JP2014085731A - Pathway formulation support program, method, and apparatus - Google Patents

Abstract

PROBLEM TO BE SOLVED: To enable medical care personnel to efficiently formulate clinical pathways.SOLUTION: In a support program for formulation of a clinical pathway for a patient to be hospitalized, a plurality of sets of medical care actions are stored into memory means in response to inputting of the plurality of sets of medical care actions applied to the patient when not hospitalized, designation of one set of medical care actions stored in the memory means is accepted, and a computer is caused to process formulation of a clinical pathway accepted as part or the whole of the set of medical care actions for the patient or another patient different from the patient.

Description

  The present invention relates to providing a path creation support program, method, and apparatus that allow a healthcare professional to efficiently create a path.

  In recent years, various medical systems have been introduced in the medical field. In such a system, a medical worker manages a clinical path (hereinafter simply referred to as “path”) created by a medical worker, which summarizes a treatment schedule including treatment and examination of a patient's disease. Standardization of medical care for patients has been carried out with less variation in medical care among persons. The treatment schedule for a patient is such that items such as meals, processing, examinations, treatments, preparations, and the like after the patient is hospitalized are associated with the calendar.

  Expectation index of healing stipulated by the clinical path selected for the same symptom based on the average value of the healing index indicating the degree to which the symptom was cured by each medical practice performed by the medical staff for the given symptom Techniques such as a simulation evaluation of the validity of this are known.

JP 2009-244980 A

  However, the above-described technology simulates and evaluates the validity of paths that have already been created, and it has not been possible to reduce the labor of medical staff when creating new paths with a wide variety of items. It was.

  Therefore, it is an issue to enable medical staff to efficiently create a path.

  According to one aspect of the present embodiment, in the path creation support program, in the clinical path creation support program at the time of hospitalization, according to the input of a set of a plurality of medical practices to be applied to a patient at the time of non-hospitalization, A clinical path that stores the plurality of medical practice groups in a storage unit, receives designation of any medical practice group stored in the storage unit, and incorporates the received medical practice group as a part or all of them Is generated for the patient or a patient different from the patient.

  Further, as means for solving the above-described problem, a path creation support method, a path creation support apparatus, and a recording medium on which the path creation support program is recorded can be used.

  According to one aspect of the present embodiment, a medical worker can efficiently create a path.

It is a figure which shows the hardware constitutions of a path | pass creation assistance apparatus. It is a figure which shows the function structural example of a path | pass creation assistance apparatus. It is a flowchart figure for demonstrating a pass screen creation process. It is a flowchart figure for demonstrating a 1st set expansion | deployment selection process. It is a flowchart for demonstrating a 2nd set expansion | deployment selection process. It is a flowchart figure for demonstrating a display update process. It is a figure which shows the path | pass screen at the time of path | pass creation. It is a figure which shows the example of an initial display by a set expansion | deployment part. It is a figure for demonstrating the example of a set expansion | deployment by selection of all the document expansion | deployment buttons. It is a figure for demonstrating the example of set expansion | deployment by selection of all the document expansion | deployment of the right click menu on a document list. It is a figure for demonstrating the selection method of a reference day. It is a figure for demonstrating expansion | deployment of the selection document. It is a figure for demonstrating the check process at the time of path | pass expansion | deployment from a set. It is a figure for demonstrating the deletion process of patient specific data. It is a figure for demonstrating the initialization check process at the time of new path | pass preservation | save. It is a figure which shows the data structural example of set index DB and set DB. It is a figure which shows the example of a data structure of expansion | deployment restriction | limiting master DB. It is a figure which shows the example of a data structure of judgment master DB. It is a figure which shows the data structural example of path master index DB and path master DB.

  Hereinafter, embodiments of the present invention will be described with reference to the drawings. In hospitals and the like, a standard path model is created in advance by a doctor before creating a clinical path (hereinafter simply referred to as “pass”) for each patient. In this embodiment, a mechanism for efficiently creating a path template is provided.

  Creating a path is a schedule of medical activities aimed at treating the patient, but apart from such a path, doctors put together multiple medical activities to treat the patient's illness There is what is called a set. Depending on the set, one or more medical actions are scheduled. The path creation support apparatus according to the present embodiment efficiently creates a path including a plurality of medical practices by using an existing set.

  The path creation support apparatus according to the present embodiment has a hardware configuration as shown in FIG. FIG. 1 is a diagram illustrating a hardware configuration of the path creation support apparatus. In FIG. 1, a path creation support device 100 is a terminal controlled by a computer, and includes a CPU (Central Processing Unit) 11, a main storage device 12, an auxiliary storage device 13, an input device 14, and a display device 15. And an output device 16, a communication I / F (interface) 17, and a drive 18, which are connected to the bus B.

