JP2010204993A - Image reading support method and system, and image reading support program - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an image reading result satisfied by a client while preventing large burden imposed on a specific image reading doctor. <P>SOLUTION: A request condition 41 transmitted from a client terminal 21 of a small-scale medical treatment facility G is received in a data center 12 (S11). A management part 46 determines a primary image reading doctor based on the request condition 41 (S12), and issues a request of image reading (S13). The management part 46 decides whether the primary image reading doctor is an expert or an unexperienced person (S14), determines an expert secondary image reading doctor (S15) when the primary image reading doctor is the unexperienced person (NO in S14), and issues a request of a check on an image reading result (S16). <P>COPYRIGHT: (C)2010,JPO&INPIT

Description

  The present invention relates to an interpretation support method and system for supporting interpretation of medical images, and an interpretation support program.

  In medical facilities such as hospitals, medical examination devices (modalities) such as CR (Computed Radiography) devices, CT (Computed Tomography) devices, and MRI (Magnetic Resonance Imaging) devices are widely used. A medical image photographed with a modality is observed by a specialist called an interpretation doctor, and an image diagnosis (interpretation) is performed. The interpretation doctor performs interpretation according to the request of a medical doctor (requester) such as a physician or surgeon, creates an interpretation report (interpretation result) describing the result, and returns it to the requester.

  In large-scale hospitals, a PACS (Picture Archiving and Communication System) for exchanging medical images and interpretation reports (hereinafter collectively referred to as medical images) on a network has been established. The clinician can exchange medical images and the like with the interpretation doctor resident in the hospital via the PACS network.

  On the other hand, in small and medium-sized hospitals and clinics (hereinafter referred to as small-scale medical facilities) where no interpreting doctor is stationed, even if modalities are introduced, interpretation cannot be performed in the facility, and the interpreting doctor is resident. I will ask an interpretation organization such as a large hospital for interpretation. The clinician at a small-scale medical facility will exchange medical images and the like with the interpreting doctor residing at the interpreting institution, but first, he will search for the interpreting doctor according to the contents of the interpretation, and It starts with making a request.

  The task of finding an interpreting doctor is a busy task for busy physicians, and it has been desired to reduce the burden of the task. In view of this, a system has been proposed in which an optimal interpreting doctor is searched based on the interpretation content input from the input terminal and a request is automatically made to the found interpreting doctor (see, for example, Patent Document 1). . According to this system, it is possible to make a request to the optimal interpreting doctor simply by inputting the interpretation content from the input terminal, so there is no need to search for an interpreting doctor, and this places a burden on the busy doctor. There is no.

JP 2006-268075 A

  However, in the system described in Patent Document 1, requests may concentrate on a specific interpreting doctor such as a capable interpreting doctor. In this case, a heavy burden is placed on the interpreting doctor who has concentrated the requests. On the other hand, an interpreting doctor who has little experience of interpretation and is relatively immature has fewer requests. In this case, an immature interpretation doctor cannot gain a lot of experience and does not grow easily. However, if the request is distributed to immature interpretation doctors, the requester cannot obtain a satisfactory interpretation result.

  The present invention has been made in view of the above-described problems, and an object of the present invention is to obtain a satisfactory interpretation result for a requester while preventing a large burden on a specific interpretation doctor. It is also aimed to train immature interpretation doctors.

  In order to achieve the above object, the image interpretation support system of the present invention reads a data list in which information of request destinations for interpretation is recorded, a memory in which the determination conditions of the request destination are written, and reads the determination conditions from the memory. The information of the request destination based on the read determination condition is searched from the data list, the first request destination is determined, and a first interpretation request is issued to the determined first request destination. The request means and the determination condition are read from the memory, the information on the request destination satisfying the predetermined evaluation criteria based on the read determination condition is searched from the data list, and the second request destination is determined. And a second request means for issuing a request for checking the interpretation result to the determined second request destination.

  The request is received from the first request means, the content of the received request is output at the first request destination, and the interpretation result created at the first request destination is received and received. The first input / output means for outputting the interpretation result, the interpretation result output from the first input / output means and the request from the second request means, and the interpretation result received. And the second input / output means for outputting the content of the received request at the second request destination, receiving the checked interpretation result, and outputting the received checked interpretation result. Receiving the checked interpretation result output from the second input / output means and outputting the received checked interpretation result at the request source; It is preferable to provide.

  The second input / output unit outputs the received checked interpretation result to the first request destination, and a feedback unit feeds back the checked interpretation result to the first request destination. It is preferable that the first input / output unit receives the checked interpretation result from the feedback unit and outputs the received interpretation result at the first request destination.

  The feedback means functions as an interpretation result return means for returning the interpretation result to the first request destination, and the first input / output means receives the interpretation result from the interpretation result return means. In this case, it is preferable to accept the interpretation result recreated at the first request destination.

  Further, it is preferable that the second input / output unit functions as an interpretation result correcting unit that receives a correction item for the received interpretation result and corrects the interpretation result based on the received correction item.

  The first input / output unit functions as a reliability accepting unit that receives the reliability of the interpretation result and outputs the accepted reliability, and the second input / output unit accepts the reliability acceptance. It is preferable that the reliability output from the means is received and the received reliability is output at the second request destination.

  The second input / output unit functions as an evaluation result receiving unit that receives an evaluation result obtained by evaluating the interpretation result at the second request destination and outputs the received evaluation result to the memory. It is preferable that information evaluation means is provided for reading the evaluation result from the memory and updating the data list based on the read evaluation result.

  And a warning means for issuing a warning that the evaluation has been lowered for the requestee whose evaluation has been lowered by updating the data list, wherein the first input / output means receives the warning from the warning means. Preferably, the received warning is output at the first request destination.

  Moreover, it is preferable that said 1st request | requirement means makes only the said request destination which does not satisfy | fill the said predetermined evaluation criteria as the object of a search.

