JP2014026375A - Electronic medical chart system, server, and electronic medical chart display method - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an electronic medical chart system which aggregates and manages medical information handled in different institutions and thereby improves perspicuity and operability of information to allow the efficient use of the information.SOLUTION: A server of the electronic medical chart system standardizes data formats of principal parts of medical information of electronic medical charts in a plurality of institutions and holds the standardized data format of principal parts of medical information, in a storage unit. In response to an acquisition request for medical information of a patient from a client terminal (all institution information acquisition request), the server acquires medical information in not only an institution where the server is installed but also other institutions in combination on the basis of the data format of medical information and displays the medical information in a list in an electronic medical chart screen, so that medical information in the plurality of institutions can be confirmed in the same electronic medical chart screen. Further, it is determined whether medical information in other institutions can be referred to or not on the basis of reference levels set to individual operators and institutions. Therefore, authority to refer to medical information of patients can be freely set.

Description

  The present invention relates to an electronic medical record system that manages medical information, business information, and the like in a medical facility.

  2. Description of the Related Art Conventionally, an electronic medical record system that electronically manages information related to work performed in a hospital has been proposed. Information handled by the electronic medical record system includes medical record information describing the patient's symptoms and treatment performed by the doctor while the doctor interacts with the patient, prescription information supporting the medication to the patient, examination information, receipt information, etc. Various types of information related to medical services are included, and a lot of this information can be shared and used efficiently by all doctors, nurses, laboratory technicians, pharmacists, office workers, etc. who are involved in medical services. On the other hand, there is a concern that handling various types of information may complicate operations and work, and may complicate display contents. In particular, if the patient's hospital history is long, it is difficult to display all medical information on a single display screen, and scrolling and switching must be frequently used. Therefore, in order to improve the operability of the electronic medical record, various improvements have been made to the display form and input tool of the electronic medical record.

For example, the electronic medical chart system disclosed in Patent Document 1 includes a “diagnosis calendar”, “patient summary”, “medical record”, “nursing record”, “temperature plate”, “examination result”, “others” in the display screen. A tab for switching the information such as etc. to display for each category is provided, and the support tool area that supports input to the input area is displayed in the same display screen, and input when switching tabs The information input in the area is maintained, and the contents displayed on the tab are changed when the input is accepted in the input area, thereby improving work efficiency.

  Moreover, in the medical cooperation system of patent document 2, when the patient information to be introduced and the referral source information are input in the referral source electronic medical record device, the referral information including the authority information of the input information and the medical information is displayed. Generate and output. When the referral information is taken in by the referral electronic medical chart apparatus, the referral information is transmitted to the data management server, and the medical information is requested. If the authorization information received via the data management server is valid information, the referral source electronic medical chart device reads the relevant medical information from the storage unit and sends it to the referral electronic chart device via the data management server To do. In this way, patient introduction between medical institutions is facilitated.

JP 2008-021015 A JP 2010-237834 A

  However, currently, medical information handled by electronic medical records is managed individually for each hospital and clinic, so that the information items handled differ between facilities and can be output in a unique format. It is often customized, and it has become difficult to share information about the same patient among different medical institutions. Therefore, for example, in order for a doctor who concurrently serves as medical facilities A and B and has access authority to both electronic medical record systems to view each medical information at facilities A and B for the patient in charge, the electronic of facility A It was necessary to log into the medical record system and the electronic medical record system at the facility B individually and obtain medical information from separate databases. In this case, medical information of different facilities cannot be displayed on the same operation screen, and various operations performed when using an electronic medical record such as search and printing cannot be performed collectively, which is inefficient.

  The present invention has been made in view of the above-described problems, and its purpose is to collect and manage medical information handled in different facilities, thereby improving the listability and operability of information, and improving efficiency. It is to provide an electronic medical record system that can be used frequently.

  In order to achieve the above-described object, the present invention is configured such that a server that manages medical information of an electronic medical record is connected to each client terminal that is disposed in a plurality of facilities to be managed by the medical information via a network. An electronic medical record system, wherein the server includes a data format unifying unit that unifies a data format of a main part of medical information of electronic medical records of the plurality of facilities, and a data format of a main part of the unified medical information. In response to the medical information acquisition request transmitted from the client terminal, the storage unit stores the medical information of a plurality of facilities to be managed based on the data format of the medical information in the storage unit Display data generating means for generating display data to be displayed on the electronic medical record screen, and display data generated by the display data generating means Transmitting means for transmitting the medical information acquisition request to the requesting client terminal, wherein the client terminal is transmitted from the server and transmitting means for transmitting the medical information acquisition request to the server. Display means for displaying the electronic medical record screen including medical information of the plurality of facilities based on display data to be displayed.

