JP2010086334A - Home care support system - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a home care support system allowing more effective removal of pain of a home care patient by properly coping with fluctuation of the pain of the home care patient. <P>SOLUTION: This home care support system has: a management server 2 installed in a central station; an attending physician terminal 3 installed in a clinic of an attending physician, communicating with the management server 1; and a patient terminal 4 installed in a residence of the home care patient, from which the home care patient or a carer notifies the management server 2 about strength of the pain and occurrence time thereof every time the home care patient feels the pain. The management server 2 sequentially records the strength of the pain of the patient and the occurrence time thereof notified from the patient terminal 4, periodically analyzes them, and sends an alarm to the attending physician terminal 3 based on a result thereof. <P>COPYRIGHT: (C)2010,JPO&INPIT

Description

  The present invention relates to a home care support system that receives a report of pain of a home patient and supports the home patient to receive appropriate pain relief treatment.

  Cancer is the leading cause of death in Japan, and it is said that one in two Japanese men and one in three women will have cancer in their lifetime. The number of deaths from cancer is said to increase further in the future as Japanese society ages. Also, most cancer patients feel unbearable pain just before they die, so palliative care to remove the patient's pain is necessary in the treatment of terminal cancer patients.

  There are also many cancer patients who want to receive their death while being watched by their family at home instead of at the hospital. However, since there are still few specialists who are familiar with palliative care in Japan, it is difficult for in-patients to receive sufficient palliative care and reach a peaceful end.

  Accordingly, a cancerousness provided with a patient state input unit that inputs a patient state including a patient's subjective symptoms, and a drug management unit that selects a drug to be administered to the patient based on the patient's subjective symptoms input to the patient state input unit A pain management system has been proposed (Patent Document 1). This cancer pain management system presents appropriate medications to doctors who visit patients' homes regularly and conduct interviews (in many cases they are not palliative care specialists). More appropriate palliative care can be given.

JP 2006-158490 A

  However, since the doctor or nurse operates the patient state input unit of the cancer pain management system of Patent Document 1, the patient state is input only when the doctor or nurse visits the patient's home. For this reason, there is a problem that it is difficult to cope with a sudden change in the patient condition because a time lag occurs between the change in the patient condition and the change of the medicine corresponding thereto.

  The present invention has been made in view of such a background, and provides a home care support system capable of more effectively removing pain of a home patient in response to a change in pain perceived by the home patient. To do.

  The home care support system according to the present invention includes a management server installed in a central office, a medical doctor terminal installed in a doctor's clinic and communicating with the management server, a home patient's residence, and the home patient Each time the patient feels pain, the home patient or caregiver includes a patient terminal that reports the intensity of pain and the time of occurrence thereof to the management server, and the management server includes the patient terminal that is reported from the patient terminal. The intensity of pain and the time of occurrence thereof are sequentially recorded, periodically analyzed, and an alarm is sent to the attending physician terminal based on the result.

  The home care support system of the present invention records the pain felt by the home patient in real time by operating a patient terminal by a home patient or a nurse, so that it can respond appropriately to changes in symptoms of the home patient. Palliative care can be given. Moreover, the pain of the said home patient can be removed more effectively.

  Hereinafter, the best mode for carrying out the present invention will be described.

[overall structure]
FIG. 1 is a conceptual configuration diagram of a home care support system showing an embodiment of the present invention. As shown in FIG. 1, the home care support system 1 includes a management server 2, an attending doctor terminal 3, and a patient terminal 4.

  The management server 2 is a central office, for example, a regional central medical institution, and a medical institution in a leadership position regarding palliative care (hereinafter referred to as a “palliative care support center” in this specification). It is a computer installed in.

  The attending physician terminal 3 is provided at an institution that provides medical services to home patients, for example, a visiting clinic where the attending physician who performs home-visit treatment for the home patient or a visiting care station where a nurse who performs home-visit nursing is stationed. It is a computer that is installed.

  The patient terminal 4 is an information communication device installed in a house (patient house) where the home patient resides, and via a communication line 5 (for example, a telephone line, an Internet communication line, etc., wired wireless is not required) Since it is connected to the management server 2, when the home patient feels pain, the home patient or a caregiver of the home patient (for example, a family, a care helper, etc.) operates and the pain intensity, pain The management server 2 is notified of the time when the error occurred.