  Further, it is preferable that the second request unit functions only when the first request destination determined by the first request unit does not satisfy a predetermined standard.

  The interpretation support method of the present invention receives a determination condition of a request destination to perform interpretation, a determination condition reception step of writing the received determination condition into a memory, and reading the determination condition from the memory to a first request unit, The request destination information based on the read determination condition is searched from the data list in which the request destination information is recorded, and the first request destination is determined by the first request means and the determined first A first request step for issuing an interpretation request from the first request means to the request destination, and reading the determination condition from the memory to the second request means, based on the read determination condition, and Information on the request destination satisfying a predetermined evaluation standard is searched from the data list, a second request destination is determined by the second request means, and the determined second request destination is Wherein the computer and the second request step of issuing a request for checking the interpretation result from the second request unit to be executed.

  The interpretation support program of the present invention receives a determination condition of a request destination to perform interpretation, a determination condition acceptance step of writing the received determination condition in a memory, and reads the determination condition from the memory to a first request unit, The request destination information based on the read determination condition is searched from the data list in which the request destination information is recorded, and the first request destination is determined by the first request means and the determined first A first requesting step for requesting interpretation from the first requesting unit to the requesting destination, and reading the determination condition from the memory to the second requesting unit, based on the read determination condition and predetermined The information of the request destination satisfying the evaluation criteria is searched from the data list, the second request destination is determined by the second request means, and the determined second request is determined Characterized in that to execute a second request step of issuing a request for checking the interpretation result from the second request unit to the computer with respect.

  According to the interpretation support method and system and the interpretation support program of the present invention, it is possible to prevent a large burden on a specific interpretation doctor. Even when an inexperienced interpreting doctor is requested to interpret an image, an experienced interpreting doctor checks it, so that a satisfactory interpretation result can be obtained. Furthermore, it is possible to nurture immature interpretation doctors by feeding back the results checked by skilled interpretation doctors.

It is an explanatory view showing roughly the composition of the medical network system of a first embodiment. It is a block diagram which shows the structure of each terminal and server. It is a figure which shows the request conditions transmitted to an interpretation support server. It is a block diagram which shows each structure constructed | assembled by CPU of the interpretation support server. It is a figure which shows the function of the management part constructed | assembled by CPU of the interpretation support server. It is a figure which shows the request information list stored in request information DB, and the radiology doctor information list stored in radiology doctor information DB. It is a figure which shows the report check screen displayed on a report preparation terminal. It is a figure which shows the evaluation result input screen displayed on a report preparation terminal. It is a flowchart explaining the processing procedure of the medical network system from when the data center receives a request for interpretation to when it issues a request to the interpretation organization. It is a flowchart explaining the process sequence of the medical network system from when a data center receives an interpretation report until it outputs an interpretation report to a small-scale medical facility. It is explanatory drawing which shows schematically the structure of the medical network system of 2nd embodiment. It is a figure which shows the reliability input screen displayed on a report preparation terminal. It is a figure which shows the report check screen displayed on a report preparation terminal. It is a figure which shows the dialog box which notifies that the rank of an interpretation doctor has gone down, (A) has shown at the time of rank down, (B) has each shown at the time of rank up.

[First embodiment]
A medical network system 11 according to the first embodiment shown in FIG. 1 includes a data center 12 and a plurality of medical facilities A, B, C, D, E, F, G, H, and I. The data center 12 and the plurality of medical facilities A to I are connected via the IP network 13, and the medical network system 11 functions as an interpretation support system that supports interpretation of the medical image 42 (see FIG. 3) online. To do.

  The IP network 13 uses a dedicated wide area IP network owned by a communication carrier as a base network, and is a closed area network in which a VPN (Virtual Private Network) is constructed on the wide area IP network. By constructing the VPN, data passing through the IP network 13 is not leaked outside the medical network system 11, and data security is ensured.

  The plurality of medical facilities A to I are classified into interpretation institutions A, B, C, D, E, and F in which an interpreting doctor resides and small medical facilities G, H, and I in which no interpreting doctor is resident. . Each of the interpretation institutions A to F has a plurality of interpreting doctors, and the interpreting doctors are classified into unskilled persons and skilled persons according to rank (see FIG. 6).

  When an interpretation doctor resident in the interpretation institutions A to F receives a request for interpretation from the small-scale medical facilities G to I, it interprets the target medical image 42 and interprets the interpretation result 61 (see FIG. 7). Hereinafter, an interpreting doctor who interprets and creates an interpretation report 61 is referred to as a primary interpreting doctor. The created interpretation report 61 is uploaded to the data center 12 from the interpretation institutions A to F. The interpretation report 61 uploaded from the interpretation institutions A to F by the primary interpretation doctor can be accessed from the interpretation institutions A to F by the secondary interpretation doctor who checks the interpretation report 61. When an expert performs interpretation as a primary interpretation doctor, the interpretation report 61 need not be checked, and the interpretation report 61 uploaded from the interpretation institutions A to F by the expert who is the primary interpretation doctor is the request source. Access is possible from the small-scale medical facilities GI.

  When an experienced interpretation doctor receives an interpretation report 61 created by an unskilled primary interpretation doctor, the doctor interprets the received interpretation report 61. Hereinafter, an interpreting doctor who checks the interpretation report 61 is referred to as a secondary interpreting doctor. The checked interpretation report 61 is uploaded to the data center 12 from the interpretation institutions A to F by the secondary interpretation doctor and interpreted by the requesting small medical facility G to I and the primary interpretation doctor who created the interpretation report 61. It becomes accessible from the institutions A to F.

  Interpretation institutions A to F are each provided with a communication interface (hereinafter abbreviated as communication I / F) 14, a client terminal 15, a report creation terminal 16, and the like. These 14-16 are mutually connected via LAN etc. in interpretation organization AF.

