JP2012053632A - Device, method and program for supporting preparation of medical report - Google Patents

Abstract

PROBLEM TO BE SOLVED: To shorten a preparation time for a medical report and to facilitate handling integrated findings.SOLUTION: A console control unit 40 of a report preparation terminal 13 displays, on a display 37b, a template window 45 which has a plurality of areas for inputting findings including a term selection input area 46 and a diagnosis name input area 48, and a report window 65 having a finding display area 67 in which findings inputted through the plurality of areas for inputting findings are brought together. An editing process unit 42 manages data of findings by adding finding IDs to the data, which is capable of distinguishing findings. The editing process unit 42 creates integrated finding information 85 which indicates the arranging order of the findings in the finding display area 67. The editing process unit 42 updates the integrated finding information 85 and the console control unit 40 changes the arranging order in the finding display area 67 per organ and per finding item, according to a click selection of display-per-organ change buttons 72a and 72b, and display-in-organ change buttons 73a and 73b.

Description

  The present invention relates to a medical report creation support apparatus, a medical report creation support method, and a medical report creation support program that accept input of a finding sentence through a plurality of finding sentence input areas including a template input area.

  In recent medical practice, medical documents such as medical records and medical reports are handled as electronic data, making it easy to create and manage medical documents, and various measures to reduce the burden on doctors such as interpretation doctors who create medical reports. Computer systems are being introduced (see Patent Document 1).

  Patent Document 1 discloses a report browsing device that displays on a display an input area for inputting a plurality of finding sentence input areas and a certainty factor prepared in pairs with the finding sentence input area. A finding ID is assigned to the finding text in each input area, and the finding text is described by dividing the input area for each lesion, or the finding text input area is divided into an observation record and a diagnosis result including a diagnosis disease name. I do. In addition, it describes that the arrangement (display) order of the input areas of observation sentences is changed by a drag operation.

JP 2009-238038 A

  In medical examinations where the examination site is not limited to a single organ, such as a so-called medical checkup, the findings on multiple organs are created at once in order to reduce the labor required for the doctor and comprehensively determine the health status of the patient. , There is a desire to browse. However, there are various types of findings such as the overall state of each organ, the details of the size and shape of the lesion, the diagnosis made as a result of interpretation, the certainty of diagnosis, and so on. Control of the storage form and display form of each finding sentence becomes complicated. There is also a problem that it takes a long time to create a medical report when finding sentences are input in multiple organs and various types.

  In the invention described in Patent Document 1, the finding sentences are input from the keyboard, and the finding sentences are not integrated. Therefore, when the input of finding sentences is multiple organs and various, and the finding sentences are integrated, the control of the storage form and display form of each finding sentence becomes complicated, and it takes time to create a medical report. It cannot be solved.

  The present invention has been made in view of the above problems, and an object of the present invention is to shorten the time for creating a medical report and make it easy to handle an integrated finding sentence.

  In order to achieve the above object, the medical report creation support apparatus of the present invention includes a plurality of finding sentences including a template input area for selectively inputting a part of a plurality of words and phrases obtained by disassembling the finding sentences constituting the medical report as input words. A display control means for displaying an input area and an integrated finding display area that integrates each finding sentence input through a plurality of finding sentence input areas, and a finding ID for identifying each finding sentence are attached. And first storage control means for storing data of each finding sentence in a storage medium.

  The first storage control means stores information indicating the arrangement order of the finding sentences in the integrated finding sentence display area in the storage medium. The display control means arranges the finding sentences in the integrated finding display area according to the information indicating the arrangement order.

  It is preferable to include first operation input control means for accepting a change in the order of the finding sentences in the integrated finding sentence display area. The display control means changes the arrangement order of the finding sentences in the integrated finding sentence display area in response to an instruction to change the arrangement order through the first operation input control means. The first storage control unit updates information indicating the arrangement order in response to an instruction to change the arrangement order.

  The finding sentence input area is configured to be able to input a finding sentence for each of a plurality of finding items such as a plurality of organs, a state of each organ, and details of a lesion. The first memory control means attaches a finding ID so that a finding sentence can be identified in units of organs and finding items. The first operation input control means receives a change in the order of finding sentences in units of organs and findings items. The display control means changes the arrangement order of the finding sentences in the integrated finding display area in units of organs and finding items in response to an instruction to change the arrangement order through the first operation input control means. The order of finding sentences may be changed in item units (diagnosis names, certainty factors, communication items between doctors, etc.) that further subdivide the finding items.

  The display control means displays the finding sentence input area used for inputting the finding sentences instructed to change the arrangement order by the first operation input controlling means. In this case, it is preferable that the first storage control means stores the selected input state data of the finding sentence input area in association with the finding ID, and displays the finding sentence input area in which the selected input state is reproduced.

  It is preferable to include second storage control means for storing data of a typical pattern of a selected input state of the finding sentence input area in a storage medium, and second operation input control means for selecting a typical pattern. The display control means displays a finding text input area in a selected input state indicated by a typical pattern selected by the second operation input control means.

  The second operation input control means accepts new addition, correction, and deletion of typical pattern data. The second storage control unit updates data of a typical pattern in accordance with an operation instruction through the second operation input control unit.

  The second storage control means stores typical pattern data for each doctor.

  The observation sentence input area can be used to create a current medical report by copying a past medical report and reproducing a selection input state at the time of creating the past medical report.

  The display control means distinguishes and displays each finding sentence. For example, the finding sentence input immediately before through the finding sentence input area is displayed separately from other finding sentences. The finding sentence that belongs to the same finding item as the finding sentence input immediately before may be displayed separately from other finding sentences.

  It is preferable to include a third operation input control means for accepting that there is no abnormality in each finding item such as all organs or the state of the organ and details of the lesion.

  The medical report creation support method according to the present invention includes a plurality of finding input areas including a template input area for selectively inputting a part of a plurality of words obtained by disassembling the finding sentences constituting the medical report as input words, and a plurality of finding sentences. A display step for displaying an integrated observation text display area obtained by integrating each finding text input through the input area on the display by the display control means, and a finding ID for identifying each finding text by the storage control means is attached. Storing the data of each finding sentence in a storage medium.

  A medical report creation support program according to the present invention includes a plurality of finding input areas including a template input area for selectively inputting, as input words, a part of a plurality of words obtained by disassembling a finding sentence constituting a medical report, and a plurality of finding sentences Stores the data of each finding sentence with a display control function that displays the integrated finding sentence display area that integrates each finding sentence entered through the input area, and a finding ID for identifying each finding sentence. A storage control function stored in a medium is realized in a computer.

  According to the present invention, a plurality of finding sentence input areas including a template input area and an integrated finding display area obtained by integrating the finding sentences input via the plurality of finding sentence input areas are displayed on the display. Since the data of each finding sentence is stored with the finding ID for identifying the sentence, it is possible to shorten the time for creating the medical report and to make the integrated finding sentence easy to handle.

It is a block diagram of a medical information system. It is a block diagram which shows the outline of the computer which comprises each terminal and a server. It is a figure which shows schematic structure of a report preparation terminal. It is a figure which shows a template window. It is a figure which shows a template window. It is a figure which shows a report window. It is explanatory drawing which shows the aspect which changes the arrangement | sequence order of a finding sentence per organ. It is explanatory drawing which shows the aspect which changes the arrangement | sequence order of a finding sentence in the small classification | category finding item unit in an organ. It is a figure which shows integrated finding text information. It is explanatory drawing which shows the outline of the update of integrated finding sentence information, and a display control process. It is explanatory drawing which shows the data structure of a report. It is a flowchart which shows the flow of a report preparation process. It is a flowchart which shows the flow of the update of integrated finding sentence information, and a display control process. It is a figure which shows a typical pattern storage table. It is a figure which shows the template window in the case of producing a finding sentence using a typical pattern storage table. It is a figure which shows the display form of the template window at the time of clicking and selecting the management button.

