JP2010262466A - Medical diagnostic support system and medical diagnostic support method - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a medical diagnostic support system allowing rapid and accurate diagnosis or medical treatment even when a resident or a doctor out of his speciality is in charge of first-aid. <P>SOLUTION: This medical diagnostic support system includes: a database registered with attribute information of each doctor; a first information terminal device processing diagnostic information of a first-aid patient by a doctor in charge when receiving the patient; an auxiliary diagnostic part performing auxiliary diagnosis based on medical information including the diagnostic information from the first information terminal device, and generating an auxiliary diagnostic result; a transmission part setting a warning level of the doctor in the charge based on attribute information registered in the database, and transmitting display information including a diagnostic result by the doctor in the charge and the auxiliary diagnostic result by an auxiliary support part to a second information terminal device for a responsible person in a display format based on the warning level; and a communication means for performing transmission between the responsible person and the doctor in the charge. <P>COPYRIGHT: (C)2011,JPO&INPIT

Description

  The present invention relates to a medical diagnosis support system and a medical diagnosis support method that enable quick and accurate diagnosis and treatment even when a trainee or a non-specialist is in charge of an emergency.

  Conventionally, in order to support doctors' diagnosis, computer-aided diagnosis (CAD), which automatically analyzes abnormal medical images using a computer and automatically extracts abnormal findings, physical findings, laboratory findings, etc. There is a disease name search system for searching for and displaying related disease names by inputting.

  On the other hand, in an emergency medical field, an unaccustomed doctor such as a resident may feel anxiety when making a diagnosis. The director or supervising doctor should pay attention to the behavior of an unfamiliar doctor and give appropriate advice, but it is sometimes difficult to give the first and last time because he / she is away. In addition, when a trainee or non-specialist is in charge of emergency services, information may be overlooked or diagnosis may be delayed, causing a problem that appropriate diagnosis cannot be performed. Therefore, in order to reduce oversight of information, research and development of CAD and disease name search systems are progressing.

  Patent Document 1 discloses a knowledge database storing a disease name and a discrimination item necessary for discrimination of a disease, a disease extraction unit that extracts one or more diseases from a knowledge database based on patient data, and an extracted disease An example of a diagnostic support system is described that includes a disease denial unit that determines whether or not to deny, and a disease classification unit that classifies a negatively determined disease and a disease that has not been denied.

  However, in the example of Patent Document 1, a patient's disease can be quickly determined. However, an unfamiliar doctor can make a determination when there is a difference between the diagnosis result that the patient gives and the diagnosis support result that the system gives. In some cases, the diagnosis could be delayed or misdiagnosed.

Japanese Patent Laid-Open No. 2004-29927

  Conventionally, in an emergency medical field, when an inexperienced doctor such as a trainee or a non-specialized doctor is in charge of emergency services, information may be overlooked or diagnosis may be delayed. In addition, there is a diagnosis support system that discriminates a disease as in Patent Document 1, but an unfamiliar doctor is confused when there is a difference between the diagnosis result made by himself and the diagnosis support result made by the system. This could lead to delayed diagnosis and misdiagnosis.

  The present invention has been made in view of the above circumstances, and provides a medical diagnosis support system and a medical diagnosis support method that enable quick and accurate diagnosis / treatment even when a trainee or a non-specialist is in charge of emergency services. The purpose is to provide.

  The medical diagnosis support system of the present invention according to claim 1 includes a database in which attribute information of each doctor is registered, and a first information terminal that processes diagnosis information of the patient by a doctor in charge when an emergency patient is received. , An auxiliary diagnosis unit that performs auxiliary diagnosis based on medical information including the diagnosis information from the first information terminal and generates an auxiliary diagnosis result, and the person in charge based on attribute information registered in the database A transmission unit that sets a warning level of a doctor and transmits display information including a diagnosis result by the doctor in charge and an auxiliary diagnosis result by the auxiliary support unit in a display format based on the warning level to the second information terminal for the person in charge And communication means for transmitting information between the responsible person and the doctor in charge.

