JP2010237833A - Medical cooperation system - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide medical facility which accepts a patient with all medical examination information on the patient without requiring a server manager to register medical examination information to a server in a previous medical facility and giving access right. <P>SOLUTION: In the regional medical cooperation system 100, when patient information on a patient who is to be transferred to the other medical facility and medical facility information are input in a medical accounting terminal 1, medical examination information on the patient of the input patient information is read from a facility internal server 2 and transmitted to a data management server 4, and transfer information including the input patient information and the medical facility information is transmitted to the data management server 4. The data management server 4 saves the medical examination information received from the medical accounting terminal 1, and gives a right to access the saved medical examination information for the patient who is to be transferred, to the medical facility that accepts the patient based on the medical examination information received from the medical accounting terminal 1 and information on the medical facility. <P>COPYRIGHT: (C)2011,JPO&INPIT

Description

  The present invention relates to a medical cooperation system.

  In recent years, medical facilities such as community medical support hospitals that handle emergency patients and special function hospitals that can receive advanced medical care are being segregated. Among them, it is important to transfer to the patient according to the patient's symptoms and the function of the medical facility, and to take over the patient. Therefore, by sharing patient medical information between local medical facilities, the burden on patients at the time of transfer is reduced in terms of contraindications, drug prescriptions, tests, etc., and patients are introduced smoothly between medical facilities. Is under way.

  For example, Patent Literature 1 discloses a technology in which a medical facility that introduces a patient registers patient information in a regional medical cooperation server, and a medical facility that introduces a patient acquires patient information from the regional medical cooperation server. Yes.

JP 2005-122380 A

  By the way, when medical information is shared between medical facilities in the region, the medical information is related to the patient's personal information, so it cannot be made public to anyone. Therefore, authority authentication is required for medical facilities and users who access medical information. As a method of authority authentication, it is performed at the level of facility authentication, node authentication, user authentication, content authentication, etc., and free browsing is not possible.

  When it is necessary to view medical information at a facility where access authority is not granted, the administrator of the server that stores the medical information is set to grant authority to that facility manually. It is supposed to bother the server administrator.

  In addition, in order to share medical information between medical facilities, it is necessary to register the patient's medical information from the original medical facility to the server at the time of transfer, but conventionally this work is done manually. Has been done. This places a burden on busy medical workers. In addition, it is difficult to confirm whether the medical information of each department can be disclosed without omission.

  An object of the present invention is to eliminate the trouble of registering medical information in a server at a medical facility of a transfer source and the trouble of granting access authority by a server administrator, and to provide patient medical information without omission to the transfer destination. That is.

In order to solve the above-mentioned problem, the invention described in claim 1
A medical cooperation system in which a medical accounting terminal connected to a storage means for storing medical information generated in a medical facility and a data management server are connected so that data can be transmitted and received,
The medical accounting terminal stores the medical information about the patient of the input patient information when the patient information of the patient to be transferred to another medical facility and the transfer destination information indicating the medical facility of the transfer destination are input. Read from the means and transmit to the data management server and the input patient information and transfer destination information to the data management server,
The data management server stores the medical information received from the medical accounting terminal, and stores the stored medical information about the patient to be transferred based on the patient information and the transfer destination information received from the medical accounting terminal. Is granted to the medical facility at the transfer destination.

The invention according to claim 2 is the invention according to claim 1,
The data management server, if the input information of the transfer destination includes a medical department or a doctor in charge in the medical facility at the transfer destination, grants access authority to the medical information about the patient to be transferred to the medical facility. It is given to the department or doctor in charge.

The invention according to claim 3 is the invention according to claim 1 or 2,
The medical accounting terminal transmits, to the data management server, medical information that is not stored in the data management server among the medical information about the patient of the input patient information stored in the storage unit.

  ADVANTAGE OF THE INVENTION According to this invention, it becomes possible to eliminate the effort of registration to the server of the medical treatment information in the medical facility of a transfer origin, and the effort of granting access authority by a server administrator. In addition, it is possible to provide patient medical information without omission to the transfer destination.

