JP2011204055A - Medical cooperation system, relay device, medical cooperation method, and medical cooperation program - Google Patents

Abstract

PROBLEM TO BE SOLVED: To manage the disclosure of medical record information between medical institutions concerning medical cooperation.SOLUTION: A medical cooperation system includes a first medical cooperation device held by a first medical institution, a second medical cooperation device held by a second medical institution, and a relay device performing communication between the first and second medical cooperation institutions. Disclosure request information including patient identification information is received from the first medical cooperation device. A disclosure level of disclosure to the first medical institution is determined concerning the medical record information of a patient managed by the second medical institution in response to the relation between the patient corresponding to the patient identification information included in the disclosure request information and the first medical institution. Then, a disclosure instruction is generated based on the disclosure level and transmitted to the second medical cooperation device. Disclosure medical record information included in the medical record information of the patient managed by the second medical institution is received from the second medical cooperation device, and the disclosure medical record information is transmitted to the first medical cooperation device.

Description

  The present invention relates to a medical cooperation system, a relay device, a medical cooperation method, and a medical cooperation program for managing the disclosure of medical chart information between medical institutions.

  In recent years, medical cooperation has been promoted for the purpose of reducing medical expenses and improving medical quality. Medical cooperation refers to sharing the functions of medical institutions, and medical institutions cooperating to treat patients. In medical cooperation, when a patient performs treatment at a plurality of medical institutions, medical chart information at a certain medical institution is also disclosed to other medical institutions.

  Medical record information is a collective term for a plurality of types of information such as consultation history information, profile information, progress information, examination order information, examination result information, and prescription order information. The medical record information is information recorded due to a medical practice for a patient in a medical institution.

  By publishing the chart information, the doctor of the medical institution A can perform medical treatment while referring to the chart information of the medical institution B of a certain patient. For example, by grasping prescription drugs prescribed by medical institution B, the doctor of medical institution A can reduce the risk of prescribing contraindicated drugs. Further, by grasping information on the examination performed at the medical institution B, the doctor of the medical institution A can avoid performing the same examination repeatedly in a short period of time. As described above, publishing medical chart information in medical cooperation contributes to effective and efficient medical care for both patients and medical institutions.

  In recent years, electronic medical chart systems that digitize and manage medical chart information that has been conventionally managed with paper have been introduced into medical institutions.

  Here, Patent Document 1 discloses a technique for sharing medical chart information managed by a plurality of medical institutions among a plurality of medical institutions.

JP 2001-318992 A

  Basically, chart information is considered to be owned by the patient. Therefore, even in the disclosure of medical chart information in medical cooperation, there are many voices questioning whether to release patient medical chart information in a certain medical institution to other medical institutions.

  Here, it is conceivable that a patient's individual sets in advance a disclosure range to be disclosed at each medical institution in his / her medical record information. For example, the patient may set in advance that only the progress information and the test result information among the profile information, the progress information, the test order information, the test result information, the prescription order information, and the medical accounting information are to be disclosed.

  However, as described above, it is more effective and efficient for both the medical institution and the patient that the medical institution can acquire as much information as possible out of the information included in the chart information. Each medical institution can obtain only a uniform range of information within the disclosure range uniformly set by the patient. Furthermore, when a patient sets the disclosure range uniformly, it may be considered that the disclosure will be released to unreliable medical institutions, and the psychology of setting the disclosure range narrowly works.

  For example, even if the patient thinks that “all medical record information may be disclosed to medical institution A”, in the above case, the medical record information is disclosed based on a uniformly set disclosure range. Is done. As a result, the doctor of the medical institution A performs medical treatment based on the medical chart information that is uniformly disclosed. Therefore, even a doctor at medical institution A who thinks that the patient may disclose all of his / her medical record information, sufficient information for effective treatment cannot be acquired.

  In addition, the operation of an electronic medical record system is often different for each medical institution. For example, as described above, various information is registered as medical chart information, but the contents registered in each information are often different for each medical institution.

  Description will be made by taking, as an example, progress information which is a type of medical record information. For example, in the medical institution A, it is assumed that the information input by the doctors of each medical department as the progress information is stored as a part of the progress information without distinction. In this case, information input by doctors such as “internal medicine” and “surgery” and information input by doctors of “psychiatry” are accumulated in the progress information.

  That is, when the progress information managed by the medical institution A is disclosed to the medical institution B, the progress information in the psychiatry of the patient is also disclosed to the medical institution B. Regardless of whether the patient intends to disclose psychiatric progress information, psychiatric information, etc. should be disclosed carefully.

  In addition, profile information usually includes patient profile and physical information such as address, date of birth, and weight. However, it is assumed that medical institution A is performing an operation in which remark information such as “I have a problem with this teacher” and “There is a history of unpaid medical examination fees” is also registered in the profile information.

  Such remark information is not information recorded by the medical institution A with permission from the patient, but information recorded as internal communication items. Therefore, patients often cannot know that remark information is recorded. Or, if you know it, you will often not want to inform other medical institutions.

  Therefore, when the profile information is disclosed from the medical institution A to the medical institution B, information that is not desired to be disclosed to the patient, such as remark information, is also disclosed.

  As described above, information that should be handled carefully by the patient may not be disclosed even if the information is included in the disclosure range.

  Accordingly, an object of the present invention is to provide a medical cooperation system, a relay device, a medical cooperation method, and a medical cooperation program that can reflect the patient's intention in the disclosure of patient chart information.

  In order to solve the above problems, a medical cooperation system disclosed in the present invention includes a first medical cooperation apparatus provided in a first medical institution, a second medical cooperation apparatus provided in a second medical institution, A first medical cooperation device and a relay device that communicates with the second medical cooperation device, and the first medical cooperation device requests disclosure of patient identification information for identifying a patient and medical chart information about the patient. And a communication unit that transmits the public request information including the information to the effect to the relay device and receives the public chart information published by the second medical institution from the relay device, the relay device The disclosure request information is received from the first medical cooperation device, a public instruction for requesting the disclosure of the medical chart information is transmitted to the second medical cooperation device, and the public medical record is further transmitted from the second medical cooperation device. information A communication unit for receiving the received medical chart information to the first medical cooperation device, and the patient corresponding to the patient identification information included in the received public request information and the first A determination unit that determines a disclosure level to be disclosed to the first medical institution in the medical chart information of the patient managed by the second medical institution according to a relationship with the medical institution, and the determined disclosure level The second medical cooperation device receives the public command from the relay device and transmits the public medical chart information, and a determination unit that generates the public command, And an extraction unit that extracts the public chart information that is a part of the chart information from a storage section that stores the chart information of the patient based on a disclosure command.

According to the present invention, medical chart information reflecting the patient's intention can be disclosed.

It is a figure which shows an example of the whole structure of the medical cooperation system in an Example. It is a figure which shows an example of the functional block of the relay apparatus in an Example. It is a figure which shows an example of the data table of a patient correlation table and an attending doctor information table in an Example. It is a figure which shows an example of the data table of the introduction information table in an Example. It is a figure which shows an example of the data table stored in the open level memory | storage part in an Example. It is a figure which shows an example of the data table stored in the disclosure range memory | storage part in an Example. It is explanatory drawing of the relationship between the chart information classification and structure information in an Example. It is a figure which shows an example of the functional block of the medical cooperation apparatus in an Example. It is a figure which shows an example of the data table stored in the patient information storage part in an Example. It is a figure which shows an example of the data table stored in the medical chart information storage part in an Example. It is a figure which shows an example of the flowchart of the patient registration process in an Example. It is a figure which shows an example of the 1st part of the flowchart of the publication | publishing process in an Example. It is a figure which shows an example of the 2nd part of the flowchart of the publication | publishing process in an Example. It is a figure which shows an example of the 3rd part of the flowchart of the publication | publishing process in an Example. It is a figure which shows the example of a screen output to the terminal device in the disclosure destination medical institution in an Example. It is a figure which shows the hardware constitutions of the relay apparatus in an Example. It is a figure which shows the hardware constitutions of the medical cooperation apparatus in an Example.