  The CPU 11 controls the path creation support device 100 in accordance with a program stored in the main storage device 12. The main storage device 12 uses a RAM (Random Access Memory) or the like, and stores a program executed by the CPU 11, data necessary for processing by the CPU 11, data obtained by processing by the CPU 11, and the like. A part of the main storage device 12 is allocated as a work area used for processing by the CPU 11.

  The auxiliary storage device 13 uses a hard disk drive and stores data such as programs for executing various processes. A part of the program stored in the auxiliary storage device 13 is loaded into the main storage device 12 and executed by the CPU 11, whereby various processes are realized. The storage unit 130 includes the main storage device 12 and / or the auxiliary storage device 13.

The input device 14 includes a mouse, a keyboard, and the like, and is used for a user such as a medical worker to input various information necessary for processing by the path creation support device 100. The display device 15 displays various information required under the control of the CPU 11. The output device 16 has a printer or the like and is used for outputting various types of information in accordance with instructions from the user. The communication I / F 17 is a device that is connected to, for example, the Internet, a LAN (Local Area Network), etc., and controls communication with an external device. Communication by the communication I / F 17 is not limited to wireless or wired.
A program for realizing the processing performed by the path creation support apparatus 100 is provided to the path creation support apparatus 100 by a storage medium 19 such as a CD-ROM (Compact Disc Read-Only Memory). That is, when the storage medium 19 storing the program is set in the drive 18, the drive 18 reads the program from the storage medium 19, and the read program is installed in the auxiliary storage device 13 via the bus B. . When the program is activated, the CPU 11 starts its processing according to the program installed in the auxiliary storage device 13. The medium for storing the program is not limited to a CD-ROM, and any medium that can be read by a computer may be used. As a computer-readable storage medium, in addition to a CD-ROM, a portable recording medium such as a DVD disk or a USB memory, or a semiconductor memory such as a flash memory may be used.

  FIG. 2 is a diagram illustrating a functional configuration example of the path creation support device. In FIG. 2, the path creation support apparatus 100 includes a path creation unit 40 and a set development unit 9. The storage unit 130 stores a set index DB 31, a set DB 32, a development restriction master DB 33, a determination master DB 34, a path master index DB 35, a path master DB 36, and the like.

  The path creation unit 40 is a processing unit that creates a new path using an existing set, and further includes a path screen creation unit 41, a selection unit 42, and a display update unit 43.

  The pass screen creation unit 41 is a processing unit that creates a pass screen for a medical worker such as a doctor, that is, a user to create a pass, and displays the pass screen on the display device 15.

  The selection unit 42 provides a selection unit for the user to perform set expansion directly from the pass screen. When the set expansion instruction is detected by selecting set expansion from the pass screen, the selection unit 42 selects the set expansion unit 9. The processing unit is activated, and further includes a first set development selection unit 42a and a second set development selection unit 42b.

  The first set development selection unit 42a is a processing unit that detects a set development instruction by the user selecting a set development button in the path screen and activates the set development unit 9. The second set expansion selection unit 42b can select a set expansion item from a menu displayed by right-clicking on the path screen, detects a set expansion instruction by the user's selection of the set expansion item, and sets the set expansion unit 9 A processing unit to be activated.

  The display update unit 43 is a processing unit that updates the display of the medical schedule in the path screen in response to the end notification from the set development unit 9.

  The set expansion unit 9 enables selection of a set managed by the set DB 32 by the user, and creates set information in which the date is adjusted so that all or part of the selected set can be expanded on the path screen, It is a processing unit that delivers to the display update unit 43.

  The set index DB 31 is a database that stores an index for searching and extracting each set. In the set DB 32, for each set associated with the index of the set index DB 31, the medical action for each slip is shown, and the medical action is stored in a state in which the medical action is scheduled. Different medical practices are managed with different slip names.

  The expansion restriction master DB 33 is a database that manages the setting of path creation impossibility and path creation impossibility from a set for each slip. The judgment master DB 34 is a database that manages a data key to be deleted at the time of expansion to a path among the medical treatment contents described in the order slip in the set. The data key to be deleted is identification information of patient-specific data, and patient-specific data is additional information that is referred to when a medical practice is performed on a patient. The data key corresponds to a tag name in document XML data described later.

  The path master index DB 35 is a database that stores an index for searching and extracting each path. The path master DB 36 is a database that stores paths created using the path screen, and is associated with the index of the path master index DB 35. In each pass, a plurality of medical treatment contents for each set are developed in the applied calendar.