It is a figure showing the whole community medical cooperation system composition in an embodiment of the invention. It is a block diagram which shows the functional structure of the medical accounting terminal of FIG. It is a figure which shows the data structural example of the transfer information stored in the transfer information DB of FIG. It is a figure which shows the data structural example of the sample test data stored in sample test DB of FIG. It is a figure which shows the data structural example of the data stored in image DB of FIG. It is a block diagram which shows the functional structure of the data management server of FIG. It is a figure which shows the data structural example of the authorization information stored in authorization information DB of FIG. It is a figure which shows the example of data storage of the authentication information table of FIG. It is a figure which shows the flow of the process performed between the apparatuses of the regional medical cooperation system of FIG. It is a figure which shows the flow of the process performed between the apparatuses of the regional medical cooperation system of FIG.

  Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings. However, the scope of the invention is not limited to the illustrated examples.

[Configuration of regional medical cooperation system 100]
In FIG. 1, the system configuration | structure of the regional medical cooperation system 100 in this Embodiment is shown.
As shown in FIG. 1, the regional medical cooperation system 100 includes a medical accounting terminal 1, an in-facility server 2 and an electronic medical record terminal 3 installed in each of a plurality of medical facilities, and data management installed in a regional data center. The server 4 is connected to the server 4 via a communication network N such as the Internet so that data can be transmitted and received. The medical accounting terminal 1, the in-facility server 2, and the electronic medical record terminal 3 of each medical facility are connected to each other via a LAN (Local Area Network) or the like so as to be able to transmit and receive data.
The regional medical cooperation system 100 is a system for sharing patient medical information between medical facilities in a region. Medical information refers to information about a patient acquired in the course of medical treatment, and includes, for example, medical images, specimen examination data, interpretation reports, pathological diagnosis reports, medical records, and the like.

[Device configuration of each device of regional medical cooperation system 100]
Hereinafter, each apparatus which comprises the regional medical cooperation system 100 is demonstrated.

[Medical accounting terminal 1]
The medical accounting terminal 1 is a terminal (receipt) that performs reception registration of patients who come to the hospital and performs accounting processing, preparation of medical remuneration statements, etc. based on the input of examinations, examinations, prescriptions, etc. performed on the patients Computer). In addition, when the accounting subject patient is transferred to another medical facility, the medical accounting terminal 1 receives the patient information of the patient and the information of the transfer destination and transmits it to the data management server 4 and the patient to be transferred to the hospital. Are sent to the data management server 4.

FIG. 2 shows a functional configuration example of the medical accounting terminal 1.
As shown in FIG. 2, the medical accounting terminal 1 includes a control unit 11, a RAM 12, a storage unit 13, an operation unit 14, a display unit 15, a communication unit 16, a timing unit 17, and the like. 18 is connected.

The control unit 11 is configured by a CPU (Central Processing Unit) or the like, reads out various programs including a system program stored in the storage unit 13, expands the program in the RAM 12, and executes various processes according to the expanded program. For example, the control unit 11 executes the process of the medical accounting terminal 1 shown in FIGS. 9A to 9B according to the program stored in the storage unit 13.

  The RAM 12 temporarily stores a work area for temporarily storing various programs, input or output data, parameters, and the like that can be executed by the control unit 11 read from the storage unit 13 in various processes controlled by the control unit 11. Form.

The storage unit 13 includes an HDD (Hard Disk Drive), a semiconductor nonvolatile memory, or the like. The storage unit 13 stores various programs as described above.

The storage unit 13 stores a patient information DB (Data Base) 131, an accounting information DB 132, a transfer information DB 133, and the like.
The patient information DB 131 is a database that stores patient information of patients who have visited the hospital. Patient information includes patient ID, patient name, date of birth, sex, address, telephone number, patient medical history, allergy, health insurance card number, family information, and the like.
The accounting information DB 132 is a database that stores accounting information generated by accounting processing. The accounting information includes information such as an accounting number, a patient ID, a patient burden amount, and an insurance claim amount.

  The hospital transfer information DB 133 is a database that stores hospital transfer information issued when a patient is transferred to another hospital. FIG. 3 shows a data configuration example of the transfer information. As shown in FIG. 3, the transfer information includes “patient information” and “transfer destination information”. “Patient information” is patient information related to a patient who has been transferred. The patient information here is a part of patient information stored in the above-described patient information DB 131 such as patient ID, patient name, date of birth, sex, address, telephone number, and the like. “Transfer destination information” includes the accounting number at the time of transfer (when the transfer procedure such as input of information on the medical facility at the transfer destination is performed), the date and time of transfer indicating the date and time of the transfer, and the name of the medical facility at the transfer destination. , Information on clinical departments, doctors in charge, etc. are included.

