JP2014211780A - Clinical information display device and operation method of clinical information display device, and clinical information display program - Google Patents

Abstract

PROBLEM TO BE SOLVED: To make it possible to keep track of a medical treatment provided to a patient and a state of the patient.SOLUTION: A clinical information display device displays a plurality of pieces of vital sign data of a patient along a time axis in order of the time the data has been monitored, displays in timeline the period during which a medical treatment is continuously provided to the patient, and when the conditions of the treatment are changed, changes the display of the timeline so that the display before the time the conditions have been changed is different from display after the time the conditions have been changed.

Description

  The present invention is capable of confirming the patient's progress by comparing the time series graph representing vital sign data output from the biological information monitor and the medication, test results, and treatment performed on the patient such as continuous intravenous infusion. The present invention relates to a clinical information display device, a method for operating the clinical information display device, and a clinical information display program.

  When a patient is brought into an intensive care unit (ICU) of a medical institution such as a hospital, a biological information monitor is attached, and vital signs such as an electrocardiogram / heart rate, blood pressure, and body temperature are monitored over a long period of time. In addition, a catheter is inserted to administer the patient, and a continuous drug and regular / temporary drugs are administered through the catheter. Further, examinations such as blood gas analysis, treatment such as endotracheal intubation, and medical equipment such as a ventilator are attached as necessary. These treatments may be performed by the doctor himself, or may be performed by the nurse based on instructions from the doctor. In fact, when performing treatment, it is important to confirm the patient's past progress and treatment performed.

  Conventionally, doctors' instructions in the ICU and the current medication status and progress of the patient have been communicated in writing. In the document, a column was provided for each route of the catheter to be administered, and the progress so far was recorded, such as the type and amount of the drug to be administered, the current situation (whether administration was completed, administration continued, etc.). On the other hand, vital signs obtained from the biological information monitor are displayed on the screen in order to confirm the condition of the patient. However, it is important to be able to observe not only the patient's condition on the screen but also the relationship with medication. In view of this, there is one that makes it easy to observe the medication and the patient's condition by displaying the administration period of the drug using a bar under the patient's vital sign graph or the test result (for example, Patent Document 1).

JP-A-6-309384

  In particular, it is important that the patient in the ICU is in a serious condition, and when changes occur in the patient, the correspondence with the treatment performed on the patient can be immediately grasped. Cited Document 1 shows that the patient's condition can be confirmed by comparing the test result with the dosing period, but in the middle of changing the administered drug or changing the infusion rate of the infusion solution, etc. The treatment performed and the patient's condition could not be contrasted.

  The present invention has been made in view of the above circumstances, and the clinical information display apparatus and clinical information display apparatus that display a medical treatment procedure performed on a patient and a progress table so that the state of the patient can be grasped. It is an object to provide a method and a clinical information display program.

  The clinical information display device of the present invention displays one or more vital sign data of a patient along the time axis in the order of monitored time, and the time at which the examination data of one or more examination items of the patient is examined. A graph that displays at least one of the displays along the time axis in order and displays a timeline along the time axis for a period in which medical treatment is continuously performed on the patient. A display means, a condition change accepting means for accepting designation of a time on the timeline, and accepting that the condition of the treatment is changed from the designated time, and designated according to acceptance of the change of the condition Timeline display changing means for changing the display of the timeline so that the display after the time is different from the display before the specified time is provided.

  The operating method of the clinical information display device of the present invention is an operating method of a clinical information display device comprising a graph display means, a condition change accepting means, and a timeline display changing means, wherein the graph display means At least one of the display along the time axis in the order of the time when the one or more vital sign data was monitored, and the display along the time axis in the order of the time when the test data of the one or more examination items of the patient was examined A graph display step for displaying either one of them and displaying a period of time during which medical treatment is continuously performed on the patient in a timeline along the time axis; A condition change accepting step for accepting designation of a time on the line and accepting that the condition of the treatment is changed from the designated time; and a timeline display changing means, A timeline display change step for changing the display of the timeline so that the display after the specified time differs from the display before the specified time according to acceptance of the change of the condition is provided. Is.