  Hereinafter, processing by each processing unit will be described with reference to flowcharts. First, the pass screen creation process by the pass screen creation unit 41 will be described with reference to FIG. FIG. 3 is a flowchart for explaining the pass screen creation process.

  In FIG. 3, the pass screen creation unit 41 reads a default vertical axis indicating a slip name to be displayed in the vertical axis direction of the preset pass screen from a predetermined storage area of the storage unit 130 (step S11), and edits the path parameter. (Step S12).

  The pass screen creation unit 41 determines whether or not the set expansion is effectively designated by the initial setting stored in the storage unit 130 (step S13). If the set expansion is not designated effectively, the pass screen creation unit 41 proceeds to step S15. On the other hand, the path screen creation unit 41 sets the set development flag 6f to ON, and creates a set development tag in the path appearance XML data 6a (step S14).

  The pass screen creation unit 41 creates an HTML pass screen from the path appearance XML data 6a using the pass screen style sheet 6b prepared in advance in the storage unit 130 (step S15). Pass screen data 6c obtained by conversion from XML to HTML by the style sheet 6b is stored in the storage unit 130. Then, the pass screen creation unit 41 displays the pass screen on the display device 15 based on the pass screen data 6c, and displays a calendar in the pass screen (step S16).

  As described above, in the path screen creation process, when the <DOSET> tag exists in the path appearance XML data 6a in the style sheet 6b, the path screen data 6c is created by converting the HTML to display the set expansion button. Therefore, there is no change or correction of the program on the pass screen.

  The first set development selection process by the first set development selection unit 42a will be described with reference to FIG. FIG. 4 is a flowchart for explaining the first set development selection process. In FIG. 4, when the first set expansion selection unit 42a detects a path expansion instruction by clicking the set expansion button from the path screen displayed on the display device 15 (step S21), the system date is set as the activation parameter of the set expansion unit 9. Is set, the set development unit 9 is activated (step S22), and this process is terminated.

  The second set expansion selection process by the second set expansion selection unit 42b will be described with reference to FIG. FIG. 5 is a flowchart for explaining the second set expansion selection process. In FIG. 5, when detecting the right click by the mouse operation on the path screen (step S31), the second set development selection unit 42b determines whether or not the set development flag 6f is ON (step S32). If the set development flag 6f is not ON, the second set development selection unit 42b ends this process.

  On the other hand, when the set development flag 6f is ON, the second set development selection unit 42b displays a “set development” item in the right-click menu and a set development button in the path screen (step S33). Then, the second set development selection unit 42b determines whether or not set development has been selected (step S34). When the set development is not selected, the second set development selection unit 42b ends this process.

  On the other hand, when set expansion is selected, that is, when a set expansion instruction is detected, the date in the calendar clicked is designated as the activation parameter of the set expansion unit 9, and the set expansion unit 9 is activated (step S35). .

  The display update process by the display update unit 43 will be described with reference to FIG. FIG. 6 is a flowchart for explaining the display update process. In FIG. 6, when the display update unit 43 receives a set expansion end notification from the set expansion unit 9 (step S41), the display update unit 43 displays the set information notified from the set expansion unit 9 on the calendar (step S42). The set information indicates a plurality of medical actions by all the documents or a selected document, which will be described later, designated by the user.

  Hereinafter, an example of set expansion processing will be described with screen transition. FIG. 7 is a diagram showing a path screen when creating a path. In FIG. 7, a path screen G50 is an initial screen at the time of path creation created by the path screen creation unit 41.

  In FIG. 7, a vertical axis item 50a, a calendar 50b, a set expansion button 50c, and the like are displayed on the pass screen G50. In the vertical axis item 50a, a default vertical axis in which slip names associated with standard medical practices are listed in the directory structure at the initial stage of path creation is displayed. The calendar 50b displays the number of days in a predetermined period with respect to the current date and time when the path is created. Here, it shows with 1 sick day, 2 sick days, 3 sick days, and so on. The set expansion button 50c is a button for starting the set expansion unit 9 in response to a click by the user.

  As another method of activating the set expansion unit 9, the user can also activate the set expansion unit 9 by right-clicking on a desired date with a mouse. When the user right-clicks on the second sick day of the calendar 50b, the right-click menu 50d is displayed by the pass screen creation unit 41. The right click menu 50d includes a “set expansion” item 50e. When the user selects the “set development” item 50e, the set development unit 9 is activated.

  Regarding the correspondence between the system date and the calendar date at the time of set expansion when the set expansion unit 9 is activated by clicking the set expansion button 50c and when the set expansion unit 9 is activated from the right click menu 50d Explained. The system date indicates the current date and is the time within the system of the path creation support device 100.