  The communication I / F 14 converts the data format between the format corresponding to the LAN in the interpretation institutions A to F and the format compatible with the IP network 13 and connects the LAN in the interpretation institutions A to F and the IP network 13. To do. The communication I / F 14 is a modem, a router, or the like, and may be appropriately selected based on the standards of the LANs of the image interpretation agencies A to F and the IP network 13.

  The client terminal 15 and the report creation terminal 16 are configured by a personal computer or the like. The client terminal 15 is used when receiving a request for interpretation.

  The report creation terminal 16 reads data related to the request received by the client terminal 15, downloads the medical image 42 and the interpretation report 61 from the data center 12, displays the downloaded medical image 42 and the interpretation report 61 on the display, and interprets the interpretation report. 61 is used for creating and checking 61 and uploading the created and checked interpretation report 61 to the data center 12. That is, the report creation terminal 16 functions as the first and second input / output means together with the client terminal 15.

  The checked interpretation report 61 uploaded to the data center 12 from the report creation terminal 16 can be accessed from the interpretation institutions A to F by the primary interpretation doctor, and the report creation terminal 16 functioning as the second input / output means includes: It also functions as feedback means for feeding back the checked interpretation report 61 to the primary interpretation doctor.

  Although details will be described later, the report creation terminal 16 returns the checked interpretation report 61 to the primary interpreting doctor, corrects the checked interpretation report 61, evaluates the checked interpretation report 61, and evaluates the evaluation result of the interpretation report 61. It is also used for uploading to the data center 12.

  That is, the report creation terminal 16 that functions as a feedback unit also functions as an interpretation result return unit that sends back the interpretation report 61 to the primary interpreting physician and instructs the interpretation to be performed again. The report creation unit 16 also functions as an interpretation result correction unit that receives correction items of the interpretation report 61 and corrects the interpretation report 61 based on the received correction items. Further, the report creation unit 16 functions as an evaluation result receiving unit that receives the evaluation result of the interpretation report 61 and uploads the received evaluation result to the data center 12.

  Each of the small medical facilities G to I is provided with a communication I / F 20, a client terminal 21, a modality 22, and the like. These 20 to 22 are connected to each other via a LAN or the like in the small-scale medical facilities G to I.

  The communication I / F 20 and the client terminal 21 have the same basic configuration as the communication I / F 14 and the client terminal 15 described above. The client terminal 21 is used for an interpretation request to the data center 12, uploading a medical image 42 to the data center 12, downloading an interpretation report 61 from the data center 12, and the like. That is, the client terminal 21 functions as a result output unit that outputs the interpretation report 61 at the request source.

  When the medical image 42 is taken by the modality 22, information such as the patient's name and a patient ID unique to each medical facility is input. The input information is stored as supplementary information in the data file of the medical image 42. The data file of the medical image 42 is stored in a DICOM (Digital Imaging and Communications) standard file format, which is a standard for medical digital images and communication.

  The DICOM standard file has an area for storing auxiliary information in addition to an area for storing image data. The incidental information stored in the file includes patient information such as “patient name”, “patient ID”, “gender”, and “age”, “modality type (examination type)”, “imaging site”, And imaging information such as “name of medical facility that performed imaging”.

  When the data center 12 receives an interpretation request from the small-scale medical facilities G to I, the data center 12 requests the primary interpretation doctor who satisfies the accepted request condition 41 (see FIG. 3). The request condition 41 includes conditions for determining a request destination for interpretation. Further, the data center 12 functions as a first requesting unit that issues a request for interpretation. At this time, the medical images 42 uploaded from the small-scale medical facilities G to I are stored in the data center 12 and can be accessed from the interpretation institutions A to F that have received the interpretation request.

  In addition, when the data center 12 requests an unskilled interpreting doctor to interpret an image, the data center 12 satisfies the request condition 41 received from the small-scale medical facilities G to I, and is the same interpretation engine as the unskilled interpreting doctor who requested the interpretation. Request the expert interpretation doctors belonging to A to F to check the interpretation report 61 created by the unskilled interpretation doctor. That is, the data center 12 functions as a second request unit that issues a request for checking the interpretation report 61. At this time, the interpretation report 61 uploaded from the interpretation institutions A to F by an unskilled interpretation doctor is stored in the data center 12 and can be accessed from the interpretation institutions A to F by a skilled interpretation doctor who has received a request for checking. .

  The data center 12 is provided with a communication I / F 23, an interpretation support server 24, an image server 25, a report server 26, and the like. These 23 to 26 are connected to each other via a LAN in the data center 12 or the like.

  The communication I / F 23 has the same basic configuration as the communication I / Fs 14 and 20 described above, and connects the LAN in the data center 12 and the IP network 13.

  The image interpretation support server 24, the image server 25, and the report server 26 are configured by a server computer or the like. Interpretation support server 24 accepts interpretation requests from small-scale medical facilities G to I, requests for interpretation to primary interpretation doctors residing in interpretation institutions A to F, and secondary interpretations residing in interpretation institutions A to F. Request the doctor to check the interpretation report 61.

  The image server 25 stores medical images 42 uploaded from the small medical facilities G to I to the data center 12 and functions as an image database (hereinafter abbreviated as DB). The medical image 42 is sorted and classified for each image ID given when stored in the image server 25, and can be searched with various search keys.

  The report server 26 stores the interpretation report 61 uploaded to the data center 12 from the interpretation institutions A to F, and functions as a report DB. The interpretation report 61 is sorted and classified for each report ID given when stored in the report server 26, and can be searched with various search keys.

  As shown in FIG. 2, the computers constituting the terminals 15, 16, and 21 and the servers 24, 25, and 26 have substantially the same basic configuration, that is, a CPU 31, a memory 32, a storage device 33, and a LAN, respectively. A port 34, a display 35, and an input device 36 such as a keyboard and a mouse are provided. These 31 to 36 are connected to each other via a data bus 37.