  The operation unit 14 includes a keyboard having cursor keys, numeric input keys, various function keys, and the like, and a pointing device such as a mouse, and a key pressing signal pressed by the keyboard and an operation signal by the mouse. Is output to the control unit 11 as an input signal.

  The display unit 15 includes a monitor such as a CRT (Cathode Ray Tube) or an LCD (Liquid Crystal Display), for example, and displays various screens according to instructions of display signals input from the control unit 11.

  The communication unit 16 includes a LAN (Local Area Network) adapter, a router, a TA (Terminal Adapter), and the like, and is connected via the communication network N and the in-facility server 2 and the electronic medical record terminal 3 connected via the hospital LAN. Data is transmitted to and received from an external device such as the data management server 4.

  The timer unit 17 is configured by an RTC (Real Time Clock) or the like, and measures the current time and the current date and outputs them to the control unit 11.

[In-facility server 2]
The in-facility server 2 stores a specimen test DB 231 and an image DB 232 that store medical information generated in the medical facility and medical information such as specimen test data. The in-facility server 2 reads out medical information in response to a request from the medical accounting terminal 1 and outputs it to the medical accounting terminal 1.

  FIG. 4 shows a data configuration example of sample test data stored in the sample test DB 231. As shown in FIG. 4, the sample test data is composed of “patient information”, “test identification information”, “sample identification information”, “container identification information”, and “test result information”. The “inspection identification information” includes information such as an inspection ID, inspection purpose, inspection content, and acquisition date / time. The “sample identification information” includes information such as a sample ID, a collection method, a collection amount, a collection date / time, and a reception date / time. The “container identification information” includes information such as a container ID, a container volume, an additive, a dilution rate, and a temperature. “Inspection result information” includes information such as an inspection item, an inspection value, a unit, a reference value, a practitioner, an analysis date, and a device ID.

  FIG. 5 shows a data configuration example of data stored in the image DB 232. As shown in FIG. 5, “patient information”, “examination information”, “series information”, “image information”, and “diagnosis report information” are stored in the image DB 232. The “inspection information” includes information such as an inspection ID, an inspection purpose, inspection contents, and an acquisition date. The “series information” includes information such as a technique, a part, a direction, and an engineer. The “image information” includes information on the number of images (the number of images in the entire series), image number, image size, and bitmap (image data). The “diagnosis report information” includes information on interpretation doctors, reference images, observation findings, and diagnosis reports.

  The in-facility server 2 may store other medical information such as a pathological diagnosis report and electronic medical record information as well as medical images and specimen examination data.

[Electronic medical chart terminal 3]
The electronic medical record terminal 3 is a computer device that is installed in each medical facility and is used by a doctor to display medical information, perform interpretation and diagnosis.

[Data management server 4]
The data management server 4 is installed in the data center and stores and manages medical information transmitted from the medical accounting terminal 1 of each medical facility. When the data management server 4 receives the transfer information from the medical accounting terminal 1 of the transfer-source medical facility, based on the received transfer information, the data management server 4 performs the medical treatment related to the patient to be transferred to the transfer-destination medical facility or medical department. The access authority to the information is granted for a certain period, and the patient's medical information is read and transmitted in response to the access from the user belonging to the medical facility to which the authority is granted.
Here, a medical facility where a patient is transferred from one medical facility to another medical facility is referred to as a transfer source, and another medical facility is referred to as a transfer destination.

FIG. 6 shows a functional configuration example of the data management server 4.
As shown in FIG. 6, the data management server 4 includes a control unit 41, a RAM 42, a storage unit 43, an operation unit 44, a display unit 45, a communication unit 46, a time measuring unit 47, etc. 48 is connected.

  The functions of the control unit 41, the RAM 42, the storage unit 43, the operation unit 44, the display unit 45, the communication unit 46, and the time measuring unit 47 of the data management server 4 are the control unit 11, the RAM 12, the storage unit 13, and the like described in FIG. Since it is substantially the same as the operation part 14, the display part 15, the communication part 16, and the time measuring part 17, only a different part is demonstrated below.