  Furthermore, the clinical information display program of the present invention displays a computer along with a time axis in order of one or more vital sign data of a patient in the order of monitored time, and inspection data of one or more inspection items of the patient. Display at least one of the displays along the time axis in the order of the time of examination, and time along the time axis during which medical treatment is continuously performed on the patient A graph display means for displaying in a line, a condition change accepting means for accepting designation of a time on the timeline, and accepting a change in treatment condition from the designated time, and responding to acceptance of a change in condition To change the timeline display so that the display after the specified time and the display before the specified time are different. It is characterized in.

  “Display vital sign data along the time axis in the order of the monitored time” is not limited as long as the vital signs data can be confirmed in the order of the monitored time in the order of the monitored time. Also, numerical values may be displayed in order of time in a tabular format. In addition, the “display along the time axis in the order of the time when the inspection data of the inspection item is inspected” may be any display as long as the transition can be confirmed in the order of the time when the inspection data is inspected. Even if displayed, numerical values may be displayed in order of time in a tabular format.

  “Medical treatment” refers to treatment performed continuously for a predetermined period of time, and includes, for example, treatment with a medical device attached to the patient, such as administration of infusion or blood transfusion to the patient or artificial respiration.

  “Timeline” refers to a period from the start to the end of these treatments, and is displayed in accordance with the time on the time axis for displaying vital sign data or examination data. When a plurality of treatments are performed, a plurality of timelines are displayed corresponding to each treatment. When infusion or transfusion is administered, a timeline is displayed for each line determined corresponding to the catheter inserted into the patient's body. Further, one treatment is performed from the start to the end of administration of one infusion / blood, and one timeline is displayed corresponding to one treatment.

  The “time on the timeline” includes not only the time on the timeline displayed on the display screen but also the time from when the treatment is started to the time when the treatment is finished.

  The condition change accepting means may accept a time corresponding to a position indicated on the displayed timeline as a designated time.

  The “position indicated on the timeline” refers to a position specified by placing a pointer on the timeline displayed on the display screen using a pointing device such as a mouse.

  Further, the clinical information display device may include a time input receiving unit that receives time input, and the condition change receiving unit may receive the input time as a designated time.

  Further, the clinical information display device further includes a connection unit that connects to a medical device on which a treatment is performed, and a detection unit that detects that a treatment is started using the connected medical device, It is desirable that the display means detects that the treatment has been started by the detection means and starts displaying the timeline corresponding to this treatment.

  The clinical information display device further includes change information receiving means for receiving change information representing a change in conditions related to treatment from a medical device, and the condition change receiving means receives the change information by the change information receiving means. It is desirable to accept the designated time as the designated time.

  “Conditions relating to treatment” refers to what determines what kind of treatment is performed on a patient, and specifically includes setting values set in medical devices and operation modes of medical devices.

  When the graph display means displays a plurality of timelines corresponding to each of a plurality of different treatments performed on a patient, the clinical information display device displays a plurality of times displayed. The condition change accepting means accepts designation of the time on the timeline selected by the timeline selection accepting means, further comprising a timeline selection accepting means for accepting selection of one timeline of the lines, and It is desirable to accept the change of the treatment condition corresponding to the selected timeline.

  According to the present invention, changes in a plurality of vital sign data and examination data of a patient are displayed along a time axis, and a period during which medical treatment is continuously performed is displayed along the time axis. When the treatment condition is changed, the treatment condition is changed by changing the timeline display so that the display after the time when the condition is changed and the display before that time are different. It is possible to create a progress table showing the change of the patient that has occurred.

  In addition, when the treatment is performed using a medical device, the display of the timeline can be started at an accurate time by detecting that the treatment is started by connecting to the medical device. . Further, it is possible to save time and effort for manual input by a person.

  Furthermore, if the change information indicating the change of the condition regarding the treatment is received from the medical device, the time when the condition is changed can be accurately reflected on the timeline.