  An example of an initial display by the set development unit 9 activated by clicking the set development button 50c will be described with reference to FIG. FIG. 8 is a diagram illustrating an initial display example by the set development unit. In FIG. 8, a set development screen G51 is displayed on the path screen G50 in response to a click on the set development button 50c.

  On the set development screen G51, an all document development button 7a, a reference date selection button 7b, a selected document development button 7c, a set list 51a, a document list 51b, and the like are displayed.

  Each medical action is instructed by a document in which the contents to be executed on each day are specified for each type of prescription, examination, or the like that becomes a medical action. One set includes one or more medical actions by one type or more. A unit of one medical action is performed once and one type, and the content of the medical action is designated by one document. If a medical practice is scheduled for morning, noon, and night with the same type, three documents are created. If the same type is scheduled for two days in a medical practice once a day, two documents are created.

  The all document expansion button 7a is a button for expanding all medical practices included in the set selected from the set list 51a into a path. The reference date selection button 7b is a button for enabling date selection by the user. The selected document expansion button 7c is a button for expanding a medical action selected from the selected set into a path.

  In the set list 51a, set names are shown in a list based on the initial development settings of user conditions related to the user, and each set can be selected by the user. In the set list 51a, existing sets such as a set created by the user in the past and a set used in common among other users are displayed in a list.

  In the document list 51b, documents showing the contents of one or more medical practices included in the set selected by the user from the set list 51a are displayed in a list in the order of dates scheduled in the past.

  When the set expansion button 50c is clicked, the system date is set as the reference date. Here, a calendar screen G52 when the system date is September 2, 2011 is displayed. Using the calendar screen G52, the user can set a date other than the system date by selecting a date using a mouse or the like and clicking the confirm button.

  FIG. 9 illustrates a case where the set development unit 9 is activated from the set development button 50c on the pass screen G50 and then the all document development button 7a is selected from the set development screen G51 to perform set development. FIG. 9 is a diagram for explaining an example of set expansion by selecting the all document expansion button.

  In FIG. 9, in the set development screen G51 displayed in response to the click of the set development button 50c, the dates in each document are changed on the dates 3a, 3b, and 3c based on the reference date. The reference date is set to the oldest date among the dates in the plurality of documents, and the other dates are calculated by adding the relative dates from the oldest date to the reference date. When the system date “2011/09/03” is the reference date, the dates 3a, 3b, and 3c in each document are “2011/09/03”, “2011/09/04”, “2011/09 / 05 "will be changed. The oldest date corresponds to the start date of the scheduled medical practice in the set.

  In the set development screen G51, when the user selects the all document development button 7c or selects the “all document development” item 51e from the menu 51d displayed by right clicking in the document list 51b, the instruction calendar G52 is displayed. Is displayed.

  In the instruction calendar G52, based on the contents of the document list 51b, the same slip name ("in-hospital general injection" in FIG. 9) is started from the date of the reference date in association with the instruction contents such as technique, medicine, and usage. The scheduled schedule 52s is shown. A plurality of documents indicating the same slip name is indicated by one order 52a.

  In this example, according to the order 52a, for each item of procedure, medicine, and usage, the instruction content of “continuous infusion peripheral main”, “Solitor T1 200 mL”, “once a day” is 9/3 (Sat. ), 9/4 (Sunday), and 9/5 (Monday).

  In the instruction calendar G52, the user confirms the contents of the prescription, treatment, examination, etc. and the schedule 52s, and then clicks the confirm button 52b to execute the set expansion, and the processing in the set expansion unit 9 ends.

  In the calendar 50b of the pass screen G50 displayed by the pass screen creation unit 41, the contents of the date “2011/09/03” of the document list 51b on the first sick day, the date “2011/09/03” of the document list 51b on the second sick day. The contents of “04” and the contents of the date “2011/09/05” in the document list 51b are sequentially developed on the third sick day. It is also possible to display and confirm the details of each document content according to the user's detailed display instruction.

  A case where the set development is performed by selecting the “all document development” item 51e from the menu 51d displayed in response to a right click on the document list 51b of the set development screen G51 will be described with reference to FIG. FIG. 10 is a diagram for explaining an example of set expansion by selecting all document expansion from the right-click menu on the document list.

  In FIG. 10, when the “set expansion” item 50e is selected from the right click menu 50d displayed when the date of the calendar 50b on the pass screen G50 is selected by right clicking, the set expansion screen G51 is displayed on the display device 15. The In this example, the system date (current date) corresponding to the first sick day is 2011/09/02, whereas the second sick day is selected by the user. The second sick day, that is, 2011/09/03 is set as the reference date.

