JP2013016204A - Therapy information management system - Google Patents

Abstract

PROBLEM TO BE SOLVED: To reduce a work load on an operator when acquiring and displaying image information generated through an examination carried out for progress observation related to a therapy in a therapy information management system.SOLUTION: The therapy information management system includes: an examination order information issuing part 11g for issuing examination order information including patient identification information, treated part information and scheduled time information on an examination for observing progress of a radiation therapy; a DB management part 11a for adding actual examination information with respect to examination requirements based on the examination order information to the examination order information; an order information DB 11B for storing the examination order information; an order information acquisition part 11j for acquiring a piece of examination order information including required patient identification information and required treated part information from the examination order information stored in the order information DB 11B; and a display device 11D for time-sequentially displaying the piece of examination order information acquired by the order information acquisition part 11j on the basis of the examination scheduled time information or the actual examination information included in the piece of examination order information acquired by the order information acquisition part 11j.

Description

  The present invention relates to a technique for managing treatment information, and in particular, in addition to treatment within the range of treatment period information, a test for observing the course of treatment inside and outside the treatment period information is performed and the information is managed. The present invention relates to a treatment information management system.

  In recent years, the processing speed of computers has improved, and in the medical field, such as X-ray CT (computed tomography) apparatus, MRI (magnetic resonance imaging) apparatus, X-ray diagnostic apparatus, ultrasonic diagnostic apparatus, NM (nuclear medical) apparatus, etc. Various modalities for diagnostic imaging have emerged.

  As described above, with the appearance of various modalities, image information to be formed is diversified. Since the generated image information and the like are diagnosed by comparing them, they are managed in common within a medical institution such as a hospital.

  As a network for exchanging data handled in a medical institution between each device and each device, for example, HIS (hospital information system), RIS (radiology information system) and PACS (picture archiving and communication system) are formed. It is like that.

  In addition, the following literature is mentioned as literature relevant to this invention.

JP 2008-65688 A

  Since the issuance of treatment order information for individual radiotherapy is performed according to the treatment plan information after setting the treatment plan information, in the conventional application of RIS, the treatment plan information is based on the treatment order ID for identifying the treatment order. Can be associated with the treatment order information. On the other hand, issuance of examination order information (radiation treatment plan (simulation) order information) for examination (diagnosis) for observing treatment progress within and outside the treatment period information is independent of setting of treatment plan information (for example, treatment Therefore, the conventional application of the RIS has a drawback that it is not possible to associate treatment plan information with examination order information.

  Therefore, in order to refer to pre-treatment, during-treatment and post-treatment image information generated by examination according to examination order information as observation of treatment progress in the radiotherapy, an operator such as a treating physician accesses PACS. Therefore, it is necessary to visually select target image information from a large amount of image information related to the patient. Therefore, the procedure for referring to the image information necessary for observing the treatment progress is complicated.

  The present invention has been made in consideration of such circumstances, and can reduce the workability of an operator when acquiring and displaying image information generated by an examination performed for follow-up related to treatment. It aims at providing the treatment information management system which can be done.

  In order to solve the above-described problem, the treatment information management system according to the present invention sets treatment part information and treatment period information for a patient corresponding to patient identification information, so that the patient identification information, the treatment part information, and Means for setting treatment plan identification information in accordance with the treatment period information, means for recording treatment order information including the treatment plan identification information, and scheduled time information of radiation treatment within the range of the treatment period information, and the treatment Means for including treatment time information for a treatment request according to the order information in the treatment order information, the patient identification information and the treatment site information, and a scheduled time of examination for observing the progress of the radiation treatment Means for recording inspection order information including information, and information on the execution of an inspection in response to an inspection request according to the inspection order information. Means for inclusion in the information, storage means for storing the treatment order information and the examination order information, and required patient identification information and required treatment plan identification information from the treatment order information stored in the storage means Acquisition means for acquiring examination order information including the required patient identification information and required treatment site information from the examination order information stored in the storage means, and Means for acquiring scheduled time information or performing time information of treatment included in the treatment order information acquired by the acquiring means, and image information corresponding to the examination order information acquired by the acquiring means; and the acquiring means Acquired by the acquisition means based on the scheduled time information or the execution time information of the examination included in the treatment order information acquired by The treatment order information and the examination order information is displayed side by side in time series, and, and a display means for displaying the related information of the image information corresponding to the examination order information.