  Detailed examples of the present invention will be described below.

  Note that the following embodiments can be appropriately combined within a range in which the contents of processing do not contradict each other.

  FIG. 1 is an overall configuration diagram of a medical cooperation system according to an embodiment of the present invention.

  The medical cooperation system in the present embodiment includes a medical cooperation apparatus A1-1, a medical cooperation apparatus B1-2, a medical cooperation apparatus C1-3, and a relay apparatus 4. Note that the number of medical cooperation devices is not limited to three.

  The medical cooperation device A1-1, the medical cooperation device B1-2, the medical cooperation device C1-3, and the relay device 4 communicate via the network 6. And medical cooperation apparatus A1-1, medical cooperation apparatus B1-2, and medical cooperation apparatus C1-3 exchange medical chart information via the relay apparatus 4. FIG.

  The medical institution A has an electronic medical chart system A2-1 and a medical cooperation apparatus A1-1. Here, the medical institution is, for example, a hospital or clinic that participates in medical cooperation.

  The electronic medical record system A2-1 may have the function of the medical cooperation apparatus A1-1 in the present embodiment. In this case, the medical cooperation system includes an electronic medical record system A2-1, an electronic medical record system B2-2, an electronic medical record system C2-3, and a relay device 4.

  The relay center 5 has a relay device 4. The relay center 5 is, for example, a data center or a core hospital in medical cooperation. When the relay center 5 is a core hospital, the relay device 4 may be a part of an electronic medical record system provided in the core hospital.

  Hereinafter, when it is not necessary to distinguish the medical cooperation device A1-1, the medical cooperation device B1-2, and the medical cooperation device C1-3, the medical cooperation device 1 will be described. Moreover, when it is not necessary to distinguish the electronic medical chart system A2-1, the electronic medical chart system B2-2, and the electronic medical chart system C2-3, they will be collectively referred to as the electronic medical chart system 2.

  The medical cooperation device 1 is a computer that acquires medical chart information from another medical cooperation device 1 possessed by another medical institution via the network and the relay device 4. Furthermore, the medical cooperation apparatus 1 transmits medical chart information to another medical cooperation apparatus 1 provided in another medical institution via the network and the relay apparatus 4. Details will be described later.

  The electronic medical chart system 2 is a computer that manages medical chart information. A user of the electronic medical chart system 2 inputs medical chart information. And the electronic medical chart system 2 memorize | stores medical chart information in the medical chart information storage part 22 (FIG. 8).

  The relay device 4 is a computer that relays transmission / reception of medical record information between medical institutions. The relay device 4 determines the disclosure level of the medical record information released from the medical institution that is the publishing source, based on the patient's visit history to the medical institution that becomes the publishing destination. Further, the relay device 4 determines the disclosure range for each medical institution based on the determined disclosure level. The disclosure range is set so as to absorb the difference in operation of the electronic medical records of each medical institution as described above. Details will be described later.

  The network 6 is a communication network such as the Internet, a mobile phone network, and a telephone network. The communication network is a wired communication network or a wireless communication network.

  A case where the medical institution A receives the chart information of the patient X from the medical institution B and the medical institution C will be described. In other words, the public medical institution is the medical institution A, and the public medical institution is the medical institution B and the medical institution C.

  The medical cooperation apparatus A1-1 of the medical institution A transmits a request for disclosure of the chart information of the patient X to the relay apparatus 4. The public request includes patient identification information for identifying the patient X. The timing at which the disclosure request is transmitted is the timing at which the medical cooperation device A1-1 receives a signal requesting the disclosure of the chart information of the patient X from the terminal device 10 (FIG. 8). For example, a signal requesting disclosure of the chart information of the patient X is transmitted from the terminal device 10 (FIG. 8) based on an input by a doctor of the medical institution A.

  The relay device 4 transmits a disclosure command to the medical cooperation device B1-2 of the medical institution B. Further, the relay device 4 transmits a disclosure command to the medical cooperation device C1-3 of the medical institution C. The disclosure command includes a disclosure range determined for each medical institution by processing described later. In other words, the disclosure ranges included in the disclosure command transmitted to the medical collaboration device B1-2 and the disclosure command transmitted to the medical collaboration device C1-3 may be different from each other.

  The medical cooperation device B1-2 of the medical institution B that has received the public instruction extracts the chart information of the patient X based on the public instruction. Then, the medical cooperation device B1-2 transmits the extracted chart information of the patient X to the relay device 4 via the network 6. Hereinafter, the extracted chart information is referred to as public chart information. And the relay apparatus 4 transmits the received public medical chart information to the medical cooperation apparatus A1-1 of the medical institution A.

  And medical cooperation apparatus A1-1 outputs public medical chart information to the terminal device 10. FIG. A doctor of the public medical institution A who operates the terminal device 10 can treat the patient X while referring to the public medical record information of the patient X in the medical institution B.

  Next, the function of the relay device 4 will be described with reference to FIG. FIG. 2 is a functional block diagram of the relay device 4.

  The relay device 4 includes a communication unit 41, a registration unit 42, a management information storage unit 43, a determination unit 44, a disclosure level storage unit 45, a determination unit 46, a disclosure range storage unit 47, and an editing unit 48.

  The relay device 4 is a computer and communicates with other computers via a network.

  The communication unit 41 is a processing unit that communicates with the medical cooperation device 1. For example, the communication unit 41 receives a disclosure request from the medical cooperation device 1. The registration unit 42 is a processing unit that registers information for commonly managing patients among a plurality of medical institutions. For example, the registration unit 42 gives the patient a unique common patient ID in a plurality of medical institutions. Then, the registration unit 42 stores the local ID and the common patient ID in each medical institution in association with each other in the patient association table stored in the management information storage unit 43.

  The management information storage unit 43 is a storage unit that stores various tables for commonly managing patients. Details will be described later.

  The determination unit 44 is a processing unit that determines a level at which patient chart information is disclosed. For example, the determination unit 44 refers to the management information storage unit 43 based on the relationship between the patient whose medical record information is disclosed and the medical institution that is the disclosure destination, and determines the disclosure level.

  The disclosure level storage unit 45 is a storage unit that stores a table that defines the type of medical record information to be disclosed for the disclosure level determined by the determination unit. Details will be described later.

  The determination unit 46 is a processing unit that determines the disclosure range for each medical institution with respect to the disclosure level determined by the determination unit 44. For example, the determination unit 46 determines the disclosure range for each medical institution for the type of medical record information that is to be disclosed.

  The type of medical record information is information attached to each type of information included in the medical record information. For example, information that mutually identifies information such as consultation history information, profile information, progress information, examination order information, examination result information, and prescription order information included in the chart information is a type.

  The disclosure range storage unit 47 is a storage unit that stores, for each medical institution, a table that defines which range should be disclosed among the types of chart information that are to be disclosed. Details will be described later.

  The patient association table 431, the attending doctor information table 432, and the introduction information table 433 stored in the management information storage unit 43 will be described with reference to FIGS.