  The storage device 33 is an HDD (Hard Disk Drive), and a control program and an application program (AP) 38 are installed. The APs 38 installed in the storage devices 33 of the terminals 15, 16, 21 and the servers 24, 25, 26 constitute an interpretation support program in association with each other.

  In addition to the program, a Web browser is installed in the storage device 33 of each terminal 15, 16, 21. When a predetermined URL is specified after the Web browser is activated, the Web browser accesses the interpretation support server 24 and makes a request for delivery of page data. As a result, predetermined page data is distributed from the image interpretation support server 24. The display 35 displays a predetermined screen based on the distributed page data.

  The memory 32 is a work memory for the CPU 31 to execute processing. The CPU 31 reads the AP 38 and other programs installed in the storage device 33 into the memory 32, and controls each part of the computer in an integrated manner. The LAN port 34 is an interface that performs transmission control with the LAN.

  As shown in FIG. 3, when requesting interpretation from the small-scale medical facilities G to I, the request condition 41 and the medical image 42 are transmitted from the client terminal 21 to the data center 12. The request condition 41 includes “requesting medical facility name”, “requesting doctor name”, “image ID”, “patient name”, “imaging site”, “examination type”, “urgency”, “Importance” and “Deadline for delivery” are included.

  As shown in FIG. 4, a transmission / reception unit 44, a DB access unit 45, and a management unit 46 are constructed in the CPU 31 of the image interpretation support server 24 in order to execute the processing steps described in the AP 38. The storage device 33 of the image interpretation support server 24 is provided with a request information DB 48, an image interpretation doctor information DB 49, and a page information DB 50.

  The transmission / reception unit 44 exchanges data with the client terminal 15 and the report creation terminal 16 provided in the interpretation institutions A to F and the client terminal 21 provided in the small-scale medical facilities GI.

  The DB access unit 45 updates and acquires data by accessing the image server 25, the report server 26, the request information DB 48, the interpretation doctor information DB 49, and the page information DB 50.

  As shown in FIG. 5, the management unit 46 searches the interpretation doctor information DB 49 via the DB access unit 45 based on the request condition 41 received via the transmission / reception unit 44 and determines the primary interpretation doctor. The management unit 46 issues an interpretation request via the transmission / reception unit 44 to the interpretation institutions A to F to which the determined primary interpretation doctor belongs.

  The management unit 46 determines whether the determined primary interpretation doctor is classified into an immature person or a skilled person (see FIG. 6). When the management unit 46 determines that the person is classified as an immature person, the management unit 46 searches the interpretation doctor information DB 49 based on the request condition 41 and requests a check of the interpretation report 61 created by the primary interpretation doctor. The next interpreting doctor is determined from skilled persons belonging to the same interpretation institutions A to F as the primary interpreting doctor. The management unit 46 issues a request for checking the interpretation report 61 via the transmission / reception unit 44 to the interpretation institutions A to F to which the determined secondary interpretation doctor belongs.

  As shown in FIG. 6, a request information list 51 is stored in the request information DB 48. The request information list 51 includes, for each request condition 41 transmitted from the client terminal 21, “management number”, “acceptance date / time”, “each item of the request condition 41”, “name of primary interpretation doctor”, “secondary The “name of the interpreting doctor” and the “name of the interpreting organization to which the interpreting doctor belongs” are recorded in the order of acceptance as request information. Note that the name of the primary interpretation doctor and the name of the interpretation organization are recorded based on data read from the interpretation doctor information DB 49 when the management unit 46 determines the primary interpretation doctor. The name of the secondary interpreting doctor is recorded based on the data read from the interpreting doctor information DB 49 when the management unit 46 determines the secondary interpreting doctor.

  The interpretation doctor information DB 49 stores an interpretation doctor information list 52. The interpretation doctor information list 52 includes, for each interpretation doctor, “interpretation doctor ID”, “name of the interpretation organization to which he / she belongs”, “name of interpretation doctor”, “year of experience”, “special field”, “number of interpretations on hand”. ”,“ Rank ”, and the like are recorded as interpretation doctor information.

  The rank is expressed in five levels from 1 to 5. In this embodiment, the interpretation doctors with ranks 1 to 4 are immature persons who engage in interpretation but do not engage in checking the interpretation report 61. On the other hand, the interpretation doctor of rank 5 is an expert and engages not only in interpretation but also in checking the interpretation report 61.

  The number of interpretations on hand is a numerical value representing the burden on the interpreting doctor, and is considered when searching for the interpreting doctor. That is, the number of interpretations on hand is a determination condition for a request destination for interpretation. By excluding an interpreting doctor whose number of interpretations on hand has reached a predetermined number from being searched, it is possible to prevent requests from being concentrated on a specific interpreting doctor.

  The page information DB 50 shown in FIG. 4 stores various page data to be displayed on the display 35 of each terminal 15, 16, 21. The page data is distributed to each terminal 15, 16, 21 in response to the distribution request.

  The report check screen 56 shown in FIG. 7 is a screen used when the secondary interpretation doctor checks the interpretation report 61, and is displayed on the display 35 of the report creation terminal 19 provided in the interpretation institutions A to F.

  The report check screen 56 includes a report display area 57 on the left side of the screen, a key image display area 58 on the upper right side of the screen, and a button display area 59 on the lower right side of the screen. On the report check screen 56, a pointer 60 used for the selection operation is displayed. The pointer 60 moves on the report check screen 56 when the mouse is operated.

  In the report display area 57, an interpretation report 61 created by the primary interpretation doctor is displayed. The interpretation report 61 includes a plurality of key images 62 and finding sentences 63 corresponding to the key images 62. When the pointer 60 is aligned with the key image 62 and clicked with the mouse, the clicked key image 62 is enlarged and displayed in the key image display area 58.

  A scroll bar 64 for scrolling and displaying the interpretation report 61 is provided at the right end of the report display area 57. The scroll bar 64 is scrolled when the mouse is operated and dragged with the pointer 60. As the image interpretation report 61 is scrolled, a key image 62 and a finding sentence 63 that have not been displayed so far are displayed.