Schematic which shows the treatment information management system of this embodiment, and its peripheral system. The figure which shows an example of the relationship between treatment plan information and the individual treatment order information within the range of treatment period information. The figure which shows an example of treatment plan information as a table. (A) is a figure which shows an example of the treatment order information before implementation of treatment as a table, (b) is a figure which shows an example of the treatment order information after implementation of treatment as a table. (A) is a figure which shows an example of inspection order information before implementation of a test | inspection as a table, (b) is a figure which shows an example of inspection order information after implementation of a test | inspection as a table. The figure which shows an example of the relationship between each treatment order information and each test | inspection order information in time series. The figure which shows an example of the screen for designating and inputting patient ID and treatment plan information. The figure which shows an example of the screen for displaying the treatment order information and examination order information based on patient ID and treatment plan information which are designated and inputted.

  An embodiment of a treatment information management system according to the present invention will be described with reference to the accompanying drawings.

  FIG. 1 is a schematic diagram showing a treatment information management system of this embodiment and its peripheral systems.

  FIG. 1 shows an HIS 10, a treatment information management system (for example, RIS) 11, a radiotherapy apparatus 12, an examination apparatus (modality) 13, and a PACS 14 according to this embodiment. The RIS 11 is interconnected with the HIS 10, the radiation therapy apparatus 12, the examination apparatus (modality) 13, and the PACS 14 through a network such as a hospital core LAN (local area network).

  The HIS 10 accepts a large number of patients (general reception), processes the reception to the department in charge such as internal medicine and surgery, patient identification information (patient ID (identification), name, gender, age, address, visit history) Management of treatment status, etc., and accounting for medical expenses.

  As the radiotherapy apparatus 12, apparatuses such as a computer-controlled cobalt irradiation apparatus (γ-ray), gamma knife (γ-ray), linac (X-ray, electron beam), Novalis (X-ray), and cyberknife (X-ray) Is mentioned. The radiotherapy apparatus 12 performs radiotherapy on the treatment site to the patient in accordance with a treatment request from the RIS 11 and transmits treatment information such as information on the execution of treatment to the RIS 11. Note that the treatment applied to the treatment site of the patient is not limited to radiotherapy, and may be, for example, ultrasonic treatment or the like.

  Examples of the inspection apparatus 13 include a computer-controlled X-ray CT apparatus, MRI apparatus, X-ray diagnostic apparatus, ultrasonic diagnostic apparatus, and NM apparatus. The inspection apparatus 13 generates image information related to the treatment site in accordance with the inspection request from the RIS 11, and transmits inspection information such as information on the execution of the inspection to the RIS 11 and image information to the PACS 14.

  The PACS 14 includes an image information DB (data base) 14 </ b> A that holds image information generated by the inspection apparatus 13. Further, the PACS 14 functions as an image information DB management unit 14a when a CPU (central processing unit) (not shown) executes a program.

  The image information DB management unit 14a has a function of recording the image information generated by the inspection apparatus 13 in the image information DB 14A according to the recording request from the inspection apparatus 13, and the image information DB 14A according to the read request from the RIS 11. And a function of performing reading processing of the image information.

  In the RIS 11, a DB server terminal (not shown) and a client terminal (not shown) are interconnected by a network such as a LAN. The terminal of the DB server of the RIS 11 includes a treatment plan information DB 11A that holds treatment plan information described later and an order information DB 11B that holds order information (treatment order information and examination order information) described later. On the other hand, the client terminal includes an input device 11C and a display device 11D. In FIG. 1, three input devices 11C are shown for convenience.

  The RIS 11 has a function of issuing order information based on patient identification information received from the HIS 10 in cooperation with the HIS 10, the radiotherapy device 12, the inspection device 13, the PACS 14, and the like online. Further, the RIS 11 performs reservation and reception of radiotherapy by the radiotherapy apparatus 12 based on the treatment order information as order information, and management of the treatment result, and the like, while the inspection apparatus 13 based on the examination order information as order information. Perform inspection reservation, inspection reception, inspection result management, etc. The RIS 11 has a function of requesting display of image information managed by the PACS 14.

  Specifically, the terminal of the DB server of the RIS 11 functions as the DB management unit 11a when a CPU (not shown) provided in the terminal executes a program.

  In accordance with a request from the client terminal, the DB management unit 11a records a treatment plan information to a treatment plan information DB 11A, which will be described later, and reads out treatment plan information from the treatment plan information DB 11A. According to the request, it has a function of recording / updating the order information to the order information DB 11B and reading the order information from the order information DB 11B.