[First embodiment]
In FIG. 1, a medical information system 2 is constructed in a medical facility such as a hospital, and a report creation terminal installed in a clinical department terminal 11 installed in a clinical department 10 and a radiation examination department (hereinafter simply referred to as an examination department) 12. 13, a database (hereinafter abbreviated as DB) server 14, and a network 15 that connects these to be communicable. The network 15 is, for example, a LAN (Local Area Network) laid in the hospital.

  The clinical department terminal 11 is operated by a doctor (hereinafter referred to as a requesting doctor) of the clinical department 10 who requests examination and interpretation. The medical department terminal 11 is used when issuing an order for requesting the examination to the examination department 12 in addition to viewing and inputting the medical chart 16. The clinical department terminal 11 displays the examination image 17 and the report 18 provided from the examination department 12 and provides them for browsing by the requesting doctor.

  The report creation terminal 13 is operated by a doctor of the examination department 12 specializing in interpretation (hereinafter referred to as an interpretation doctor). The report creation terminal 13 is used when the interpretation doctor confirms the order or creates the report 18. The report creation terminal 13 supports the creation of the report 18 by displaying an image display window and various report editing windows (see FIGS. 4 to 6).

  In the DB server 14, a plurality of DBs such as a medical record DB 19, an image DB 20, and a report DB 21 are constructed. The medical record DB 19 stores medical record 16 data for each patient. The image DB 20 stores data of the inspection image 17 photographed by the modality 22 of the examination department 12 such as a CR apparatus, a CT apparatus, and an MRI apparatus. The report DB 21 stores data of the report 18 created by the report creation terminal 13.

  The DB server 14 receives the data of the inspection image 17 from the modality 22 through the network 15 and stores the received data of the inspection image 17 in the image DB 20. That is, the DB server 14 functions as a so-called PACS (Picture Archiving and Communication Systems) server and constitutes a PACS together with the modality 22.

  The data of the inspection image 17 has an image ID for identifying each inspection image 17. The data of the inspection image 17 is stored in the image DB 20 in a file format compliant with, for example, DICOM (Digital Imaging and Communication in Medicine). A DICOM tag that records incidental information including items such as a patient ID, an examination ID, an examination date, and an examination type is assigned to the file of the examination image 17. The data of the inspection image 17 stored in the image DB 20 can be searched using various items of the DICOM tag as search keys.

  The DB server 14 constitutes a medical chart system together with the medical department terminal 11 and the medical chart DB 19. The DB server 14 constitutes a report creation support system together with the report creation terminal 13, the image DB 20, and the report DB 21. The data of the report 18 has a report ID for identifying each report 18 like the data of the examination image 17 and can be searched by a search key such as a report ID, an examination ID, a patient ID, and a patient name. . In addition, in this example, although each DB19-21 was demonstrated in the example constructed | assembled in one DB server 14, you may construct | assemble each DB19-21 in a separate DB server.

  The order issued by the medical department terminal 11 has various items for recording information such as patient ID, patient name, request date, request source, examination type (CT, MRI, etc.), examination purpose, necessity of interpretation. Information such as the affiliation, name, and doctor ID of the requesting doctor such as internal medicine and brain surgery is recorded in the request source item. Information such as a therapeutic effect determination for determining a therapeutic effect on a lesion being treated and a metastasis search for examining the presence or absence of a metastatic lesion are recorded in the items for examination.

  The order issued by the clinical department terminal 11 is transmitted to an order reception terminal (not shown) installed in the examination department 12 and accepted by the examination department 12. The order receiving terminal assigns an inspection ID to the received order and manages the order data. The examination ID is transmitted from the order reception terminal to the clinical department terminal 11 together with the reception completion notification. The staff (inspection engineer) of the examination department 12 performs imaging by the modality 22 based on the order received at the order reception terminal.

  When interpretation is necessary (when an item for whether or not order interpretation is necessary), an order with an examination ID is transmitted from the order reception terminal to the report creation terminal 13. The interpretation doctor confirms the order via the report creation terminal 13 and reads the data of the examination image 17 to be interpreted from the image DB 20. Then, the interpretation results of the read inspection image 17 are collected in a report 18. When the purpose of examination is to observe the progress of a lesion such as determination of therapeutic effect, the report 18 is created by copying the previous report 18 of the patient and correcting a different part from the previous report.

  When the creation of the report 18 is completed, the interpretation doctor transmits a creation completion notice to the order issuer's department terminal 11 through the report creation terminal 13. The creation completion notification includes addresses in the DBs 20 and 21 where the inspection image 17 and the report 18 are stored. The requesting physician accesses the address included in the creation completion notification through the medical department terminal 11 and browses the examination image 17 and the report 18.

  Each of the terminals 11 and 13 and the DB server 14 is configured by installing a control program such as an operating system and an application program such as a client program or a server program based on a computer such as a personal computer, a server computer, or a workstation. The

  In FIG. 2, the computers constituting the terminals 11 and 13 and the DB server 14 have substantially the same basic configuration, and each includes a CPU 30, a memory 31, a storage device 32, a LAN port 33, and a console 34. Yes. These are interconnected via a data bus 35.

  The storage device 32 is, for example, an HDD (Hard Disk Drive). The storage device 32 stores a control program and application program (hereinafter referred to as AP) 36. In addition, the storage device 32 of the report creation terminal 13 includes the selection states of the panels 50 and 51, the term selection button 52, the pull-down menu 55, and the input states of the input boxes 54 and 56 (see FIG. 4 and FIG. 5). Hereinafter, a finding sentence creation definition and drawing data for creating a finding sentence according to a selection input state) are stored. The drawing data defines the type, arrangement, size, color, etc. of GUI (Graphical User Interface) of various operation screens displayed on the display 37.

  Further, the DB server 14 is provided with, for example, a disk array in which a plurality of HDDs are connected as the DB storage device 32, in addition to the HDD storing the program. The disk array may be built in the main body of the DB server 14, or may be provided separately from the main body and connected to the main body through a cable or a network.

  The memory 31 is a work memory for the CPU 30 to execute processing. The CPU 30 loads the control program stored in the storage device 32 into the memory 31 and executes processing according to the program, thereby comprehensively controlling each part of the computer. The memory 31 temporarily stores data of the selected input state and data of the integrated finding text information 85 (see FIG. 9).

  The LAN port 33 is a network interface that performs transmission control with the network 15. The console 34 includes a display 37 and an input device 38 such as a keyboard and a mouse.

  In the medical department terminal 11, client programs such as chart software for browsing and editing the chart 16 and viewer software for browsing the examination image 17 and the report 18 are installed as the AP 36. When the client program is activated, a GUI operation screen is displayed on the display 37 of the medical department terminal 11. The operation screen includes a display screen for displaying the chart 16, the inspection image 17, and the report 18 read from the chart DB 19, the image DB 20, and the report DB 21, respectively.

  The medical department terminal 11 receives an operation instruction such as an instruction to input / edit the medical chart 16 and an instruction to input / issue an order through the input device 38. The input chart 16 and order data are stored in the chart DB 19.

  A report editing client program for supporting report creation is installed in the report creation terminal 13 as an AP 36. The report creation terminal 13 performs display processing of the inspection image 17 and editing processing of the report 18 by a client program for editing the report. In the DB server 14, a server program is installed as the AP 36, which executes processing in response to requests from the terminals 11 and 13 as clients and responds with processing results.

  In FIG. 3, when the CPU 30 of the report creation terminal 13 starts a client program for report editing, a console control unit (corresponding to display control means and operation input control means) 40, a DB access unit 41, an edit processing unit (storage control) And an order acquisition unit 43. The order acquisition unit 43 acquires an order from the order reception terminal via the network 15. The acquired order is registered in an order table (not shown) provided in the storage device 32 of the report creation terminal 13, for example.

  The report creation terminal 13 has a configuration in which two displays 37 a and 37 b are connected to a terminal body provided with a CPU 30. An image display window used for observing the inspection image 17 is output to one display 37a. Various report editing windows used to create the report 18 are output to the other display 37b.