The figure which shows schematic structure of the medical information system to which the clinical information display apparatus by the 1st Embodiment of this invention is applied. Functional block diagram of the clinical information display apparatus according to the first embodiment of the present invention The flowchart which shows the flow of a process of the medical information system by the 1st Embodiment of this invention. Example of progress chart showing vital sign data and timeline represented by line graph (part 1) Example of progress table showing change and inspection timeline of inspection data Example of the flow rate change input screen The figure which shows schematic structure of the medical information system to which the clinical information display apparatus by the 2nd Embodiment of this invention is applied. Functional block diagram of a clinical information display device according to a second embodiment of the present invention The flowchart which shows the flow of a process of the medical information system by the 2nd Embodiment of this invention (the 1) Example of progress chart showing vital sign data and timeline expressed in line graph (Part 2) The flowchart which shows the flow of a process of the medical information system by the 2nd Embodiment of this invention (the 2) Example of setting value change input screen

  A first embodiment of a clinical information display device of the present invention will be described with reference to the drawings. FIG. 1 is a diagram showing a schematic configuration of a medical information system to which a clinical information display device according to an embodiment of the present invention is applied, and FIG. 2 is a functional block diagram of the clinical information display device in the present embodiment.

  As shown in FIG. 1, the medical information system 10 includes a bedside terminal 2A, a nurse station terminal 2B, a medical department terminal 2C, a biological information monitor 3, a medical information management server 5, an electronic medical record management server 6, and an examination room terminal 7. Are communicably connected via the network 8.

The biological information monitor 3 includes a measurement unit attached to a patient and a display device that displays vital sign data continuously acquired from the measurement unit, and has a function of monitoring patient vital sign data over a plurality of times. In addition, it has a function of issuing an alarm if necessary. Test items of the biological information monitor 3 include an electrocardiogram, heart rate, respiratory rate, body temperature, invasive blood pressure, non-invasive blood pressure, oxygen saturation (SpO ₂ ), etc., and an electrocardiogram electrode connected to the biological information monitor 3 Vital sign data is acquired from measurement units such as body temperature measurement probes, cuffs, and SpO ₂ measurement probes. Further, it is connected to the network 8 via the biological information monitor interface device 31, and vital sign data is transmitted to the medical information management server 5 in association with each patient ID. The vital sign data transmitted to the medical information management server 5 is stored in the medical information database 51 for each patient.

  The biological information monitor interface device 31 is constituted by, for example, a LAN conversion device or a server, and connects the biological information monitor 3 to the medical information management server 5 or each terminal via the network 8.

  The bedside terminal 2 </ b> A is placed near the patient's bed, connected to the medical information management server 5 via the network 8, and receives various information such as vital sign data of each patient from the medical information management server 5. The bedside terminal 2A is used for displaying a progress table such as a vital sign of the patient obtained by the biological information monitor 3 and inputting treatment information relating to a treatment performed on the patient such as administration of infusion and blood transfusion. The computer includes a display device that is a general display and an input device including a keyboard and a mouse. In addition to standard software such as an operating system, the bedside terminal 2A is installed with application software for viewing a patient progress table and inputting an executed procedure. Further, the medical information management server 5 is connected to the medical information management server 5 via the network 8, and the treatment information is transmitted to the medical information management server 5 in association with the patient ID and stored in the medical information database 51 for each patient.

  The nurse station terminal 2B is a computer that is placed in the nurse station and used to confirm patient information in the intensive care unit and instruction information given to the patient, and is a general display. And an input device including a keyboard and a mouse. The nurse station terminal 2B is connected to the medical information management server 5 via the network 8 and is also used for browsing the progress table of the patient who is entering the intensive care unit. The nurse station terminal 2B is installed with standard software such as an operating system and application software for browsing instruction information and a progress table issued to the patient.

  The medical department terminal 2C is a computer that is used for inputting medical information, a reading of an electronic medical record, an input of an examination order, etc. by which a doctor in the medical department examines a patient, a display device that is a general display, a keyboard, And an input device such as a mouse. Further, the medical department terminal 2C is connected to the medical information management server 5 via the network 8, and is used for browsing the instruction information and the progress table issued to the patient who enters the intensive care unit. . The medical department terminal 2C includes standard software such as an operating system, an application for inputting medical information, browsing an electronic medical record, inputting a test order, and viewing instruction information and a progress table issued to a patient. Software is installed respectively.

  The electronic medical record management server 6 is a computer including an electronic medical record database 61 in which electronic medical records are stored, and an operating system and database management software are incorporated therein. The electronic medical record management server 6 is connected to the bedside terminal 2A, the nurse station terminal 2B, and the medical department terminal 2C via the network 8, and medical information input from each medical department terminal 2C and the like is recorded in the electronic medical chart, Managed by the electronic medical record database 61.