  Further, the client terminal of the RIS 11 is configured so that a CPU (not shown) provided in the terminal executes a program to thereby obtain a patient identification information acquisition unit 11b, a treatment plan information setting unit 11c, a treatment order information issuing unit 11d, a treatment request unit 11e, It functions as a treatment information acquisition unit 11f, an examination order information issue unit 11g, an examination request unit 11h, an examination information acquisition unit 11i, an order information acquisition unit 11j, and an image information request / acquisition unit 11k. In addition, each part 11b thru | or 11k may function by one terminal, and may be shared and functioned by many terminals.

  The patient identification information acquisition unit 11b sets the treatment plan information by the treatment plan information setting unit 11c, and obtains the patient identification information from the HIS 10 such as a patient ID, and the examination order information is issued by the examination order information issuing unit 11g. In order to issue, it has the function to acquire patient ID from HIS10.

  The treatment plan information setting unit 11c sets the treatment site (treatment name or radiation irradiation site) information and treatment period information for the patient corresponding to the patient ID acquired by the patient identification information acquisition unit 11b, so that the patient ID, It has a function of setting treatment plan information including treatment site information and treatment period information, and a function of instructing the DB management unit 11a to record the set treatment plan information in the treatment plan information DB 11A. Note that different treatment plan information, for example, a treatment plan ID, is attached to at least one of the patient identification information, treatment site information, and treatment period information. The treatment plan information may further include information on the total dose [cGy] of radiation.

  The treatment order information issuing unit 11d receives the patient ID, the treatment plan ID, and the treatment site information set by the treatment plan information setting unit 11c and the input device 11C so as to conform to the treatment plan information after setting the treatment plan information. The function of issuing treatment order information including the scheduled time information of each treatment within the range of the type of treatment and the treatment period information, and instructing the DB management unit 11a to record the issued treatment order information in the order information DB 11B It has the function to do. The treatment order information may further include information on the radiation treatment apparatus 12 that is the treatment request destination.

  FIG. 2 is a diagram illustrating an example of the relationship between treatment plan information and individual treatment order information within the range of treatment period information.

  As shown in FIG. 2, for the treatment plan information (treatment period: 2007.7.2 to 2007.7.6), the treatment order information issuing unit 11d performs five treatments within the range of the treatment period information. Is scheduled. FIG. 3 is a diagram illustrating an example of treatment plan information as a table, and FIG. 4A is a diagram illustrating an example of treatment order information before the treatment is performed. Since the treatment order information is issued according to the treatment plan information after the treatment plan information is set, the treatment order information includes a treatment plan ID as shown in FIG.

  Further, the treatment request unit 11e shown in FIG. 1 has a function of requesting the radiotherapy apparatus 12 to treat a treatment site of a patient according to the treatment order information issued by the treatment order information issuing unit 11d.

  The treatment information acquisition unit 11f has a function of acquiring treatment information such as information at the time of treatment from the radiotherapy apparatus 12 when treatment is performed on a treatment site of a patient according to treatment order information, and a treatment information to be obtained. It has a function of instructing the DB management unit 11a to join the execution time information to the treatment order information stored in the order information DB 11B. FIG. 4B is a table showing an example of the treatment order information after the treatment is performed, that is, the treatment order information after the treatment execution information is added. In the table shown in FIG. 4 (a), information on the scheduled time of treatment is included, but since no treatment has been performed yet, information on the time of performing treatment is not included. On the other hand, in the table shown in FIG. 4 (b), since the scheduled treatment time information is included and the treatment execution time information acquired by the treatment information acquisition unit 11f is added, the treatment execution time information is included. (For example, in FIG. 4B, the scheduled treatment date and the implementation date coincide with each other).

  In addition, the examination order information issuing unit 11g illustrated in FIG. 1 independently of the setting of the treatment plan information, the patient ID acquired by the patient identification information acquiring unit 11b and the examination part information ( Treatment site information), a function of issuing examination order information including type and scheduled time information of each examination, and a function of instructing the DB management unit 11a to record the issued examination order information in the order information DB 11B. Have The inspection order information may further include information on the inspection requesting inspection apparatus 13 or the like. FIG. 5A shows an example of inspection order information before the inspection is performed as a table. Since issuance of examination order information is often performed independently of setting of treatment plan information, the treatment plan ID is unknown in the examination order information as shown in FIG. However, when issuance of examination order information is performed in accordance with the treatment plan information after setting the treatment plan information, the treatment plan ID may be included in the examination order information in the same manner as the treatment order information.