  The image display window and the report edit window constitute a GUI operation screen. The console control unit 40 reads drawing data corresponding to the operation of the input device 38 from the storage device 32, and outputs these operation screens to the respective displays 37a and 37b based on the read drawing data. The console control unit 40 receives an operation instruction input from the input device 38 through the operation screen.

  The image display window and the report editing window are activated in conjunction. When an examination ID including the examination image 17 to be interpreted is input from the report editing window, the console control unit 40 acquires data of the examination image 17 corresponding to the examination ID from the image DB 20 through the DB access unit 41. . The console control unit 40 activates an image display window when outputting the acquired inspection image 17 to the display 37a.

  The image display window is generated based on an ultrasonic image taken by an ultrasonic diagnostic device, a fluoroscopic image taken by a CR device, a tomographic image taken by a CT device or an MRI device, or a tomographic image. Various inspection images 17 such as three-dimensional images are displayed. The image display window can display a plurality of inspection images 17 simultaneously, such as arranging and displaying six-frame tomographic images on one screen. The image display window is provided with various operation tools constituting the GUI such as operation buttons, list boxes, and icons. Various operation instructions are input from the input device 38 through such an operation tool.

  The DB access unit 41 transmits a processing request to the DB server 14 and receives a processing result based on commands from the console control unit 40 and the editing processing unit 42. The processing request for the image DB 20 includes a search request for searching the inspection image 17 using information such as the inspection ID and the image ID as search keys. The processing request for the report DB 21 includes a storage request for storing the data of the generated report 18, and a search request for the data of the generated report 18 and the data of the report 18 being generated.

  The DB access unit 41 receives the data that is the target of the storage request from the editing processing unit 42 and transmits it to the DB server 14. In addition, the search target data is received from the DB server 14 and delivered to the console control unit 40.

  The CPU 30 of the DB server 14 functions as a storage processing unit and a search processing unit for data of the inspection image 17 and the report 18 by executing the server program. The storage processing unit executes data storage processing in each of the DBs 19 to 21 in response to a data storage request from a client such as the report creation terminal 13 or the modality 22. In response to the distribution request for each data from the department terminal 11 and the report creation terminal 13, the search processing unit searches and extracts the requested data from each of the DBs 19 to 21, and distributes the extracted data to the request source. To do.

  The report editing windows include template windows 45a and 45b shown in FIGS. 4 and 5, and a report window 65 shown in FIG. 4 and 5, the template windows 45 a and 45 b have the same basic configuration, and are composed of a term selection input area 46, other finding input area 47, diagnosis name input area 48, and other diagnosis input area 49. ing. These areas 46 to 49 are various operation tools that constitute the GUI. Various operation instructions are input from the input device 38 through such an operation tool.

  The term selection input area 46 is used to input observation records such as the state of the lesion, which is recognized by the image interpretation doctor by observing the examination image 17 by a mouse click operation, that is, a sentence (hereinafter referred to as a finding sentence) representing the finding. It is also called a template type operation tool. The term selection input area 46 includes a large classification panel 50 for each organ such as “liver” and “bile duct”, and a small classification panel 51. The small classification panel 51 has findings items that categorize items to be entered as findings for each organ, such as “liver morphology” and “mass lesion”. Each panel 50, 51 can be switched and selected by a tab. 4 and FIG. 5, “liver” is selected as the large classification panel 50, “liver morphology” is selected as the small classification panel 51 in FIG. 4, and “mass lesion” is selected in FIG.

  In the term selection input area 46, a plurality of term selection buttons 52 are provided. The term selection buttons 52 are arranged side by side for each observation item such as “margin”, “swelling”, “part”, “size”, “shape”, etc., which further subdivides the finding items. For example, the observation item “edge” in FIG. 4 includes “acute angle”, “slightly dull”, “dull”, and the observation item “shape” in FIG. 5 includes “similar circle”, “irregular”, There are input phrases such as “Lump” and “Deep”. As the term of the term selection button 52, a medical term that is frequently used in each observation item is used. Further, all the terms of the term selection button 52 represent the degree and shape of the finding item and the observation item, and are words that modify the finding item and the observation item.

  When the pointer 53 is placed on the desired term selection button 52 and a click operation is performed with the mouse, the finding sentence based on the selected term is displayed in the finding sentence display area 67 of the report window 65 in FIG.

  Only one term selection button 52 can be selected for each observation item. For this reason, for example, when “edge-acute angle” is selected and “edge-slightly blunt” is selected again, the selection of “edge-acute angle” is automatically canceled.

  The term selection buttons 52 are not provided for the observation items “part” and “size” in FIGS. 4 and 5, and an input box 54 for receiving keyboard input is provided instead. The input box 54 is also provided at the right end of the observation item “number”. The input box 54 includes “right lobe”, “left lobe”, “S1” to “S8” and other calcifications, phrases indicating the location of a mass lesion, “15”, “10”, “3”, and the like. Numerical values representing the size and location can be input by keyboard operation. The input box 54 at the right end of the observation item “number” is used when there are a large number of calcified portions and mass lesions appearing in the examination image 17 and the portions, sizes, and states of the calcified portions and the respective lesions are exactly the same. The

  In FIG. 4, as the term selection button 52, as shown by diagonal lines, “edge-slightly dull”, “surface-irregularity”, “swelling degree-mild”, “swelling site-left lobe”, “substantial echo level” “Low echo”, “Substantial echo density-roughness”, “Substantial echo distribution—non-uniform”, “Presence / absence of calcification—Yes”, and “Shape-point” are selected. In the input box 54, “part-left lobe” and “size—30 mm × 20 mm” are input from the keyboard. Similarly, in FIG. 5, “shape-unshaped”, “internal echo-low echo”, “echo pattern-mixing”, “uniformity-nonuniform”, and “blood flow signal-slight” are selected by clicking. “Site-S4” and “Size—20 mm × 10 mm” are input from the keyboard.

  Note that the term selection button 52 and the input box 54 need not all be selected and input, as indicated by the observation item “degree of atrophy” in FIG. 4, “boundary”, “edge” in FIG. What is not selected and input only does not create a finding sentence.

  The diagnosis name input area 48 is provided with a pull-down menu 55 for inputting a certainty factor and an input box 56 for inputting a diagnosis name. When an inverted triangle mark beside the pull-down menu 55 is clicked, options indicating the degrees of certainty of “confirmed”, “suspect”, and “exclusion” are displayed in a pull-down manner. When “Confirmation” is relatively high in confidence, “Suspect” is less certain than “Confirmation”, and when “Confirmation” cannot be said to be “Confirmation”, “Exclusion” is low in certainty, but keep in mind Selected when necessary. In the input box 56, a diagnostic name derived as a result of interpretation is input by the interpretation doctor. In FIG. 4, the certainty factor “suspect” is selected, the diagnosis name “alcoholic cirrhosis” is entered in the input box 56, and the certainty factor “suspect” and the diagnosis name “hepatic mass (other / unknown)” are entered in FIG. 5. Has been.

  In the other finding input area 47 and the other diagnosis input area 49, input boxes 57 and 58 for inputting natural sentences related to findings and diagnoses that cannot be expressed in the term selection input area 46 and the diagnosis name input area 48 are arranged. . Each of these areas 47 and 49 can also be used as a simple memo function such as filling in a communication item from the interpreting doctor to the requesting doctor. If there are no special items, nothing can be entered in the input boxes 57 and 58 as shown in FIG. In FIG. 5, “Other findings of liver tumor” are input to the input box 57 of the other findings input area 47, and “Other diagnosis of liver tumor” is input to the input box 58 of the other diagnosis input area 49. ing.