  On the set development screen G51, the date in each document is changed based on the reference date “2011/09/03”. The method for changing the date is the same as that in FIG.

  In the set development screen G51, the user selects an “all document development” item 51e from a menu 51d displayed by right-clicking in the document list 51b, whereby an instruction calendar G52 is displayed. In the instruction calendar G52, based on the contents of the document list 51b, the schedule starting from the date of the reference date is shown in association with the instruction contents such as procedures, medicines, and usages, and the confirmation button 52b is clicked. The set expansion is executed, and the processing in the set expansion unit 9 ends.

  The case of selecting the reference date after displaying the set development screen G51 will be described with reference to FIG. FIG. 11 is a diagram for explaining a reference date selection method. In FIG. 11, the user clicks the “reference date selection” item 51f of the menu 51d displayed by clicking the reference date selection button 7b on the set development screen G51 or by right-clicking on the document list 51b on the set development screen G51. By doing so, the instruction calendar G52 is displayed.

  In the instruction calendar G52, the system date “2011/09/02” which is the default of the reference date is displayed so as to be visually recognized. When the user selects “2011/09/03” as the reference date, the document list 51 b is displayed on the display device 15. Each date in the plurality of documents in the document list 51b is changed and displayed according to the selected reference date. When the user selects the “select all documents” item 51e in the menu 51d by right clicking on the document list 51b, the set is expanded according to the reference date selected by the user.

  The expansion of the selected document from the document list 51b on the set expansion screen G51 will be described with reference to FIG. FIG. 12 is a diagram for explaining the development of the selected document. In FIG. 12, the user selects a “selection document expansion” item 51g from a selected document expansion button 7c on the set expansion screen G51 or a menu 51d displayed by right-clicking on the document list 51b on the set expansion screen G51. As a result, a screen G53 corresponding to the slip name designated by the selected document is displayed on the display device 15.

  In this example, a screen G53 corresponding to the slip name “general shooting” of the selected document is displayed, and the examination date 53a is “2011/09/05” calculated from the reference date. When the user clicks the confirmation button 53b in the screen G53, the selected document indicating the content of the medical practice is developed on the calendar 50b in the pass screen G50.

  Next, various check processes performed by the set development unit 9 at the time of set development will be described with reference to FIGS. FIG. 13 is a diagram for explaining a check process at the time of path expansion from a set. FIG. 13 shows an example of a check process performed when the set development unit 9 develops a document selected from the document list 51b on the set development screen G51. It is determined whether or not a medical action that makes it impossible to create a path is specified in the selected document by a plurality of check processes. The slip name of the selected document among the slip names 8a, 8b, 8c,. In the selected set “injection and X-ray”, in addition to “specimen examination” of slip name 8a, “hospital prescription” of slip name 8b, and “general injection” of slip name 8c, “NTS intervention request”, “ It is assumed that other slips such as “change department” and “hospital prescription” are included and scheduled.

  In the first check process, it is checked whether or not a slip name that is not registered as an item in the vertical axis item 50a of the pass screen G50 is specified for the selected document. If designated, a warning screen G54 including a warning message 54a such as “Next slip is not registered on the vertical axis and cannot be expanded. ◆ NST intervention request” is displayed. The warning message 54a indicates a slip name “NST intervention request” that cannot be expanded.

  In the second check process, it is checked whether or not a slip name for which a path creation impossible flag is set in the development restriction master DB 33 is specified for the selected document. If it is designated, a warning screen G54 including a warning message 54b such as “The next slip cannot be used for path creation and cannot be expanded. In the warning message 54b, the slip name “transfer” that cannot be expanded is indicated.

  In the third check process, it is checked whether or not a slip name for which a set unexpandable flag is set in the expansion restriction master DB 33 is specified for the selected document. If specified, a warning screen G54 including a warning message 54c such as “The next slip cannot be used for path creation from the set and cannot be expanded. ◆ Inpatient prescription” is displayed. The warning message 54c indicates the slip name “hospital prescription” that cannot be expanded.

  The expansion of the document indicating the slip displayed in the warning message 54a to the calendar 50b on the pass screen G50 is suppressed, and the document indicating the other slip is expanded on the calendar 50b.

  In addition to the various check processes described above, the set development unit 9 performs a process for deleting patient-specific data as shown in FIG. FIG. 14 is a diagram for explaining a deletion process of patient-specific data. In FIG. 14, the set development screen G51 shows a document example of the slip name “general shooting”. This document includes patient-specific data 51h for clinical diagnosis “liver dysfunction” and patient-specific data 51i for pregnancy “present”. Even in either case, the same processing described below is performed.