  The inspection room terminal 7 is a computer that is placed in an inspection room in the ICU and used to acquire inspection data obtained from inspection of inspection items performed in the inspection room, and is a general display device. And an input device including a keyboard and a mouse. The inspection room terminal 7 incorporates software for inputting an inspection start in addition to standard software such as an operating system. The examination data is acquired from the examination room terminal 7 in association with the examination order and patient ID. Further, the medical information management server 5 also functions as a management server for examination data acquired by the laboratory terminal 7, and the entered examination data is stored in the medical information database 51.

  The medical information management server 5 is a computer including a medical information database 51, and an operating system and database management software are incorporated therein. The medical information management server 5 is connected to the bedside terminal 2A, the nurse station terminal 2B, the medical department terminal 2C, the electronic medical record management server 6, and the examination room terminal 7 via the network 8, and from each connected server and terminal, etc. Based on the patient ID, vital sign data, treatment information, examination data of various examinations, and the like of the patient are acquired and stored in association with the patient ID.

  As shown in FIG. 2, the clinical information display device 1 of the first embodiment includes a patient designation receiving means 21, a graph display means 22, a timeline selection receiving means 23, a time input receiving means 24, a condition change receiving means 25, And timeline display changing means 26.

  The bedside terminal 2A functions as the clinical information display device 1 in the present embodiment, and the clinical information display program according to the present embodiment is installed. By executing this clinical information display program, the bedside terminal 2A causes the patient designation receiving means 21, the graph displaying means 22, the timeline selection receiving means 23, the time input receiving means 24, the condition change receiving means 25, and the timeline display changing means. 26 functions. In the computer of the bedside terminal 2A, a clinical information display program may be installed from a recording medium such as a CD-ROM, or may be installed after being downloaded from a storage device of a server connected via a network.

  FIG. 3 shows a flowchart showing the processing flow of the medical information system 10 and the clinical information display device 1. With reference to FIGS. 1-3, the procedure at the time of displaying a progress table with the clinical information display apparatus 1 is demonstrated.

When a patient is brought into an ICU such as a hospital from an operation room or the like, the bed is determined and the bedside terminal 2A and the biological information monitor 3 are started up. First, the ECG electrode, cuff, SpO ₂ measurement probe, body temperature measurement probe, etc. of the biological information monitor 3 are attached to each part of the patient, and the electrocardiogram, heart rate, respiratory rate, body temperature, invasive blood pressure, non-invasive blood pressure, Monitoring of vital signs such as oxygen saturation (SpO ₂ ) is started (S1).

  Next, when the patient ID is input to the input frame displayed on the display screen of the bedside terminal 2A (S2), the input patient ID is received by the patient designation receiving means 21, and a progress table for the patient ID is received. Is displayed on the display screen.

  The graph display means 22 displays a plurality of vital signs data of the patient on the progress table in the order of the monitored time along the time axis, and medical treatment is continuously performed on the patient. The period is displayed on the timeline along the time axis. In addition, the transition of examination data of examinations conducted in the examination room is also important for grasping the patient's condition. Therefore, the graph display means 22 also displays the test data for the plurality of test items of the patient along the time axis in the order of the time tested in accordance with the time axis for displaying the vital sign data on the progress table.

  First, vital sign data monitored by the biological information monitor 3 is transmitted to the medical information management server 5 via the network 8, and the vital sign data corresponding to each patient ID is sent from the medical information management server 5 to the bedside terminal 2A. Sent (S3).

  The graph display means 22 generates a line graph in which the values of vital sign data are connected in the order of the time acquired by the biological information monitor 3, and displays it on the progress table (S4). In the laboratory, tests are performed using blood gas analyzers, biochemical analyzers, blood cell coefficient devices, etc., and inspection items such as pH, pO2, pCO2, K +, Na +, Ca ++, Cl-, Hb, Glu, Lac Is obtained and stored in the medical information management server 5. Therefore, the examination data of the examination items examined in the examination room corresponding to the patient ID is acquired from the medical information management server 5 (S5), and the values of the examination data are displayed in the order of the times examined by the graph display means 22. Is displayed on the progress table (S6). This table displays the numerical value of the inspection data by combining the time when the inspection data is acquired and the time on the time axis of the line graph of the vital sign data.