  With the electronic medical record system or the like of the present invention, medical information handled at different facilities is collected and managed, thereby improving the listability and operability of information and making it possible to use it efficiently.

The figure which shows the system configuration | structure of the electronic medical chart system 1 The figure which shows the hardware constitutions of the server 10 DB configuration diagram constructed in the storage unit 102 of the server 10 The figure which shows an example of medical treatment information 122A, 122B, 122C of each facility The figure which shows an example of the operator information 111 The flowchart explaining the flow of the electronic medical record screen display processing The figure which shows an example of the electronic medical chart screen 7A when the own facility display tab is selected The flowchart explaining the flow of the reference level determination process and the facility narrowing-down process The figure which shows an example of the other facility information reference availability table 115 The figure which shows an example of the electronic medical chart screen 7B when the all facilities display tab is selected

Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings.
First, a schematic configuration of the electronic medical record system 1 of the present invention will be described with reference to FIG.

  As shown in FIG. 1, the electronic medical record system 1 includes a server 10 that integrates and manages various types of information related to medical work, and each client terminal 2A arranged in each facility such as a facility A, a facility B, and a facility C. 2B and 2C are connected via the network 4. Also, peripheral devices 3A, 3B, 3C such as printers connected to the network 4 may be included in the electronic medical chart system 1.

  1 shows an example in which the server 10 is installed in a facility other than the facilities A, B, and C such as a data processing center, but the server 10 is one of the facilities A, B, and C. It may be arranged in the facility. The facilities included in the electronic medical record system 1 are three facilities A, B, and C, but are not limited to three facilities, and may be a plurality of facilities. Further, although an example in which one client terminal is arranged in each facility is shown, a plurality of client terminals may be arranged. In the following description, the individual client terminals 2A, 2B, and 2C are referred to as client terminals 2 when it is not necessary to distinguish them.

  A facility is a facility to be managed as medical information in the electronic medical chart system 1, and is a hospital, a clinic, a care facility, a rehabilitation facility, a pharmacy, a health center, or other facilities that perform medical operations. Also, the facilities do not necessarily have to be distinguished in units of buildings, and even within the same building, if different operations are performed, they may be distinguished in units of operations, and each may be referred to as one facility.

The network 4 is preferably a local area network (LAN) or a wide area network (WAN) connected to the electronic medical record system 1 by a dedicated communication line 5 from the viewpoint of security, but security such as information leakage is ensured. Assuming that this is done, a public communication line such as the Internet may be used. The communication connection in the network 4 may be wired or wireless.
The server 10 and the client terminal 2 transmit / receive data to / from each other via the network 4.

  The server 10 collects, stores, and manages medical information handled in a plurality of facilities A, B, and C to be managed, and responds to requests from the client terminal 2 installed in each facility. The computer provides data for displaying electronic medical charts and various operation pages for operating the electronic medical charts (hereinafter referred to as electronic medical chart screens).

FIG. 2 shows the internal configuration of the server 10.
As shown in FIG. 2, the server 10 includes a control unit 101, a storage unit 102, an input unit 103, a display unit 104, a media input / output unit 105, a communication I / F 106, a peripheral device I / F 107, and the like via a bus 109. Connected. However, the example of FIG. 2 is a general example, and various configurations can be adopted depending on the application and purpose. For example, the output unit of the server 10 may be connected to a printer or the like.

  The control unit 101 includes a CPU (Central Processing Unit), a ROM (Read Only Memory), a RAM (Random Access Memory), and the like. The CPU calls and executes a program stored in the storage unit 102, ROM, recording medium, or the like to a work memory area on the RAM, and drives and controls each device connected via the bus 109. The ROM is a non-volatile memory and permanently holds a computer boot program, a program such as BIOS, data, and the like. The RAM is a volatile memory, and temporarily stores a program, data, and the like loaded from the storage unit 102, ROM, recording medium, and the like, and includes a work area used by the control unit 101 for performing various processes.

  The storage unit 102 is an HDD (hard disk drive), and stores a program executed by the control unit 101, data necessary for program execution, and the like. As for the program, a control program corresponding to the OS and an application program corresponding to processing to be described later are stored. Each of these program codes is read by the control unit 101 as necessary, transferred to the RAM, read by the CPU, and executed as various means.

The input unit 103 inputs data and includes, for example, a keyboard, a pointing device such as a mouse, and an input device such as a numeric keypad.
The display unit 104 includes a display device such as a CRT monitor and a liquid crystal panel, and a logic circuit (such as a video adapter) for realizing a video function of a computer in cooperation with the display device.