  When the pain intensity of the home patient is reported from the patient terminal 4 to the management server 2, the management server 2 records it, analyzes it periodically or as necessary, and based on the result An alarm requesting the attending physician to visit the home patient's home when the attending physician or nurse (hereinafter referred to as “the attending physician”) determines that the home patient needs to be examined or nursing. And sent to the attending physician terminal 3 via the communication line 6. A method for determining whether or not the attending doctor's home visit is required by the attending physician will be described later.

  When the attending doctor terminal 3 receives the alarm sent from the management server 2, the attending doctor terminal 3 transfers the alarm to the portable terminal 7. The mobile terminal 7 is an information communication device (for example, a mobile phone) carried by the attending physician or the like, and is connected to the primary doctor terminal 3 via a communication means 8 (for example, a communication line of a mobile phone).

  In this way, the attending physician or the like recognizes a visit request to the home patient home and heads to the home patient home. Also, since the home patient information (name, address, medical history, etc.) is transmitted from the management server 2 to the mobile terminal 7 via the attending doctor terminal 3 along with the alarm, the attending doctor etc. You can know the information.

  In addition, the attending doctor or the like can record the symptoms of the home patient and the treatment for the at-home patient in the portable terminal 7, and can transmit the same to the management server 2 via the attending doctor terminal 3.

[Management Server]
As shown in FIG. 2, the management server 2 includes a CPU 21, a communication interface 22, and an external storage device (not shown).

  The CPU 21 is a processing device that executes arithmetic processing according to a program written in an internal storage device (not shown). A specific example of the program will be described later.

  The communication interface 22 is an interface that controls input / output of information between the management server 2, the attending doctor terminal 3, and the patient terminal 4.

  The storage area of the external storage device is divided and used as a pain report history file 23, a pain pattern file 24, a medical history file 25, a palliative care knowledge database 26, and a list file 27 such as a physician.

  The pain report history file 23 is a file that stores, in time series, the intensity of pain sent from the patient terminal 4 and complained by the home patient and the time when the pain occurred. In addition, data related to pain of the home patient recorded in the pain report history file 23 is periodically analyzed (for example, every 24 hours) by the CPU 21, and changes in pain with time (hereinafter referred to as "pain pattern"). ) Is calculated.

  The pain pattern file 24 is a file that records a plurality of pain patterns in a typical case, and the CPU 21 calculates the pain pattern of the home patient calculated from the record of the pain report history file 23 and the pain of the case read from the pain pattern file 24. The patterns are compared, and if the pain pattern of the home patient matches the pain pattern of a specific case, an alarm is sent to the attending physician terminal 3 to request a visit to the patient's home such as the attending physician.

  The medical history file 25 is a file for recording a medical history of a home patient (disease history, treatment and medication history, side effect history, etc.). When the CPU 21 sends an alarm to the attending doctor terminal 3, the medical history of the home patient related to the alarm is read from the medical history file 25 and sent to the attending doctor terminal 3.

  The palliative care knowledge database 26 is a database in which knowledge relating to palliative care, for example, knowledge relating to treatment according to patient symptoms, prescription of drugs, and the like is accumulated. When the CPU 21 sends an alarm to the attending physician's terminal 3, the palliative care knowledge database 26 is searched using the treatment history, pain pattern, etc. of the home patient related to the alarm as a key, and the treatment suitable for the symptom of the home patient The prescription is extracted and sent to the attending doctor terminal 3.

  The attending physician list file 27 is a file in which the contact information of the attending physician and the nurse in charge of the home patient, that is, the transmission destination of the alarm or the like is described. When sending an alarm or the like to the attending doctor terminal 3, the CPU 21 refers to the attending doctor etc. list file 27 and determines the destination of the alarm or the like.

[Physician terminal]
As shown in FIG. 3, the attending physician terminal 3 includes a CPU 31 and a communication interface 32. The CPU 31 is a processing device that executes arithmetic processing in accordance with a program written in an internal storage device (not shown), and the communication interface 32 controls input / output of information between the attending doctor terminal 3, the management server 2, and the portable terminal 7. Interface.

