SOLUTION: A clinic reserves medical inspection of a hospital via a data center and requests the medical inspection. The hospital performs the accepted medical inspection and records the inspection data on a computer system. The computer system of the hospital records the access histories of users who have accessed the inspection data through a terminal in the hospital. Once the inspection is completed, the inspection data and the access histories are uploaded to the data center from the hospital. The computer system of the data center determines the importance of each inspection databased on the access histories and distributes the determination results to the clinic. <P>COPYRIGHT: (C)2009,JPO&INPIT

Description

  The present invention relates to an examination data management apparatus and method for managing examination data relating to a medical examination, and a medical network system.

  Medical services that provide online application services using computer systems, such as medical examination reservation services that make medical examination reservations between medical facilities, and diagnostic assistance services that provide diagnostic assistance by automatically analyzing examination images obtained by medical examinations A network system is known (see, for example, Patent Document 1). A medical network system includes a plurality of computer systems installed in a plurality of medical facilities and a computer system installed in a data center of a service provider, in a wide area such as a wide area IP (Internet Protocol) network, a public telephone network, and a dedicated line. It is configured by connecting with a communication network (WAN).

  The computer system of the data center includes a server that relays data related to an examination reservation transmitted from a medical examination request source to a request destination and medical examination data transmitted from the request destination to the request source. The server receives data transmitted from the client terminal of the request source or the request destination, stores the data in the data storage, and distributes the data read from the data storage in response to a request from the client terminal. Examination data includes numerical data obtained from physiological examinations and specimen examinations, examination images taken by CT (Computed Tomography) examinations and endoscopic examinations, and medical reports that summarize the examination results. included.

  Depending on the type and medical condition of the patient undergoing the medical examination, a plurality of types of medical examinations are performed at the requested medical facility. The examination results of these medical examinations are compiled into a medical report in each examination department, and are reported to a doctor in charge in charge of the patient together with examination images and numerical data. The attending physician makes a comprehensive diagnosis (final diagnosis) in consideration of the reported test results.

In principle, all inspection data recorded at the request destination is uploaded to the data center and sent to the request source. The requesting party grasps the basis of the definitive diagnosis at the requesting party while identifying the important examination data such as examination images and medical reports that the requesting party prioritized until the definitive diagnosis from the received examination data. Determine post-test treatment policy.
JP 2001-265877 A

  As a matter of course, the requester has a problem that it takes time to select important inspection data when the amount of inspection data is large. If the sorting work takes time, the work efficiency deteriorates and the decision on the treatment policy after the examination is delayed. The diagnosis support service of Patent Document 1 can support the operation of selecting an inspection image showing a lesion from among a plurality of inspection images, but can be used for selecting the important inspection data. Therefore, it could not be a solution to the above problem.

  The present invention has been made in view of such a background, and an object thereof is to support selection work of important inspection data.

  The test data management apparatus according to the present invention diagnoses each test data based on the access history acquisition unit that acquires an access history of a user who accesses through a terminal for each of a plurality of test data related to a medical test. Importance determining means for determining importance as a measure of utility value, importance recording means for recording the importance in association with the test data, and output means for outputting the determination result of the importance It is characterized by having.

  Here, the access history acquisition means receives an access history recording means for recording an access history based on information transmitted from the terminal for each access and a transfer of the access history recorded by the access history recording means. At least one means for receiving access history.

  For example, the importance level determination unit calculates a score according to the contents of the access history, and determines the importance level based on the calculated score.

  It is preferable that the access history includes at least one of access date / time and access count for each inspection data, in addition to the user ID of the user and the ID of the inspection data. The ID of the inspection data is, for example, a file name.

  In addition, the plurality of examination data is examination data relating to a plurality of medical examinations performed on one patient, for example. By determining the importance of each of the plurality of examination data, it becomes easy to select important examination data from the plurality of examination data of one patient.

  Further, it is preferable that the importance level determination unit determines the importance level based on a weighting given according to the profile of the user. The profile includes, for example, at least one of a doctor's qualification, affiliation, and position. By changing the weighting according to the profile of such a user (staff), the importance can be determined more appropriately.

  In addition, it has an access purpose determination means for determining whether the purpose of accessing the examination data is at least one of a purpose used for creating a medical report and a purpose used for definitive diagnosis, The importance level determination unit preferably determines the importance level based on a determination result of the access purpose determination unit.

  Further, it is preferable that the importance level determination unit determines the importance level based on a weight given in accordance with a determination result of the access purpose determination unit.

  The access purpose determination means preferably determines the access purpose based on the user ID and the access date and time.

  Further, it is preferable that the importance level determination unit determines the importance level by examining a browsing history of the inspection data from the access history.

  In addition, it is preferable that the importance level determination unit determines the importance level by checking a citation history indicating that the inspection data is cited in another inspection data from the access history.

  It is preferable that storage period determining means for determining each storage period of the inspection data based on the importance is provided.

  The test data management apparatus according to the present invention provides an access history acquisition step of acquiring an access history of a user accessing through a terminal for each of a plurality of test data related to a medical test, and is important for each test data based on the access history. An importance level determining step for determining a degree and an importance level recording step for recording the importance level in association with the inspection data.

  The medical network system of the present invention is connected to the first computer system of the inspection facility that transmits inspection data from the inspection facility that is the request destination of the medical inspection to the requester, and to be communicable with the first computer system via the network. In the medical network system including the second computer system of the data center that distributes the examination data received from the first computer system to the requester, the first computer system stores a plurality of the examination data related to the medical examination. First access data storage means, and access history recording means for recording an access history of a user who has accessed each of the plurality of inspection data in the first data storage means through a terminal in the inspection facility. The second computer system has a plurality of fronts. Based on the access history receiving means for receiving the access history corresponding to the inspection data from the first computer system via the network, and determining the importance for each of the plurality of the inspection data based on the received access history Importance level determining means, importance level recording means for recording the importance level in association with each inspection data, and determination result of the importance level corresponding to each inspection data in response to a request from the requesting terminal And a distribution means for distributing.

  The second computer system further includes a second data storage unit for storing the inspection data, and a storage period for determining a storage period for each of the inspection data in the second data storage unit based on the importance. And determining means.