  All organ normal buttons 59 are arranged on the upper part of the template windows 45a and 45b. In addition, an abnormality-free button 60 is provided above the term selection input area 46. The all-organ normal button 59 is click-selected when the image interpretation doctor determines that all the organs are normal without observing lesions or the like by observing the examination image 17. Similarly, the no abnormality button 60 is click-selected when it is determined that there is no abnormality in the finding item selected on the small classification panel 51. When the buttons 59 and 60 are clicked and selected, the observation texts are, for example, “All organs are normal” and “Nothing is abnormal with respect to XX (finding items)”.

  4 and 5 exemplify the template windows 45a and 45b of the small classification panels 51 of “liver morphology” and “mass lesion” when “liver” is selected in the large classification panel 50. Other large classification panels 51 such as “gallbladder” and “kidney” also have various small classification panels 51, and various template windows corresponding thereto are also provided.

  Here, the sections related to the observation items “swelling” and “atrophy” indicate which part (whole liver, right lobe, or left lobe) has any degree (slight, moderate, or high) of swelling or atrophy. Yes, it is assumed that there is no enlargement or atrophy other than the selected site, or that there is no enlargement or atrophy at any site in the liver.

  However, in the present example, the term selection buttons 52 for “the degree of swelling” and “the part of swelling” and “the degree of atrophy” and “the part of atrophy” are simultaneously displayed on the template window 45a. In this case, it is also possible to select “degree-none” and select “site—right lobe or left lobe”. If this is the case, it can be seen that there is no swelling or atrophy in either the right or left lobe, but it is unclear whether the right or left lobe is enlarged or atrophy. turn into.

  Therefore, when the “None” option is mixed in the observation items as described above, a rule for creating a finding sentence is determined in advance so that the finding sentence is not unclear. For example, the observation item format is used in the order of registration of the definition for creating a finding sentence. In the above example, the registration order of the finding sentence creation definition is “part” and “degree”, and “none” of “degree” after the registration order is adopted. Therefore, when “degree-none” is selected, no matter what “site” is selected, the observation text is “no swelling (atrophy)” or “swelling (atrophy)”. No. "

  Of course, measures may be taken so that negative and positive usage forms do not coexist in the observation items. For example, the “part” and “degree” term selection buttons 52 are not displayed on the template window 45a at the same time, but only the “degree” term selection buttons 52 are initially displayed. Then, when any of “mild”, “moderate”, and “high” other than “none” is selected, a “part” term selection button 52 is displayed. The same applies to the observation items “intrahepatic vascular abnormality”, “liver calcification” in FIG. 4, “infiltration” in FIG. 5, and the like. The example which does not display an item is shown. However, it is preferable to adopt this example in which the term selection buttons 52 of all observation items are displayed at the same time from the beginning because there are interpretation doctors who feel annoyance when the display / non-display of the term selection buttons 52 is switched. It is more preferable that the aspect can be selected by the interpretation doctor.

  The report window 65 is activated in conjunction with the template window 45. In FIG. 6, the report window 65 has a basic information display area 66, a finding sentence display area 67, a diagnosis name display area 68, and an operation button area 69.

  In the basic information display area 66, the interpretation doctor name “Fuji Fujio”, the patient name “Shiro Tominaga”, the examination date (the photographing date of the examination image 17) “2010/8/25 (August 25, 2010)”, the examination Basic information such as type “ultrasonic” and requested department “internal medicine” is displayed. The basic information is read from the order.

  In the upper part of the basic information display area 66, a past report button 70 and a reference image button 71 are provided. The past report button 70 is selected when the past report 18 is used for copying. The reference image button 71 is selected when the inspection image 17 is displayed on the display 37a.

  When the past report button 70 is clicked and selected, a pop-up window (not shown) for inputting a report ID or patient ID as a search key is displayed. The DB access unit 41 transmits a search request for searching the data of the past report 18 stored in the report DB 21 to the DB server 14 using the search key input in the pop-up window. The search processing unit of the DB server 14 searches and extracts the data of the past report 18 that matches the search key from the report DB 21, and distributes the extracted data to the DB access unit 41 as a search result. The console control unit 40 receives the data of the past report 18 from the DB access unit 41, and causes the display 37b to display a template window 45 and a report window 65 that reproduce the selected input state of the data, the finding sentence, and the diagnosis name.

  In addition, using information such as the patient ID of the order received by the order acquisition unit 43 and the examination purpose as a search key, whether the patient has been previously examined under the same conditions or not is searched from the past orders. Thus, it may be determined whether the order is the first inspection or a reexamination such as follow-up observation. If it is determined to be the first inspection, a template window 45 and a report window 65 for creating a new report 18 are displayed, and if it is determined to be a reexamination, the previous report 18 is automatically searched for the selection input state and findings. A template window 45 and a report window 65 reproducing the sentence and diagnosis name are displayed. Since only the difference from the past report 18 needs to be corrected, the report 18 can be created quickly.

  When the reference image button 71 is clicked and selected, a search request using the examination ID as a search key is transmitted from the DB access unit 41 to the DB server 14. The search processing unit of the DB server 14 searches and extracts data of the inspection image 17 that matches the search key from the image DB 20. The extracted data of the inspection image 17 is distributed to the DB access unit 41 and displayed on the image display window of the display 37a by the console control unit 40.

  In the finding sentence display area 67, a finding sentence based on a term or a natural sentence selected and inputted in each of the input areas 46 to 49 of the template window 45 is displayed. The finding sentence displayed in the finding sentence display area 67 can be corrected and added by clicking and selecting it and operating the keyboard.

  The finding sentence based on the term selection input area 46 is displayed in the finding sentence display area 67 when one or more term selection buttons 52 are selected. The display of the finding sentence is updated every time the term selection button 52 is additionally selected. The data of the selection input state of the memory 31 is also updated every time the term selection button 52 is additionally selected. For example, when the term selection button 52 for the two observation items is selected and the term selection button 52 for the third observation item is selected, the selection of the term selection button 52 is performed for the same observation item. Including the case of redoing.

  The console control unit 40 displays all the finding sentences based on the selection input state of the template window 45 of each panel 50, 51 in the finding sentence display area 67. Findings of the same organ (major classification panel 50) are put together in one paragraph with “XX (organ name):” at the beginning. Of the finding sentences in one paragraph of the same organ, the finding sentences selected and input in each template window 45 are also displayed together for each template window 45.

  The console control unit 40 displays the finding sentences in the finding sentence display area 67 in the order selected and input in the template window 45. For example, when “kidney” in the large classification panel 50 is selected and a finding is input, and “liver” is selected and entered, the paragraph of the finding sentence based on the “kidney” template window 45 precedes “liver”. Findings will be displayed later. In addition, after selecting and inputting in the template window 45a of FIG. 4, when the tab of the small classification panel 51 is switched and selected and input in the template window 45b of FIG. 5, the finding sentence based on the selection input state of the template window 45a is first displayed in the template window 45a. The findings in the window 45b are displayed later. However, for each of the input areas 46 to 49 of each template window 45, the observation texts are arranged in the order of the term selection input area 46, the other finding input area 47, the diagnosis name input area 48, and the other diagnosis input area 49 regardless of the selection order. Is displayed.

  The console control unit 40 displays the finding sentence selected and input immediately before in the template window 45, the finding sentence selected and inputted in the template window 45 being input, and other finding sentences in the finding sentence display area 67. . For example, the finding sentence selected and input immediately before is displayed in green, the finding sentence selected and input in the template window 45 being input is displayed in blue, and the other finding sentences are displayed in black. It may be distinguished by italics, bold, font, underline, etc.

  In FIG. 6, as a finding corresponding to the selection input state shown in FIG. 4, after “liver:” indicating the selection state of the large classification panel 50, “edge slightly dull, surface irregularity. The left lobe is slightly swollen. The real echo is uneven, the density is coarse, and the echo is low, the left lobe is 30x20mm in diameter, and punctate calcification is observed. Alcoholic cirrhosis is suspected. " As a result of the observation, "There is an irregular shape of 20x10mm in size in S4, a non-uniform, mixed mass with low internal echo. The blood flow signal is slight. Other findings of the liver mass. "Unknown" is suspected. Other diagnosis of liver mass "shows the state displayed in the finding text display area 67 in one paragraph.