The media input / output unit 105 is a media input / output device such as a floppy (registered trademark) disk drive, PD drive, CD drive, DVD drive, and MO drive, and performs data input / output.
The communication I / F (interface) 106 has a communication control device, a communication port, and the like, and is a communication interface that mediates communication between the server 10 and the network 4, and is connected to another computer (client terminal 2 </ b> A) via the network 4. 2B, 2C).

The peripheral device I / F 107 is a port for connecting a peripheral device to the computer.
The bus 109 is a path that mediates transmission / reception of control signals, data signals, and the like between the devices.

  Here, with reference to FIGS. 3 to 5, the DB configuration of the electronic medical record system 1 according to the present embodiment and the data handled by the electronic medical record system 1 will be described.

  As shown in FIG. 3, the storage unit 102 of the server 10 is provided with an all-facility display DB 11, facility-specific DBs 12A, 12B, 12C, and the like. The facility-specific DB 12A is a storage area for storing medical information 122A and the like input and transmitted from the client terminal 2A of the facility A. Similarly, the facility-specific DB 12B stores medical information 122B and the like of the facility B, and the facility-specific DB 12C is a storage area for storing the medical information 122C and the like of the facility C.

  In addition, facility reference levels 121A, 121B, and 121C are stored in the facility-specific DBs 12A, 12B, and 12C, respectively. The facility reference levels 121A, 121B, and 121C are indices for determining permission / non-permission of access to the medical information DBs 122A, 122B, and 122C by the control unit 101 of the server 10. As will be described later, the facility reference levels 121A, 121B, and 121C are compared with the operator reference level (included in the operator information 111 in FIG. 5) preset for each operator by the control unit 101, and based on the comparison result. It is determined whether or not the operator can access the medical information DBs 122A, 122B, and 122C. The facility reference levels 121A, 121B, and 121C are, for example, “3” for a large-scale facility such as a regional core hospital or general medical center, “2” for a clinic, and “1” for a care facility. ”Is set in advance by the administrator of the electronic medical chart system 1. Note that the values of the facility reference levels 121A, 121B, and 121C described above are examples, and arbitrary values may be set. In addition, the facility reference levels 121A, 121B, and 121C may be set with indices other than numerical values.

The facility-specific DBs 12A, 12B, and 12C are provided with medical information DBs 122A, 122B, and 122C, respectively.
As shown in FIG. 4, in the medical information DB 122A (122B, 122C), patient ID, patient attribute information (age, gender, etc.), medical records, test result information, order information, etc. Is stored as a main part of the medical information. Then, the server 10 unifies the data format of the main part of the medical information of the electronic medical records of a plurality of facilities A, B, and C, and stores the data format of the main part of the unified medical information in the storage unit 102. The medical information DBs 122A, 122B, and 122C of each facility store the main parts of the above-described medical information in a unified data format. The main part of the medical information is, for example, essential data for generating an electronic medical record, such as patient ID, patient attribute information, medical record, test result information, order information, and the like. In addition, receipt information or the like may be included. It is desirable that incidental information other than the main part of medical information can be freely held in each facility.

  Here, it is assumed that patient information is managed by giving a patient ID unified in advance at each facility. Alternatively, a patient information association table (not shown) for associating patient identification information (for example, an examination ticket number) assigned to each facility with each other is stored in the storage unit 102, and patient identification information of a certain facility and other information It is assumed that the patient information of the facility is uniquely associated. Assume that patient association between facilities is performed based on, for example, a patient's name, date of birth, sex, address, and the like.

  The medical information stored in the medical information DBs 122A, 122B, and 122C is updated at the facility where the patient has been examined. Each time the medical information is updated, the client terminal 2 transmits the updated medical information to the server 10. When the server 10 receives the update information of the medical information from the client terminal 2, the server 10 updates and registers the medical information of the corresponding patient in the corresponding facility-specific DB 12A (12B, 12C).

The all-facility display DB 11 in FIG. 3 is a storage area for storing information for collectively displaying medical treatment information of a plurality of facilities on the same electronic medical record screen.
Specifically, operator information 111, examination view information 112, all facility medical information 113, and the like are stored in the all facility display DB 11.

The operator information 111 is information relating to an operator who uses the electronic medical chart system 1. As shown in FIG. 5, the operator information 111 stores the operator ID, name, job, operator reference level, authentication information, and the like of each operator.
The operator reference level is an index for determining which facility's medical information each operator can refer to, for example, a higher level such as “5” or “4” for a doctor, and “ It is set to a middle level such as “3” or “2”, and a lower level such as “1” for the medical staff.
The authentication information is authentication information such as a password for the operator to log in to the electronic medical record system 1.