  According to the medical diagnosis support method of the present invention described in claim 6, when an emergency patient is received, the diagnosis information of the patient by the doctor in charge is processed by the first information terminal, and the medical information including the diagnosis information is obtained. Based on the attribute information registered in the database, the auxiliary diagnosis unit performs an auxiliary diagnosis, sets the warning level of the doctor in charge, and sets the warning level from the transmission unit to the second information terminal for the responsible person. Transmitting display information including a diagnosis result by the doctor in charge and an auxiliary diagnosis result by the auxiliary support unit in a display format based on the information, and transmitting information between the person in charge and the doctor in charge via communication means Features.

  According to the present invention, even when a trainee or a non-specialist is in charge of emergency, it is possible to receive advice and instructions from the person in charge of emergency, and to perform accurate and quick diagnosis and treatment by reducing oversight of information. A diagnosis support system can be provided.

The block diagram which shows the structure of the medical diagnosis assistance system which concerns on one Embodiment of this invention. The block diagram which shows the structure of the principal part of the embodiment. Explanatory drawing which shows an example of the attribute information registered into the database. Explanatory drawing which shows an example of the display information displayed on the information terminal device for a responsible person. Explanatory drawing which shows the other example of the display information displayed on the information terminal device for a responsible person.

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

  FIG. 1 is a configuration diagram showing a configuration of a medical diagnosis support system according to an embodiment of the present invention. In FIG. 1, reference numeral 10 denotes a medical image diagnostic apparatus, which includes an X-ray CT apparatus 11, an ultrasonic diagnostic apparatus 12, and the like. The medical image diagnostic apparatus 10 is connected to the network 100.

  The network 100 is connected to a diagnosis support unit 20, a plurality of information terminal devices 30, 40, and 50, and an image server 60 that stores image data. The medical image diagnosis device 10, the diagnosis support unit 20, and the information terminal device 30, 40, 50 and the image server 60 can communicate with each other via the network 100.

  The information terminal devices 30, 40, and 50 include display units 31, 41, and 51 and input units 32, 42, and 52 such as a keyboard and a mouse, and can be operated by a user (doctor). In the present embodiment, the information terminal device 30 is operated by an emergency outpatient physician, and the information terminal device 40 is operated by an emergency outpatient manager. In addition, the information terminal device 50 will be described as being operated by a specialist who is qualified as a person in charge.

  The diagnosis support unit 20 includes a database 21, an auxiliary diagnosis unit 22, and a transmission unit 23. The database 21 stores attribute information of all doctors belonging to a medical institution. The auxiliary diagnosis unit 22 is a computer diagnostic device, analyzes medical information, automatically extracts abnormal findings and disease names, and transmits auxiliary diagnosis results to the transmission unit 23.

  The transmission unit 23 sets a warning level based on the attribute information registered in the database 21 and displays information including a diagnosis result by the emergency department doctor and an auxiliary diagnosis result by the auxiliary diagnosis unit 22 in a display format based on the warning level. Is transmitted to the information terminal device 40 (or the information terminal device 50).

  FIG. 2 is a block diagram showing a configuration of a main part of the medical diagnosis support system of the present invention. FIG. 2 is a diagram illustrating the exchange of information with peripheral devices at the center of the diagnosis support unit 20. The database 21 of the diagnosis support unit 20 stores attribute information of all doctors belonging to a medical institution. The stored attribute information includes the presence or absence of manager qualifications by officers, specialists, etc., belonging departments, certified physician qualifications, years of doctor experience, number of experience cases, and the like.

  The auxiliary diagnosis unit 22 analyzes CAD information and automatically extracts abnormal findings, CAD (Computer-Aided diagnosis), a device that promotes necessary tests according to guidelines and supports differential diagnosis based on test results, and physical findings It is composed of a disease name search system that displays disease name candidates by inputting laboratory findings, etc., and other diagnostic devices.

  Further, all the doctors may use the same auxiliary diagnostic unit 22, but for example, a head diagnostic support system, a chest diagnostic support system, an abdominal diagnostic system, an internal diagnostic system, an ophthalmic diagnostic support system, an obstetrician A diagnosis support system for each part or department may be used like a departmental diagnosis system. In the following description, an example in which the auxiliary diagnosis unit 22 is equipped with CAD will be described.