  Among the findings corresponding to the selection input state shown in FIG. 5 of the latter, “The irregular shape of 20 × 10 mm in size, non-uniform and mixed mass is recognized in S4. The blood flow signal is slight. "Is green (indicated by coarse dots)," is other findings of liver mass. I suspect hepatic mass (other / unknown). Other diagnoses of liver mass "is blue (indicated by fine dots), other The observation text is displayed in black. In other words, Fig. 6 uses the term selection input area 46 of the template window 45b, "S4 shows irregular shape of 20x10mm size, unevenness with internal low echo, mixed mass. The blood flow signal is slight. . ”Shows a state immediately after the input of the finding sentence.

  The finding sentence displayed in the finding sentence display area 67 can be selected by clicking in units of organs or finding items. When the pointer 53 is clicked on the finding sentence of the same organ in the finding sentence display area 67 and clicked, the finding sentence of the one paragraph is selected, and when the pointer 53 is placed on the desired finding sentence and clicked, the finding is displayed. A sentence is selected. The finding sentence selected by clicking is displayed (for example, displayed in red) separately from other finding sentences.

  In the diagnosis name display area 68, the diagnosis names input in the input box 56 of the diagnosis name input area 48 of each template window 45 are listed. As in the case of the finding sentence display area 67, the console control unit 40 displays the diagnosis names of the same organ (major classification panel 50) together in the diagnosis name display area 68. In addition, the console control unit 40 displays the diagnosis name in the diagnosis name display area 68 in the order input in the template window 45. In this example, “alcoholic cirrhosis” input in the template window 45a is displayed first, and “hepatic mass (other / unknown)” input in the template window 45b is displayed later.

  Next to the finding text display area 67, organ unit display change buttons 72a and 72b and organ display change buttons 73a and 73b are provided. The organ unit display change buttons 72a and 72b are used to change the order of the observations in the same organ for each paragraph, and the organ internal display change buttons 73a and 73b are used to change the order of the finding sentences in the observation item unit. Is done. When changing the order of the finding sentence of one paragraph selected by clicking or the finding sentence of each finding item up, the organ unit display change button 72a, the organ internal display change button 73a, and the organ unit display change button when changing down 72b, the organ internal display change button 73b is selected by clicking.

  FIG. 7 shows a state in which a group of finding sentences of “liver” and “kidney” are displayed in the finding sentence display area 67 and a group of finding sentences of “liver” is selected by clicking. In (A), the finding of “liver” is displayed after “kidney”. When the organ unit display change button 72a is clicked and selected in this state, as shown in (B), the arrangement order of the findings of “liver” and “kidney” is switched, and the finding of “liver” is the finding of “kidney”. Is displayed earlier. On the contrary, when the organ unit display change button 72b is clicked and selected in the state of (B), the finding sentence of “liver” is displayed after the finding sentence of “kidney”.

  Fig. 8 shows that in the "Liver" finding text, the finding entered in the template window 45a "The liver is severely swollen. The parenchymal echo is coarse in density. Suspected alcoholic cirrhosis." The selected state is shown. In (A), the finding text entered in the template window 45a is the finding text entered in the template window 45b. “The boundary is unclear in S2 and a solid mass is observed with internal low echo. The blood flow signal is slight.” It is displayed before. When the internal organ display change button 73b is clicked and selected in this state, the order of the finding sentences is changed as shown in (B), and the finding sentence inputted in the template window 45a is replaced with the finding sentence inputted in the template window 45b. Will be displayed later. Conversely, when the in-organ display change button 73a is clicked and selected in the state of (B), the finding sentence input in the template window 45a is displayed before the finding sentence input in the template window 45b.

  In FIG. 6, similarly to the diagnosis name display area 68, organ unit display change buttons 74a and 74b and organ display change buttons 75a and 75b are also provided. The functions and operations of these buttons are the same as those of the organ unit display change buttons 72a and 72b and the organ internal display change buttons 73a and 73b in the finding sentence display area 67, and thus the description thereof is omitted.

  Various operation buttons 76 to 78 are provided in the operation button area 69. The confirmation button 76 is used to end editing of the report 18. When the confirm button 76 is selected, the data of the report 18 is confirmed and saved. Editing of the report 18 that has been confirmed and saved is prohibited in order to prevent unauthorized tampering. The temporary save button 77 is for temporarily interrupting the creation of the report 18. When the temporary save button 77 is selected, the data of the report 18 being created is temporarily saved. The cancel button 78 is selected when closing the template window 45 and the report window 65.

  The edit processing unit 42 receives selection input states of the panels 50 and 51, the term selection button 52, and the like through the console control unit 40. The edit processing unit 42 creates a finding sentence according to the selection input state of each panel 50, 51, term selection button 52, etc. based on the finding sentence creation definition stored in the storage device 32. The definition for creating a finding sentence has a hierarchical structure in the order of the observation item, observation item, and words for each observation item, with the organ item in the term selection input area 46 as a vertex, and the position in the observation sentence of the section of each observation item , And the order of words in each observation item section. The definition for creating a finding sentence is, for example, categorizing a finding sentence into a main part and a predicate for each observation item and observation item, and categorizing the main part and the predicate into a main part and a modifying part that modifies the main part. The words that make up the sentence are divided into parts.

  For example, in the definition for creating a finding sentence of the observation item “swelling” in the template window 45a of FIG. 4, the modifier “XX” in the predicate (where “XX” indicates a part such as “left leaf”). ), “XX” (where XXX contains a word indicating the degree of “mild”, etc.) and the predicate body part “swelling” are registered.

  When any one of the term selection buttons 52 is selected, the edit processing unit 42 first follows the organ items and the findings item hierarchy in the definition for creating the finding sentence corresponding to the selection state of each panel 50 and 51. Then, the phrase of the observation item corresponding to the selected term selection button 52 is read from the finding sentence creation definition. The edit processing unit 42 converts the word / phrase of each part read out from the finding sentence creation definition into the main part modifier part, the body part, the predicate modifier part, and the body part order (the order (registration) order of the finding sentence creation definition) ) To create a finding sentence.

  Further, the edit processing unit 42 creates a finding sentence corresponding to the selection input state of the pull-down menu 55 and the input box 56 in the diagnosis name input area 48. For example, if “Confirm” is selected in the pull-down menu 55, “Diagnose as XX (diagnosis name)” is selected. If “Sustain” is selected, “XX (diagnosis name) is suspected. And so on. Note that the natural sentences input in the input boxes 57 and 58 in the other finding input area 47 and the other diagnosis input area 49 are directly handled as one finding sentence without going through the editing processing unit 42.

  The editing processing unit 42 attaches a finding ID for identifying each finding sentence data (hereinafter referred to as finding data) in each of the input areas 46 to 49 of the template window 45 and records it in the data of the report 18. The finding ID indicates a finding sentence input in which input area of which template window.

  The finding ID is composed of a large classification (organ), a small classification, and symbols indicating the input areas 46 to 49 in order. For example, the major category “liver” is “LIV”, “kidney” is “KID”, minor category “liver morphology” is “1”, “mass lesion” is “2”, and “other” is “3”. The term selection input area 46 is “a”, the other finding input area 47 is “b”, the diagnosis name input area 48 is “c”, and the other diagnosis input area 49 is “d”. Therefore, the finding ID of the finding sentence input in the term selection input area 46 of the template window 45a is “LIV-1-a”, and the finding ID of the finding sentence input in the diagnosis name input area 48 of the template window 45b is “ LIV-2-c ".

  The edit processing unit 42 adds information such as examination ID, patient ID, patient name, and selection input state read from the order to the data of the report 18 in addition to the finding data. The data in the selected input state is data stored in the memory 31 when the report 18 is confirmed and saved.