  The medical treatment view information 112 is display data in which the layout of the electronic medical record screen, the elements constituting the electronic medical record screen, links of information, etc. (information on the storage destination, etc.) are defined. Information related to the display of combined medical information and the display position, font, ruled line, modification, etc. of the medical information is defined by the electronic medical record screen display processing described later.

  The all-facility medical treatment information 113 is obtained from the facility-specific DBs 12A, 12B, and 12C based on the medical information data format of the storage unit 102 based on the medical information data format of the storage unit 102 in the electronic medical record screen display process described later. This is a storage area for medical information acquired by combining.

The client terminals 2A, 2B, and 2C are computers arranged in the facilities A, B, and C, respectively. The client terminals 2A, 2B, and 2C include a control unit, a storage unit, an input unit, a display unit, a media input / output unit, a communication I / F, a peripheral device I / F, and the like.
The client terminals 2A, 2B, and 2C are each equipped with a web browser, and data is transmitted to and received from the server 10 via the web browser.
Further, the client terminals 2A, 2B, and 2C may be portable information terminals such as tablet terminals and smartphones. In this case, since the client terminal 2 is assumed to be used by moving inside and outside the facility, in the electronic medical record screen display process described later, the client terminal 2 is mainly used to distinguish the own facility from other facilities. It is desirable to store the identification information of the facility to which the facility belongs in the storage unit of the client terminal 2.

  Next, the details of the electronic medical record screen display process in the electronic medical record system 1 will be described with reference to FIG.

FIG. 6 is a flowchart showing the flow of the electronic medical record screen display process. The storage unit 102 of the server 10 of the electronic medical record system 1 stores programs and data necessary for execution of the electronic medical record screen display process. The control unit of the client terminals 2A, 2B, and 2C, and the control unit 101 of the server 10 Reads the above-mentioned program and data from the storage unit, and executes each process according to the flowchart of FIG.
The electronic medical record system 1 is assumed to perform communication connection to the server 10 and transmission / reception of requests / responses via a web browser or the like mounted on the client terminal 2.

  As shown in the flowchart of FIG. 6, first, the operator performs a login process in the client terminal 2 (step S101). That is, when the client terminal 2 accesses the server 10 of the electronic medical record system 1 via a web browser or the like, the server 10 transmits a login screen to the client terminal 2 that is the access request source. The login screen is provided with an operator ID input field and a password (authentication information) input field. The client terminal 2 receives input of operator authentication information such as an operator ID and a password, and transmits the input authentication information to the server 10. Upon receiving the operator authentication information, the server 10 performs an operator authentication process based on the operator information 111 stored in the storage unit 102, and returns an authentication result to the client terminal 2 (step S102). In step S102, if the authentication is successful, the server 10 transmits a patient information input screen for inputting patient information for obtaining an electronic medical record. If the authentication fails, the server 10 displays a warning to that effect on the client terminal 2.

  When patient information (patient ID, patient name, etc.) to be obtained electronic medical records is input to the patient information input screen displayed on the client terminal 2, and an instruction to read the corresponding patient information is input (step S103) ) The client terminal 2 transmits the input patient information to the server 10 together with the information acquisition request (step S104). Note that it is assumed that facility identification information for identifying the facility (own facility) where the client terminal 2 is arranged is added to the information acquisition request.

  Upon receipt of the patient information and information acquisition request, the server 10 searches the medical information DB of the requesting facility and acquires the medical information of the corresponding patient (step S105). For example, when there is an information acquisition request from the facility A, the server 10 searches the medical information DB 122A stored in the facility-specific DB 12A of the facility A, and acquires the medical information of the corresponding patient.

  The server 10 determines the layout of the electronic medical record screen so that the acquired medical information is displayed as a list (step S106), generates medical view information including the determined layout information and medical information, and transmits the medical view information to the client terminal 2 (Step S107).

  The client terminal 2 displays the electronic medical record screen 7A (FIG. 7) on the display unit based on the medical treatment view information received from the server 10 (step S108). At this stage, only the medical information of the own facility is displayed as a list on the electronic medical record screen 7A.

FIG. 7 shows an example of an electronic medical record screen 7A on which the medical information of the own facility is displayed.
As shown in FIG. 7, the electronic medical record screen 7A includes a patient information display area 71, a medical record display area 72, a detailed information display / input area 73, an input support tool 74, a button group 75, an own facility display tab 76, and all facilities. A display tab 77, menu tabs 78a to 78e, and the like are provided.