  According to the present invention, since the importance of the inspection data is determined based on the access history of the user, it is possible to support the selection work of important inspection data.

  A medical network system 10 shown in FIG. 1 includes a computer system of a data center 11 and computer systems of medical facilities of a hospital 12 and a clinic 13 connected to the computer system by a communication network. The hospital 12 is, for example, a relatively large-scale medical facility among local medical facilities, and possesses advanced medical examination equipment (modality) such as CT (Computed Tomography) apparatus and MRI (Magnetic Resonance Imaging) apparatus, It is a medical laboratory that accepts inspection requests from external medical facilities. The clinic 13 is an example of a relatively small medical facility that does not have such a modality and entrusts a medical examination to the hospital 12. The hospital 12 accepts an examination request from the clinic 13 via the data center 11 and accepts a medical examination.

  The computer system of the data center 11 is communicably connected to client terminals 14 and 15 constituting the computer systems of the hospital 12 and the clinic 13 via a WAN (Wide Area Network) 16. , 15, application services such as an inspection reservation service and an inspection data distribution service are provided. For example, browser software corresponding to HTTP (Hypertext Transfer Protocol) is installed in each of the client terminals 14 and 15 and communicates with the computer system of the data center 11 through the browser software to receive an application service.

  As the WAN 16, for example, a VPN (Virtual Private Network) that virtually constructs a dedicated line on a shared network such as an IP network or the Internet provided by a telecommunications carrier in consideration of a balance between information security and communication cost is used. Is done.

  The computer system of the data center 11 includes an examination reservation management server 17, a center DB server 18, and a router 19. The examination reservation management server 17 stores schedule data corresponding to the reservation acceptance frame of each hospital 12 as a request destination, and distributes the schedule data in response to a distribution request from the client terminals 14 and 15. The distributed schedule data is displayed on the client terminals 14 and 15 in, for example, a calendar format. The request source confirms the availability from the displayed schedule, and transmits the reservation application information addressed to the requested hospital from the client terminal 15 to the examination reservation management server 17.

  The reservation application information includes the name of the requesting clinic, the name of the patient, the desired date of consultation, the purpose of the examination, and the like. The purpose of the inspection is the name of the patient's injury or illness and the items that the client wants to inspect. The examination reservation management server 17 receives the reservation application information, updates the schedule data, and distributes the updated schedule data to the requested hospital 12. The requested hospital 12 confirms the schedule data at the client terminal 14 and accepts the examination request.

  When the medical examination is completed, the examination data addressed to the request source is uploaded from the hospital 12 to the data center 11 through the client terminal 14, and the received examination data is stored in the center DB server 18. The data center 11 notifies the request source that the inspection data has been uploaded, and the center DB server 18 distributes the inspection data in response to a distribution request from the client terminal 15 of the request source.

  As will be described later, the center DB server 18 receives an access history in the hospital 12 for the examination data from the hospital 12. The access history is a record of which inspection data is accessed (viewed) by who and when. The center DB server 18 determines the importance of the inspection data based on the access history, and distributes the determination result to the request source. Here, the importance is an index serving as a measure of utility value at the time of diagnosis of test data.

  The router 19 is a transfer device that exchanges data between different networks such as a LAN (Local Area Network) 20 and the WAN 12 in the data center 11, and includes a LAN port connected to the LAN 20 and a WAN port connected to the WAN 12. ing. The examination reservation management server 17 and the center DB server 18 are connected to the LAN port of the router 19.

  The computer system of the hospital 12 includes client terminals 14 and a hospital DB server 21, and is connected to the WAN 16 via a router 22 similar to the router 19. Each client terminal 14 is connected to the data center 11 for receiving reservation application information, an external connection terminal, a medical department terminal arranged in each medical department such as surgery and internal medicine, and each examination department such as radiology and endoscopy Are used as various terminals such as an examination request management terminal and a medical report creation terminal. In each terminal, application programs such as a medical record editing program, an examination request management program, and a medical report editing program are installed according to applications.

  Each client terminal 14 is connected to be communicable via the LAN 23 in the hospital 12, and communication such as mail communication is performed between the terminals 14. Further, the client terminal 14 can communicate with the hospital DB server 21 via the LAN 23 to access data in the hospital DB server 21.

  In order to prevent unauthorized use, the client terminal 14 performs user authentication (login) by requesting input of a user's staff ID (ID assigned to the staff in the hospital 12) and a password at the time of use. After logging in, recording of the operation history of the user who uses the client terminal 14 is started, and the staff ID is transmitted from the client terminal 14 to the access destination accessed through the LAN 23. When receiving access from the client terminal 14, the hospital DB server 21 uses the terminal ID, the staff ID of the user who uses the terminal, and the access type (new creation, update, browsing, etc.) as an access history. Record.

  In addition, a plurality of modalities 24 are connected to the LAN 23, and examination images captured by the modalities 24 are transmitted to the hospital DB server 21 through the LAN 23 and stored. Similarly to the client terminal 14, the modality 24 is logged in at the time of use, and the access history is recorded when the hospital DB server 21 is accessed.

  As shown in FIG. 2, the hospital DB server 21 is configured, for example, by installing a DBMS (Data Base Management System) 33 that is software for managing a DB based on a computer such as a workstation or a personal computer. The The hospital DB server 21 includes a CPU 26, a memory 27, an HDD (Hard Disk Drive) 28, a LAN port 29, a storage unit 30 in which various DBs are constructed, and a console 31, which are connected via a data bus 32. It is connected. The console 31 includes a display and input devices such as a keyboard and a mouse, and is used for managing and setting the hospital DB server 21.

  The HDD 28 stores a control program such as an operating system and a DBMS 33. The memory 27 is a work memory for the CPU 26 to execute processing. The CPU 26 controls each part of the hospital DB server 21 by loading a control program stored in the HDD 28 into the memory 27 and executing processing according to the program. The LAN port 29 is a network interface that performs transmission control with the LAN 23.

  The CPU 26 functions as the request processing unit 26 a and the history recording unit 26 b by executing the DBMS 33. The request processing unit 26 a accepts various processing requests issued from each client terminal 14 or modality 23. Specifically, a data write request to the DB such as new creation or update of data, a search request to search the DB for data that matches a specified search condition (patient ID, examination ID, etc.), searched and extracted For example, a data read request. The request processing unit 26 a executes processing according to the received request content, and notifies the request source of the processing result through the LAN port 29.