  In addition to the finding ID, the editing processing unit 42 adds a doctor ID for identifying the interpretation doctor who has input the finding sentence to each finding data. The doctor ID is input by the interpretation doctor at the time of user authentication when the report creation terminal 13 is activated. Finding data can be searched by finding ID or doctor ID.

  The edit processing unit 42 creates integrated finding sentence information 85 shown in FIG. 9 and stores it in the memory 31. The integrated finding text information 85 indicates the order of arrangement of all finding sentences displayed in the finding sentence display area 67, and is expressed in a hierarchical structure by dividing the finding ID into a large classification, a small classification, and input areas 46 to 49. It is. The integrated finding text information 85 is added to the data of the report 18 together with the finding ID and the like.

  In the integrated finding text information 85 illustrated in FIG. 9, the major classification “KID (kidney)” is first, followed by “GAL (gallbladder)” and “LIV (liver)”. This shows that the panel 50 has been selected to create a finding sentence. The major category “KID” is registered with the minor category “2” first, “1” later, “GAL”, and “LIV” with the minor category “1” first and “2” later. It can be seen that the finding sentence was created by selecting the small classification panel 51. Further, for the minor classification “2” of the major classification “KID” and “1” of “LIV”, all of the input areas “a” to “d” are registered, and all of the input areas 46 to 49 are used. Represents that. For the minor classification “1” of the major classification “KID”, “2” of “GAL”, the input areas “a” and “c” are registered, and the term selection input area 46 and the diagnosis name input area 48 are used. I understand that.

  The flag is set on the line representing the input area of the template window for which the input operation has been completed immediately before. In this example, the input area “c” of the minor classification “2” of the major classification “LIV” is found to be immediately after the input operation of the diagnosis name input area 48 of the template window 45b is finished.

  In FIG. 10, the edit processing unit 42 adds a new line to the last line so far of the integrated finding sentence information 85 each time a finding sentence is created using the template window 45 of the large classification and the small classification. The major classification, the minor classification, and the symbol of the input area are registered in the added line, and the contents of the integrated finding sentence information 85 are updated. For example, after completing the input operation of the diagnosis name input area 48 of the template window 45b, when a finding sentence is created using the term selection input area 46 of the template window 45 of the minor classification “others” of the major classification “liver”, “ After the line “LIV-2-c”, the minor classification “3” and the input area “a” are registered, and the flag is set in the line.

  The edit processing unit 42 replaces the lines of the integrated finding information 85 of the large classification or the small classification instructed to change the arrangement order by the organ unit display change buttons 72a and 72b and the organ display change buttons 73a and 73b. The content of the finding sentence information 85 is changed. In the case of the example in FIG. 7, the order is changed for each row of the major classifications “KID” and “LIV”, including the lower hierarchy, and in the example of FIG. 8, the minor classifications “1” and “2” of the major classification “LIV”. Swap every line.

  The console control unit 40 performs display control of the finding sentence display area 67 based on the integrated finding sentence information 85. The console control unit 40 arranges the natural sentences input in the input boxes 57 and 58 of the finding sentence, the other finding input area 47 and the other diagnosis input area 49 created by the editing processing part 42 as the integrated finding sentence information 85. They are arranged according to the order, and are displayed in the observation sentence display area 67 in one paragraph in units of organs. When the change of the arrangement order is instructed by the organ unit display change buttons 72a and 72b and the in-organ display change buttons 73a and 73b, the contents of the integrated finding text information 85 are also changed according to the instructions. This is also reflected in the display order of the finding sentences in the area 67.

  The console control unit 40 displays the finding sentence selected and inputted in the input area of the line where the flag of the integrated finding sentence information 85 is set in green, the finding sentence selected and inputted in the template window in blue, and the other finding sentences in black. To display in the observation text display area 67. In the example of FIG. 9, the finding sentence selected and input in the diagnosis name input area 48 of the template window 45b is displayed in green, and the finding sentence selected and input in the term selection input area 46 is displayed in blue.

  The diagnosis name in the diagnosis name display area 68 is also assigned a diagnosis name ID similar to that of the finding sentence, and integrated diagnosis name information (not shown) similar to the integrated finding sentence information 85 is created. As in the case of the finding sentence, the editing processing unit 42 updates the integrated diagnosis name information, and the console control unit 40 controls the display of the diagnosis name in the diagnosis name display area 68 with reference to the integrated diagnosis name information.

  In FIG. 11 showing the data structure of the report 18, the report 18 includes patient information such as patient ID and patient name, examination ID, examination date, examination information such as examination purpose, finding information, and the aforementioned integrated finding sentence information 85 and the like. It has as. The finding information includes a finding ID, finding data, a doctor ID of an interpretation doctor, a selection input state, and the like. In addition to this, the report 18 stores integrated diagnosis name information, the image ID of the examination image (key image) referred to when the report 18 was created, information on the order, and the like.

  When the past report button 70 is operated to instruct to use a copy of the past report 18, the console control unit 40 does not select the term selection button 52 from the drawing data of the storage device 32, and enters the input box 54 or the like. Drawing data representing the template window 45 in a plain state where nothing is input is read out. Further, the data of the selected input state of each finding information of the past report 18 used for copying is read out, and the selected input state is reproduced in the plain template window 45 and displayed on the display 37b. Further, the console control unit 40 reads the integrated finding text information 85 of the past report 18 to be used for copying, and performs display control of the finding sentence display area 67 based on this. Note that when the report 18 is viewed on the clinical department terminal 11, display control is similarly performed by the console control unit of the clinical department terminal 11.

  Hereinafter, the operation of the above configuration will be described with reference to the flowcharts shown in FIGS. The requesting doctor issues an order using the medical department terminal 11. The report creation terminal 13 receives the order issued from the clinical department terminal 11 via the order reception terminal of the examination department 12.

  The interpretation doctor accesses the report creation terminal 13 to confirm the order and starts creating the report 18. When the report edit window is displayed on the display 37b, an image display window is displayed on the display 37a in conjunction with the report edit window. The radiologist interprets the observation text for each organ in the observation text display area 67 of the report window 65 using the template window 45 while observing the examination image 17 in the image display window.

  The input of the finding sentence is performed by selecting and inputting a GUI such as the term selection button 52, the input box 54, and the pull-down menu 55. In FIG. 12, when a GUI such as the term selection button 52 is selected and input (Yes in step (hereinafter abbreviated as S) 10), each panel 50, 51, term selection is sent from the console control unit 40 to the editing processing unit 42. The selection input state of the button 52 or the like is notified. The selected input state is sent to the memory 31 through the console control unit 40 and stored in the memory 31 (S11).

  Next, a search for a finding sentence creation definition based on the selection input state of each panel 50, 51, term selection button 52, etc. is executed by the editing processing unit 42, and the words and phrases of each observation item are read from the finding sentence creation definition. (S12).

  Then, the various words that have been read out are linked in the order in which the finding sentence creation definition is arranged, and the finding sentence is created (S13). The observation sentence created by the definition for the observation sentence creation, and the natural sentence inputted in the input boxes 57 and 58 in the other observation input area 47 and the other diagnosis input area 49 are transferred to the console control unit 40 and controlled by the console. It is displayed on the finding sentence display area 67 under the control of the unit 40 (S14). In this manner, the image interpretation doctor inputs a finding sentence while selecting the term selection button 52 or inputting a phrase in the input box 54. These series of processes are repeatedly executed every time the term selection button 52 is additionally selected.

  When the interpretation doctor finishes inputting the finding sentence, it selects the confirmation button 76 (yes in S15). When the confirmation button 76 is selected, a data storage request for the report 18 is transmitted from the DB access unit 41 to the DB server 14. When a storage request is received from the report creation terminal 13, in the DB server 14, the storage processing unit executes data storage processing for the report 18. The data of the report 18 is stored in the report DB 21. This completes the process of creating a single report 18.