The patient information display area 71 displays the patient ID of the designated patient, the patient's name, age, date of birth, sex, patient classification, disease name, and the like.
In the medical record display area 72, a list of medical records (medical information) of designated patients is displayed. On the electronic medical record screen 7A in a state where the own facility display tab 76 as shown in FIG. 7 is selected, only the medical information in the own facility is displayed as a list in time series, for example.
In the detailed information display / input area 73, detailed information of the medical information selected by a click operation or the like from the medical records (medical information) displayed in a list in the medical record display area 72 is displayed. For example, it is displayed together with past medical records, doctors, departments, progress records, prescriptions, treatments, etc. of the corresponding patient. In addition, an operation button and a feed button for switching information to be displayed are also displayed. In addition, by double-clicking the detailed information display / input area 73, new information can be input. Information can be input using an input support tool 74 provided on the right side of the screen.

The input support tool 74 displays a numeric keypad and various input tools for inputting a progress record.
The button group 75 is an operation button for operating the electronic medical record and moving to another screen, a screen update button for updating information displayed on the screen, a patient information button for shifting to the patient information input screen, Order search button for transition to order search screen, foreign reservation button for transition to foreign reservation screen, “Close” button for exiting electronic medical record, insurance information button for transition to insurance information screen, printing A print button or the like for performing is provided.

  The own facility display tab 76 and the all facility display tab 77 are operation units for switching whether to display only the medical information of the own facility or the medical information of all the facilities for the designated patient. When the own facility display tab 76 is selected, only medical information about the own facility is displayed in the medical record display area 72 as shown in FIG. When the all facility display tab 77 is selected, the medical record display area 72 displays a list of medical information of corresponding patients in a plurality of facilities as shown in FIG. Details of the display of all facilities will be described later.

  The menu tabs 78a to 78e are tabs for switching the operation menu of the electronic medical chart, and are a diagnosis calendar tab 78a for displaying the “diagnosis calendar” menu, a medical record tab 78b for displaying the “medical record” menu, and “nursing record”. A nursing record tab 78c for displaying a menu, a temperature measurement table tab 78c for displaying a "temperature measurement table" menu, a nursing plan tab 78e for displaying a "nursing plan" menu, and the like are provided. In the present embodiment, the default display on the electronic medical record screen is the “medical record” menu.

Returning to the description of FIG.
When the all facility display tab 77 is selected on the electronic medical record screen 7A on which the medical information of the own facility is displayed, the client terminal 2 transmits an all facility information acquisition request to the server 10 (step S109).

Upon receiving the all facility information acquisition request from the client terminal 2, the server 10 performs a reference level determination process (step S110), and narrows down facilities for acquiring medical information according to the reference level determination result (step S111).
The reference level determination process and the facility narrowing-down process in steps S110 to S111 will be described with reference to the flowchart in FIG.

  As shown in FIG. 8, first, the server 10 acquires the reference level of the operator who has transmitted the information acquisition request. That is, the server 10 acquires the operator reference level of the corresponding operator from the operator information 111 of the all-facility display DB 102 in the storage unit 102 based on the operator ID acquired in the login process in step S101 of FIG. 6 (step S201). ).

  Next, the server 10 compares the acquired operator reference level with the facility reference level. First, it is determined whether there is an uncompared facility among all the facilities to be managed (facility A, B, C) (step S202). If there is an uncompared facility (step S202, Yes), The facility reference level 121A (121B, 121C) of the uncompared facility is acquired from the facility-specific DB 12A (12B, 12C) (step S203). Then, the server 10 compares the operator reference level with the facility reference level (step S204), and if the operator reference level is higher (Yes in step S204), the facility information DB 122A of the facility A (B, C). Access to (122B, 122C) is set to “permitted”, and the medical information at the facility for the corresponding patient is combined with other acquired medical information (step S205).

  Here, combining medical information refers to combining storage locations (addresses of the storage unit 102) of each medical information when acquiring corresponding medical information from a plurality of different facility-specific DBs 12A, 12B, and 12C. It is to be described.

  If it is determined in step S204 that the operator reference level is higher (Yes in step S204), the server 10 displays the facility selection button 72a (72b) (see FIG. 10) in the medical record display area 72. (Step S206). That is, in step S204, when the reference level determination is made for the facility A, a flag for setting display / non-display of the facility selection button 72a of the facility A is turned ON. When the flag is set to ON, the layout is determined so that the facility selection button 72a of the corresponding facility A is displayed in a layout determination process (step S112 in FIG. 6) described later.

  In step S204, if the facility reference level is higher than the operator reference level (No in step S204), access to the medical information DB of the facility is set to “impossible”, and the medical information of the facility is not combined and the processing returns to step S202. Return.

  The server 10 repeats the processes in steps S202 to S206 for all the facilities to be managed. That is, it is determined whether or not each facility can access the facility-specific DB, and based on the determination result, the combination of medical information and the display / non-display flag of the facility selection button are set.