  In the button display area 59, an approval button 65, a correction button 66, a return button 67, and an evaluation button 68 are arranged. When the pointer 60 is aligned with the approval button 65 and clicked with the mouse, the image interpretation report 61 displayed in the report display area 57 is uploaded to the data center 12 and is the requesting small-scale medical facility GI. Or, the primary interpretation doctor who created the interpretation report 61 can access from the interpretation institutions A to F. The secondary interpretation doctor clicks the approval button 65 when the interpretation report 61 has been checked.

  When the pointer 60 is aligned with the correction button 66 and clicked with the mouse, a report correction screen (not shown) is displayed instead of the report check screen 56. By operating the input device 36 according to the report correction screen and inputting correction items, the interpretation report 61 is corrected based on the input correction items.

  On the report correction screen, a correction completion button (not shown) is arranged. When the pointer is placed on a correction completion button (not shown) and clicked with the mouse, the report check screen 56 is displayed again instead of the report correction screen.

  When the pointer 60 is placed on the send-back button 67 and clicked with the mouse, the image interpretation report 61 displayed in the report display area 57 is uploaded to the data center 12 and creates the image interpretation report 61. It becomes accessible from. That is, the secondary interpretation doctor sends back the interpretation report 61 and clicks the return button 67 when the primary interpretation doctor orders the interpretation of the interpretation again. When the return button 67 is clicked, it is impossible to click the approval button 65 until the interpretation report 61 displayed on the report check screen 56 is replaced with a report recreated by the primary interpretation doctor. Become.

  When the pointer 60 is placed on the evaluation button 68 and clicked with the mouse, an evaluation result input screen 71 shown in FIG. 8 is displayed instead of the report check screen 56. The evaluation result input screen 71 is a screen used when the secondary interpretation doctor evaluates the interpretation report 61, and five radio buttons 73 and decision buttons (not shown) are arranged for each evaluation item 72. The evaluation items 72 include “appropriate findings?”, “Appropriate diagnosis?”, “Appropriate key image?”, And the like.

  The radio button 73 is an option whose evaluation contents are defined in advance, and is defined as “very bad”, “bad”, “normal”, “good”, and “very good” in order from the left. When the pointer 60 is placed on the radio button 73 and clicked with the mouse, the clicked radio button 73 is checked, and the evaluation content is selected.

  The evaluation content selected by the radio button 73 is transmitted to the data center 12 when the pointer 60 is placed on the determination button and clicked with the mouse. The evaluation content transmitted to the data center 12 is recorded in the remarks column provided in the interpretation doctor information list 52 for each interpretation doctor who created the evaluated interpretation report 61. When a predetermined condition is satisfied for the evaluation contents recorded in the interpretation doctor information list 52, the rank recorded in the interpretation doctor information list 52 is updated. The rank update is performed by the DB access unit 45 based on a command from the management unit 46 built in the CPU 31 of the image interpretation support server 24. That is, the DB access unit 45 functions as an information updating unit that updates the radiogram interpretation doctor information list 52 based on the evaluation result. The timing for updating the rank is, for example, increased or decreased depending on how much the average value of 10 evaluation contents is above or below the predetermined standard value of the current rank. .

  When the determination button is clicked, a report check screen 56 shown in FIG. 7 is displayed instead of the evaluation result input screen 71. The approval button 65 cannot be clicked until the decision button is clicked on the evaluation result input screen 71, and can be clicked thereafter by clicking the decision button on the evaluation result input screen 71. Become.

  Next, a processing procedure of the medical network system 11 that functions as an interpretation support system will be described. First, a processing procedure from when a request for interpretation is received from the small-scale medical facilities G to I until a request is made to the interpretation doctors of the interpretation institutions A to F will be described with reference to the flowchart of FIG.

  The doctor of the small medical facility G operates the input device 35 of the client terminal 21, inputs the request condition 41 and the medical image 42, and requests the interpretation doctors of the interpretation institutions A to F to interpret (see FIG. 3). . The input request condition 41 and medical image 42 are transmitted from the client terminal 21 to the data center 12 via the IP network 13 and accepted by the data center 12 (step (hereinafter abbreviated as S) 11).

  The medical image 42 transmitted to the data center 12 is stored in the storage device 33 of the image server 25.

  On the other hand, the request condition 41 transmitted to the data center 12 is written in the memory 32 of the image interpretation support server 24. The request condition 41 written in the memory 32 is read to the management unit 46 via the transmission / reception unit 44 (see FIG. 4). The management unit 46 accesses the request information DB 48 via the DB access unit 45 and records the request information in the request information list 51 based on the read request condition 41.

  Further, the management unit 46 accesses the interpretation doctor information DB 49 via the DB access unit 45, searches the interpretation doctor information list 52 (see FIG. 6) based on the read request condition 41, and requests the interpretation. Is determined (S12).

  Interpretation doctor information relating to the determined primary interpretation doctor is read out to the management unit 46 via the DB access unit 45. The management unit 46 requests the interpretation via the transmission / reception unit 44 to the interpretation institutions A to F to which the primary interpretation doctor belongs based on “name of the interpretation organization to which the primary interpretation doctor belongs” that is one of the read interpretation doctor information. (S13).

  Further, the management unit 46 accesses the request information DB 48 via the DB access unit 45, and based on the read interpretation doctor information, the request information recorded in the request information list 51 (the name of the primary interpretation doctor, the interpretation doctor Update the name of the institution to which you belong).

  Furthermore, the management unit 46 determines whether the primary interpreting doctor is classified as an inexperienced person or an expert based on the rank that is one of the read interpreting doctor information (S14). When the rank is any one of 1 to 4, it is determined that the person is immature, and when the rank is 5, the person is determined to be an expert.