  The history recording unit 26b records an access history when each client terminal 14 and modality 24 accesses the DB.

  The storage unit 30 includes a plurality of DBs including a medical record DB 38 storing electronic medical record data of a patient, a test data DB 39 storing various types of test data, and an access history DB 40 storing access history. Has been. The data in each DB 38, 39, 40 is stored in association with the patient ID. The storage unit 30 is composed of, for example, a disk array in which a plurality of HDDs are connected. The storage unit 30 may be directly connected to the server body, or may be connected via a network.

  In this example, an example in which a plurality of types of DBs are built on one server is described. However, a server for each type of data such as a medical record server storing a medical record DB 38 and an inspection data server storing an inspection data DB 39 is used. Alternatively, the servers may be divided for each type of test data such as images, reports, and other data (numerical data and electrocardiograms of physiological tests and specimen tests).

  A chart display screen 41 shown in FIG. 3 is an example of a chart data display screen stored in the chart DB 38. The chart data is displayed on the client terminal 14 in which the chart editing display program is installed, such as a medical department terminal. The electrocardiogram 43, the CT image 44, the CT report 45, the ES (endoscope) image 46, the ES report 47, and the pathology report 48 are examples of examination data stored in the examination data DB 39.

  The medical record data includes the name of the doctor in charge in charge of the patient, the staff ID of the doctor in charge assigned in the hospital 12, patient basic information, and medical records. The patient basic information includes, for example, a remarks column in which the patient ID, patient name, date of birth, sex, name of the requesting clinic, etc. are recorded. The medical record includes a medical record such as a chief complaint, a finding, a definitive diagnosis by the attending physician, and various examination records performed, and a recording date and time is input for each item. In this example, in the hospital 12, a plurality of types of examinations such as a physiological examination, a CT examination, an ES examination, and a pathological examination are performed in this order on a patient who is hospitalized for examination. Here, the definitive diagnosis is a diagnosis made comprehensively based on the examination results (a plurality of examination data including examination images and reports created by interpretation) performed by the attending physician.

  The medical record data is edited by the attending physician belonging to the medical department through the clinical department terminal. The medical department terminal can perform ordering to the examination department in addition to editing the chart data, and request information (not shown) to the examination department is also recorded in the chart data. In addition, the medical department terminal sends from the examination department the notification of the examination execution regarding the ordered examination, the notification of the completion of the medical report, and the storage address in the examination data DB 39 of each examination data corresponding thereto. The notification and storage address received by the department terminal are recorded in the chart data.

  The storage address of each examination data is set as a hyperlink so that the examination data can be read out from the medical chart display screen of the department terminal by clicking the mouse and displayed on the department terminal. Specifically, link information is set between the text data indicating the execution record and the storage address so as to correspond to the display position of the inspection execution record (inspection execution notification or report completion notification) described in the medical record. Is done.

  The electrocardiogram 43, CT image 44, and ES image 46 are generated by the modality 24, and the CT report 45, ES report 47, and pathology report 48 are created and edited by the client terminal 14, respectively. Each of these examination data includes a file name (“ECG0405010”, “CT04060612”, “R-CT04006012”, etc.), a patient ID (“01234”), and a creator ID (“D-IR9”, “D”). -ES3 "and the like are assigned and stored in the inspection data DB 39.

  For example, an identifier for identifying the examination type (ECG, CT, ES, etc.) and the data type (image or report) is given to the file name. There are a plurality of CT images 44 and ES images 46, and a file name, a patient ID, and a staff ID are assigned to each. In the case of an examination image, the creator of the examination data is an examination engineer of a CT apparatus or an endoscopist who performs an endoscopic examination. It is.

  As shown in FIG. 4, when there is access to the inspection data DB 39 from the client terminal 14 or modality 24, the history recording unit 26b generates one access record 49 for each access, and the access history Record in DB40. The access record 49 corresponds to, for example, the file name, access date and time, access type (new creation, browsing, etc.), staff ID that accessed the test data, identification of the doctor in charge, terminal ID, and the test data. A field in which items such as a patient ID to be recorded is recorded is included. The doctor in charge identification is information for identifying whether or not the staff who has accessed the examination data is the doctor in charge of the patient corresponding to the examination data.

  The history recording unit 26b first receives request data representing the request content from the client terminal 14 received by the request processing unit 26a, and from the request data, accesses target information (file name, access type, patient ID of examination data) and The access source information (staff ID, terminal ID) is read.

  Next, using the patient ID acquired from the request processing unit 26a as a search key, corresponding chart data is read from the chart DB 38, and the staff ID of the doctor in charge of the patient ID is read. Then, the history recording unit 26b compares the staff ID of the doctor in charge with the staff ID of the access source information, and if they match, the history recording unit 26b determines that the access source is the doctor in charge and handles the access record 49. The determination result is recorded in the medical identification. Further, the history recording unit 26b acquires the access date and time from a system timer (not shown) of the hospital DB server 21, and generates an access record 49 by combining those data items into one.

  The access history list 50 shown in FIG. 5 is a list example generated by extracting each access record 49 of a plurality of examination data from the access history DB 40 for one patient (patient ID “01234”). Since there are a plurality of CT images 44 and ES images 46, an access record 49 is generated in image units (“001”, “002”...).

  The access type is classified into, for example, “new creation”, “update”, “browse”, “citation”, and “complete”. “New” is recorded when new inspection data is stored in the inspection data DB 39, “Update” is recorded when the already created inspection data is updated, and “Browse” Recorded when data is read from the inspection data DB 39 and viewed.

  “Quotation” is used when, for example, an inspection image is attached to a report or a hyperlink from a report to an inspection image is set. It is recorded as the access history of the previous inspection image. The citation history is acquired by the following method, for example. When the hospital DB server 21 distributes test data to the client terminal 14, the request processing unit 26a attaches a script or a program module (applet) for monitoring the quoting operation of the client terminal 14 to the test data. And deliver. As a result, the browser of the client terminal 14 notifies the hospital DB server 21 of the quoting operation such as pasting or hyperlink, and the history recording unit 26b receives the notification, thereby quoting the citation. History is acquired.