  The auxiliary diagnosis unit 22 receives the patient diagnosis information 24 from the information terminal device 30 by the emergency outpatient doctor and the diagnosis image information 25 obtained by the medical image diagnosis apparatus 10 such as an X-ray CT apparatus or an ultrasonic diagnosis apparatus. Medical information including is supplied. The auxiliary diagnostic unit 22 analyzes the diagnostic image information 25 using CAD, automatically extracts abnormal findings, and sends this information together with the diagnostic information 24 to the transmission unit 23 as the auxiliary diagnostic result 26. The diagnosis information 24 by the emergency outpatient doctor includes information on the patient's physical findings and test results.

  In addition to the auxiliary diagnostic result from the auxiliary diagnostic unit 22, the transmission unit 23 is supplied with diagnostic information 24, diagnostic image information 25, and information on the diagnostic result 33 by the emergency physician in charge from the information terminal device 30. Further, the attribute information from the database 21 is supplied to the transmission unit 23, and the transmission unit 23 sets a warning level for each emergency outpatient physician and warns the information terminal device 40 (or the information terminal device 50). The display information 27 including the diagnosis result by the emergency department doctor and the auxiliary diagnosis result by the auxiliary diagnosis unit 22 is transmitted in the display format according to the above.

  The information terminal device 40 (or the emergency outpatient manager who operates the information terminal device 40) and the information terminal device 30 (or emergency outpatient doctor) communicate information by communication means such as a telephone, a video conference system, the Internet, and an intranet. The emergency department manager can give appropriateness of diagnosis, advice, and instructions via the communication line 70 for the diagnosis result made by the emergency department doctor. The communication line 70 constitutes a part of communication means.

  In addition, the information terminal device 50 (or a specialist who operates the information terminal device 50) and the information terminal device 30 (or the emergency department doctor) can also transmit information via the communication means (communication line 70). The specialist can give appropriateness of diagnosis, advice, and instructions for the diagnosis result given by the attending physician. The specialist is a doctor who has the qualification of a supervisor as well as the emergency department manager.

  Further, the auxiliary diagnosis result 26 from the auxiliary diagnosis unit 22 is also transmitted to the information terminal device 30, and the emergency department doctor can change the diagnosis result given by himself / herself as necessary.

  Hereinafter, the operation of the medical diagnosis support system of FIG. 2 will be specifically described. For example, it is assumed that there are two patients on duty at a medical institution one day, emergency physician A (orthopedic surgeon) and emergency physician E (deputy director / abdominal physician). Suppose that she was transported complaining of abdominal pain. Further, it is assumed that the emergency outpatient manager E in the abdominal medicine department is in the process of handling another patient, and the orthopedic emergency outpatient doctor A is inevitably in charge of the patient.

  The emergency outpatient clinician A immediately starts the examination and examination of the patient on the suspicion of acute abdomen. The examination contents are, for example, palpation, blood examination, abdominal ultrasound examination, and abdominal CT examination. The diagnostic information 24 showed that abdominal pain was strong, but fever, vomiting, abdominal tenderness, abdominal muscular anti-acupuncture were mild, and the white blood cell count was 10,000 / μl. It is assumed that no serious abdominal disease was found in the diagnostic image information 25 as well.

  Further, based on the diagnosis information 24 and the diagnostic image information 25, it is assumed that the diagnosis result 33 for the patient of the emergency outpatient doctor A is “suspected acute gastroenteritis” and “follow-up”. The information of the diagnosis result 33, the diagnosis information 24, and the diagnosis image information 25 are both sent to the transmission unit 23 via the hospital information system (HIS) or the like, and are recorded in the recording unit 231 in the transmission unit 23.

  On the other hand, the medical image including the diagnostic information 24 by the emergency outpatient doctor A and the diagnostic image information 25 from the medical image diagnostic apparatus 10 is transmitted to the auxiliary diagnostic unit 22 via the HIS or the like. The auxiliary diagnostic unit 22 analyzes the diagnostic information 24 and the diagnostic image information 25, and uses the CAD information from the diagnostic image information 25 and the information “abdominal muscular defense” and “white blood cell count 10,000 / μl” in the diagnostic information 24. Assume that the auxiliary diagnosis result 26 “suspected of acute peritonitis” is transmitted to the transmitting unit 23 from the suspicion of the presence of automatically extracted free air.

  The auxiliary diagnosis result 26 is also sent to the information terminal device 30 and is confirmed by the emergency outpatient doctor A, and the emergency outpatient doctor A may change the diagnosis result 33 in comparison with his / her own diagnosis result. In this embodiment, it is assumed that the emergency outpatient physician A does not change the information of the diagnosis result 33 and selects “suspected acute gastroenteritis” and “follow-up”.