  If it is determined that the primary interpreting doctor is an immature person (NO in S14), the management unit 46 accesses the interpreting doctor information DB 49 via the DB access unit 45, and the request condition 41 read out earlier is set. Based on this, the interpretation doctor information list 52 is searched, and a secondary interpretation doctor who requests checking of the interpretation report 61 (see FIG. 7) created by the primary interpretation doctor is determined (S15). When determining a secondary interpreting doctor, a skilled interpreting doctor with a rank of 5 is searched from those who belong to the same interpretation institutions A to F as the primary interpreting doctor.

  The interpreting doctor information related to the determined secondary interpreting doctor is read out to the management unit 46 via the DB access unit 45. The management unit 46 interprets the interpretation report via the transmission / reception unit 44 to the interpretation institutions A to F to which the secondary interpretation doctor belongs based on “name of the interpretation organization to which the secondary interpretation doctor belongs” that is one of the read interpretation doctor information. A check request 61 is issued (S16).

  Also, the management unit 46 accesses the request information DB 48 via the DB access unit 45 and updates the request information (name of the secondary interpreting doctor) recorded in the request information list 51 based on the read interpreting doctor information. To do.

  In determining each of the primary and secondary interpreting doctors, the balance between the request condition 41 and each item of the interpreting doctor information list 52 is taken into consideration. For example, whether or not “imaging part” in the request condition 41 and “special field” in the interpretation doctor information list 52 match, “the number of interpretations on hand” that can correspond to “emergency” or “desired delivery date”. Whether or not the “year of experience” is in proportion to the “importance”. Since the primary interpreting doctor is assigned to the interpreting doctor who meets the request condition 41 as much as possible, there is a high probability that a skilled interpreting doctor will be determined as the primary interpreting doctor. However, as a result of taking into account the balance between the request condition 41 and each item of the interpretation doctor information list 52, an unskilled interpretation doctor may be determined as the primary interpretation doctor.

  Secondly, a processing procedure from when the interpretation report 61 is received from the interpretation institutions A to F until the interpretation report 61 is output to the small-scale medical facilities GI will be described with reference to the flowchart of FIG.

  The primary interpretation doctors A to F that have received the request for interpretation operate the input device 35 of the report creation terminal 16 to access the data center 12 and download the target medical image 42. The medical image 42 downloaded to the report creation terminal 16 is written in the memory 32 and displayed on the display 35 so that it can be interpreted.

  The primary interpretation doctor operates the input device 35 to create an interpretation report 61. The created image interpretation report 61 is transmitted from the report creation terminal 16 to the data center 12 via the IP network 13 and accepted by the data center 12 (S21).

  The interpretation report 61 transmitted to the data center 12 is stored in the storage device 33 of the report server 26 and is written in the memory 32 of the interpretation support server 24. The interpretation report 61 written in the memory 32 is read out to the management unit 46 via the transmission / reception unit 44. The management unit 46 accesses the request information DB 48 via the DB access unit 45, reads the request information from the request information list 51, and determines whether the interpretation report 61 needs to be checked (S22). Specifically, the management unit 46 determines that the interpretation report 61 needs to be checked when “secondary interpretation doctor name” is recorded in the request information list 51, and determines that it is not necessary when it is not recorded. To do.

  If it is determined that the interpretation report 61 needs to be checked (YES in S22), the secondary interpretation doctor belongs based on “name of the interpretation facility to which the interpretation doctor belongs” which is one of the read request information. A notification that the image interpretation report 61 has been created is sent to the image interpretation institutions A to F via the transmission / reception unit 44 (S23).

  Receiving the notification that the interpretation report 61 has been created, the secondary interpretation doctors of the interpretation institutions A to F operate the input device 35 of the report creation terminal 16 to access the data center 12 and the target interpretation report. Download 61. The image interpretation report 61 downloaded to the report creation terminal 16 is written in the memory 32 and displayed on the display 35 so that it can be viewed.

  The secondary interpretation doctor operates the input device 35 to appropriately correct, send back, and evaluate the interpretation report 61, and then clicks the approval button 65 with the mouse. When the approval button 65 is clicked, the checked interpretation report 61 is transmitted from the report creation terminal 16 via the IP network 13 and accepted by the data center 12 (S24).

  The interpretation report 61 transmitted to the data center 12 is stored in the storage device 33 of the report server 26 and is written in the memory 32 of the interpretation support server 24. The interpretation report 61 written in the memory 32 is read out to the management unit 46 via the transmission / reception unit 44.

  When the interpretation report 61 received in S24 is read by the management unit 46, or when it is determined that checking of the interpretation report 61 is unnecessary (NO in S22), the management unit 46 passes through the DB access unit 45. The request information DB 48 is accessed, and the request information of the read interpretation report 61 is read. Based on the “name of the requesting medical facility” that is one of the read request information, the management unit 46 completes the interpretation via the transmission / reception unit 44 toward the requesting small medical facility G to I. A notification to the effect is issued (S25).

  The doctors of the small-scale medical facilities GI that have received the notification that the interpretation has been completed operate the input device 35 of the client terminal 21 to access the data center 12 and download the target interpretation report 61 ( S26). The interpretation report 61 downloaded to the client terminal 21 is written in the memory 32 and displayed on the display 35 so that it can be browsed.

  As explained above, when the number of interpretation requests to a specific interpreting doctor has reached a predetermined number, the interpretation request is made to another interpreting doctor. Therefore, it is possible to prevent a large burden from being placed on a specific interpretation doctor. In addition, when a request for interpretation is made to an unskilled interpretation doctor, since the expert interpretation doctor checks the interpretation report 61, the doctors of the small medical facilities G to I who requested the interpretation are convinced. Interpretation results can be obtained. Further, when an inexperienced interpreting doctor creates an interpretation report 61, an expert interpreting doctor checks the interpretation report 61 and feeds back the result, so that the inexperienced interpreting doctor can gain experience.