  “Completed” is a record attached when editing of a newly created report is completed and the content is finalized, and is an access type unique to the report. For example, in order to prevent tampering, access to only the creator is permitted until the creation of the report is completed, and a user other than the creator cannot view or update the report. When the creation of the report is completed, the report in the inspection data DB 39 is released and the staff other than the creator is allowed to browse, but the update is prohibited.

  Further, after the completion of the report creation, the main recording portion of the report such as the observation column is also prohibited from being updated by the creator. The history recording unit 26b receives the completion notification from the client terminal 14 received by the request processing unit 26a, and acquires the history. The completion notification is transmitted to the hospital DB server 21 from the client terminal 14 in which the report editing program is installed, for example, by a completion notification function realized by the report editing program.

  The staff ID is given an identifier for identifying each occupation (qualification) such as “N” for a nurse, “D” for a doctor, and “IT” for a laboratory technician. The doctor's staff ID is “IR” for the interpreting physician, “P” for the physician, “ES” for the endoscopist, “PT” for the pathologist, etc. Given an identifier. For example, the identifier of “at” is given to the doctor identification information included in the access record 49. In this example, since the physician with the staff ID “D-P21” is the attending physician, the identifier “at” is added to “D-P21”.

  As shown in FIG. 6, the center DB server 18 is configured by installing a DBMS, which is software for managing a DB, based on a computer such as a workstation or a personal computer, like the hospital DB server 21. . The center DB server 18 includes a CPU 51, a memory 52, an HDD (Hard Disk Drive) 53, a LAN port 54, a storage unit 56 in which various DBs are constructed, and a console 57, which are connected via a data bus 55. It is connected. The console 57 includes a display and an input device such as a keyboard and a mouse, and is used for managing and setting the center DB server 18. Since the basic configuration of the center DB server 18 is the same as that of the hospital DB server 21, the description of common parts is omitted for the sake of convenience, and differences are mainly described.

  The HDD 53 stores an importance level determination program 53b in addition to the DBMS 53a. The CPU 51 functions as the request processing unit 51a by executing the DBMS 53a, and functions as the importance level determination unit 51b by executing the importance level determination program 53b. In addition, the CPU 51 functions as an output unit that outputs the determination result of the importance determination unit 51b in response to an output request such as a display request or a distribution request on the display.

  The request processing unit 51 a receives an upload request from the client terminal 14 of the hospital 12 or the hospital DB server 21 via the WAN 16 and stores the uploaded data in each DB in the storage unit 56. From the hospital 12 to the data center 11, in addition to examination data addressed to the request source, access history data and medical chart data corresponding thereto are uploaded.

  Each of these data is given a patient ID (for example, “01234”) given by the hospital 12, and the request processing unit 51a assigns a facility ID (“H1”) that is an identifier of each hospital 12 to this patient ID. ”,“ H2 ”...) Are added to convert the patient ID, and each data is stored in each DB in the storage unit 56. Thereby, even when the same patient ID is given in each hospital 12, the uniqueness of the patient ID in the center DB server 18 is ensured. In addition, the request processing unit 51a receives a distribution request from the client terminal 15 of the clinic 13 via the WAN 16, and performs a distribution process of examination data and importance data corresponding thereto.

  In the storage unit 56, a medical record DB 58 for storing medical record data, an inspection data DB 59 for storing inspection data, and an access history DB 61 for storing access history data are constructed. In each of these DBs 58, 59, 61, each data is stored in association with a patient ID, as in the hospital DB server 21. In addition, like the hospital DB server 21, these DBs may be distributed and constructed on a plurality of servers.

  In the storage unit 56, in addition to the DBs 58, 59, 61, an importance DB 62 is constructed. The importance level DB 62 stores importance level data that is a determination result determined by the importance level determination unit 51b. The importance DB 62 stores first and second weighting tables 67 and 68 (see FIGS. 8 and 9) that are referred to when the importance determination unit 51b performs importance determination processing. One set of the first and second weighting tables 67 and 68 is prepared for each hospital 12, and each set is stored in association with a facility ID (“H1, H2...”).

  As illustrated in FIG. 7, the importance level determination unit 51b reads the medical record data from the medical record DB 58, reads the patient access history data corresponding to the medical record data from the access history DB 61, and based on the read medical record data and the access history data. Thus, importance determination processing is performed for each inspection data. As the determination result, one importance record 66 is generated for each examination data, and each importance record 66 is associated with the patient ID and recorded in the importance DB 62 as one record of the importance data.

  Test data is considered to be of high importance because there are many opportunities to be used if the number of accesses in the hospital 12 is large. Among them, test data viewed by doctors involved in definitive diagnosis and report creation is particularly important. It is considered high. Therefore, the importance level determination unit 51b weights elements based not only on the number of accesses but also on who (viewer) and what purpose (viewing purpose) based on the access history data and medical record data. To determine the importance of the inspection data.

  The importance DB 62 stores in advance a first weighting table 67 for weighting according to the viewer and a second weighting table 68 for weighting according to the viewing purpose. As shown in FIG. 8, in the first weighting table 67, the staff ID and the value of the first weighting coefficient Wsp are stored in association with each other. For example, the first weighting coefficient Wsp is set to “5” for doctors and “1” for laboratory technicians and nurses. In the remarks column of the first weighting table 67, special items such as a position such as a professor or an assistant professor and an authority of cancer are recorded. The first weighting table 67 is created based on, for example, a staff record submitted from each hospital 12 (profile data including each staff's qualification, position, affiliation, specialized area, special remarks, and the like).

  As shown in FIG. 9, the second weighting table 68 stores the browsing purpose and the value of the second weighting coefficient Wba in association with each other. The browsing purpose is, for example, “confirmed diagnosis” and “report creation”, and the second weighting coefficient Wba is “20” for “confirmed diagnosis” and “5” for “report creation”. “1” is set for each of the others. Each value in the first weighting table 67 and the second weighting table 68 can be appropriately changed by the operator through the console 57 of the center DB server 18, for example. For example, in this example, the weights for doctors are uniform, but the weights of doctors in charge may be higher than those for other doctors.