  Next, the nurse determines the location and number of catheters inserted into the patient's body. The screen of the bedside terminal 2A is switched to the display of the instruction book (instruction information) in which the instruction contents once instructed by the doctor are recorded, the infusion is set in the determined route, and the flow rate of the infusion pump or the syringe pump is adjusted. Then, the administration of the infusion is started. Again, the screen of the bedside terminal 2A is switched to the progress table, the drug name of the infusion and the route for administration are selected from the input screen (not shown), and the flow rate for administration is input (S7).

  When the input of the infusion administered from each route is completed, the graph display means 22 starts displaying the infusion timeline in accordance with the time axis of the line graph (S8). The vital sign data is transmitted from the biological information monitor 3 to the medical information management server 5 each time measurement is performed, and further transmitted from the medical information management server 5 to the bedside terminal 2A. Further, every time an examination is performed in the examination room, examination data associated with the patient ID is additionally stored in the medical information management server 5. The graph display unit 22 updates the line graph every time vital sign data is received. Also, the test data is acquired from the medical information management server 5 at predetermined time intervals, and the values are added to the table and displayed. Line graphs and tables will gradually expand to the side over time. In addition, the timeline also extends horizontally as time passes until the end of treatment is input (S12).

  In FIG. 4, each vital sign data is displayed in a line graph at the top of the screen with the horizontal axis as the time axis and the vertical axis as the monitor value axis. The example of the progress table which displayed the period when the infusion solution was administered to the patient from each of the line of one catheter by the timeline is shown.

  In FIG. 5, the numerical values of the examination data inspected in the laboratory are arranged in a table format along the time axis at the top of the screen, and the infusion is administered to the patient along the time axis at the bottom of the screen. An example of the progress table which displayed the period in the timeline is shown. Inverted numerical values in FIG. 5 are abnormal values. 4 and 5 show the transition of vital sign data up to the current time, the transition of inspection data, and the timeline.

  If necessary, the nurse changes the flow rate of the infusion pump or syringe pump of the infusion administered according to the patient's condition. When the change of the flow rate of the infusion is completed, the nurse changes the flow rate of the timeline in the progress table from the display screen of the bedside terminal 2A. Alternatively, before changing the flow velocity, it may be set to change the flow velocity in the timeline of the progress table at the scheduled time.

  First, a timeline corresponding to the infusion with the flow rate changed is selected from a plurality of timelines in the displayed progress table with a mouse or the like (S9). FIG. 6 shows a state where the top timeline is selected from the three timelines. A pull-down menu is displayed near the selected timeline.

  The timeline selection accepting unit 23 accepts that the top timeline is selected from the plurality of timelines displayed in the progress table (S9-YES).

  Furthermore, when “change flow velocity” is selected from the pull-down menu of FIG. 6, a flow velocity change input screen D1 is displayed, and it becomes possible to input a time for changing the flow velocity and the flow velocity. On the flow velocity change input screen D1, a time such as the current time, 10 minutes before or 10 minutes after the current time is input as the flow velocity change time. The time input reception means 24 receives the change time input from the flow velocity change input screen D1.

  Further, when the flow velocity is input from the flow velocity change input screen D1, the condition change receiving means 25 receives the change time input from the flow velocity change input screen D1 as the time when the change of the treatment condition is designated and is input. The flow rate is accepted as a treatment change condition corresponding to the selected timeline (S10). If the treatment is to administer infusion / blood from the catheter, the conditions to be changed include changing the flow rate, continuing (when the bottle of the drug being administered is gone, the same drug bottle is replaced with a new bottle) Continue administration by exchanging) and administration route change.

  Subsequently, the timeline display changing means 26 displays the designated time by changing the color of the timeline selected before and after that time (S11). If the specified time is the current time, the color is changed from the end point of the selected lime line. If the specified time is before the current time, the color is changed from the specified time slightly before the end point of the already displayed timeline. Alternatively, if the specified time is later than the current time, the timeline is extended without changing the color until the specified time is reached, and the color is changed when the specified time is reached ( S12). Furthermore, the changed condition such as the changed flow velocity value is displayed near where the color of the timeline has changed. In addition, since all the current administration conditions cannot be displayed near the timeline, when a timeline is selected with a mouse or the like, a window may be opened to display all administration conditions.