  When the selected document expansion 51g is selected from the menu 51d displayed by right-clicking by the user, the set expansion unit 9 refers to the determination master DB 34 and the data key to be deleted exists in the selected document. In this case, the screen G55 corresponding to the slip name “general shooting” of the selected document, in which the value of the data key is initialized, is displayed on the display device 15.

  When the screen G55 is displayed on the display device 15, the setting 55h corresponding to the patient specific data 51h and the setting 55i corresponding to the patient specific data 51i are initialized. The patient-specific data specified by the data key is deleted by initializing to a state where there is no setting or to a default value.

  A part 50j of the document content from which the patient-specific data has been deleted is developed on the calendar 50b of the pass screen G50. When a part 50j of the document content is selected from the calendar 50b by the user, a screen G51-2 for confirming the entire selected document content is displayed. On the screen G51-2, the item itself is not displayed for the patient-specific data 51h initialized to a state without setting, and the default value is displayed for the patient-specific data 51i initialized to the default value.

  The set information obtained by the processing by the set expansion unit 9 as described above, which is all or a part of the set processed for expansion on the calendar 50b of the pass screen G50, is notified by the processing notification by the set expansion unit 9. Then, it is transferred to the display update unit 43 of the path creation unit 40, and the display update unit 43 updates the calendar 50b of the pass screen G50. Using the buffer, the set information is transferred from the set development unit 9 to the display update unit 43.

  When the user can confirm the medical treatment schedule on the updated calendar 50b of the pass screen G50, the user saves the created pass. The path is newly added and stored in the path master DB 36 by the display update unit 43.

  The display update unit 43 performs an initialization check when storing a new path. FIG. 15 is a diagram for explaining initialization check processing when a new path is stored. In FIG. 15, when the user clicks the save button 50k for saving a new path or the path information button 50p for changing process information on the path screen G50 in which the calendar 50b is updated, the display update unit 43 displays the path master DB 36. Check the document contents of the new path saved in. It is checked whether there are any items in which patient-specific data such as disease name, blood type, height, and weight are input in the document content.

  In the initialization check process, when it is determined that patient-specific data remains, a screen G56 indicating the check result is displayed on the display device 15. When the user clicks the close button 56a on the screen G56, an error 50r is displayed in association with the corresponding slip name in the vertical axis item 50a on the pass screen G50. The corresponding slip name is highlighted and displayed so that the user can easily recognize it.

  Next, a data configuration example of the database in the present embodiment will be described with reference to FIGS. FIG. 16 is a diagram illustrating a data configuration example of the set index DB and the set DB.

  In FIG. 16, the set index DB 31 is a database that manages an index to each set. , Items such as order, set name, slip code, use date and time.

  Set document No. Indicates a number for identifying a set in which a plurality of documents indicating the contents of medical practices managed by the set DB 32 are combined. The order indicates a slip number of a medical practice performed in the past. The order specifies, for example, the order 52a (FIG. 10) of the instruction calendar G52.

  The set name indicates a name for specifying a set displayed on the set list 51a of the set development screen G51. The slip code is a code for specifying a medical practice, and is used when creating a pass, set, order, or the like. The slip name corresponding to each slip code may be separately managed in another database and associated with the slip code. The use date indicates the date when the set was used.

  The set DB 32 is a set document No. Is a database for managing documents indicating the contents of medical activities scheduled in the set. , Slip code, document XML data, and the like. The set index DB 31 and the set DB 32 are set document Nos. Associated with.

  Set document No. Is a set document No. managed by the set index DB 31. Indicates a number that matches. The slip code is a set document No. of the set index DB 31. Indicates the value that matches the slip code combined with. Set document No. And the slip code identify the document. The document XML data is data in which a document indicating the contents of medical treatment instructed for each scheduled day is described in XML.

  FIG. 17 is a diagram illustrating a data configuration example of the expansion restriction master DB. In FIG. 17, the expansion restriction master DB 33 is a database that manages the setting of the path creation disabled and the path creation disabled from the set for each slip, as described in FIG. It has items such as a path creation impossible flag and a set development impossible flag.

  The slip code is a code for specifying a medical practice, and is used when creating a pass, set, order, or the like. The slip name indicates a name associated with the slip code, and medical treatment can be identified.

  The path creation impossibility flag indicates that the medical treatment is incapable of creating a path. When “1” is set in the path creation impossible flag, the medical treatment specified by the slip code indicates that the path cannot be created. If it is not set, it indicates that a path can be created.