  As described above, the attending physician terminal 3 receives from the management server 2 an alarm requesting the attending physician to visit a home patient home, a treatment history of the home patient related to the alarm, a search result of the palliative care knowledge database 26, and the like. When sent out, the attending doctor terminal 3 transfers them to the portable terminal 7.

[Patient terminal]
As shown in FIG. 4, the patient terminal 4 includes a CPU 41, a communication interface 42, and an input device 43. The CPU 41 is a processing device that executes arithmetic processing in accordance with a program written in an internal storage device (not shown), and the communication interface 42 is an interface that controls input / output of information between the patient terminal 4 and the management server 2. . The input device 43 is a device that allows the home patient or a caregiver to input the intensity of the pain when the home patient complains of pain.

  For example, a plurality of push buttons may be arranged on the patient terminal 4, and the plurality of push buttons may be used as the input device 43. In this case, when a push button corresponding to the intensity of pain is pressed, the time when the button is pressed is sent to the management server 2 as the time of occurrence of pain. Or, it is equipped with a display device with a touch panel, and it is interactive in the slogan such as the intensity and type of pain (for example, “severe pain that comes with zoon”, “sounding pain”, “pain where electricity runs”) May be input.

[Mobile devices]
As shown in FIG. 5, the mobile terminal 7 includes a CPU 71, a communication interface 72, an input device 73, a display device 74, and a patient information storage device 75. The CPU 71 is a processing device that executes arithmetic processing in accordance with a program written in an internal storage device (not shown), and the communication interface 72 is an interface that controls input / output of information with the attending doctor terminal 3. The input device 73 is a device that inputs various types of information to the mobile terminal 7, such as a keyboard. The display device 74 is a display device that displays various information transferred from the attending doctor terminal 3 or various information input from the input device 73. The patient information storage device 75 is a device that temporarily stores home patient information (name, address, medical history, etc.) transferred from the attending physician terminal 3 or home patient information that the attending physician etc. inputs from the input device 73. It is.

  With this configuration, the attending physician or the like checks the information on the home patient transferred from the attending physician terminal 3 with the mobile terminal 7, records the medical treatment result of the home patient on the mobile terminal 7, and passes through the attending physician terminal 3. Then, it can be sent to the management server 2.

[Pain pattern]
FIG. 6 is a diagram showing pain patterns recorded in the pain pattern file 24. In the figure, the horizontal axis indicates the passage of time, and the vertical axis indicates the degree of pain (intensity and size). FIG. 6A shows a pattern a in which the degree of pain changes at a low level, and shows a state in which palliative care functions effectively. That is, in this case, it is not necessary to change and add palliative care (for example, administration of a drug having a stronger effect, increase in dosage). Fig. 6 (b) shows a pattern b in which there is usually almost no symptom but strong pain occurs several times a day. Fig. 6 (c) shows a strong pain from the usual, and it becomes stronger in the day. Pattern c, which is weakened or weakened, FIG. 6D shows a pattern d in which intense pain continues throughout the day. In the case of patterns b, c, and d, it is necessary to add changes in palliative care. In other words, the attending physician needs to examine the patient.

[Management program]
FIG. 7 is a flowchart showing an outline of a management program installed in the management server 2 and executed by the CPU 21. Hereinafter, this management program will be described with reference to FIG.

(Step S <b> 1) The pain level (intensity and magnitude) of the home patient reported from the patient terminal 4, the occurrence time, etc. are received and written in the pain report history file 23.

(Step S2) If the pain history of the home patient is to be analyzed, the process proceeds to step S3. If not, the process returns to step S1. Normally, the program is programmed to proceed to step S3 every time a predetermined time (for example, 24 hours) elapses. However, in order to cope with a sudden change in the condition of the home patient, an abnormal value (for example, pain intensity) is received from the patient terminal 4. May be set so that the analysis is performed temporarily.

(Step S3) The pain report history of the home patient is read from the pain report history file 23 and analyzed to create a pain pattern.