  When the next condition change is not input (S9-NO), the timeline continues to be displayed as it is in the currently designated color (S12).

  Here, the time line of line 2 in FIG. 4 will be specifically described. FIG. 4 shows that the color changes when the hatching is changed for convenience. Line 2 continues the administration by setting a new bottle of infusion without changing the flow rate from “6.6 ml / h” at time 5:15, and the flow rate from “6.6 ml / h” to “3.9” at time 8:30. The flow rate was changed from “3.9 ml / h” to “2.6 ml / h” at time 12:00.

  The color on the timeline may be changed when the condition changes, but a color corresponding to the changed condition may be determined and changed to a color according to the condition. Changing the color makes it easy to see where the condition has changed, and makes it easy to understand the correspondence with vital sign data and other inspection data.

  Or, instead of changing the color of the timeline, the line type of the timeline or the pattern may be changed so that the display after the specified time is different from the display before the specified time. .

  Here, the case where the time is input from the flow velocity change input screen D1 has been described. However, the condition change accepting unit 25 can change the condition as it is at the time corresponding to the position indicated on the timeline using a mouse or the like. It may be accepted as the designated time, and only the condition for changing the flow velocity or the like may be input from the flow velocity change input screen D1.

  As described above in detail, at the bedside terminal 2A, it is possible to confirm the time at which the conditions of the treatment performed on the patient, such as administration of an infusion solution, are changed along with changes in vital sign data and test data. is there. Thereby, it becomes easy to recognize the relationship between the change in the patient's condition and the condition under which the treatment is performed, and it can be connected to an appropriate treatment.

  In the first embodiment, the clinical department terminal 2C and the nurse station terminal 2B receive vital sign data, examination data, treatment information, and the like from the medical information management server 5 via the network 8, so that The progress table may be displayed on the department terminal 2C or the nurse station terminal 2B. Thereby, it becomes possible to grasp the patient's condition even at a terminal remote from the patient.

  Next, a second embodiment of the clinical information display apparatus of the present invention will be described with reference to the drawings. FIG. 7 shows a schematic configuration of a medical information system to which a clinical information display device according to an embodiment of the present invention is applied. FIG. 8 shows a functional block diagram of the clinical information display device in the present embodiment. This embodiment demonstrates the case where the state which has mounted | wore the patient with the medical device is displayed on a timeline. The same components as those of the above-described embodiment are denoted by the same reference numerals, detailed description thereof is omitted, and only different components are described in detail.

  As shown in FIG. 7, the medical information system 10a includes a bedside terminal 2A, a nurse station terminal 2B, a medical department terminal 2C, a biological information monitor 3, a medical device 4, a medical information management server 5, an electronic medical record management server 6, and The examination room terminal 7 is configured to be communicably connected via the network 8.

  Medical devices 4 include ventilators, dialysis machines, intra-aortic balloon pumping (IABP), percutaneous cardiopulmonary assist devices (PCPS), extracorporeal circulation devices (IABP, PCPS), membrane oxygenators (ECMO extracorporeal membrane oxygenation) ), Pacemakers, etc., but the case where the medical device is a ventilator will be described.

  The ventilator 4 is attached to a patient via a mask, an intubation tube, or the like, and assists the patient's breathing. The operation modes of the ventilator 4 are CMV (Continuous mandatory ventilation), IPPV (intermittent positive pressure ventilation), SIMV (Synchronized intermittent mandatory ventilation), PSV ( There are multiple modes such as Pressure support ventilation, CPAP (Continuous positive airway pressure), BIPAP (Biphasic positive airway pressure), etc., which are selected according to the patient's condition. Also, set values such as FiO2 (oxygen concentration), PS (Pressure support), PEEP (positive end expiratory pressure), f (ventilation frequency), and PC (inspiratory pressure) appropriate for the ventilator 4 depending on the patient's physique and pathology Is set.