  The set undeployable flag indicates that the medical treatment is incapable of creating a path from an existing set. When “1” is set in the set development impossible flag, the medical treatment specified by the slip code indicates that a path cannot be created from the existing set. If it is not set, it indicates that a path can be created from the existing set.

  FIG. 18 is a diagram illustrating a data configuration example of the determination master DB. In FIG. 18, as described in FIG. 14, the judgment master DB 34 deletes values when creating a path from an existing set, such as data that cannot be input at the time of creating a path and patient-specific data in each document instructing medical treatment contents. A database for managing process names, section names, data keys, availability, and remarks. An item whose value is to be deleted is indicated by a <> tag in the document XML data of the set DB 32.

  A record is specified by a process name and a section name, and a tag name in which a value to be deleted is set in the record is designated by a data key. The availability indicates whether or not it can be used when creating a path from a set. When “NG” is indicated, it indicates that the diversion from the set at the time of path creation is not possible, and this indicates that this is an item for deleting the value set in the tag specified by the data key. In the remarks, for example, contents such as “path creation, registration prohibited item attribute” are shown for the item indicating “NG”.

  To delete a value means to delete the value itself (make it blank) or to set it to a default value.

  Further, in the common check performed when the newly created path is stored in the path master DB 36, the patient-specific data set in the diverted set document is not mixed into the path by referring to the determination master DB 34 again. You may check it. When patient-specific data is detected in the newly created path by the common check, a message such as “patient-specific items are set in the path” is displayed on the error screen.

  FIG. 19 is a diagram illustrating a data configuration example of the path master index DB and the path master DB. In FIG. 19, a path index table 35 is a database that manages an index to each path. , Pass code, SEQ, and path name.

  The path ID is identification information for identifying a path managed by the path data DB. The date and time when a new path is created may be included in the path ID. The classification is information for identifying the department into which the created path is classified. The affiliation of the user who created the path may be indicated by classification. The pass code indicates a number that uniquely identifies each path. SEQ indicates the serial number of the path. The path name indicates the name of a path given for each path.

  Further, the path data DB 36 manages the contents of one or more medical treatments instructed by the user scheduled for each path, and includes items such as a path ID, a relative number of days, a tool flag, a path view, and document XML data. The path ID is identification information for identifying a path, and is associated with the path ID in the path index DB 35. The relative number of days indicates the number of days from the start date (first disease day) scheduled in the pass. The tool flag manages a flag of a tool corresponding to the developed medical practice.

  The path view stores data indicating the contents of scheduled daily medical activities displayed on the screen 50b illustrated in FIGS. 9, 10, and 12. The path view data with the same path ID corresponds to the set information transferred from the set development unit 9. The document XML data is actual XML data for displaying the pass screen G50.

  As described above, according to the present embodiment, by making it possible to select an existing set by the user from the path screen G50, it is possible to efficiently create a model of a path used when creating a path for each patient. it can.

  When a set date is specified from the pass screen G50, the reference date is specified, so that the oldest date in the selected set is associated with the reference date, and according to the schedule of medical care performed in the past indicated by the set. Depending on the relative number of days from the oldest date, a plurality of medical practices are deployed on the calendar 50b displayed on the pass screen G50.

  The present invention is not limited to the specifically disclosed embodiments, and various modifications and changes can be made without departing from the scope of the claims.