  FIG. 3A is a data table example of the patient association table 431.

  The patient association table 431 stores information related to the common patient ID 4311, the medical institution ID 4312, and the local patient ID 4313 in association with each other. In the embodiment, the patient association table 431 may include necessary items as appropriate.

  The item “common patient ID” 4311 of the patient association table 431 is a data area for storing information for uniquely identifying a patient in a plurality of medical institutions. For example, “0001” is stored. The item “medical institution ID” 4312 of the patient association table 431 is a data area for storing information for uniquely identifying a plurality of medical institutions. For example, “A” is stored. The item “local patient ID” 4313 of the patient association table 431 is a data area storing information for uniquely identifying a patient in a single medical institution attached to each medical institution. For example, “00012” is stored.

  The creation process of the patient association table 431 will be described later. By having the patient association table, it is possible to use the local patient ID assigned by each medical institution. That is, referring to the patient association table based on the common patient ID, it can be seen that the patient with the local patient ID “00012” in the medical institution A corresponds to the local patient ID “02000” in the medical institution B. As described above, by having a patient association table, it is possible to associate and manage patient local IDs in a plurality of medical institutions.

  FIG. 3B is a data table example of the attending physician information table 432.

  The attending doctor information table 432 stores information related to each of the common patient ID 4321, the medical institution ID 4322, and the attending doctor ID 4323 in association with each other. The attending physician information table 432 need not include all these items. In the embodiment, necessary items may be installed as appropriate.

  The item “common patient ID” 4321 of the attending doctor information table 431 is a data area for storing information for uniquely identifying a patient in a plurality of medical institutions. For example, “0001” is stored. The item “medical institution ID” 4322 of the attending doctor information table 431 is a data area for storing the medical institution ID of the medical institution where the attending doctor exists. For example, “A” is stored. The item “primary physician ID” 4323 of the primary physician information table 431 is a data area for storing information for identifying the primary physician of the patient. For example, “DR001” is stored. The primary doctor ID stores the same information as the doctor ID for identifying the doctor.

  That is, for the patient with the common patient ID “0001”, the doctor with the primary doctor ID “DR001” of the medical institution with the medical institution ID “A” is the primary doctor. The attending physician is also called a home doctor or family doctor, and is a doctor who is trusted by the patient. The attending doctor is registered in the attending doctor information table when the patient registers the attending doctor. A plurality of doctors may be registered. In addition, it is possible to designate a medical institution as a primary clinic without designating a doctor.

  FIG. 4 is a data table example of the introduction information table 433.

  The introduction information table 433 stores information on each of the common patient ID 4331, the referral source medical institution ID 4332, the referral source doctor ID 4333, the referral destination medical institution ID 4334, and the referral doctor ID 4335 in association with each other. In the embodiment, necessary items may be installed as appropriate.

  The item “common patient ID” 4331 of the introduction information table 433 is a data area for storing information for uniquely identifying a patient in a plurality of medical institutions. For example, “0001” is stored. The item “introduction source medical institution ID” 4332 of the introduction information table 433 is a data area for storing information for identifying the introduction source medical institution. For example, “B” is stored. Here, the term “introduction” refers to changing a medical institution that provides medical care to a patient at the discretion of a doctor. Therefore, the medical institution in which the doctor who made the introduction exists becomes the referral source medical institution.

  The item “introducing doctor ID” 4333 of the introduction information table 433 is a data area for storing a doctor ID related to a doctor who has introduced an item. For example, “DR005” is stored. The item “introduction medical institution ID” 4334 of the introduction information table 433 is a data area for storing a medical institution ID related to the medical institution of the introduction destination. For example, “A” is stored. The item “referral doctor ID” 4335 of the introduction information table 433 is a data area for storing a doctor ID related to a doctor who has introduced an item. For example, “DR013” is stored.

  FIG. 4 shows that a patient with a common patient ID “0001” is referred to by a doctor with an introduction source doctor ID “DR005” of a medical institution with an introduction source medical institution ID “B”. It shows that it was introduced to the doctor of “DR013”.

  The introduction information table 433 is registered by the registration unit 42 when the relay apparatus 4 receives introduction information from the medical cooperation apparatus 1 of the introduction medical institution. The introduction information includes a local patient ID, an introduction source medical institution ID, an introduction source doctor ID, an introduction destination medical institution ID, and an introduction destination doctor ID in the introduction source medical institution. The registration unit 42 acquires a common patient ID corresponding to the local patient ID in the referral source medical institution ID. Then, the registration unit 42 sets the acquired common patient ID in the common patient ID 4331 of the introduction information table 433.

  Next, the public level storage unit 45 will be described with reference to FIG. FIG. 5 is a data example of the disclosure level definition table 450. The public level definition table 450 is a data table stored in the public level storage unit 45.

  The disclosure level definition table 450 stores information relating to the disclosure level 451, the chart information type ID 452, and the chart information type 453 in association with each other. In the embodiment, necessary items may be installed as appropriate.

  The item “public level” 451 of the public level definition table 450 is a data area for storing information for identifying the public level. For example, “1” is stored. The item “chart information type ID” 452 of the disclosure level definition table 450 is a data area for storing information for identifying the type of medical record information. For example, “M1” is stored. The item “chart information type” 453 of the disclosure level definition table 450 is a data area for storing the type name of the chart information represented by the corresponding chart information type ID. For example, “profile information” is stored. That is, the chart information type ID “M1” is information for identifying profile information among various types of chart information.

  Further, in the example of FIG. 5, if the publication level is “3”, the chart information of the chart information type IDs “M1”, “M2”, “M3”, and “M4” among the chart information of the public source medical institution is Indicates that the information is to be disclosed to the public medical institution.

  In FIG. 5, the chart information type disclosed at a certain level is uniformly set for all patients, but the chart information type disclosed for each level may be set for each patient. Such setting for each patient is referred to as customization setting.

  In the case of customization settings, the public level definition table 450 further includes a common patient ID. Then, if the chart information is disclosed to the patient who has performed the customization setting, the present embodiment can disclose the chart information based on the set contents. Furthermore, the medical record information type ID for disclosure at a certain level may be set for each medical institution.

  Next, the disclosure range storage unit 47 will be described with reference to FIG. FIG. 6 is a data example of the disclosure range definition table 470. The disclosure range definition table 470 is a data table stored in the disclosure range storage unit 47.

  The disclosure range definition table 470 stores information relating to each of the medical institution ID 471, the chart information type ID 472, and the configuration information ID 473 in association with each other. Note that the disclosure range definition table 470 includes necessary items as appropriate in the embodiment.

  The item “medical institution ID” 471 of the open range definition table 470 is a data area for storing information for identifying a medical institution. For example, “B” is stored. The item “chart information type ID” 472 of the disclosure range definition table 470 is a data area for storing the chart information type ID. For example, “M1” is stored. The item “configuration information ID” 473 of the open range definition table 470 is a data area for storing information for identifying information constituting the corresponding type of chart information. For example, “M1-1” is stored. The item “configuration information name” 474 of the disclosure range definition table 470 is a data area for storing the name of the configuration information represented by the corresponding configuration information ID. For example, “body information” is stored. That is, the configuration information ID “M1-1” is the information constituting the “profile information” that is the medical record information type “M1” in the medical institution ID “B”, and represents physical information. .

  The disclosure range definition data table 470 of FIG. 6 will be described in detail with reference to FIG. FIG. 7 is a diagram illustrating a relationship between various types of medical record information registered and managed using the electronic medical record system in the medical institution B and the configuration information.