  In FIG. 13, in the process of creating a finding sentence using each template window 45 of the large classification and small classification panels 50 and 51, each panel 50 and 51 (template window 45) is switched to newly select and input a finding sentence. When it is performed (yes in S20), or when the change of the arrangement order is instructed by the organ unit display change buttons 72a and 72b and the in-organ display change buttons 73a and 73b (yes in S21), the editing processing unit 42 performs integration. The contents of the finding sentence information 85 are updated. Further, the display of the finding sentence display area 67 is changed by the console control unit 40 based on the updated integrated finding sentence information 85 (S22).

  When the creation of the report 18 is completed, a report of completion of creation is transmitted from the report creation terminal 13 to the medical department terminal 11 of the requesting doctor. The requesting doctor accesses the report DB 21 through the medical department terminal 11 and reads the report 18 based on the address of the report 18 included in the creation completion notification. The display 37 of the medical department terminal 11 outputs a report display screen and an image display window that displays the examination image 17 related to the report 18. The requesting doctor browses these screens and confirms the contents of the report 18.

  As described above, according to the present invention, observation sentences selected and input via a plurality of template windows 45 and a plurality of input areas 46 to 49 are associated with each template window 45 and each input area 46 to 49. Since the information is stored and managed in a unit of information, the display form such as the order of the integrated finding sentences in the finding sentence display area 67 can be easily controlled.

  By selecting a finding sentence and operating a button, it is possible to rearrange the finding sentences in the organ unit or the organ. There is no troublesome operation, and the order of the integrated finding sentences can be freely changed according to the interpretation doctor's preference. It is possible to easily realize an effective sentence structure in which variations in the arrangement order of the finding sentences are abundant and the finding sentence that the interpretation doctor particularly wants to emphasize is brought forward.

  The observation text selected and input immediately before in the template window 45 and the observation text selected and input in the template window 45 being input are displayed separately from other observation texts, so the current observation text etc. can be grasped at a glance. can do. This is especially effective when the integrated findings are relatively long. Since the selection input operation of the template window 45 can be performed while confirming the contents of the findings displayed in distinction, the selection mistake of the term selection button 52 and the like can be found immediately.

  In addition, when the template sentence 45 which selected and input the finding sentence is not displayed when the finding sentence of the finding sentence display area 67 is clicked and selected, it is preferable to display the template window 45. It is more preferable to display the template window 45 by reproducing the selection input state of the term selection button 52 or the like.

  For example, when clicking and selecting a group of finding sentences of the large classification “liver” shown in FIG. 7 or clicking and selecting a finding sentence of the small classification “liver form” of the large classification “liver” shown in FIG. Consider a case where the template window 45 of the large classification “kidney” is displayed. The console control unit 40 receives an operation signal indicating that the finding sentence has been click-selected from the input device 38, and displays the drawing data in a plain state representing the template window 45a of the large classification “liver” and the selection input state of the template window 45a. Are temporarily read from the storage device 32 and the memory 31, respectively. Then, the display is switched from the template window 45 of the large category “kidney” to the template window 45a reproducing the selection input state. When the state is switched to the small classification “massage lesion” in this state, the template window 45b reproducing the selection input state is displayed based on the temporary storage data of the selection input state read out from the memory 31 in the same manner.

  When the observation text is clicked and selected, a template window 45 that automatically reproduces the selection input state is automatically displayed. Therefore, it is possible to save the trouble of selecting the panels 50 and 51 and switching the display of the template window 45, and to select and input the template window 45. It is possible to respond quickly when, for example, it is desired to slightly correct.

[Second Embodiment]
In order to further reduce the labor required for report creation and shorten the creation time, a typical pattern of the selected input state of the template window 45 is stored in association with the name and the like, and the name can be designated by the interpretation doctor. The term selection buttons 52 and the like may be input collectively by using the corresponding typical pattern, and the selection input operation may be omitted.

  In FIG. 14, in the typical pattern storage table 90 showing an example of storing typical patterns, the type of the template window 45, the disease name (typical pattern name), and the selected input state are stored in association with each other. The typical pattern storage table 90 is stored in the storage device 32.

  The type of the template window 45 is a combination of the major classification “LIV” and the like with the minor classifications “1” and “2”, as in the first half of the finding ID. The type “LIV-1” indicates the template window 45 of the minor classification “liver morphology” of the major classification “liver”, that is, the template window 45a of FIG. In the disease name “alcoholic cirrhosis” of the type “LIV-1”, “swelling degree−highly swollen site−entire liver certainty−suspicious diagnosis name−alcoholic cirrhosis” is registered as a selection input state. In addition, the disease name “liver angiomyolipoma” of type “LIV-2”, “kidney stone” of type “KID (kidney) -1”, “nephrotic syndrome”, type “PAN (pancreas) — A number of typical patterns (selected input states) such as “1” “glucagonoma” are stored.

  In the template window 45 of the present embodiment, a pull-down menu 95 for batch input and a management button 96 are provided as in the template window 45a shown in FIG. Here, the template window 45a is illustrated, but the pull-down menu 95 and the management button 96 are similarly arranged in the other template windows 45. The pull-down menu 95 is a disease name of a typical pattern registered in the type of the template window 45 (in this example, “alcoholic cirrhosis”, “hepatocellular carcinoma”, “amebic liver abscess” of the type “LIV-1”). Etc.) in a pull-down display.

  When the disease name is selected by operating the pull-down menu 95, the console control unit 40 reads the data of the selected input state corresponding to the designated disease name from the typical pattern storage table 90, and the template window according to the read selected input state. The display of 45 is switched. For example, when “alcoholic cirrhosis” is selected, as shown in the drawing, the term selection button 52 “swelling degree” “high”, “swelling site” “whole liver”, and pull-down menu 55 “confidence” The template window 45a in which “alcoholic cirrhosis” is input is displayed in the input box 56.

  The management button 96 is operated when changing the contents of the typical pattern storage table 90. When the management button 96 is selected by clicking, as shown in FIG. 16, an input box 97, a pull-down menu 98, a save button 99, an overwrite button 100, and a delete button 101 are displayed in the template window 45a.

  After selecting and inputting the term selection button 52, etc., when a desired disease name is entered into the input box 97 with the keyboard and the save button 99 is selected by clicking, the edit processing unit 42 creates a new line in the corresponding type of the typical pattern storage table 90. Is done. Then, the disease name input in the input box 97 and the data of the selected input state stored in the memory 31 at that time are registered in the newly established line.

  Similar to the pull-down menu 95, the pull-down menu 98 displays a pull-down list of typical pattern disease names registered in the type of the template window 45. When the disease name is selected by operating the pull-down menu 98 and the overwrite button 100 is clicked, the editing processing unit 42 stores the data of the selected input state of the disease name in the typical pattern storage table 90 at that time in the memory 31. Is changed to the data of the selected input state stored in. When the disease name is selected by operating the pull-down menu 98 and the delete button 101 is click-selected, the edit processing unit 42 deletes the row of the disease name in the typical pattern storage table 90.

  If a typical pattern of the selection input state of the template window 45 is read and used as appropriate, the selection input of the term selection button 52 and the like can be completed with some additional correction. In addition, it is possible to further improve convenience by adopting a configuration in which an interpreting doctor can freely add, modify, and delete a typical pattern.

  Note that a typical pattern may be newly added to the image interpretation doctor as described above, or a certain number of default patterns may be prepared in advance. The data of the selection input state stored in the typical pattern storage table 90 is not limited to the selection input state of the term selection button 52, and may be a numerical value such as a size input to the input box 54.

  The typical pattern storage table 90 may be managed for each interpretation doctor by using a doctor ID input by the interpretation doctor at the time of user authentication at the time of starting the report creation terminal 13 or the like. A typical pattern specific to each interpretation doctor can be presented.

  Note that a GUI such as an add button may be provided in the diagnosis name input area, and a plurality of certainty factors and diagnosis names may be selected and input by clicking the add button. Similarly, observation items such as “part” and “size” in the term selection input area may be added so that a plurality of lesion states can be input in one term selection input area. Alternatively, the term selection input area itself may be newly added, or the selection input state may be copied to add the term selection input area.