The following additional notes are further disclosed with respect to the embodiment including the above examples.
(Appendix 1)
In the clinical path creation support program at the time of hospitalization,
In response to input of a plurality of medical practice sets to be applied to a non-hospitalized patient, the plurality of medical practice sets are stored in a storage means;
Accepting designation of any medical practice set stored in the storage means;
Creating a clinical path that captures a part or all of the accepted medical practice set for the patient or a patient different from the patient;
A clinical path creation support program that causes a computer to execute processing.
(Appendix 2)
In the creation, when an instruction to expand the medical practice group is detected from a path screen that supports creation of a clinical path, the medical practice group stored in the storage unit is included in the medical practice group. Adjust each date of the scheduled medical practice based on the reference date specified when instructing the deployment to create set information,
When the created set information is received, the calendar displayed on the pass screen is caused to cause the computer to execute a process of starting the medical practice from the reference date and expanding the display every day to update the display of the calendar. The path creation support program according to appendix 1, which is characterized.
(Appendix 3)
When the change of the reference date from the start date of the calendar displayed on the pass screen to the date after the second disease day is detected, the start date of the scheduled medical practice is set to 2 of the displayed calendar. The path creation support program according to appendix 2, wherein the computer is configured to execute a process of setting the reference date changed after the sick day and developing the medical practice daily from the reference date according to the schedule .
(Appendix 4)
Setting the reference date as the start date in the schedule of medical practice, and shifting the date of each medical practice according to the schedule;
When a deployment instruction that selects one part from the medical practice group is detected, the computer is caused to execute a process of deploying one part of the selected medical practice group to the calendar according to the schedule every day. The path creation support program according to appendix 2 or 3.
(Appendix 5)
When the set information includes a medical action indicating that the creation of a clinical path managed by the development restriction master database is impossible with reference to the development restriction master database stored in advance in the storage unit, the path screen The path creation support program according to any one of appendices 2 to 4, which causes the computer to execute a process of outputting information indicating that the medical action cannot be developed on the calendar.
(Appendix 6)
When patient-specific data to be initialized at the time of deployment managed by the judgment master database is included in the set information with reference to the judgment master database stored in advance in the storage means, the patient in the set information The path creation support program according to any one of appendices 2 to 5, which causes the computer to execute processing for initializing unique data.
(Appendix 7)
A path creation support method executed by a computer,
In the clinical path creation support program at the time of hospitalization,
In response to input of a plurality of medical practice sets to be applied to a non-hospitalized patient, the plurality of medical practice sets are stored in a storage means;
Accepting designation of any medical practice set stored in the storage means;
Creating a clinical path that captures a part or all of the accepted medical practice set for the patient or a patient different from the patient;
A path creation support method characterized by that.
(Appendix 8)
Storage means for storing a plurality of medical practice sets in response to input of a plurality of medical practice sets to be applied to a non-hospitalized patient;
Accepting means for accepting designation of any medical practice set stored in the storage means;
A path creation support apparatus, comprising: a creation unit that creates a clinical path that includes a part or all of the received medical practice group for the patient or a patient different from the patient.

6a Pass appearance XML data 6b Style sheet 6c Pass screen data 9 Set development unit 11 CPU
12 Main storage device 13 Auxiliary storage device 14 Input device 15 Display device 16 Output device 17 Communication I / F
18 drives 19 storage media 31 set index DB
32 set DB
33 Expansion restriction master DB
34 Judgment master DB
35 Path Master Index DB
36 Path Master DB
40 path creation unit 41 path screen creation unit 42 selection unit 42a first set development selection unit 42b second set development selection unit 43 display update unit 100 path creation support device 130 storage unit

Claims (6)

In the clinical path creation support program at the time of hospitalization,
In response to input of a plurality of medical practice sets to be applied to a non-hospitalized patient, the plurality of medical practice sets are stored in a storage means;
Accepting designation of any medical practice set stored in the storage means;
Creating a clinical path that captures a part or all of the accepted medical practice set for the patient or a patient different from the patient;
A clinical path creation support program that causes a computer to execute processing. In the creation, when an instruction to expand the medical practice group is detected from a path screen that supports creation of a clinical path, the medical practice group stored in the storage unit is included in the medical practice group. Adjust each date of the scheduled medical practice based on the reference date specified when instructing the deployment to create set information,
When the created set information is received, the calendar displayed on the pass screen is caused to cause the computer to execute a process of starting the medical practice from the reference date and expanding the display every day to update the display of the calendar. The path creation support program according to claim 1, wherein: When the change of the reference date from the start date of the calendar displayed on the pass screen to the date after the second disease day is detected, the start date of the scheduled medical practice is set to 2 of the displayed calendar. 3. The path creation support according to claim 2, wherein the computer is configured to execute a process of setting the reference date changed after the sick day and developing the medical practice daily from the reference date according to the schedule. program. Setting the reference date as the start date in the schedule of the medical practice set, and shifting the date of each medical practice according to the schedule;
When a deployment instruction that selects one part from the medical practice group is detected, the computer is caused to execute a process of deploying one part of the selected medical practice group to the calendar according to the schedule every day. The path creation support program according to claim 2 or 3. A path creation support method executed by a computer,
In the clinical path creation support program at the time of hospitalization,
In response to input of a plurality of medical practice sets to be applied to a non-hospitalized patient, the plurality of medical practice sets are stored in a storage means;
Accepting designation of any medical practice set stored in the storage means;
Creating a clinical path that captures a part or all of the accepted medical practice set for the patient or a patient different from the patient;
A path creation support method characterized by that. Storage means for storing a plurality of medical practice sets in response to input of a plurality of medical practice sets to be applied to a non-hospitalized patient;
Accepting means for accepting designation of any medical practice set stored in the storage means;
A path creation support apparatus, comprising: a creation unit that creates a clinical path that includes a part or all of the received medical practice group for the patient or a patient different from the patient.

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