  For example, in the operation of the medical institution B, the medical record information type ID “M1 (profile information)” 71 includes “physical information” as the configuration information ID “M1-1” and configuration information ID “M1-2”. “Cautions to be noted” and “family contact information” having the configuration information ID “M1-3” are to be registered (solid line frame 71).

  However, information such as “payment is delayed”, “violent acts”, “many claims” are registered in the precautions (M1-2). That is, this information is considered to be information that the patient does not want to be disclosed to the public medical institution. Therefore, when “profile information: M1” is disclosed, the configuration information “physical information (M1-1)”, “family contact information (M1-3)”, and “notes requiring attention (M1-2)” in the solid line 71 are disclosed. There is a problem in making all of “

  6, in the medical institution ID “B”, the configuration information constituting the profile information “M1” is “physical information (M1-1)” and “family contact information (M1-3). ) ". That is, the dotted frame 81 in FIG. 7 is the apparent profile information (M1) when the medical chart information is disclosed to the public medical institution.

  Similarly, in the operation of the medical institution B, the information of “internal medicine input (M3-1)”, “surgical input (M3-2)”, and “psychiatric input (M3-3)” is the medical record information type “progress”. Information (M3) ”is registered (solid line frame 72). However, when medical institution B becomes a public medical institution, “medical input (M3-1)” and “surgical input (M3-2)” are disclosed as the chart information type “progress information (M3)”. (Dotted line frame 82).

  Further, the records indicated by the arrows 91 and 92 in FIG. 6 will be described with reference to FIG. In the operation of the medical institution B, it is assumed that “counseling result (M5-1)” based on the dialogue with the hospital counselor is registered in the medical record information type “mental information (M5)” (solid line frame 73). However, in terms of operation, mental information should be registered in the configuration information “psychiatric input (M3-3)” included in the progress information.

  Therefore, when the medical institution B discloses the chart information type “mental information”, the configuration information “counseling result (M5-1)” and the configuration information “psychiatric input (M3-3)” are disclosed (dotted line frame). 83). Therefore, the record of the arrow 91 in FIG. 6 indicates that when the medical institution ID “B” discloses “mental information” with the medical record type ID “M5”, the “psychiatric input” of the configuration information ID “M3-3”. Also shows that it will be released. Similarly, when the medical institution ID “B” discloses “special item information” with the chart type ID “M6”, the record indicated by the arrow 92 in FIG. "Matter" is to be released.

  Subsequently, each function of the medical cooperation device 1 and the electronic medical record system 2 will be described. FIG. 8 is a functional block diagram of the medical cooperation device 1 and the electronic medical chart system 2.

  The medical cooperation device 1 includes a first communication unit 11, an extraction unit 12, a public information generation unit 13, a second communication unit 14, and a request generation unit 15.

  The electronic medical record system 2 includes a patient information storage unit 21 and a medical record information storage unit 22. As described above, the electronic medical record system 2 may have some or all of the functions of the medical cooperation apparatus.

  In addition to the storage units illustrated in FIG. 8, the electronic medical chart system has each function of a conventional electronic medical chart system. For example, there are a prescription order function and an accounting process function.

  First, each processing unit of the medical cooperation device 1 will be described. The first communication unit 11 is a processing unit that communicates with the relay device 4. For example, the first communication unit 11 transmits a publication request to the relay device 4. The extraction unit 12 extracts predetermined information from the patient information storage unit 21 or the chart information storage unit 22. For example, the extraction unit 12 extracts predetermined chart information from the chart information storage unit 22. The public information generation unit 13 converts the extracted chart information into a predetermined format. For example, the conversion unit converts public medical chart information into a format common to other medical institutions.

The 2nd communication part 14 is a process part which communicates with the terminal device which a user operates. For example, medical chart information released from another medical institution is transmitted to the terminal device. The request generation unit 15 is a processing unit that generates a publication request. For example, when the second communication unit 14 receives a disclosure request for patient chart information from the terminal device 10, the request generation unit 15 generates a disclosure request. The disclosure request is information including the medical institution ID of the disclosure destination medical institution, the local patient ID of the patient to be disclosed, and the search condition information. The part will be described. The patient information storage unit 21 is a storage unit that stores patient information. Details will be described later. The chart information storage unit 22 is a storage unit that stores various types of chart information. Details will be described later. Note that the chart information may be stored in a different storage unit for each type.

  The patient information table 210 stored in the patient information storage unit 21 will be described with reference to FIG.

  FIG. 9 is a data table example of the patient information table 210. Further, FIG. 9 shows a patient information table in the medical institution B which is a public medical institution in the present embodiment. Each medical institution is provided with a patient information table 210 for each medical institution to manage patients.

  The patient information table 210 stores information related to the local patient ID 211, the patient name 212, the date of birth 213, and the insurer number 214 in association with each other. The patient information table 210 does not have to include all these items, and necessary items may be appropriately installed in the embodiment.

  The item “local patient ID” 211 of the patient information table 210 is a data area for storing the above-mentioned local patient ID. For example, a local ID “02000” for uniquely identifying a patient in the medical institution B is stored. The item “patient name” 212 of the patient information table 210 is a data area for storing the name of the patient. For example, “Yamada Taro” is stored.

  The item “birth date” 213 of the patient information table 210 is a data area for storing the birth date of the patient. For example, “1980.1.1.1” is stored. This indicates that he was born on January 1, 1980. The item “insurer number” 214 of the patient information table 210 is a data area for storing an insurer number provided to the patient from the national or local government. For example, “12345678” is stored. The patient information table 210 may further include a data area for storing a symbol number written on the insurance card.

  Next, the chart information table 220 stored in the chart information storage unit 22 will be described with reference to FIG.

  FIG. 10 is a data table example of the chart information table 220. Furthermore, FIG. 10 shows a medical record information table in the medical institution B which is a public medical institution in the present embodiment. Each medical institution is provided with a medical chart information table 220 for managing medical chart information generated at each medical institution.

  The medical chart information table 220 stores information related to the local patient ID 221, the registration date 222, the configuration information ID 223, and the registration data 224 in association with each other. The medical chart information table 220 does not have to include all these items, and necessary items may be appropriately set in the embodiment.

  The item “local patient ID” 221 of the medical chart information table 220 is a data area for storing the above-mentioned local patient ID. For example, a local ID “02000” for uniquely identifying a patient in the medical institution B is stored.

  The item “registration date” 222 of the chart information table 220 is a data area for storing the date on which the chart information is registered. For example, the registration date “2010.3.1” is stored. In addition, the chart information of the record is registered on March 1, 2010. The item “registration date” 222 may further store time information.

  The item “configuration information ID” 222 of the chart information table 220 is a data area for storing the above-described configuration information ID. For example, “M3-1” is stored. The item “registered data” 224 of the chart information table 220 is a data area for storing registered data. For example, “decreased appetite” is stored.

  In addition, since the amount of registration data can be enormous, it is possible to register the storage location of registration data. For example, a database for storing X-ray images (hereinafter referred to as DB) and information indicating the storage location in the DB may be stored in the medical record information table instead of the registration data. In this case, in the extraction of medical chart information by the medical cooperation apparatus 1 described later, the medical record information table is referred to search the DB where the data is stored. And a medical cooperation apparatus will extract the actual data of the target chart information from DB.

  Subsequently, in the relay device 4 and the medical cooperation device 1 included in the medical cooperation system, the movements associated with the processing units illustrated in FIGS. 2 and 8 will be described with reference to FIGS. 11 to 14.