The storage unit 43 stores various programs executed by the control unit 41. In addition, the storage unit 43 stores a specimen test DB 431, an image DB 432, an authorization information DB 433, an authentication information DB 434, and the like.
The sample test DB 431 stores sample test data transmitted from the medical accounting terminal 1. The specimen test data is the same as that shown in FIG.
The image DB 432 stores medical images transmitted from the medical accounting terminal 1 and information related to medical images. The data stored in the image DB 432 is the same as that shown in FIG.

  Note that the storage unit 43 may store other medical information such as a pathological diagnosis report and electronic medical record information as well as medical images and specimen examination data.

The authorization information DB 433 stores authorization information generated by the processing of the data management server 4 illustrated in FIGS. 9A to 9B.
FIG. 7 shows a data configuration example of the authorization information stored in the authorization information DB 433. As shown in FIG. 7, the authorization information includes information on a patient ID, a facility name, a department, and a doctor in charge. Details of the authorization information will be described later.

The authentication information table 434 includes authentication information of each medical facility (medical facilities A, B, C... In which the electronic medical record terminal 3 is installed), a medical department, and a doctor in charge that can use the services of the regional medical cooperation system 100. Is stored.
FIG. 8 shows a data storage example of the authentication information table 434. As shown in FIG. 8, the authentication information table 434 includes identification information of each medical facility (clinical department, doctor in charge) that can use the services of the regional medical cooperation system 100 and the medical facility (clinical department, doctor in charge). The network address information (IP address, etc.) of the electronic medical record terminal 3 installed in the room) and the user ID of the doctor in charge of the medical facility are stored in association with each other.

[Operation of regional medical cooperation system 100]
Next, the operation of the regional medical cooperation system 100 will be described in detail.
9A to 9B show the flow of processing between the devices constituting the regional medical cooperation system 100. The processing in each device is executed in cooperation with the control unit of each device and a program stored in the storage unit.

  When the patient ID of the patient to be accounted for is input by the operation unit 14 in the medical accounting terminal 1 of the medical facility of the transfer source (step S1), the accounting process for the patient is executed (step S2). Specifically, an input screen for the contents of examination, examination, diagnosis, etc. performed in relation to the patient is displayed on the display unit 15 and stored in the patient information DB 131 with the content input from the input screen by the operation unit 14. In accordance with the patient information about the patient, accounting processing including issuance of accounting calculation, receipt, prescription and the like is executed.

  When the transfer procedure is necessary, the operator inputs an instruction to shift to the transfer procedure through the operation unit 14. In the medical accounting terminal 1, when the operation unit 14 instructs to shift to the transfer procedure (step S <b> 3; YES), the transfer unit information input screen is displayed on the display unit 15, and the transfer unit information is input by the operation unit 14. If done (step S4), the transfer information is generated based on the patient information of the patient to be accounted for and the inputted transfer destination information, and is registered in the transfer information DB 133 (step S5).

  Next, the medical information about the accounting target patient input in step S1 is read from the in-facility server 2 (step S6). Specifically, the patient ID of the patient to be accounted for is transmitted to the in-facility server 2, and transmission of medical information that matches the patient ID is requested. In the in-facility server 2, the specimen test data of the patient ID is searched from the specimen test DB 231, and the medical image of the patient ID is searched from the image DB 232. Then, the retrieved result is transmitted to the medical accounting terminal 1.

  Next, an inquiry about medical information about the patient to be accounted for is made to the data management server 4 (step S7). Specifically, the patient ID of the patient to be accounted for is transmitted to the data management server 4 and an inquiry is made as to whether or not medical information in which the patient information matches the patient ID is stored. In the data management server 4, the specimen test data of the patient ID is searched from the specimen test DB 431, and the medical image of the patient ID is searched from the image DB 432. Then, the search result is transmitted to the transfer source medical accounting terminal 1 by the communication unit 46.

  When the medical accounting terminal 1 receives a search result from the data management server 4, the search result is compared with the medical information read from the in-facility server 2, and the medical information read from the in-facility server 2 is compared. It is determined whether there is medical information that is not stored in the data management server 4. If it is determined that there is medical information not stored in the data management server 4 in the medical information read from the in-facility server 2 (step S9; YES), the medical information not stored in the data management server 4 is stored. The data is transmitted to the data management server 4 by the communication unit 16 (step S10). In the data management server 4, the received medical information is stored in the sample examination DB 431 or the image DB 432 (step S11).