  The importance record 66 includes fields in which items such as the examination data file name, comprehensive evaluation, total score TS, presence / absence of use at the time of definitive diagnosis, number of browsing Nb, number of citations Nr, storage period, and the like are recorded. The total score TS is a determination result of the importance level determination process, and the comprehensive evaluation is determined based on the total score TS. The importance DB 62 stores a comprehensive evaluation determination table 69. As shown in FIG. 10, the overall evaluation determination table 69 stores the correspondence between the value of the total score TS and the level of the overall evaluation (L1 to L3). Each test is performed according to the value of the total score TS. A comprehensive evaluation of the data is determined. For example, L1 has the lowest importance and L3 has the highest importance. Of course, the level may be other than three levels.

  Each item of the presence / absence of use at the time of definitive diagnosis, the number of browsing times Nb, and the number of citations Nr is a parameter used when calculating the total score TS, and each is a breakdown item of the total score TS.

  The presence / absence of use at the time of definitive diagnosis is information indicating whether or not the test data has been used for definitive diagnosis. As will be described later, the access date and time included in the access history and the definitive diagnosis date and time recorded in the chart data are collated. Is determined. The browsing count Nb is the number of times inspection data has been browsed by the user. In the example of the CT report in FIG. 5, the browsing count Nb is three.

  The number of citations Nr is, for example, the number of times that a certain inspection data is cited in other inspection data such that a report or image has a reference hyperlink set or pasted in another report. As the number of times of citation is increased, the importance of the inspection data is considered to be higher. Therefore, when the total score TS is calculated, the number of times of citation Nr is taken into consideration. The CT image (002) and ES image (002) in FIG. 5 are cited once each.

  The storage period is a period in which the data center 11 stores the inspection data uploaded to the data center 11, and is determined based on the importance determination result. A storage period determination table 70 is stored in the importance DB 62. As shown in FIG. 11, the storage period determination table 70 stores each level of comprehensive evaluation of importance and storage periods at each level. The correspondence is remembered. The importance level determination unit 51b refers to the storage period determination table 70 and determines a storage period according to the importance level. The storage period is delivered to the requester together with the importance determination result.

  The values of the comprehensive evaluation determination table 69 and the storage period determination table 70 can be appropriately changed by the operator through the console 57 of the center DB server 18 as in the tables 67 and 68 described above. In this example, the overall evaluation determination table 69 and the storage period determination table 70 are different from the above-described tables 67 and 68, but a table common to a plurality of hospitals 12 is used. A table with different values may be used.

  The importance level determination process executed by the importance level determination unit 51b will be described with reference to the flowchart shown in FIG. The importance level determination unit 51b reads access history data and medical record data related to a plurality of examination data for one patient from the access history DB 61 and the medical record DB 58, respectively (step (S) 101). In S102, an access record 49 relating to one inspection data (for example, a CT report or one CT image) is read from the access history data, and an access record (viewing record) whose access type is “browsing” is extracted therefrom. To do. The number of extracted browsing records is recorded in the field of the browsing count Nb of the importance record 66.

  In S103, the importance level determination unit 51b reads the staff ID and the access date / time (browsing date / time) from one browsing record. In step S104, a viewer is identified based on the staff ID, and the first weighting coefficient Wsp corresponding to the staff ID is read from the first weighting table 67.

  In next S105, the importance level determination unit 51b determines the browsing purpose related to the browsing record based on the browsing date and time. If the viewer is an interpreting physician, the browsing objective is estimated to be the report creation purpose for all viewing, but among the examination data browsed by the interpreting physician, the interpreting physician emphasized the report creation in particular. The browsing purpose is determined based on the browsing date so that a high score is given to the inspection data. The importance level determination unit 51b checks the report creation period of the interpretation doctor from the record of the access history data, and the viewing purpose is the report creation purpose for the viewing record whose viewing time is included in the report creating period. Is determined. The report creation period is, for example, a period from a newly created date and time when the interpretation doctor has started creating a report to a confirmed date and time when the report is confirmed.

  For example, in the case of a browsing record with a browsing date of “07/04/07/09: 0” by the interpreting doctor (staff ID: D-IR9) of the CT image (“002”) shown in FIG. Since the creation period (new creation “07/04/06/15: 00” to completion “07/04/07/11: 00”) is entered, the viewing purpose is determined as the report creation purpose. On the other hand, in the case of a viewing record with a viewing date and time of “07/04/06/11: 30” of the CT image (“001”), since it is not in the CT report creation period, it is not determined as the report creation purpose. As described above, even when browsing by an interpreting doctor, a high score is given to examination data particularly important by the interpreting doctor by changing the weighting according to the viewing date and time. When it is determined that the browsing purpose is the report creation purpose, the importance level determination unit 51b reads the second weighting coefficient Wba (“5”) corresponding to the report creation purpose from the second weighting table 68.

  In addition, when the staff ID of the browsing record is the doctor in charge (“D-P21-at”), it is estimated that the browsing purpose is the purpose of the definitive diagnosis. The importance determination unit 51b examines the definitive diagnosis period by the attending doctor from the record of the medical record data so that a high score is given to the examination data particularly emphasized by the attending doctor, and browses the browsing records included in the definitive diagnosis period. It is determined that the purpose is a definitive diagnosis purpose. The definitive diagnosis period is, for example, a period from the date and time when all examinations and reports are completed to the definitive diagnosis date and time.

  For example, in the example of FIG. 3, the date and time when all the examinations and reports are completed is “07/04/09/14: 00” that is the date and time when the creation of the pathological report is completed, and the definitive diagnosis date and time is “07 / 04/10/10: 0 ”, the period between them is the definitive diagnosis period. The CT image (“002”), ES image (“002”), CT report, ES report, and pathology report are important because the browsing time is included in the definite diagnosis period. The degree determination unit 51b determines that the browsing purpose is a definitive diagnosis purpose for those browsing records. On the other hand, the electrocardiogram, CT image (“001”), and ES image (“001”) are viewed by the attending physician, but the viewing date and time of these viewing records are not within the definitive diagnosis period, Is not determined. The importance level determination unit 51b reads out the second weighting coefficient Wba corresponding to the browsing purpose from the second weighting table 68 based on the browsing purpose determined in this way.