  First, with reference to FIG. 11, a process for registering patient information in the relay device 4 for a patient who visits each medical institution will be described. FIG. 11 is a flowchart of patient registration processing. FIG. 11 illustrates a process of registering information on a patient who has visited the medical institution A in the relay apparatus and associating the registered patient with a local patient ID in another medical institution B. There may be a plurality of other medical institutions other than the medical institution B.

  The process of FIG. 11 is, for example, a process executed at a point in time when the medical institution introduces the medical cooperation device 1 or every predetermined time. For example, it is executed every 24 hours.

  First, the first communication unit 11 of the medical cooperation device A1-1 included in the medical institution A transmits a patient registration request including the local patient ID of the patient to be registered, the medical institution ID, and a part of the patient information to the relay device 4. (S101). For example, it is assumed that the local ID in the medical institution A of the patient to be registered is “0012”. In this case, the local patient ID “0012” and the medical institution ID “A” are included in the patient registration request.

  In addition, you may provide the item which stores the information of whether it registered to the relay apparatus 4 in the patient information table. And the request production | generation part 15 produces | generates the patient registration request containing the local patient ID of the said patient as a patient who wants to register the patient who is not registered.

  The part of the patient information is information extracted by the extraction unit 12 from the patient information table 210 stored in the patient information storage unit 21 included in the electronic medical record system 2. For example, a patient name, an insurer number, and the like are included in the patient registration request. A part of the patient information included in the patient registration request is hereinafter referred to as search condition information.

  The communication unit 41 of the relay device 4 receives the patient registration request (S201). And the communication part 41 transmits a patient search command with respect to the 1st communication part 11 of medical cooperation apparatus B1-2 with which the medical institution B is provided (S202). The patient search command is transmitted to a plurality of medical cooperation devices 1 that communicate with the relay device 4 such as the medical cooperation device B1-2 and the medical cooperation device C1-3. The patient search command includes search condition information. For example, the insurer number “12345678” received in S201 is included.

  The first communication unit 11 of the medical cooperation device B1-2 receives a patient search command (S301). And the extraction part 12 which received the patient search command refers to the patient information table 210 stored in the patient information storage part 21 with which the electronic medical record system B2-2 of the medical institution B is provided. And the extraction part 12 extracts local patient ID from the patient information containing search condition information based on the search condition information contained in a patient search command (S302). For example, in the patient information table 210 of the medical institution B illustrated in FIG. 9, the extraction unit 12 extracts the local patient ID “02000” that includes the insurer number “12345678” that is the search condition in the patient information.

  And the 1st communication part 11 transmits the patient search result containing extracted local patient ID and medical institution ID to the communication part of the relay apparatus 4 (S303). For example, a patient search result including a local patient ID “02000” and a medical institution ID “B” is transmitted.

  If patient information that matches the search condition information does not exist in the patient information storage unit 21, information indicating that the corresponding patient does not exist is generated. Then, the first communication unit 11 transmits the patient search result including information indicating that the corresponding patient does not exist. For example, when there is no corresponding patient, a patient search result including “00000” and the medical institution ID “B” is transmitted.

  The communication unit of the relay device 4 receives the patient search result from the medical cooperation device 1 (S204). Then, the registration unit 42 refers to the patient association table 431 and determines whether there is a record including the local patient ID and the medical institution ID included in the patient search result (S205). Note that the following processing is not performed when a patient search result including information indicating that the corresponding patient does not exist is received. The relay device 4 waits until receiving a patient search result from another medical cooperation device 1.

  If it exists (YES in S205), it is determined that a common patient ID has already been assigned to the patient. Therefore, the registration unit 42 acquires the common patient ID included in the record (S206). Then, the registration unit 42 adds a record including the local patient ID, the medical institution ID, and the common patient ID included in the patient registration request to the patient association table (S207).

  For example, in the patient association table 431, it is assumed that there is no record indicated by an arrow 93 and a record indicated by an arrow 94 exists in FIG. 3A.

  In S205, the registration unit 42 determines that there is a record (arrow 94) including the local patient ID “02000” and the medical institution ID “B” included in the patient search result. Therefore, the registration unit 42 acquires the common patient ID “0001” included in the record (arrow 94) (S206). In this case, before the patient registration request from the medical cooperation device A1-1, the patient has been registered by the medical cooperation device B1-1.

  Then, the registration unit 42 adds a record (arrow 93) including the local patient ID “00012”, the medical institution ID “A”, and the common patient ID “0001” included in the patient registration request to the patient association table. (S207).

  On the other hand, when there is no record (NO in S208), it is determined that the common patient ID is not assigned to the patient. Therefore, the registration unit 42 assigns a common patient ID (S208). Then, the registration unit 42 adds a record including the local patient ID, the medical institution ID, and the common patient ID included in the patient registration request to the patient association table (S209). Further, the registration unit 42 adds a record including the local patient ID, the medical institution ID, and the common patient ID included in the patient search result to the patient association table (S209). Then, this process ends.

  For example, it is assumed that there are no records of arrows 93 and 94 in the patient association table 431.

  In S205, the registration unit 42 determines that there is no record (arrow 94) including the local patient ID “02000” and the medical institution ID “B” included in the patient search result. The registration unit 42 assigns a common patient ID “0001” (S208). Then, the registration unit 42 adds a record (arrow 93) including the local patient ID “00012”, the medical institution ID “A”, and the common patient ID “0001” included in the patient registration request to the patient association table. (S209).

  Furthermore, the registration unit 42 adds a record (arrow 94) including the local patient ID “02000”, the medical institution ID “B”, and the common patient ID “0001” included in the patient search result to the patient association table. (S209).

  Through the above processing, the local patient ID of a patient who has visited each medical institution can be associated with the local patient ID of another medical institution.

  Here, there is a case where the patient performs a procedure for participation in medical cooperation in advance, a common patient ID is given to the patient, and the patient visits each medical institution with the common patient ID. In this case, a chart information disclosure process described later is executed based on a common patient ID that uniquely identifies a patient at a plurality of medical institutions in advance.

  That is, the item “common patient ID” is provided instead of the item “local patient ID” in the patient information table 210 in each medical institution. Then, patient chart information corresponding to the common patient ID is exchanged. And it becomes unnecessary to link the local patient ID of a certain medical institution with the local patient ID of another medical institution.

  On the other hand, by associating the local patient ID with the process disclosed in FIG. 11, a later-described disclosure process using the local patient ID becomes possible. By using the local patient ID, for example, it is possible to omit the registration work for giving a common patient ID in advance. Furthermore, even when the patient forgets the common patient ID, it can be handled.

  Subsequently, a chart information disclosure process in medical cooperation will be described with reference to FIGS. 12 to 14. 12 to 14 are flowcharts of the chart information disclosure process.

  First, the second communication unit 14 of the medical cooperation device A <b> 1-1 of the disclosure destination medical institution receives a chart information disclosure request from the terminal device 10. The medical record information disclosure request includes the local patient ID. Then, the request generation unit 15 generates a publication request. The disclosure request is information including a medical institution ID as a disclosure destination, a local patient ID of a patient to be disclosed, and search condition information.

  Then, the first communication unit 11 transmits a publication request to the relay device 4 (S401). For example, a publication request including a local patient ID “00012”, a medical institution ID “A”, and a search condition “insurer number 12345678” is transmitted.

  The communication unit of the relay device 4 receives the publication request (S501). The determination unit 44 that has received the disclosure request extracts the medical institution ID and the local patient ID from the disclosure request. And the determination part 44 determines whether the record which has medical institution ID and local patient ID exists with reference to the patient correlation table 43 of the management information storage part 43 (S502).