  A skilled interpretation doctor may be involved in creating and checking the interpretation report 61. However, since it is easier to check the interpretation report 61 than to create it from scratch, the amount of work is relatively reduced. It is also possible to grasp the proficiency level of an immature interpretation doctor. On the other hand, an inexperienced interpreting doctor can absorb the skill of an expert interpreting doctor from the check results, and measures such as what to do to create a satisfactory interpretation report 61 can be easily taken.

  Since an expert interpreter who is an expert in interpretation interprets the check, the check is accurate and appropriate as compared with a case where a doctor in a small-scale medical facility G to I who requests interpretation is evaluated.

  In the above-described embodiment, the data center 12 is provided independently from the interpretation institutions A to F, and the interpretation doctors belonging to the interpretation institutions A to F make a request for interpretation from the small-scale medical facilities G to I. Although described as an example, an information management facility having a function equivalent to that of the data center 12 may be provided in a large-scale hospital, and the image interpretation support system may be completed in one large-scale hospital.

[Second Embodiment]
A medical network system 81 according to the second embodiment shown in FIG. 11 includes an information management facility 80 provided in the large-scale hospital X, a plurality of medical departments L, M, R, S, and T in the large-scale hospital X. Small-scale medical facilities G, H, and I. The information management equipment 80 is connected to each medical department L, M, R to T via the LAN 82 and is connected to each small medical facility G to I via the IP network 13. The information management facility 80 has a function equivalent to that of the data center 12 in the first embodiment, and includes a communication I / F 23, an image interpretation support server 24, an image server 25, and a report server 26.

  The medical departments L, M, and R to T are classified into an interpretation department L and M in which an interpreting doctor resides, and a clinical department R, S, and T in which a clinician who requests interpretation is resident. The interpretation support server 24 in this embodiment accepts interpretation requests not only from the small medical facilities G to I but also from the clinical departments R to T. In addition, description is abbreviate | omitted about the structure similar to 1st embodiment. The processing procedure and effects are the same as those in the first embodiment, and a description thereof will be omitted.

  In each of the above embodiments, when an inexperienced primary interpretation doctor creates the interpretation report 61, the interpretation doctor himself / herself may be able to input the interpretation reliability. By notifying the reliability to the secondary interpreting doctor who checks the interpretation report 61, the burden of the check can be reduced. Also, based on this reliability, it is possible to feed back from the secondary interpretation doctor to the primary interpretation doctor.

  A reliability input screen 86 shown in FIG. 12 is a screen used when an unskilled interpreting doctor creates an interpretation report 61, and is a display of the report creation terminal 16 provided in the interpretation institutions A to F and the interpretation departments L and M. 35.

  On the reliability input screen 86, five radio buttons 88 and a decision button (not shown) are arranged for each item 87. The item 87 includes “appropriate findings?”, “Appropriate diagnosis?”, “Appropriate key image?”, And the like.

  The radio button 88 is an option in which the reliability is defined in advance, and in order from the left, “not confident”, “somewhat unconfident”, “normal”, “some confident”, “confident” Is defined. When the radio button 88 is checked, the reliability is selected. That is, the report creation terminal 16 functions as a reliability accepting unit that accepts the reliability of the interpretation report 61.

  When the pointer 60 is placed on the determination button and clicked with the mouse, the reliability selected by the radio button 88 is transmitted to the data center 12 and stored in the storage device 33 of the report server 26 together with the interpretation report. . The reliability stored in the storage device 33 is downloaded together when the interpretation report 61 is downloaded to the interpretation institutions A to F and the interpretation departments L to Q by the secondary interpretation doctor.

  A report check screen 91 shown in FIG. 13 is obtained by adding a reliability display area 92 on the lower left side of the screen to the report check screen 56 shown in FIG. In the reliability display area 92, the reliability 93 for each item 87 input by the primary interpretation doctor in the interpretation institutions A to F and the interpretation departments L and M is displayed. The secondary interpretation doctor checks the interpretation report 61 with reference to the reliability 93 and performs evaluation. For example, measures such as checking the ones with low reliability 93 intensively, or reducing the evaluation when appropriate interpretation is not performed even though the reliability 93 is high are taken.

  In each of the above embodiments, when the rank of the interpreting doctor is down, the interpreting doctor may be notified of the fact. The interpretation doctor notified to that effect can know that his / her ability has fallen or has risen.

  When the interpretation doctor information list 52 is updated and the rank is lowered, the display 35 of the report creation terminal 16 provided in the interpretation institutions A to F and the interpretation departments L and M to which the interpretation doctor belongs is displayed on the display 35 of FIG. A dialog box 96 shown in A) is displayed. The dialog box 96 is accompanied by a message warning the primary interpreting physician that the rank has been lowered. The management unit 46 built in the CPU 31 of the image interpretation support server 24 provided in the data center 12 functions as a warning means for notifying rank down.

  On the other hand, when the rank is increased, a dialog box 97 shown in FIG. 14B is displayed on the display 35 of the report creation terminal 16. In the dialog box 97, a message for notifying the primary interpreting physician that the rank has been increased is added. It is an opportunity to inspire an interpreting doctor whose rank has been lowered, and encouragement to an interpreting doctor who has increased in rank.

  In each of the above-described embodiments, when a skilled interpretation doctor receives an interpretation request and creates an interpretation report 61, the interpretation report 61 is output without being checked, but this is limited to this form. It is not something. For example, an inexperienced interpreting doctor may be in charge of creating the interpretation report 61, and an experienced interpreting doctor may be dedicated to checking the interpretation report 61.

  In this case, when determining the primary interpreting doctor (see S12), searching for an immature interpreting doctor with a rank of 1 to 4 and deciding whether the determined primary interpreting doctor is an immature person or an expert. It is different from the above embodiments that it is not necessary to determine whether or not.