  In addition to the information on the diagnostic information 24, the diagnostic image information 25, the diagnostic result 33, and the auxiliary diagnostic result 26, the attribute information of the emergency outpatient doctor A is supplied from the database 21 to the transmission unit 23. The attribute information is called from the database 21 when the emergency outpatient physician A inputs an ID number or the like to the information terminal device 30.

  The attribute information registered in the database 21 includes, for example, information such as the presence / absence of responsible qualifications by officers / specialists, affiliation departments, certified physician qualifications, years of experience with doctors, and the number of experience cases. A “notification level” is set in advance based on the years of experience of the doctor.

  FIG. 3 is a diagram illustrating an example of attribute information registered in the database 21. The attribute information in FIG. 3 is composed of columns of a doctor name, presence / absence of a responsible person, years of doctor experience, clinical department, certification, notification level, and display. The “notification level” varies depending on, for example, the years of experience of the doctor, and the trainees and doctors (A, B) with less experience have “warning level 5: contact required”, and the doctor C has “warning level 5: inquiry required”. It has become. Doctors (D, E, F) who have many years of experience are “no warning / inquiry required”.

  Thus, when the diagnosis result 33 and the auxiliary diagnosis result 26 do not coincide with each other, and the warning level indicated by “notification level” exceeds a predetermined level, the emergency outpatient officer E (information terminal device 40) displays a display format based on the warning level. The display information 27 is transmitted. For example, when transmitting to the emergency department manager E (information terminal device 40), a warning is displayed in the color defined in the display field of FIG. In addition to the method of displaying by color, a warning may be given by blinking display.

  FIG. 4 shows an example of a display screen based on the display information 27 on the information terminal device 40. As shown in FIG. 4, as the display information 27, the patient name, the auxiliary diagnosis result, the doctor diagnosis result and treatment, and the doctor in charge are displayed, and the display information is displayed in a display format according to “warning level” and “display” in FIG. 27 is displayed. When the doctor in charge is doctors A and B, for example, a warning is displayed in red, and when the doctor is doctor C, a warning is displayed in yellow. For doctors with a low “warning level”, the auxiliary diagnosis result 26 and the diagnosis result 33 of the attending doctor are not displayed, and no warning color is displayed.

  Further, the display screen of the information terminal device 40 may be displayed as shown in FIG. In FIG. 5, in addition to the patient name, the auxiliary diagnosis result, the doctor diagnosis result and treatment, and the attending doctor, the patient's consciousness level and the physical findings by the emergency outpatient doctor are displayed as the display information 27. Further, based on the “warning level” and “display” in FIG. 3, when the doctor in charge is doctors A and B, for example, a warning is displayed in red, and when the doctor is doctor C, a warning is displayed in yellow. As shown in FIG. 5, the diagnostic information by the attending physician, such as the patient's consciousness level and physical findings, is also displayed at the same time, so that the emergency outpatient manager E can easily determine the validity or invalidity of the diagnosis.

  In this way, the emergency outpatient manager E checks the display screen (FIG. 4 or 5) of the information terminal device 40 to confirm whether or not the diagnosis result of the emergency outpatient doctor A is correct, there is no error, and the like. Appropriate advice and instructions can be given to the emergency department physician A via the (communication line 70). The warning level (skill level of the attending physician A) can be determined according to the display color. If the emergency outpatient clinician A is about to start an erroneous procedure, he / she is prompted to cancel the procedure, Reduction can be achieved.

  In the above embodiment, the case where there is one person in charge E and one person in charge A is explained. However, as shown in FIGS. 4 and 5, one person in charge E has a plurality of persons in charge A, B, It is also possible to see C .... When there are a plurality of responsible persons including specialists, the transmission unit 23 selects and displays the optimal responsible person E or specialist (information terminal device 40 or 50) based on the diagnostic information 24, the diagnostic image information 25, and the like. Information 27 may be transmitted. That is, from the auxiliary diagnosis result 26 of the auxiliary diagnosis unit 22, the state of the patient's disease is grasped and the person in charge (specialist) is selected, and the display information 27 is transmitted to the selected information terminal device for the person in charge.