  If it exists (YES in S502), it is determined that the patient has visited the public medical institution in the past to indicate that the patient registration process has been performed previously. Subsequently, the determination unit 44 acquires a common patient ID included in the corresponding record (S500).

  The determination unit 44 refers to the attending doctor information table 432 of the management information storage unit 43 and determines whether there is a record including the common patient ID and the medical institution ID (S503). If it exists, it is determined that the public medical institution is a family medical institution for the patient. The publication request may include the doctor ID of the doctor who made the publication request. In that case, the determination unit 44 further refers to the attending physician information table 432 of the management information storage unit 43 to determine whether there is a record including the common patient ID, the medical institution ID, and the doctor ID. If it exists, the doctor who makes it public is determined to be the attending physician.

  Then, the determination unit 44 sets the disclosure level of the chart information disclosed from the disclosure source medical institution to “4” for the disclosure destination medical institution (S505). As shown in FIG. 5, the disclosure level “4” has more chart information types to be disclosed as compared to other disclosure levels having a low level value. In other words, when the attending physician (or family medical institution) where the patient's trust is expected to be large is the disclosure destination, more information can be set to be disclosed from the disclosure medical institution.

  If there is no corresponding record in the attending doctor information table (NO in S503), the determination unit 44 determines that the disclosed medical institution is not a family medical institution. Then, the determination unit 44 sets the disclosure level of the chart information disclosed from the disclosure source medical institution to “2” for the disclosure destination medical institution (S506). The relay device 4 advances the process to S515 in FIG.

  On the other hand, in S502, when there is no corresponding record in the patient association table (NO in S502), the determination unit 44 determines that the patient has visited a public medical institution for the first time. And the relay apparatus 4 advances a process to S507 of FIG.

  The communication unit 41 of the relay device 4 transmits a patient search command (S507). Similar to S202, the search condition information is included in the patient search command. The search condition information is search condition information extracted from the publication request.

  Here, S507 is S202, S508 is S203, S509 is S204, S601 is S301, S602 and S302, and S603 is the same processing as S303. Therefore, explanation is omitted.

  When the patient search result is received in S509, the registration unit 42 extracts the medical institution ID and the local patient ID from the patient search result. Then, the registration unit 42 refers to the patient association table 431 and acquires a common patient ID using the medical institution ID and the local patient ID as keys (S510).

  When transmitting a patient search command to a plurality of medical cooperation devices 1, the relay device 4 receives a plurality of patient search results from each medical cooperation device 1. Therefore, the patient search result transmitted from the other medical cooperation device 1 when the patient search result including the local patient ID is received instead of the patient search result including the information that the corresponding patient does not exist as described above. It is good also as destroying.

  If no patient search result including the local patient ID is received from any medical cooperation device 1, there is no medical institution having medical chart information. Therefore, the relay device 4 notifies the medical cooperation device 1 of the public medical institution that there is no public medical record information.

  Returning to the description of FIG. 13, the registration unit 42 registers the acquired common patient ID, the medical institution ID included in the disclosure request, and the local patient ID in the patient association DB in association with each other (S511). By this processing, a patient who has visited a public medical institution for the first visit is associated with a patient local ID in another medical institution. That is, for example, when the process of FIG. 11 is performed every predetermined time, there is a possibility that patient registration is not performed depending on the timing of the disclosure process. Therefore, it is possible to associate the patient who has missed the process of FIG. 11 by the processes of S507 to S511.

  Subsequently, the determination unit 44 refers to the introduction information table 433 using the common patient ID as a key. Then, the determination unit 44 determines whether there is a record having the medical institution ID in the introduction destination medical institution ID 4334 and having the common patient ID (S512).

  If it exists (YES in S512), the determination unit 44 determines that the public medical institution is the referral medical institution and that the patient has visited the public medical institution through the introduction of the referral original medical institution. Then, the determination unit 44 sets the disclosure level of the medical institution of the referral source medical institution ID stored in the referral source medical institution ID 4332 of the record to “3” (S513).

  The introduction of the patient by the referral source medical institution is because it is required to provide information on medical treatments, examinations, and prescriptions previously performed at the referral source. Furthermore, the determination unit 44 sets the disclosure level of other medical institutions to “2” (S513). The set disclosure level of the public medical institution is stored on the memory in association with the medical institution ID (not shown).

  On the other hand, when there is no corresponding record (S514), the determination unit 44 determines that the patient has visited the first public medical institution without being introduced. Then, the determination unit 44 sets the disclosure level of the public medical institution to “1” (S514).

  For example, in S502, it is assumed that there is no record (arrow 93 in FIG. 3A) having the medical institution ID “A” and the local patient ID “00012” in the patient association table (S502).

  The communication unit 41 of the relay device 4 transmits a patient search command including the search condition “insurer number 12345678” (S507).

  Then, it is assumed that the patient search result including the medical institution ID “B” and the local patient ID “02000” is received from the medical cooperation device B1-2 in S509. The registration unit 42 extracts the medical institution ID “B” and the local patient ID “02000” from the patient search result. Then, the registration unit 42 refers to the patient association table 431 and acquires the common patient ID “0001” using the medical institution ID “B” and the local patient ID “02000” as keys (S510).

  The registration unit 42 registers the acquired common patient ID “0001”, the medical institution ID “A” included in the disclosure request, and the local patient ID “00012” in association with each other in the patient association DB (S511).

  Subsequently, the determination unit 44 refers to the introduction information table 433 using the common patient ID as a key. Then, the determination unit 44 determines whether there is a record having the medical institution ID “A” in the referral destination medical institution ID 4334 and having the common patient ID “0001” (S512).

  Since it exists (S512 YES), the determination unit 44 sets the disclosure level of the medical institution with the referral source medical institution ID “B” stored in the referral source medical institution ID 4332 of the record to “4” (S513). Furthermore, the determination unit 44 sets the disclosure level of the other medical institution C to “2” (S513).

  And the relay apparatus 4 advances a process to S515 of FIG.

  The determination unit 46 reads a record existing in the patient association table 431 having the common patient ID acquired in S500 or S510 (S515). Then, the determination unit 46 determines the disclosure range for each medical institution corresponding to the medical institution ID included in the record (S516).

  For example, when the chart information of the common patient ID “0001” is disclosed to the medical institution A in S515, the records of medical institutions other than the medical institution A are read. For example, first, the record of the medical institution ID “B” is read. Here, it is assumed that the disclosure level of the patient's medical record information to the public medical institution is “3”.

  The determining unit 46 refers to the disclosure level definition table 450 and sequentially reads records having the disclosure level “3”. For example, it is assumed that a record having a disclosure level “3”, a chart information type ID “M3”, and a chart information type “prescription information” is read. The determination unit 46 refers to the disclosure range definition table 470 and reads all records corresponding to the chart information type ID “M3” and the medical institution ID “B”.

  Here, a record including a medical institution ID “B”, a chart information type ID “M3”, and a configuration information ID “M3-1”, a medical institution ID “B”, a chart information type ID “M3”, and a configuration information ID “ A record including “M3-2” is read out. That is, the configuration information IDs “M3-1” and “M3-2” are the configuration information included in the disclosure range. In addition, since the disclosure level is “3”, the profile information (ID = M1), the visit history information (ID = M2), and the prescription information (ID = M4) are similarly set to the disclosure source medical institution. The configuration information ID to be disclosed is determined.