  When the processing of step S202 to step S206 is performed for all facilities (No in step S202), the server 10 receives the patient's medical information from the facility-specific DBs 12A, 12B, and 12C of the plurality of facilities combined by the processing of step S205. Are stored in the all-facility display DB 11 as all-facility medical treatment information 113 (step S207).

  Returning to the description of FIG. When the reference level determination in step S110 and step S111 and the narrowing down of facilities based on the determination result are completed, the server 10 determines the layout of the electronic medical record screen (step S112), and the medical treatment including the determined layout information and medical information The view information is generated and transmitted to the client terminal 2 that has requested the medical information acquisition request (step S113).

  The client terminal 2 displays the electronic medical record screen 7B (FIG. 10) on the display unit based on the medical treatment view information received from the server 10 (step S114). The electronic medical record screen 7B displays a list of medical information of a plurality of facilities narrowed down based on the above reference level determination.

The result of reference level determination and facility narrowing will be described with reference to the other facility information reference availability table 115 in FIG.
Here, when the operator is a doctor, the operator reference level is set to “5” or “4”. When the operator is a nurse, the operator reference level is set to “3” or “2”. When the operator is a medical staff, the operator reference level is set to “1”. Shall. The level difference in the same job may be determined by, for example, years of experience or job title.
The facility reference level is set to “3” at the core hospital, “2” at the clinic, and “1” at the care facility.

As shown in FIG. 9, for example, when an operator (doctor) with an operator reference level “5” or “4” logs in to the electronic medical record system 1 from the client terminal 2B of the facility B, the facility A, facility All medical information of B and facility C can be acquired. However, when the facility selection button (facility selection buttons for facilities A, B, and C are displayed on the electronic medical record screen) is operated and the facilities are narrowed down, only the medical information about the narrowed down facilities is combined, To be acquired.
In addition, when an operator (nurse) with an operator reference level “3” logs in to the electronic medical record system 1 from the client terminal 2B of the facility B, the medical information of the facility A cannot be referred to in all the facility displays, and the facilities B and C It is determined that the medical information can be referred to. However, when the operator (nurse) at the operator reference level “3” logs in to the electronic medical record system 1 from the client terminal 2A of the facility A, the medical treatment information of the facility A is the own facility and can be referred to (FIG. 6). (Self-facility display of steps S104 to S108), and medical information of facilities B and C can also be referred to by reference level determination. When an operator (nurse) at the operator reference level “2” logs in to the electronic medical record system 1 from the client terminal 2A of the facility A, the medical treatment information of the facility A can be referred to because it is the own facility, and the medical treatment of the facility B Information cannot be referred to by reference level determination, and medical information of the facility C can be referred to by reference level determination. When the reference level of the operator is “1”, the medical information about other facilities cannot be referred to, but the medical information of the own facility can be referred to.

FIG. 10 shows an example of an electronic medical record screen 7B in which medical information of all facilities is displayed as a list.
As shown in FIG. 10, the electronic medical record screen 7B includes a patient information display area 71, a medical record display area 72, a detailed information display / input area 73, an input support tool 74, a button group 75, an own facility display tab 76, and all facilities. A display tab 77, display information switching tabs 78a to 78e, and the like are provided. In the medical record display area 72, facility selection buttons 72a and 72b are provided.

  In addition, the electronic medical record screen 7B in a state where the all facility display tab shown in FIG. 10 is selected is displayed on each part (patient information display area 71, detailed information display / input area other than the medical record display area 72 and facility selection buttons 72a and 72b). 73, the input support tool 74, the button group 75, the own facility display tab 76, the all facility display tab 77, and the display information switching tabs 78a to 78e) are the same as the electronic medical record screen 7A during the own facility display shown in FIG. .

On the electronic medical chart screen 7B for displaying all facilities, a list of medical information of corresponding patients in a plurality of facilities is displayed in the medical record display area 72. The medical information displayed as a list here is the medical information of the patient in the facility whose reference is permitted by the reference level determination in step S111.
For example, in the example of FIG. 10, medical information at the facility A on Monday, December 5, 2011, medical information at the facility B on Tuesday, December 6, 2011, and water on December 7, 2011 (Wednesday). Medical information and the like in the facility B are displayed in a time series list. In addition, the medical information in the column selected from the list display (in FIG. 10, the medical information in the facility A on Monday, December 5, 2011) is displayed in other fields, for example, in bold or colored. The medical information may be identified and displayed. Further, the contents of the medical information in the selected column are displayed in the detailed information display / input area 73.