  When the interpretation unit is determined by the management unit 46, other items may be referred to instead of or in addition to the items exemplified in the above embodiments. For example, taking into account whether the request source of the request condition 41 has been interpreted before, how many radiographs of the request condition 41 have been interpreted in the past, the attendance status of the interpreting doctor, the qualifications possessed by the interpreting doctor, etc. May be. Alternatively, a conditional expression in which each item is digitized and weighted is created, and calculation is performed by applying the request condition 41 to the conditional expression, and an interpretation doctor may be determined according to a comparison result between the calculation result and a certain threshold value.

  In the first embodiment, an interpreting doctor belonging to the same interpreting institutions A to F as the primary interpreting doctor is determined as a secondary interpreting doctor and a check request is issued. The interpreting doctor who belongs to F may be determined as a secondary interpreting doctor, and a check request may be issued.

  In the first embodiment, the interpretation doctor is determined as the request destination and the request is issued. However, the interpretation organizations A to F are determined as the request destination without specifying the interpretation doctor, and the request is issued. Good.

11, 81 Medical network system 12 Data center 15 Client terminal 16 Report creation terminal 21 Client terminal 24 Interpretation support server 31 CPU
32 Memory 33 Storage device 35 Display 38 Application program (AP)
41 Request Condition 42 Medical Image 45 DB Access Unit 46 Management Unit 48 Request Information DB
49 Interpretation Doctor Information DB
51 Request Information List 52 Interpretation Doctor Information List 56 Report Check Screen 61 Interpretation Report 71 Evaluation Result Input Screen 80 Information Management Equipment 86 Reliability Input Screen 96 Dialog Box A, B, C, D, E, F Interpretation Organization G, H, I Small medical facilities L, M Interpretation department R, S, T Clinical department X Large hospital

Claims (12)

A data list that records the information of the client to be interpreted,
A memory in which the determination condition of the request destination is written;
The determination condition is read from the memory, the request destination information based on the read determination condition is searched from the data list, a first request destination is determined, and for the determined first request destination The first request means to issue a request for interpretation,
The determination condition is read from the memory, the request destination information satisfying a predetermined evaluation criterion based on the read determination condition is searched from the data list, and a second request destination is determined and determined. An interpretation support system comprising: second request means for issuing a request for checking the interpretation result to the second request destination. The request is received from the first request means, the content of the received request is output at the first request destination, and the interpretation result created at the first request destination is received and received. A first input / output means for outputting an interpretation result;
The interpretation result output from the first input / output unit and the request from the second request unit are received, and the received interpretation result and the content of the received request are displayed as the second request destination. And the second input / output means for receiving the checked interpretation result and outputting the received checked interpretation result;
A result output unit that receives the checked interpretation result output from the second input / output unit and outputs the received checked interpretation result at a request source. The interpretation support system according to Item 1. The second input / output means functions as a feedback means for outputting the received checked interpretation result to the first request destination and feeding back the checked interpretation result to the first request destination. And
The first input / output unit receives the checked interpretation result from the feedback unit, and outputs the received interpretation result at the first request destination. Interpretation support system. The feedback means functions as an interpretation result return means for returning the interpretation result to the first request destination,
4. The first input / output unit receives an interpretation result recreated at the first request destination when the interpretation result is returned from the interpretation result return unit. Interpretation support system described in 1.   3. The second input / output unit functions as an interpretation result correction unit that receives a correction item for the received interpretation result and corrects the interpretation result based on the received correction item. The interpretation support system in any one of -4. The first input / output unit receives a reliability indicating whether or not the interpretation result is confident, and functions as a reliability receiving unit that outputs the received reliability.
6. The second input / output unit receives the reliability output from the reliability receiving unit and outputs the received reliability at the second request destination. Interpretation support system described in any of the above. The second input / output unit functions as an evaluation result receiving unit that receives an evaluation result obtained by evaluating the interpretation result at the second request destination and outputs the received evaluation result to the memory.
The image interpretation support system according to claim 2, further comprising an information update unit that reads the evaluation result from the memory and updates the data list based on the read evaluation result. A warning means for issuing a warning that the evaluation has been lowered with respect to the requestee whose evaluation has been lowered by updating the data list;
The image interpretation support system according to claim 7, wherein the first input / output unit receives the warning from the warning unit and outputs the received warning at the first request destination.   9. The image interpretation support system according to claim 1, wherein the first requesting unit searches only the request destination that does not satisfy the predetermined evaluation criterion.   The second request unit functions only when the first request destination determined by the first request unit does not satisfy a predetermined criterion. Interpretation support system. A determination condition receiving step of receiving a determination condition of a request destination to perform interpretation and writing the received determination condition in a memory;
The determination condition is read from the memory to the first request means, the request destination information based on the read determination condition is searched from the data list in which the request destination information is recorded, and the first request destination is determined. A first requesting step of determining by the first requesting means and issuing an interpretation request from the first requesting means to the determined first request destination;
The determination condition is read from the memory to a second requesting unit, information on the request destination that satisfies the predetermined evaluation criteria based on the read determination condition is searched from the data list, and a second request destination is determined. The computer executes a second requesting step of determining by the second requesting unit and issuing a request for checking the interpretation result from the second requesting unit to the determined second requesting destination. Interpretation support method characterized by A determination condition receiving step of receiving a determination condition of a request destination to perform interpretation and writing the received determination condition in a memory;
The determination condition is read from the memory to the first request means, the request destination information based on the read determination condition is searched from the data list in which the request destination information is recorded, and the first request destination is determined. A first requesting step for determining by the first requesting means and requesting the first requesting means to perform interpretation from the first requesting means;
The determination condition is read from the memory to a second request unit, information on the request destination satisfying a predetermined evaluation criterion based on the read determination condition is searched from the data list, and a second request destination is determined. And making the computer execute a second requesting step of making a request for checking the interpretation result from the second requesting unit to the second requesting destination determined by the second requesting unit. Interpretation support program characterized by

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