  And the determination part 46 produces | generates the public instruction | indication containing all the structure information ID contained in a record, medical institution ID, and local patient ID in the said medical institution. The local patient ID is acquired from the patient association table.

  For example, a public instruction having configuration information IDs “M3-1” and “M3-2”, a medical institution ID “B”, and a local patient ID “02000” corresponding to a common patient ID “0001” in the medical institution B is created. Is done. In addition, the public instruction includes configuration information IDs “M1-1”, “M1-3”, “M2-1”, and “M4-1”.

  Subsequently, the communication unit 41 transmits the disclosure command to the medical cooperation device B1-2 included in the medical institution corresponding to the medical institution ID included in the disclosure command (S517). Then, the determination unit 46 of the relay device 4 determines whether or not the disclosure range has been determined for all records existing in the patient association table 431 having the common patient ID (S518). The processing from S515 to S516 is repeated until the end.

  On the other hand, the first communication unit 11 of the medical cooperation device B1-2 receives a disclosure command (S604). Then, the extraction unit 12 extracts, from the medical record information table 220, information corresponding to the configuration information ID to be disclosed included in the disclosure command, out of the configuration information configuring the medical record information of the local patient ID included in the disclosure command. . In the present embodiment, the registration data, the registration date, and the configuration information ID are the public chart information.

  For example, among the records having the local patient ID “02000” in the medical record information table 220, the configuration information IDs “M3-1”, “M3-2”, “M1-1”, “M1-3”, and “M2-1” ”And“ M4-1 ”, the registration data and the registration date of the record are extracted.

  Here, the registration date “2010.3.1”, the registration data “decreased appetite”, the configuration information ID “M3-1”, the registration date “2013.15”, the registration data “influenza”, and the configuration information ID “M3-1” or the like is extracted as public chart information.

  Then, the public information generation unit 13 converts the format of the extracted public medical record information (S606). For example, the data is converted into a predetermined data format. Then, the first communication unit 11 transmits public information including the converted public medical record information, the medical institution ID, and the local patient ID (S607).

  Then, the communication unit 41 of the relay device 4 receives the public information (S519). Then, the editing unit 48 refers to the patient association table, and creates the other medical institution chart information when the public information is received from all the medical institutions having the medical institution ID corresponding to the common patient ID acquired in S510. The other medical institution chart information is information including the public information transmitted from the public medical institution acquired from the patient association table and the medical institution ID of the medical institution from which the public information is transmitted.

  And the communication part 41 transmits to medical cooperation apparatus A1-1 of a disclosure destination medical institution (S520). Note that the communication unit 41 may transmit other medical institution chart information every time public information is received, even before reception from all medical institutions.

  The first communication unit 11 of the medical cooperation device A1-1 receives other medical institution chart information (S402). Then, the second communication unit 14 outputs other medical institution chart information to the terminal device 10. Then, the doctor or the like can treat the patient while referring to the other medical institution chart information that has been output.

  For example, the screen 100 shown in FIG. 15 is displayed on the terminal device 10. FIG. 15 is an example of a screen displayed on the terminal device 10. The patient's information such as the patient's name is displayed as the public medical chart information released from another medical institution B. In the present embodiment, the registration data is displayed for each chart information type, but the present invention is not limited to this. Regardless of the chart information type, the registered data may be sorted in time series.

  As described above, the medical cooperation system described in the present embodiment can set the public level according to the relationship between the patient and the public medical institution. Furthermore, the medical cooperation system can set an appropriate disclosure range according to the operation of the electronic medical record system of the public medical institution.

  The embodiment of the present invention is not limited to the above.

  For example, the medical cooperation device 1 may have the disclosure range definition table 470. In this case, after determining the disclosure level, the relay device 4 refers to the disclosure level definition table 450 and acquires the chart information type ID to be disclosed at the corresponding level. Then, the relay device 4 transmits a disclosure command including the chart information type ID to be disclosed and the local patient ID in the disclosure medical institution to the medical cooperation device 1 of the disclosure medical institution. The medical cooperation device 1 that has received the disclosure command refers to the disclosure range definition table, and acquires the configuration information ID in its own medical institution for the medical record information ID included in the disclosure command. And medical cooperation device 1 extracts public chart information from a chart information table based on acquired composition information ID.

  Further, the terminal device 10 operated by the user may function as the medical cooperation device 1.

  Further, the public process may be performed using the common patient ID without using the local patient ID. In this case, when the common patient ID is numbered in the patient registration process, the relay device 4 sends the information that associates the local patient ID and the common patient ID to the medical cooperation device that has transmitted the patient registration request. Send to 1.

  The medical cooperation device 1 stores the common patient ID in the patient information table 210 in association with the local patient ID. If it does in this way, each medical institution can grasp | ascertain common patient ID with respect to the patient by whom patient registration was performed. Therefore, in the disclosure process, the relay device 4 may include the common patient ID instead of the local patient ID in the disclosure command. Furthermore, the medical institution apparatus 1 that performs the disclosure request may include the common patient ID in the disclosure request if the common patient ID is a patient that exists in the patient information table.

  Hereinafter, with reference to FIG. 16, the relay device 4 illustrated in the above embodiment and a computer that executes a relay program having the same function as the relay device 4 will be described as an example. FIG. 16 is a diagram illustrating an example of a hardware configuration of the relay device 4.

  The relay device 4 includes a CPU (Central Processing Unit) 401, a ROM (Read Only Memory) 402, a RAM (Random Access Memory) 403, a communication unit 404, an HDD (Hard Disk Drive) 405, an input unit 406, and a display unit 407. Each part is connected to each other via a bus 408. Data can be transmitted and received between them under the control of the CPU 401.

  The CPU 401 is a central processing unit that controls operation of the entire relay device 4. The communication unit 404 receives a signal from the medical cooperation device 1 via the network and passes the content of the signal to the CPU 401. Further, the communication unit 404 transmits a signal to the medical cooperation apparatus 1 via the network in response to an instruction from the CPU 401.

  The HDD 405 stores a program for causing the computer to execute at least each process of the relay device 4 of FIGS. 12 to 14 as a program that causes the computer to exhibit the same functions as those of the relay device 4 described in the above embodiment. .

  The CPU 401 reads out this program from the HDD 405 and executes it to function as the determination unit 44 and the determination unit 46 shown in FIG. This program may be stored in the ROM 402 or the RAM 403 accessible to the CPU 401.

  Further, the management information storage unit 43, the disclosure level storage unit 45, and the disclosure range storage unit 47 shown in FIG. Similar to the program, the management information storage unit 43, the disclosure level storage unit 45, and the disclosure range storage unit 47 may be stored in the ROM 402 or RAM 403 accessible to the CPU 401.

  The input unit 406 receives data input under the control of the CPU 401. The display unit 407 outputs each information to the display device.

  Next, with reference to FIG. 17, a medical cooperation device 1 and a computer that executes a medical cooperation program having the same function as the medical cooperation device 1 described in the above embodiment will be described as an example. FIG. 16 is a diagram illustrating an example of a hardware configuration of the medical cooperation device 1.

  The medical cooperation apparatus 1 includes a CPU 101, a ROM 102, a RAM 103, a communication unit 104, an HDD 105, an input unit 106, and a display unit 107, and each unit is connected to each other via a bus 108. Data can be transmitted and received with each other under the control of the CPU 101.

  The CPU 101 is a central processing unit that controls the operation of the medical cooperation apparatus 1 as a whole. The communication unit 104 receives signals from the relay device 4 and the terminal device 10 and passes the contents of the signals to the CPU 101. Further, the communication unit 104 transmits a signal to the relay device 4 or the terminal device 10 in response to an instruction from the CPU 101.