The facility selection buttons 72a and 72b are buttons for narrowing down the facilities to be displayed in a list when the all facility display tab 77 is selected. As described in step S206 of the reference level determination process in FIG. 8, the facility selection buttons 72a and 72b are generated only for facilities whose reference level is determined to be referable and whose flag is set to “ON”. And displayed.
In FIG. 10, a facility selection button 72a for "facility A" and a facility selection button 72b for "facility B" are displayed. That is, access to the medical treatment information of the facility A and the facility B is permitted by the reference level determination.

  When the facility selection button 72a of “facility A” is selected by an operation on the client terminal 2, only the medical information of “facility A” is displayed in a list in the medical record display area 72, and the facility selection button 72b of “facility B” is displayed. Is selected, the medical record display area 72 displays only the medical information of “facility B” as a list. In this way, in the all facility display, the facilities to be displayed as a list can be narrowed down by the facility selection button, so that the operator can quickly search and display the medical information to be referred to.

Note that the layout (output format) of the electronic medical record may be different for each facility. For example, as shown in FIG. 4, in addition to the main part of the medical information stored in a unified data format, other incidental information is stored in each facility, as shown in FIG. Medical information (accompanying information) that is not can be reflected in the layout (output format) for each facility. Also, the operator may select which facility layout (output format) to output the electronic medical chart out of the layout (output format) for each facility. That is, for example, a format selection field is provided on the electronic medical chart screen, and the server 10 determines the layout in the format selected in the format selection field.
In this way, for example, even when a doctor who also serves as the facilities A and B logs in to the electronic medical record system 1 from the client terminal 2B of the facility B, the output format for the facility A is set in the format selection field described above. If selected, an electronic medical record layout is generated and displayed in an output format for facility A. Therefore, it is possible to provide a screen configuration that is easy for the operator to use, and work efficiency is improved.

As described above, in the electronic medical chart system 1 of the present embodiment, the data format of the main part of the medical information of a plurality of facilities is unified, the unified data format is held in the server 10, and the client terminal 2 When there is a request for acquiring medical information of a patient, the medical information is acquired by combining not only the own facility but also other facilities, and the list is displayed.
For this reason, the operator can check medical information in a plurality of facilities on the same electronic medical record screen with a single login without logging in to the electronic medical record system of each facility.
Further, since it is determined whether or not the medical information of other facilities can be referred to based on the reference level set for each operator and facility, the authority to refer to the medical information of each facility can be freely set.

  In addition, on the electronic medical chart screen, the entire facility display for displaying all the medical information of the facilities that can be referred to and the own facility display for extracting and displaying the medical information of the own facility are displayed on the own facility display tab and the all facility display tab. Therefore, the display can be easily switched and the operability is improved. In the above-described embodiment, the operator's tab selection operation switches between the own facility display and the entire facility display. However, the operation method is not limited to this, for example, a touch panel type If the operation screen is adopted, the display of the own facility and the display of all facilities are switched by a predetermined input operation to the touch panel (for example, an operation such as flicking the screen with a finger and turning the page). May be.

  In addition, in the all facility display, facility selection buttons 72a and 72b for selecting and inputting the facility for displaying the medical information are further provided, and the client terminal 2 provides the medical information about the facility selected by the operation of the facility selection button. Is displayed. Thereby, since the facilities to be displayed in a list can be narrowed down, the operator can quickly search and display the medical information to be referred to.

  In addition, the layout (output format) of each electronic medical record used in each facility can be selected and input in which layout (output format) the electronic medical record is output, and the server 10 is selected by the client terminal 2. The format may determine the layout (output format) of the electronic medical record. As a result, a layout that is easy for the operator to use can be provided, and the work efficiency of the operator is improved.

  The preferred embodiments of the electronic medical chart system 1 and the like according to the present invention have been described above with reference to the accompanying drawings, but the present invention is not limited to such examples. For example, in the above-described embodiment, the own facility display is the default display form of the electronic medical record screen, but is not limited to this, and the entire facility display may be the default display form. In the case where the all facility display is set to the default display form, in the flowchart of FIG. 6, the all facility information acquisition request is transmitted to the server 10 in step S104, steps S105 to S109 are omitted, and the processing after step S110 is first performed. To do so. In addition, the display form, operation method, and the like of the electronic medical record screen exemplified in the present embodiment are examples, and the present invention is not limited thereto. In addition, it is obvious that those skilled in the art can arrive at various changes or modifications within the scope of the technical idea disclosed in the present application, and these naturally belong to the technical scope of the present invention. It is understood.