  Further, based on the diagnostic information 24 and the diagnostic image information 25, the notification level (warning level) may be changed by the transmission unit 23 to change the warning method. That is, it is determined which diagnosis department is appropriate based on the diagnosis information 24 and the diagnosis image information 25, and when the doctor who is different from the specialized field is in charge of emergency outpatient, the notification level is increased even if the years of experience are large.

  As described above, according to the embodiment of the present invention, even if a resident doctor or a non-specialist is in charge of emergency, advice or instructions from the responsible person or specialist can be received, and information is overlooked or mistaken. Can be reduced and accurate diagnosis and treatment can be performed.

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

DESCRIPTION OF SYMBOLS 10 ... Medical image diagnostic apparatus 20 ... Diagnosis support part 21 ... Database 22 ... Auxiliary diagnosis part 23 ... Transmission part 30 ... Information terminal device (for emergency department personnel)
40 ... Information terminal equipment (for emergency department managers)
50 ... Information terminal device (specialist)
31, 41, 42 ... display units 32, 42, 53 ... operation unit 60 ... image server 70 ... communication line 100 ... network

Claims (10)

A database in which the attribute information of each doctor is registered;
A first information terminal device for processing diagnostic information of the patient by a doctor in charge when receiving an emergency patient;
An auxiliary diagnosis unit that performs auxiliary diagnosis based on medical information including the diagnosis information from the first information terminal device, and generates an auxiliary diagnosis result;
The warning level of the doctor in charge is set based on the attribute information registered in the database, and the diagnosis result by the doctor in charge and the auxiliary are displayed in a display format based on the warning level in the second information terminal device for the person in charge. A transmission unit for transmitting display information including an auxiliary diagnosis result by the support unit;
A communication means for transmitting information between the responsible person and the doctor in charge;
A medical diagnosis support system comprising: The diagnostic information includes findings and examination information of the patient by the doctor in charge,
The medical information includes the diagnostic information and the image information of the patient acquired by a medical image diagnostic apparatus,
The auxiliary diagnostic unit is a computer diagnostic device that analyzes the medical information and automatically generates the auxiliary diagnostic result, and supplies the auxiliary diagnostic result to the first information terminal device and the transmission unit, respectively. The medical diagnosis support system according to claim 1, wherein:   When there are a plurality of responsible persons, the transmitting unit selects a responsible person based on the auxiliary diagnosis result by the auxiliary diagnostic part, and the display format based on the warning level is selected in the selected information terminal device for the responsible person The medical diagnosis support system according to claim 1, wherein the display information is transmitted in a step.   The medical diagnosis support system according to claim 1, wherein the transmission unit includes information on findings by the doctor in charge in the display information and transmits the information to the second information terminal device.   The medical diagnosis support system according to claim 1, wherein the database registers at least information on years of experience, medical departments, and qualifications of managers as the attribute information. When receiving an emergency patient, the diagnosis information of the patient by the doctor in charge is processed by the first information terminal device,
Based on the medical information including the diagnostic information, perform an auxiliary diagnosis in the auxiliary diagnosis unit,
Based on the attribute information registered in the database, set the warning level of the doctor in charge,
Transmitting display information including a diagnosis result by the doctor in charge and an auxiliary diagnosis result by the auxiliary support unit in a display format based on the warning level from the transmission unit to the second information terminal device for the responsible person,
A medical diagnosis support method, wherein information is transmitted between the person in charge and the doctor in charge via a communication means. The diagnostic information includes findings and examination information of the patient by the doctor in charge,
The medical information includes the diagnostic information and the image information of the patient acquired by a medical image diagnostic apparatus,
The said auxiliary diagnostic part analyzes the said medical information, produces | generates the said auxiliary diagnostic result, and supplies the said auxiliary diagnostic result to the said 1st information terminal device and the said transmission part, respectively. Medical diagnosis support method.   When there are a plurality of responsible persons, the transmitting unit selects a responsible person based on the auxiliary diagnosis result, and displays the display information in a display format based on the warning level on the information terminal device for the selected responsible person. The medical diagnosis support method according to claim 6, wherein:   The medical diagnosis support method according to claim 6, wherein the transmission unit includes information on findings by the doctor in charge in the display information and transmits the information to the second information terminal device.   7. The medical diagnosis support method according to claim 6, wherein the database registers at least information on years of experience, medical departments, and qualifications of managers as the attribute information.

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