  For example, examination order information may be issued before setting treatment plan information by the treatment plan information setting unit 11c.

  FIG. 6 is a diagram showing an example of the relationship between individual treatment order information and individual examination order information in time series.

  As shown in FIG. 6, in the treatment plan information (treatment period: 2007.7.2 to 2007.7.6), five treatments based on the five treatment order information are scheduled within the treatment period information. (It has been implemented. In addition, examination order information is inserted once before treatment, during treatment, and after treatment, and three examinations are scheduled (implemented). Note that the test order information inserted before, during, and after treatment is not limited to once, but may be multiple times.

  The examination request unit 11h illustrated in FIG. 1 has a function of requesting the examination apparatus 13 to examine a treatment site of a patient according to the examination order information issued by the examination order information issuing unit 11g.

  The examination information acquiring unit 11i has a function of acquiring examination information such as information on the execution of the examination from the examination apparatus 13 when the examination is performed on the treatment site of the patient according to the examination order information, and the execution of the obtained examination. It has a function of instructing the DB management unit 11a to join the time information with the inspection order information stored in the order information DB 11B. FIG. 5B is a table showing an example of the inspection order information after the inspection is performed, that is, the inspection order information after the inspection execution information is added. In the table shown in FIG. 5A, the scheduled time information of the inspection is included, but since the inspection has not yet been performed, the inspection time information is not included. On the other hand, in the table shown in FIG. 5B, information on the scheduled time of the examination is included, and information on the time when the examination is obtained acquired by the examination information obtaining unit 11i is added. (For example, in FIG. 5B, the scheduled date of the inspection and the date of execution do not match).

  Further, the order information acquisition unit 11j shown in FIG. 1 performs designation from the treatment order information stored as the DB when the designation input of the desired patient ID and treatment plan information is executed via the input device 11C. It has a function of instructing the DB management unit 11a to acquire treatment order information including the input patient ID and treatment plan information.

  FIG. 7 is a diagram illustrating an example of a screen for designating and inputting a patient ID and treatment plan information.

  The operator inputs the patient ID “AB1234” into the input box (upper left of the screen shown in FIG. 7) via the display device 11 </ b> D using the input device 11 </ b> C and displays “Search”. Click. By the click, the order information acquisition unit 11j instructs the DB management unit 11a to acquire treatment order information including both the patient ID “AB1234” and the type “treatment” from the order information DB 11B. And the order information acquisition part 11j displays all the treatment plan information contained in the acquired treatment order information via the display device 11D (upper right of the screen shown in FIG. 7). For example, FIG. 7 shows a case where the patient ID “AB1234” is displayed, and two treatment plan information related to the treatment plan IDs “XY987” and “XY786” are displayed.

  Further, the operator selects one treatment plan information from the two treatment plan information using the input device 11C from the pull-down menu on the screen displayed as shown in FIG. 7 via the display device 11D. When one treatment plan information, for example, a treatment plan ID “XY9876” is selected, the order information acquiring unit 11j acquires treatment order information including the treatment plan ID “XY9876”. Moreover, all treatment plan information may be displayed.

  On the other hand, when one treatment plan information, for example, treatment plan ID “XY9876” is selected, the order information acquisition unit 11j receives the patient ID “AB1234”, the treatment site information “hypopharynx”, and the type “order” from the order information DB 11B. The DB management unit 11a is instructed to acquire inspection order information including “inspection”.

  The display device 11D includes treatment order information and examination order information, which are different information acquired by the order information acquisition unit 11j, in scheduled treatment information or execution time information included in the treatment order information, and examination order information. Displayed in chronological order based on the scheduled time information or execution time information.

  FIG. 8 is a diagram showing an example of a screen for displaying treatment order information and examination order information based on a patient ID and treatment plan information that are designated and inputted.

  As shown in FIG. 8, the schedule (execution) of three tests is added to the schedule (execution) of five treatments and displayed. Here, since the first examination based on the first examination order information is scheduled (implemented) before the treatment period, “pre-treatment examination” may be displayed. Since the second examination based on the second examination order information is scheduled (implemented) within the range of the treatment period information, “in-treatment examination” may be displayed. Further, since the third examination based on the third examination order information is scheduled (implemented) after the treatment period, “post-treatment examination” may be displayed.