In S106, the importance level determination unit 51b calculates the score Sb of one browsing record based on the formula (1).
Sb = 1 × Wsp × Wba (1)
The basic score for one browsing is “1” points, and the higher the first weighting coefficient Wsp corresponding to the viewer and the second weighting coefficient Wba corresponding to the browsing purpose, the higher the score Sb. For example, when an interpreting doctor browses for the purpose of creating a report, “5” points are given to the first weighting coefficient Wsp and “5” points are given to the second weighting coefficient Wba, so the score Sb is “25” points. It becomes. Further, when the attending physician browses for the purpose of definitive diagnosis, “5” points are given to the first weighting coefficient Wsp, “20” points are given to the second weighting coefficient Wba, and the score Sb is “100” points. Become.

The importance level determination unit 51b calculates the score Sb for all the browsing records related to one inspection data (S107), and in S108, the scores of all the browsing records related to one inspection data based on the following equation (2). Sb1, Sb2,... Sbn are summed to obtain a total value TSb.
TSb = Sb1 + Sb2 +... + Sbn (2)

  In S109, the importance level determination unit 51b counts the number of citations Nr in which the inspection data is cited in other inspection data from the access history data. The importance level determination unit 51b extracts the access record 49 whose access type is “quote” for the inspection data from the access history data, and counts the number of citations Nr. Since the CT image (“002”) and the ES image (“002”) are cited once each, the number of citations Nr of each inspection data is one. The number of citations Nr is recorded in the corresponding field of the importance record 66.

In S110, the importance level determination unit 51b calculates the final score TS by adding the number of citations Nr to the total value TSb as shown in the following equation (3).
TS = TSb + Nr (3)
Thus, the score TS based on the access history is obtained for one inspection data. This score TS is recorded in the corresponding field of the importance record 66.

  In S111, the importance level determination unit 51b refers to the comprehensive evaluation determination table 69 and determines the comprehensive evaluation according to the score TS. Furthermore, in S112, the importance level determination unit 51b refers to the storage period determination table 70 and determines the storage period according to the comprehensive evaluation. The overall evaluation and storage period of importance are recorded in corresponding fields of the importance record 66, respectively. The importance record 66 generated in this way is recorded in association with the inspection data (S113). The importance level determination unit 51b executes the importance level determination process for all examination data for one patient (S114), and generates and records an importance level record for each examination data.

  An inspection data list 71 shown in FIG. 13 is an example of an inspection data list displayed on the client terminal 15 that is the request source. The importance level data is included in the list data of the inspection data and distributed to the requester. The request processing unit 51a extracts the corresponding list data and importance data from the inspection data DB 59 and the importance DB 62 and sends them to the requesting client terminal 15 when there is an inspection data distribution request from the client terminal 15. To do. In the client terminal 15, for example, the browser generates a display screen of the inspection data list 71 based on the distributed list data and importance data, and displays the display screen on the display.

  The examination data list 71 includes an examination facility name (requested medical facility name), an examination date of each examination, a field for displaying the examination data file name as an examination result of each examination, and important for each examination data. Contains a field to display the degree data. The field for displaying the importance level data includes a plurality of fields corresponding to the items of comprehensive evaluation, presence / absence of use at the time of definitive diagnosis, number of browsing Nb, number of citations Nr, and storage period. In the comprehensive evaluation represented by L1 to L3, the number of stars is assigned to each level so that the level of importance can be easily confirmed.

  Since the items other than the comprehensive evaluation are items related to the breakdown of the comprehensive evaluation, for example, in the initial state, only the comprehensive evaluation is displayed, and when the detailed button is clicked, the items other than the comprehensive evaluation are displayed. For items other than the comprehensive evaluation, display and non-display may be switched. Of course, all items related to the importance level including the comprehensive evaluation may be switched between display and non-display.

  By notifying the requesting party of the storage period, it becomes a notification of the inspection data deletion to the requesting source. On the other hand, the data center 11 can smoothly delete the inspection data that has passed the storage period. Since the data center 11 stores a large amount of examination data relating to a plurality of medical facilities, if the examination data left for a long time can be smoothly deleted, the data storage facility can be operated efficiently.

  When the request processing unit 51a receives the inspection data distribution request from the inspection data list 71 at the client terminal 15 after distributing the inspection data list 71, the request processing unit 51a extracts the specified inspection data from the inspection data DB 59. And distributed to the client terminal 15. In addition to the inspection data, the request processing unit 51a distributes medical chart data in response to a medical record data distribution request from the client terminal 15.

  The operation of the above configuration will be described below with reference to the flowcharts of FIGS. The clinic 13 accesses the examination reservation management server 17 through the client terminal 15 and makes an examination request to the hospital 12 via the data center 11. The requested hospital 12 accesses the examination reservation management server 17 from the client terminal 14 and receives examination reservation data from the request source. In this way, the examination reservation data from the request source to the request destination is relayed by the data center 11.

  When a medical examination is performed in the hospital 12, the hospital DB server 21 of the hospital 12 accumulates a plurality of examination data of the performed medical examination. The hospital DB server 21 generates an access record 49 shown in FIG. 4 for each access to the examination data from the client terminal 14 in the hospital 12, and associates it with the patient ID as access history data. Store in the access history DB 40. In the medical record data created by the attending physician, the medical treatment contents including the examination execution date and time, the report completion notification, and the finalized diagnosis date and time are recorded.

  When the medical examination is completed in the hospital 12, the examination result (the medical chart data and the examination data) and the access history data corresponding thereto are uploaded to the data center 11 through the client terminal 14. When the center DB server 18 receives the uploaded data, the center DB server 18 stores the received data in each DB. The center DB server 18 performs importance determination processing for the received inspection data in the procedure shown in FIG. The importance determination unit 51b stores the determined importance data in the importance DB 62.

  When the center DB server 18 receives the inspection data distribution request from the client terminal 15 after the importance level determination processing ends, the center DB server 18 distributes the inspection data list 71 in response to the distribution request. The distributed inspection data list 71 is displayed on the display of the client terminal 15. Since the importance is displayed for each examination data in the examination data list 71, it is possible to confirm which examination data is important in the requested hospital 12. This makes it possible to easily select important inspection data from a large amount of inspection data at the request source.