  The HDD 105 stores a program that causes the computer to execute at least each process in the medical cooperation device 1 of FIGS. 12 to 14 as a program that causes the computer to perform the same function as the medical cooperation device 1 described in the above embodiment. ing.

  The CPU 101 reads out and executes this program from the HDD 105, thereby functioning as the request generation unit 15, the extraction unit 12, and the public information generation unit 13 illustrated in FIG. This program may be stored in the ROM 102 or the RAM 103 accessible to the CPU 101.

  The input unit 106 receives data input under the control of the CPU 101. The display unit 107 outputs each information to the display device.

  The program describing the processing content shown in the flowchart can be recorded on a computer-readable recording medium. Examples of the computer-readable recording medium include a magnetic recording device, an optical disk, a magneto-optical recording medium, and a semiconductor memory. Examples of the magnetic recording device include an HDD, a flexible disk (FD), and a magnetic tape (MT).

  Examples of the optical disc include a DVD (Digital Versatile Disc), a DVD-RAM, a CD-ROM (Compact Disc-Read Only Memory), and a CD-R (Recordable) / RW (ReWriteable). Magneto-optical recording media include MO (Magneto-Optical disk). When this program is distributed, for example, a portable recording medium such as a DVD or CD-ROM in which the program is recorded may be sold.

  In the computer that executes the program, for example, a medium reading unit (not shown) reads the program from a recording medium in which the program describing the processing contents shown in the flowchart is recorded. The CPU of each computer stores the read program in the HDD, ROM, or RAM. Then, the computer reads the program from the HDD, ROM, or RAM, which is its own storage device, and executes processing according to the program.

DESCRIPTION OF SYMBOLS 1 Medical cooperation apparatus 10 Terminal apparatus 11 1st communication part 12 Extraction part 13 Public information generation part 14 Second communication part 15 Request generation part 2 Electronic medical record system 21 Patient information storage part 22 Medical record information storage part 4 Relay apparatus 41 Communication part 42 Registration unit 43 Management information storage unit 44 Determination unit 45 Public level storage unit 46 Determination unit 47 Public range storage unit 48 Editing unit 6 Network

Claims (9)

A first medical cooperation device provided in the first medical institution, a second medical cooperation device provided in the second medical institution, a relay device that communicates with the first medical cooperation device and the second medical cooperation device A medical cooperation system having
The first medical cooperation device is
Publication request information including patient identification information for identifying a patient and information requesting publication of medical chart information related to the patient is transmitted to the relay device, and released from the relay device by the second medical institution. It has a communication unit that receives public chart information,
The relay device is
The disclosure request information is received from the first medical cooperation device, a public instruction for requesting the disclosure of the medical chart information is transmitted to the second medical cooperation device, and the disclosure is further transmitted from the second medical cooperation device. A communication unit that receives medical chart information and transmits the received medical chart information to the first medical cooperation device;
Of the medical chart information of the patient managed by the second medical institution according to the relationship between the patient corresponding to the patient identification information included in the received disclosure request information and the first medical institution A determination unit for determining a disclosure level to be disclosed to the first medical institution;
And a determination unit that generates the disclosure command based on the determined disclosure level.
A communication unit that receives the public command from the relay device and transmits the public medical chart information;
A medical cooperation system comprising: an extraction unit that extracts the public chart information that is a part of the chart information from a storage section that stores the chart information of the patient based on the disclosure command.   The determination unit of the relay device, based on the determined disclosure level, at least one configuration that causes the extraction unit of the second cooperative device to extract among a plurality of types of configuration information configuring the chart information 2. The medical cooperation system according to claim 1, wherein information is determined, and the public instruction including designation of the determined at least one piece of configuration information is generated.   The determination unit of the relay device provides information on whether the patient has visited the first medical institution in the past, and introduces the patient to the first medical institution from the second medical institution. Determining the disclosure level based on at least one of information on whether or not the patient has visited and information on whether or not the patient has set the first medical institution as a family clinic. The medical cooperation system according to claim 1 or 2, wherein the medical cooperation system is characterized. The relay device further includes
Patient information for storing the patient identification information, which is information for identifying the patient in the first medical institution, and other patient identification information, which is information for identifying the patient in the second medical institution, in association with each other Having a storage unit,
The determination unit refers to the patient information storage unit, extracts the other patient identification information corresponding to the patient identification information included in the disclosure request information, and includes the extracted other patient identification information The medical cooperation system according to any one of claims 1 to 3, wherein a public instruction is generated. The communication unit of the relay device is
The patient information of the patient corresponding to the patient identification information is transmitted to the second medical cooperation device, and the other patient identification information of the patient corresponding to the patient information is received from the second medical cooperation device And
The relay device further includes:
A registration unit that registers the received patient identification information in the second medical institution in association with the patient identification information in the first medical institution in the patient information storage unit; The medical cooperation system according to claim 4.   The medical cooperation system according to claim 5, wherein the patient information is at least one of the patient name information, date of birth information, and insurer number information. A relay device that communicates with the first medical cooperation device provided in the first medical institution and the second medical cooperation device provided in the second medical institution,
The relay device is
From the first medical cooperation device, receiving public request information including patient identification information for identifying a patient and information requesting the release of medical chart information related to the patient, and to the second medical cooperation device, the second medical cooperation device A release command for requesting release of medical record information, and further receiving from the second medical cooperation device public medical record information included in the medical record information of the patient managed by the second medical institution, A communication unit that transmits the received medical chart information to the first medical cooperation device;
Of the medical chart information of the patient managed by the second medical institution according to the relationship between the patient corresponding to the patient identification information included in the received disclosure request information and the first medical institution A determination unit for determining a disclosure level to be disclosed to the first medical institution;
A relay apparatus comprising: a determination unit that generates the disclosure command based on the determined disclosure level. A medical cooperation program to be executed by a computer that communicates with a first medical cooperation device provided in the first medical institution and a second medical cooperation device provided in the second medical institution,
In the computer,
Receiving, from the first medical cooperation device, disclosure request information including patient identification information for identifying a patient and information requesting disclosure of medical chart information related to the patient;
Of the medical chart information of the patient managed by the second medical institution according to the relationship between the patient corresponding to the patient identification information included in the received disclosure request information and the first medical institution Determining a disclosure level to be disclosed to the first medical institution, and generating a disclosure command based on the determined disclosure level;
Transmitting the generated public instruction to the second medical cooperation device;
Receiving, from the second medical cooperation device, public medical chart information included in the medical chart information of the patient managed by the second medical institution;
And a step of transmitting the received public medical chart information to the first medical cooperation device. A medical cooperation method executed by a computer that communicates with a first medical cooperation device provided in a first medical institution and a second medical cooperation device provided in a second medical institution,
The computer is
Receiving, from the first medical cooperation device, disclosure request information including patient identification information for identifying a patient and information requesting disclosure of medical chart information related to the patient;
Of the medical chart information of the patient managed by the second medical institution according to the relationship between the patient corresponding to the patient identification information included in the received disclosure request information and the first medical institution Determining a disclosure level to be disclosed to the first medical institution, and generating a disclosure command based on the determined disclosure level;
Transmitting the generated public instruction to the second medical cooperation device;
Receiving, from the second medical cooperation device, public medical chart information included in the medical chart information of the patient managed by the second medical institution;
And a step of transmitting the received public medical chart information to the first medical cooperation device.

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