  As shown in FIG. 8, by displaying the treatment order information and examination order information acquired by the order information acquisition unit 11j in time series, each examination is a pre-treatment examination, an in-treatment examination, or It can be easily identified as a post-treatment examination.

  As shown in the upper right corner of the screen in FIG. 8, the treatment order information and the examination order information are displayed at the time of “2007.7.3, 18:00”. Tests are “performed” while treatments and tests after the display remain “scheduled”. Therefore, the treatment order information (first and second treatments in FIG. 8) related to the treatment before the display time includes both the scheduled time information and the execution time information. In this case, based on the execution time information. It is assumed that time series display is performed. Similarly, the inspection order information (first and second inspections in FIG. 8) relating to the inspection before the display time includes both the scheduled time information and the execution time information. It is assumed that time series display is performed on the basis.

  Further, the image information request / acquisition unit 11k shown in FIG. 1 displays a function for requesting and acquiring image information corresponding to the examination order information acquired by the order information acquisition unit 11j from the PACS 14 and the acquired image information. And a function of displaying via the device 11D. Specifically, using the input device 11C, the operator clicks “viewer” provided at the position of the examination order information arranged on the screen shown in FIG. Therefore, in this embodiment, the desired patient ID and treatment site information acquired by the order information acquisition unit 11j are acquired from the PACS 14 instead of acquiring image information corresponding to all examination order information related to the desired patient ID. Since only the image information corresponding to the inspection order information related to can be acquired, it is possible to save the trouble of selecting the acquired image information.

  According to the treatment information management system 11 of the present embodiment, when the treatment order information is referred to only by changing the application on the display side using the conventional DB, the follow-up observation related to the treatment from among a large number of image information. Therefore, it is possible to accurately and efficiently acquire and display the image information generated by the inspection performed for the purpose. Therefore, according to the treatment information management system 11 of the present embodiment, it is possible to reduce the workability of the operator when acquiring and displaying image information generated by an examination performed for follow-up related to treatment.

10 HIS
11 RIS
11A Treatment plan information DB
11B Order Information DB
11a DB management unit 11b Patient identification information acquisition unit 11c Treatment plan information setting unit 11d Treatment order information issue unit 11e Treatment request unit 11f Treatment information acquisition unit 11g Examination order information issue unit 11h Examination request unit 11i Examination information acquisition unit 11j Order information acquisition Unit 11k Image information request / acquisition unit 12 Radiotherapy device 13 Inspection device 14 PACS

Claims (4)

Means for setting treatment plan identification information according to the patient identification information, the treatment site information and the treatment period information by setting treatment site information and treatment period information for a patient corresponding to patient identification information;
Means for recording treatment order information including the treatment plan identification information and scheduled time information of radiation treatment within the range of the treatment period information;
Means for including, in the treatment order information, information on performing treatment for a treatment request according to the treatment order information;
Means for recording examination order information including the patient identification information and the treatment site information, and scheduled examination information for observing the progress of the radiotherapy;
Means for including, in the inspection order information, information at the time of inspection for an inspection request according to the inspection order information;
Storage means for storing the treatment order information and the examination order information;
Treatment order information including required patient identification information and required treatment plan identification information is acquired from the treatment order information stored in the storage means, and the examination order information stored in the storage means An acquisition means for acquiring examination order information including the required patient identification information and required treatment site information from within,
Means for acquiring scheduled time information or performing time information of treatment included in the treatment order information acquired by the acquiring means, and image information corresponding to the examination order information acquired by the acquiring means;
Based on the examination scheduled time information or execution time information included in the treatment order information acquired by the acquisition means, the treatment order information and the examination order information acquired by the acquisition means are displayed in time series. And display means for displaying related information of the image information corresponding to the examination order information;
A treatment information management system comprising:   2. The treatment according to claim 1, wherein the examination order information is information relating to an examination using at least one of an X-ray CT apparatus, an MRI apparatus, an X-ray diagnostic apparatus, an ultrasonic diagnostic apparatus, and an NM apparatus. Information management system.   When the treatment order information includes both the scheduled treatment time information and the execution time information, the display means includes both the scheduled treatment information and the execution time information in the examination order information. If included, the examination order information acquired by the acquisition means, or the treatment order information and the examination order information are displayed side by side in time series based on the examination time information, respectively. The treatment information management system according to claim 1 or 2.   The treatment information management system according to any one of claims 1 to 3, further comprising means for receiving, from the HIS, the patient identification information set by a HIS (hospital information system).

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