  In the above embodiment, taking a medical network system composed of a computer system of a data center and a computer system of a hospital as an example, the importance is determined at the data center based on the access history recorded at the hospital, and the determined importance is requested. Although explained in the example used in the original clinic, the test data management apparatus of the present invention performs access history acquisition and importance determination by a hospital computer system, and the determined importance is stored in the hospital. It can also be applied when used. In that case, for example, the importance level determination program is installed in the hospital DB server so that the CPU of the hospital DB server functions as the importance level determination unit, and the importance level DB is also provided in the hospital DB server. Configure the device.

  If a test data management device is incorporated in a hospital computer system and the importance is distributed and displayed on client terminals in the hospital, the doctor of the hospital can check the importance of a plurality of test data. As a result, for example, when the doctor in charge makes a definitive diagnosis with reference to a report that summarizes the results of previous tests, the test data that the report creator has paid attention to can be easily confirmed. This makes it easier to grasp the diagnosis, and can also be expected to improve the diagnostic efficiency of the attending physician.

  Of course, a storage period determination unit may be provided in addition to the importance determination unit in the examination data management device of the hospital. In this case, the importance and storage period are displayed on the display device that constitutes the hospital computer system, such as a hospital DB server console and terminal, so that the system operator can use the importance and storage period. Also good. In this way, the person in charge of the computer system checks the importance and storage period, and from the large amount of inspection data stored in the computer system, the inspection data that should be stored and the inspection data that can be deleted Can be easily selected, and data storage facilities can be used effectively.

  In addition, the computer system of the hospital or data center is provided with a data deletion unit that checks whether or not the storage period of examination data stored in a database has passed and automatically deletes the examination data that has passed the storage period. May be. In this way, the operation of the computer system can be performed more simply and efficiently.

  The method for determining the importance of inspection data in the above embodiment is merely an example, and another method may be used. For example, in the above embodiment, the importance of the inspection data has been described based on an example in which the importance of the inspection data is calculated based on the number of browsing, the profile of the viewer (staff), and the browsing purpose. It is not necessary to use it, and you may calculate using only any one. Further, although both the purpose used for the definitive diagnosis and the purpose used for report creation are determined as the browsing purpose, the determination may be made only for one of the purposes.

  Moreover, in the said embodiment, although a score is calculated according to the content of the access history for every test | inspection data, and importance is determined based on the calculated score, a score does not need to be calculated. For example, if a specific person in charge browses at a specific timing, such as when viewed by a doctor in charge at the time of a definitive diagnosis, or when viewed by a radiology doctor at the time of report creation, a flag to that effect is set in the access record. Record it. The importance level determination unit checks the presence or absence of the flag, and determines that the importance level is high when the flag is present and low when the flag is not present.

  In addition, as a method of determining the browsing purpose, the browsing purpose is determined by examining the report creation period and the definitive diagnosis period from the access history data and medical record data, but the browsing purpose is determined based on the viewer's profile and the number of browsing times. You may judge. For example, when the viewer is a doctor in charge or an interpreting physician, if the number of times of browsing for one examination data is equal to or more than a predetermined number, the viewing purpose is determined as a definitive diagnosis purpose or a report creation purpose.

  Also, the report creation period is determined from the access history data and the confirmed diagnosis period is determined from the chart data. However, the report creation period may be determined from the chart data, or the confirmed diagnosis period may be determined from the access history. You may judge from data. When determining the definite diagnosis period from the access history data, before uploading the access history to the data center, the hospital computer system records data related to the definite diagnosis period from the chart data in the access history data.

  In addition, as shown in the above embodiment, when a special note related to a specific disease such as an authority of cancer is included in the viewer's profile, such special note is used as a parameter for determining the importance. May be. For example, the patient's injury / illness information is read from the medical record data, the injury / illness information and the viewer's special remarks are collated, and when the both injuries / illnesses match, the score of the access history of the viewer is added. In the case of cancer, the relationship between the medical department and the wound may be used as a parameter for determining the importance so that the weight of the medical department (for example, internal medicine) in charge of the wound is increased. Further, the weight may be changed according to the position of the doctor (professor, associate professor, lecturer). Further, in addition to the positions shown on the left, an intern may be added to the doctor's position.

  In addition, the importance may be simply determined by the number of times of browsing regardless of the profile of the viewer and the purpose of browsing. In this case, for example, each inspection data is compared between inspection data, and it is determined that the inspection data having a relatively large number of inspections is high in importance. Moreover, although the example which performs an importance determination by giving a score to the browsing history whose access type is browsing among the access histories has been described, a score may also be given to updates other than browsing or new creation.

  In addition, regarding the number of citations of examination data to other examination data, in the above example, the number of citations between examination data of one patient is used as a parameter for determining the importance. The number of secondary uses in which the data is used for examination data of another patient may be used as a parameter for determining the importance. For example, when the examination data of a patient has a high utility value as an important case, the number of secondary uses increases. Of course, the number of secondary uses is difficult to use as a parameter for determining the importance when selecting important examination data from the examination data of the patient with the requesting party. This is effective as a parameter for determining the importance when selecting inspection data to be stored and inspection data that can be deleted from a large amount of inspection data regarding a plurality of patients.

  In the above embodiment, when obtaining the total score that is the basis for determining the importance level, the citation count Nr is simply added to the browsing history score as it is, but depending on the size of the citation count Nr. The number of citations Nr may be multiplied by a coefficient so as to increase the score, and the score may be added to the score of the browsing history. For example, when the number of citations Nr is 3 or more, a coefficient that increases as the number of citations Nr increases is provided, such as 2 times when the number of citations Nr is 5 or 10 times when the number exceeds 5 times. In addition, for the citation history, a score may be obtained for each access record as in the browsing history.

  In this way, various methods can be considered as the score calculation method for the access history, and the score calculation method can be appropriately selected in consideration of when, who, what type of access and how much importance is given. Is possible.

  In the above embodiment, the DB server that stores the inspection data has been described as an example of acquiring and recording the user's access history to the inspection data. However, the DB server and the history recording server that acquires and records the access history are separately provided. You may comprise. In this case, the DB server may transfer the access request transmitted from the terminal to the DB server, or the access request transmitted from the terminal to the DB server may be transmitted to the DB server via the history recording server. You may make it transmit to.