1 ... Electronic medical record system 10 ... Servers A, B, C ... Facility 2A, 2B, 2C ... Client terminal 4 ...・ ・ ・ ・ ・ ・ ・ ・ Network 11 ・ ・ ・ ・ ・ ・ ・ ・ DB for all facilities display
111 ... Operator information 112 ... Medical treatment view information 113 ... All facilities medical information 12A ... Facility for facility A Another DB
121A ······ Facility A reference level 122A ············· Facility A medical information DB
12B ・ ・ ・ ・ ・ ・ ・ ・ DB for facility B
121B ... Facility reference level 122B of Facility B ... Medical information DB of Facility B
12C ... Facility-specific DB for Facility C
121C ... Facility reference level 122C for facility C ... Medical information DB for facility C
7A ..... Electronic medical record screen 7B when own facility display tab is selected .... Electronic medical record screen 72 when all facilities display tab is selected. Medical record display area 76... Self-facility display tab 77...

Claims (8)

An electronic medical record system in which a medical information management server for electronic medical records and client terminals arranged in a plurality of facilities to be managed by the medical information are connected via a network,
The server
A data format unifying unit for unifying the data format of the main part of medical information of the electronic medical records of the plurality of facilities;
A storage unit for storing a data format of a main part of the unified medical information;
In response to the medical information acquisition request transmitted from the client terminal, the medical information of a plurality of facilities to be managed is acquired based on the data format of the medical information in the storage unit, and the electronic medical record screen Display data generating means for generating display data for display on the display;
Transmission means for transmitting the display data generated by the display data generation means to a client terminal that is a request source of the medical information acquisition request, and
The client terminal is
Transmitting means for transmitting the medical information acquisition request to the server;
Display means for displaying the electronic medical record screen including medical information of the plurality of facilities based on display data transmitted from the server;
An electronic medical chart system comprising: The storage unit stores an operator reference level set for each operator with reference authority for the medical information, and a facility reference level set for each facility,
The server
Based on the operator reference level and facility reference level stored in the storage unit, further comprising a determination means for determining a facility where an operator operating the client terminal can refer to the medical information,
The display data generation means narrows down facilities for acquiring medical information from the storage unit according to a determination result by the determining unit, acquires the narrowed down medical information of the facility from the storage unit, acquires the electronic information The electronic medical chart system according to claim 1, wherein display data to be displayed in the medical chart screen is generated.   2. The medical chart system according to claim 1, wherein medical information of the plurality of facilities is displayed in a list on the electronic medical chart screen.   The electronic medical record screen is switched between an all-facility display screen that displays a list of all medical treatment information of facilities that can be referred to according to an operation on the client terminal, and a self-facility display screen that extracts and displays the medical information of the own facility The electronic medical chart system according to claim 1, wherein The electronic medical record screen further includes a facility selection unit for selecting and inputting a facility for displaying medical information on the all facility display screen,
5. The display data generating means of the server, when the facility selection unit is operated by the client terminal, narrows down the facilities for obtaining medical information from the storage unit to the selected facility. Electronic medical record system described in 1. A format selection means for selecting and inputting in which output format the electronic medical record is output among the output formats of the electronic medical records used in the facility where the client terminal is arranged and other facilities,
The server display data generation means includes:
2. The electronic medical record system according to claim 1, wherein the display data is generated in a format selected by the format selection means. A server for managing medical information of the electronic medical record, which is connected via a network to each client terminal arranged in a plurality of facilities where the medical information of the electronic medical record is managed,
The server
A data format unifying unit for unifying the data format of the main part of medical information of the electronic medical records of the plurality of facilities;
A storage unit for storing a data format of a main part of the unified medical information;
In response to the medical information acquisition request transmitted from the client terminal, the medical information of a plurality of facilities to be managed is acquired based on the data format of the medical information in the storage unit, and the electronic medical record screen Display data generating means for generating display data for display on the display;
Transmitting means for transmitting the display data generated by the display data generating means to the requesting client terminal of the medical information acquisition request;
A server comprising: An electronic medical record display method in an electronic medical record system in which a server for managing medical information of an electronic medical record and each client terminal arranged in a plurality of facilities to be managed by the medical information are connected via a network,
The server unifying the data format of the main part of the medical information of the plurality of facilities;
The server storing a data format of a main part of the unified medical information;
The client terminal transmitting an acquisition request for the medical information to the server;
In response to the medical information acquisition request, the server acquires and acquires the medical information of a plurality of facilities to be managed based on the data format of the medical information in the storage unit, and displays it on the electronic medical record screen Generating display data for use,
The server transmits the generated display data to a client terminal that is a request source of the medical information acquisition request;
The client terminal displaying the medical information of the plurality of facilities based on electronic medical chart display data transmitted from the server;
An electronic medical chart display method comprising:

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