(Step S4) The pain pattern of the home patient is compared with the pain pattern recorded in the pain pattern file 24 to determine which of the above-mentioned patterns a to d the home patient's pain pattern belongs to. If the pattern is pattern a, the process proceeds to step S9, and if the pattern is patterns b to d, the process proceeds to step S5.

(Step S5) The medical history of the home patient is read from the medical history file 25.

(Step S6) The palliative care knowledge database 26 is searched to extract treatments and prescriptions corresponding to the state of the home patient.

(Step S7) The list file 27 of the attending physician etc. is searched to extract the address of the attending physician terminal 3 such as the attending physician of the home patient.

(Step S8) Data such as an alarm and medical history of the patient at home is sent to the address.

(Step S9) If stop processing of the management server 2 (for example, operation of a stop switch (not shown)) is instructed, the execution of the management program is terminated. If not instructed, the processing returns to Step S1 and continues processing.

  As described above, the home care support system 1 notifies the management server 2 of the pain intensity of the home patient at any time using the patient terminal 4, so that the home patient pain can be grasped almost in real time. Appropriate palliative care can be given at the right time. In addition, since the palliative care knowledge database 26 is provided to present the treatment and prescription suitable for the condition of the home patient to the attending physician, even the attending physician who is not proficient in palliative care should perform treatment and prescription close to the specialist. I can do it.

It is a notional block diagram of a home care support system showing an embodiment of the present invention. It is a notional block diagram of a management server. It is a notional block diagram of an attending doctor terminal. It is a notional block diagram of a patient terminal. It is a notional block diagram of a portable terminal. It is a figure which shows the example of a pain pattern. It is a flowchart which shows the example of a management program.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Home care support system 2 Management server 3 Primary doctor terminal 4 Patient terminal 5 Communication line 6 Communication line 7 Portable terminal 8 Communication means 21 CPU
22 Communication interface 23 Pain report history file 24 Pain pattern file 25 Medical history file 26 Palliative care knowledge database 27 List file of doctors etc. 31 CPU
32 Communication interface 41 CPU
42 Communication Interface 43 Input Device 71 CPU
72 Communication interface 73 Input device 74 Display device 75 Patient information storage device.

Claims (7)

A management server installed in the central office,
An attending physician terminal installed in the attending physician's clinic and communicating with the management server;
Each time the home patient or caregiver is installed in the home patient's home and feels pain, the home patient or caregiver has a patient terminal that reports the pain intensity and the time of occurrence to the management server,
The management server sequentially records the pain intensity and time of occurrence of the patient reported from the patient terminal, periodically analyzes them, and sends an alarm to the attending doctor terminal based on the result Home care support system characterized by that. The management server
With medical history storage means for storing the medical history of the home patient,
The home care support system according to claim 1, wherein a medical history of the home patient is sent to the attending physician terminal together with the alarm. The management server
Palliative care information storage means for accumulating information related to palliative care means,
By comparing the treatment history of the home patient read from the treatment history storage unit with the information on the palliative care stored in the palliative care information storage unit, information on the palliative care suitable for the medical condition of the home patient is extracted. With palliative care information search means to
The home care support system according to claim 1, wherein information related to palliative care suitable for a medical condition of the home patient is transmitted to the attending doctor terminal together with the alarm. A portable terminal carried by the attending physician or nurse,
The home care support system according to any one of claims 1 to 3, wherein the attending doctor terminal transfers the alarm to the portable terminal when receiving an alarm transmitted from the management server. The said attending doctor terminal sends the information regarding the palliative care suitable for the medical history of the home patient which concerns on the said alarm, and the said medical condition to the said portable terminal with the said alarm to the said portable terminal. Home care support system. The portable terminal is a home patient information input means for inputting information related to a medical condition of a home patient or a treatment performed on the home patient;
The home care support system according to claim 5, further comprising home patient information storage means for storing information on the home patient input from the home patient information input means. The portable terminal reads out information related to the home patient from the home patient information storage means, and sends the information to the attending doctor terminal.
The home care support system according to claim 6, wherein the attending doctor terminal transfers information on the home patient received from the portable terminal to a management server.

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