  In the above embodiment, the data center uploads access history data for determining the importance of the inspection data from the request destination to the data center in addition to the inspection data addressed to the request source from the request destination, and then the computer of the data center. For example, if online access via a WAN is possible in real time from a data center computer system to a hospital computer system, the data center computer system When performing the importance determination process, online access to the hospital computer system may be performed, and access history data necessary for the importance determination process may be read in real time as necessary.

  In the above-described embodiment, the medical network system of the present invention is composed of a computer system of a plurality of medical facilities that is a test request destination and a data center computer system that relays test results from the request destination to the request source. However, the present invention can be applied to other forms. For example, there may be a medical network system in which a single hospital has a plurality of bases, each base serves as a request source, a request destination, and a data center, and a plurality of computer systems at each base are connected via a network. Alternatively, a medical network system in which computer systems of a plurality of hospitals are connected via a network may be used. In this case, one of the hospitals becomes a data center and plays a host role. In any of the above cases, the network connecting the computer systems may be a WAN or a LAN.

  In the above-described embodiment, the example of the combination of the physiological examination, the specimen examination, the CT examination, and the endoscopic examination has been described as an example of the examination.

  The inspection data management apparatus of the present invention may be configured by a computer system including a single server, or may be configured as a computer system in which processing is distributed to a plurality of servers.

  As shown in the above embodiment, the present invention naturally extends to a program form and further to a storage medium for storing the program.

It is a block diagram which shows the outline of a medical network system. It is a block diagram which shows the outline of a hospital DB server. It is explanatory drawing of a medical chart screen and test | inspection data. It is explanatory drawing which shows the processing content of a log | history recording part. It is explanatory drawing which shows the example of an access history list. It is a schematic block diagram of a center DB server. It is explanatory drawing which shows the production | generation recording procedure of an importance record. It is explanatory drawing of a 1st weighting table. It is explanatory drawing of a 2nd weighting table. It is explanatory drawing of the table for comprehensive evaluation determination. It is explanatory drawing of the table for storage period determination. It is a flowchart which shows the procedure of an importance determination process. It is explanatory drawing of a test | inspection data list. It is a flowchart explaining the flow from the examination reservation in the medical network system to reception of the examination result.

Explanation of symbols

10 Medical Network System 11 Data Center 11
12 Hospital 13 Clinic 14 Client Terminal (Hospital)
15 Client terminal (clinic)
16 WAN
17 Examination reservation management server 18 Center DB server 21 Hospital DB server 26, 51 CPU
26b History recording part 38,58 chart DB
39,59 Inspection data DB
40, 61 Access history DB
51b Importance Level Determination Unit 62 Importance Level DB
66 Importance record 67 First weighting table 68 Second weighting table 69 Importance evaluation table 70 Storage period determination table 71 Inspection data list

Claims (15)

Access history acquisition means for acquiring an access history of a user accessing through a terminal for each of a plurality of test data related to a medical test,
Importance determination means for determining an importance that is a measure of utility value at the time of diagnosis for each examination data based on the access history;
Importance recording means for recording the importance in association with the inspection data;
An inspection data management apparatus comprising: output means for outputting the determination result of the importance.   2. The examination data management apparatus according to claim 1, wherein the importance level determination unit calculates a score according to the contents of the access history, and determines the importance level based on the calculated score.   3. The inspection according to claim 1, wherein the access history includes at least one of an access date and time and an access count for each inspection data, in addition to the user ID and inspection data ID of the user. Data management device.   The examination data management apparatus according to claim 1, wherein the plurality of examination data are examination data relating to a plurality of medical examinations performed on one patient.   The inspection data management apparatus according to claim 1, wherein the importance level determination unit determines the importance level based on a weighting given according to a profile of the user.   6. The examination data management apparatus according to claim 5, wherein the profile includes at least one of a doctor's qualification, affiliation, and position. An access purpose determining means for determining whether or not the purpose of accessing the examination data is at least one of a purpose used for creating a medical report and a purpose used for definitive diagnosis;
The inspection data management apparatus according to claim 1, wherein the importance level determination unit determines the importance level based on a determination result of the access purpose determination unit.   8. The examination data management apparatus according to claim 7, wherein the importance level determination unit determines the importance level based on a weighting given in accordance with a determination result of the access purpose determination unit.   9. The examination data management apparatus according to claim 7, wherein the access purpose determination unit determines the access purpose based on the user ID and the access date and time.   The inspection data management apparatus according to claim 1, wherein the importance level determination unit determines the importance level by examining a browsing history of the inspection data from the access history.   The importance level determination unit determines the importance level by checking a citation history indicating that the test data is cited by another test data from the access history. Inspection data management device of description.   The inspection data management apparatus according to claim 1, further comprising a storage period determining unit that determines each storage period of the inspection data based on the importance. An access history acquisition step for acquiring an access history of a user accessing through a terminal for each of a plurality of test data related to a medical test,
An importance level determining step for determining an importance level for each inspection data based on the access history;
An inspection data management method comprising: an importance level recording step for recording the importance level in association with the inspection data. The first computer system of the inspection facility that transmits inspection data to the requester from the inspection facility that is the request destination of the medical inspection, and the first computer system that is communicably connected to the first computer system via the network, and received from the first computer system In a medical network system comprising a second computer system of a data center that distributes the examination data to a requester,
The first computer system includes first data storage means for storing a plurality of the examination data related to the medical examination;
An access history recording unit that records an access history of a user who has accessed each of the plurality of the inspection data in the first data storage unit through a terminal in the inspection facility;
The second computer system has access history receiving means for receiving the access history corresponding to a plurality of the inspection data from the first computer system through the network;
Importance determination means for determining importance for each of the plurality of inspection data based on the received access history;
Importance recording means for recording the importance in association with each inspection data;
A medical network system comprising: distribution means for distributing the determination result of the importance corresponding to each examination data in response to a request from the requesting terminal. The second computer system further includes second data storage means for storing the inspection data;
15. The medical network system according to claim 14, further comprising a storage period determination unit that determines a storage period of each of the examination data in the second data storage unit based on the importance.

Images