  Instead of providing each display change button, the arrangement order may be changed by dragging and dropping the finding sentences in units of organs or finding items. It is also possible to change the order in which observation sentences are arranged for each observation item obtained by subdividing the observation items, a term selection input region, and other observation input regions. Further, instead of creating the integrated finding text information, the finding ID may be included in the finding ID.

  In each of the above embodiments, a keyboard and a mouse have been described as examples of the input device. However, the selection of the term selection button 52 may be received by voice using a microphone as the input device.

  In each of the above-described embodiments, the examination performed by the examination department 12 is described as an example. However, the examination type is not limited to these, and may be a PET (Positron Emission Tomography) examination, an endoscopic examination, or the like. In addition, although the report 18 exemplifies a report that summarizes the interpretation results of the inspection image 17, it may be a report that summarizes findings on inspection data other than the inspection image. Examples of the inspection data other than the inspection image include numerical data obtained by specimen inspection such as pathological inspection, physiological inspection, and the like, or a waveform diagram such as an electrocardiogram. Moreover, the report in which the findings regarding various data such as inspection data of different inspection types are written may be used.

  In each of the embodiments described above, an example in which there is one report creation terminal has been described, but a plurality of report creation terminals may be used. Alternatively, the typical pattern storage table may be stored in the DB server, and the data of the typical pattern storage table may be taken into the report creation terminal through the DB access unit.

  In the case of a client-server type information system comprising a client (report creation terminal) and a server (DB server) as in the above embodiments, a dedicated program is used as the client program for report editing. Alternatively, a general-purpose browser corresponding to a WWW (World Wide Web) protocol such as HTTP (Hyper Text Transfer Protocol) may be used.

  When a dedicated program is used, the report editing window is generated based on screen data defined by the dedicated program. When a general-purpose browser is used, for example, the report edit window data is stored in the Web server, and the client accesses the Web server, and the report edit window data processed into the Web page format is stored. to download. The client browser interprets the received web page source code and generates a report editing window. The Web server may be shared by the DB server or may be a server different from the DB server. When a general-purpose browser is used, the CPU of the Web server configures an editing processing unit, a console control unit, and the like in cooperation with the CPU of the client or independently.

  The data storage device in which the DB is constructed may be other than the DB server, and for example, a storage device connected via a network such as NAS (Network Attached Storage) or SAN (Storage Area Network) may be used. Thus, the physical configuration of the computer system can be changed as appropriate.

  In each of the above embodiments, the LAN is described as an example of the network. However, when the clinical department and the examination department are distributed at a plurality of bases, the LAN and the WAN (Wide Area Network) are combined as the network. May be used.

  Note that, as shown in the above embodiments, the present invention naturally extends to a program form and further to a storage medium for storing the program.

2 Medical Information System 13 Report Creation Terminal 30 CPU
31 Memory 32 Storage Device 34 Console 36 Application Program (AP)
37 Display 38 Input Device 40 Console Control Unit 42 Editing Processing Unit 45, 45a, 45b Template Window 46 Term Selection Input Area 47 Other Findings Input Area 48 Diagnosis Name Input Area 49 Other Diagnosis Input Area 52 Term Selection Buttons 54, 56, 57, 58 Input box 55 Pull-down menu 59 All organ normal button 60 No abnormality button 65 Report window 67 Observation text display area 68 Diagnosis name display area 70 Past report button 72a, 72b Organ unit display change button 73a, 73b Organ display change button 85 Integration Observation text information 90 Typical pattern storage table 95 Pull-down menu 99 Save button 100 Overwrite button 101 Delete button

Claims (16)

A plurality of finding input areas including a template input area for selecting and inputting a part of a plurality of words / phrases obtained by disassembling the finding sentences constituting the medical report, and each finding inputted through the plurality of finding sentence input areas Display control means for displaying on the display an integrated observation sentence display area in which sentences are integrated;
A medical report creation support apparatus, comprising: first storage control means for storing data of each finding sentence in a storage medium with a finding ID for identifying each finding sentence. The first storage control means stores information indicating an arrangement order of each finding sentence in the integrated finding display area in a storage medium,
The medical report creation support apparatus according to claim 1, wherein the display control unit arranges the finding sentences in the integrated finding sentence display area according to information indicating the arrangement order. Comprising a first operation input control means for accepting a change in the order of each finding sentence in the integrated finding sentence display area;
The display control means changes the arrangement order of the finding sentences in the integrated finding display area according to the instruction to change the arrangement order through the first operation input control means,
The medical report creation support apparatus according to claim 2, wherein the first storage control unit updates information indicating the arrangement order according to an instruction to change the arrangement order. The observation text input area is a configuration in which a finding text can be input for each of a plurality of finding items such as a plurality of organs, a state of each organ, and details of a lesion.
The first memory control means attaches a finding ID so that a finding sentence can be identified by an organ unit and a finding item unit,
The first operation input control means accepts a change in the order of finding sentences in units of organs and findings items,
The display control means changes the arrangement order of each finding sentence in the integrated finding sentence display area in units of organs and finding items in response to an instruction to change the arrangement order through the first operation input control means. The medical report creation support apparatus according to claim 3.   5. The medical use according to claim 3, wherein the display control means displays a finding sentence input area used for inputting the finding sentences instructed to change the arrangement order by the first operation input controlling means. Report creation support device. The first storage control means stores the data of the selected input state of the finding sentence input area in association with the finding ID,
The medical report creation support apparatus according to claim 5, wherein the display control unit displays a finding sentence input area in which a selection input state is reproduced. Second storage control means for storing data of a typical pattern of the selected input state of the finding sentence input area in a storage medium;
A second operation input control means for selecting a typical pattern,
7. The medical use according to claim 1, wherein the display control means displays a finding text input area in a selected input state indicated by a typical pattern selected by the second operation input control means. Report creation support device. The second operation input control means accepts new addition, correction, deletion of typical pattern data,
8. The medical report creation support apparatus according to claim 7, wherein the second storage control unit updates data of a typical pattern in accordance with an operation instruction through the second operation input control unit.   The medical report creation support apparatus according to claim 7 or 8, wherein the second storage control unit stores data of a typical pattern for each doctor.   The observation sentence input area can be used to create a current medical report by copying a past medical report and reproducing the selected input state when the past medical report was created. The medical report preparation assistance apparatus in any one of Claims 1 thru | or 9.   The medical report creation support apparatus according to claim 1, wherein the display control unit displays each finding sentence separately.   The medical report creation support apparatus according to claim 11, wherein the display control unit displays a finding sentence input immediately before through a finding sentence input area in distinction from other finding sentences. The observation text input area is a configuration in which a finding text can be input for each of a plurality of finding items such as a plurality of organs, a state of each organ, and details of a lesion.
The display control means displays a finding sentence belonging to the same finding item as the finding sentence input immediately before through the finding sentence input area, separately from other finding sentences. The medical report creation support apparatus described.   14. The medical report creation support according to claim 1, further comprising third operation input control means for accepting that there is no abnormality in each finding item such as all organs, the state of the organ, and the details of the lesion. apparatus. A plurality of finding input areas including a template input area for selecting and inputting a part of a plurality of words / phrases obtained by disassembling the finding sentences constituting the medical report, and each finding inputted through the plurality of finding sentence input areas A display step of causing the display control means to display an integrated observation sentence display area in which sentences are integrated;
A medical report creation support method comprising: a storage step of storing data of each finding sentence in a storage medium with a finding ID for identifying each finding sentence by a storage control means. A plurality of finding input areas including a template input area for selecting and inputting a part of a plurality of words / phrases obtained by disassembling the finding sentences constituting the medical report, and each finding inputted through the plurality of finding sentence input areas A display control function that displays an integrated observation text display area that integrates sentences on the display;
A medical report creation support program that causes a computer to realize a storage control function for storing data of each finding sentence in a storage medium with a finding ID for identifying each finding sentence.

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