  Next, in the medical accounting terminal 1, the hospital transfer information generated in step S5 is transmitted to the data management server 4 by the communication unit 16, and a request for granting authority to the medical facility of the hospital transfer destination is requested (step S12).

In the data management server 4, when the transfer information is received from the medical accounting terminal 1 by the communication unit 46, authorization information is generated based on the received hospital transfer information and registered in the authorization information DB 433 (step S13).
The authorization information includes the patient ID, the facility name, the department, and the doctor in charge included in the transfer information (see FIG. 7). The authority grant information is information indicating that a medical facility or the like (a facility name, a medical department, a doctor in charge) of a transfer destination is authorized to access medical information regarding a patient to be transferred (patient with a patient ID).
The access authority may be given to the facility unit of the transfer destination, may be given to the medical department unit of the facility, or may be given to the doctor in charge.
In the present embodiment, as an example, access authority is given in units corresponding to transfer information. In other words, if only the name of a medical facility is included in the transfer information, access authority is granted to the entire medical facility, and if the facility name and department are included and the doctor in charge is not included Access authority is given to the medical department of the facility, and if the facility name and the doctor in charge are included, the access authority is given to the doctor in charge.
In this embodiment, the authority to access all medical information of the patient to be transferred is given to the medical facility at the transfer destination, but the type of medical information to which the access authority is given is restricted. It is good.

  In the electronic medical record terminal 3 of the transfer destination medical facility, when the patient ID of the patient who has been transferred is specified by the operation unit and the start of the diagnosis is instructed, the patient of the specified patient ID is sent to the data management server 4 The medical information acquisition request is transmitted (step S14).

In the data management server 4, when the medical information acquisition request is received by the communication unit 46, the authorization information DB 433 and the authentication information DB 434 are referred to, and authorization authentication is performed (step S15). For example, first, a user authentication screen is transmitted to the requesting electronic medical record terminal 3 to request input of a user ID. When the user ID is received from the electronic medical chart terminal 3 by the communication unit 46, the authentication information table 434 is referred to, and a record with the matching user ID is searched. If no matching record is found as a result of the search, it is determined that the user who tried to access has no user authority, that is, no access authority.
On the other hand, as a result of the search, when a record with a matching user ID is searched from the authentication information table 434, the authorization information DB 433 is referred to, and the access authority to the patient's medical information of the received patient ID performs user authentication. It is determined whether the user is assigned to the medical facility to which the user belongs (the medical department of the medical facility or the user himself / herself). Specifically, in the authorization information DB 433, the name of the medical facility to which the patient ID matches the received patient ID and the user who performed user authentication belongs (if the medical department belongs to the record, the medical to which the user belongs) In the case where the facility name, department, and doctor in charge of the facility are included, if there is a record including the facility name of the medical facility to which the user belongs and the doctor in charge), it is determined that the user has access authority. If there is no corresponding record, it is determined that there is no access authority.
In the present embodiment, an example of performing authority authentication based on user authentication using a user ID is taken as an example, but node authentication using the network address of the electronic medical record terminal 3 or the like may be performed. That is, based on the authentication information table 434 and the authorization information DB 433, it is determined whether or not the requesting electronic medical record terminal 3 is an electronic medical record terminal 3 of a medical facility (clinical department, doctor in charge) to which access authority is granted. It is good also as judging and authorizing authority.

  As a result of the authority authentication, if it is determined that the requester of the medical information has access authority (step S16; YES), the specimen examination data and medical image of the received patient ID are searched in the specimen examination DB 431 and the image DB 432. Then, a list of medical information is generated and transmitted to the requesting electronic medical record terminal 3 via the communication unit 46 (step S17).

  In the electronic medical record terminal 3, when the medical information to be referred to is selected from the medical information list received by the operation of the operation unit (step S18), the selected medical information is stored in the data management server 4 from the storage unit 43. The data is read and transmitted to the requesting electronic medical record terminal 3 by the communication unit 46 (step S19). Then, the received medical information is displayed on the electronic medical record terminal 3 (step S20), and the series of processing ends.

  As a result of the authority authentication, when it is determined that the request source of the medical information does not have the access authority (step S16; NO), the series of processing ends without permitting the request source access.

  As described above, according to the regional medical cooperation system 100, when the patient information and the transfer destination information of the patient who is transferred to another medical facility are input in the medical accounting terminal 1, the patient whose patient information is input. Is read from the in-facility server 2 and transmitted to the data management server 4, and transfer information including the input patient information and transfer destination information is transmitted to the data management server 4. The data management server 4 stores the medical information received from the medical accounting terminal 1, and accesses the stored medical information about the patient to be transferred based on the patient information and the transfer destination information received from the medical accounting terminal 1. The authority is given to the medical facility of the transfer destination.

  Accordingly, when patient information and transfer destination information are input for the transfer procedure in the medical accounting terminal 1 at the transfer source medical facility, the medical information corresponding to the patient information is automatically registered in the data management server 4. Therefore, there is no need to separately register the medical information of the patient to be transferred to the data management server 4, and the burden on the medical staff can be reduced. It is possible to prevent omission of registration of medical information. In addition, since the right to access the medical information of the patient stored in the data management server 4 is automatically granted to the medical facility at the transfer destination, the data management server 4 is troublesome for the server administrator. It is possible to grant access authority without using it.

  In addition, when the department or doctor in charge is included in the transfer destination information, access authority to the medical information about the patient who has been transferred is granted to the department or doctor in charge at the medical facility at the transfer destination. The range of authority can be limited to a truly necessary range, and the security of the patient's personal information can be further improved.

  Further, the medical accounting terminal 1 registers the medical information not stored in the data management server 4 among the medical information about the target patient stored in the in-facility server 2 in the data management server 4. 4 can prevent duplication of data.

  In addition, the description content in the said embodiment is a suitable example of this invention, and is not limited to this.

  For example, in the above embodiment, the medical information of the patient in the medical facility is stored in the in-facility server 2, but the medical accounting terminal 1 may include a medical information storage unit.

  In the above description, an example in which an HDD, a semiconductor nonvolatile memory, or the like is used as a computer-readable medium for the program according to the present invention is disclosed, but the present invention is not limited to this example. As other computer-readable media, a portable recording medium such as a CD-ROM can be applied. Further, a carrier wave is also applied as a medium for providing program data according to the present invention via a communication line.

  In addition, the detailed configuration and detailed operation of each device constituting the regional medical cooperation system 100 can be changed as appropriate without departing from the spirit of the invention.

100 Regional Medical Cooperation System 1 Medical Accounting Terminal 11 Control Unit 12 RAM
13 Storage unit 131 Patient information DB
132 Accounting Information DB
133 hospital transfer information DB
14 Operation unit 15 Display unit 16 Communication unit 17 Timekeeping unit 18 Bus 2 Facility server 231 Specimen test DB
232 Image DB
3 Electronic Medical Record Terminal 4 Data Management Server 41 Control Unit 42 RAM
43 Storage Unit 431 Specimen Test DB
432 Image DB
433 Authorization information DB
434 Authentication information table 44 Operation unit 45 Display unit 46 Communication unit 47 Timekeeping unit 48 Bus N Communication network

Claims (3)

A medical cooperation system in which a medical accounting terminal connected to a storage means for storing medical information generated in a medical facility and a data management server are connected so that data can be transmitted and received,
The medical accounting terminal stores the medical information about the patient of the input patient information when the patient information of the patient to be transferred to another medical facility and the transfer destination information indicating the medical facility of the transfer destination are input. Read from the means and transmit to the data management server and the input patient information and transfer destination information to the data management server,
The data management server stores the medical information received from the medical accounting terminal, and stores the stored medical information about the patient to be transferred based on the patient information and the transfer destination information received from the medical accounting terminal. Medical cooperation system that grants the access authority to the medical facility at the transfer destination.   The data management server, if the input information of the transfer destination includes a medical department or a doctor in charge in the medical facility at the transfer destination, grants access authority to the medical information about the patient to be transferred to the medical facility. The medical cooperation system according to claim 1, which is given to a medical department or a doctor in charge.   The medical accounting terminal transmits, to the data management server, medical information that is not stored in the data management server among medical information about the patient of the input patient information stored in the storage unit. The medical cooperation system according to 1 or 2.

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