  The ventilator 4 is connected to a connecting portion (not shown) in the bedside terminal 2A of the present embodiment. The bedside terminal 2A transmits the setting value of the ventilator 4 and the like as treatment information to the medical information management server 5 in association with the patient ID, and the treatment information is stored in the medical information database 51 for each patient. Since the bedside terminal 2A is substantially the same as that of the first embodiment except that the artificial respirator 4 is connected, detailed description thereof is omitted.

  As shown in FIG. 8, the clinical information display device 1a according to the second embodiment includes a patient designation receiving unit 21, a graph displaying unit 22a, a time input receiving unit 24a, a condition change receiving unit 25a, and a timeline display changing unit 26. , Connecting means 27, detecting means 28, and change information receiving means 29.

  The bedside terminal 2A functions as the clinical information display device 1a in the present embodiment, and the clinical information display program according to the present embodiment is incorporated. By executing this clinical information display program, the bedside terminal 2A detects the patient designation reception means 21, the graph display means 22a, the time input reception means 24a, the condition change reception means 25a, the timeline display change means 26, the connection means 27, and the detection. Functions as means 28 and change information receiving means 29. In the computer of the bedside terminal 2A, a clinical information display program may be installed from a recording medium such as a CD-ROM, or may be installed after being downloaded from a storage device of a server connected via a network.

  FIG. 9 shows a flowchart showing the processing flow of the medical information system 10a and the clinical information display device 1a. With reference to FIGS. 7-9, the procedure at the time of displaying a progress table with the clinical information display apparatus 1a is demonstrated.

  When a patient is brought into an ICU such as a hospital from an operation room or the like, the bed is determined and the bedside terminal 2A and the biological information monitor 3 are started up. First, the vital sign monitor 3 is attached to each part of the patient, and vital sign monitoring is started (S21). In addition, the ventilator 4 attached to the patient is connected to the connecting portion of the bedside terminal 2A, and data is transmitted and received by the connecting means 27 of the bedside terminal 2A.

  The connecting means 27 has a communication function for connecting to a medical device such as a ventilator to be treated, and transmits and receives data via the connecting portion of the bedside terminal 2A.

  Next, when the patient ID is input to the input frame displayed on the display screen of the bedside terminal 2A (S22), the input patient ID is received by the patient designation receiving means 21, and the progress table for the patient ID is received. Is displayed on the display screen. The vital sign data monitored by the biological information monitor 3 is transmitted to the medical information management server 5 via the network 8, and further transmitted from the medical information management server 5 to the bedside terminal 2A (S23).

  First, the graph display means 22 generates a line graph in which the values of vital sign data are connected in the order of the time acquired by the biological information monitor 3, and displays it on the progress table (S24). Also. The examination data of the examination item examined in the examination room corresponding to the patient ID is acquired from the medical information management server 5 (S25), and the values of the examination data are passed in the order of the examination time in the graph display unit 22 Display in the table (S26).

  The doctor attaches a mask, an intubation tube, etc. to the patient, selects an operation mode, sets an appropriate set value for the ventilator 4 according to the patient's physique and pathological condition, and starts the operation of the ventilator 4.

  The detection means 28 receives a signal indicating that the ventilator 4 has started operating from the connection means 27, and detects that treatment by the ventilator 4 has been started (S27).

  When the graph display means 22 detects the start of operation of the ventilator 4 from the detecting means 28, the graph display means 22 starts displaying the timeline of the ventilator 4 in accordance with the time axis of the line graph (S28). The vital sign data is transmitted from the medical information management server 5 to the bedside terminal 2A every time measurement is performed. Further, every time an examination is performed in the examination room, examination data associated with the patient ID is additionally stored in the medical information management server 5. The graph display unit 22 updates the line graph every time vital sign data is received. Also, the test data is acquired from the medical information management server 5 at predetermined time intervals, and the values are added to the table and displayed. Line graphs and tables will gradually expand to the side over time. Further, the timeline also extends sideways with time until the ventilator 4 stops (S32).

  In FIG. 10, at the top of the screen, the horizontal axis is the time axis and the vertical axis is the axis of the test value, the test data of each test item is displayed in a line graph, and the artificial respiration is aligned with the time axis below the line graph. The example of the progress table which displayed the period when the device 4 is mounted | worn with the patient on the timeline is shown. Moreover, the set value of the ventilator 4 is displayed together with the timeline. Furthermore, the numerical value of the inspection data inspected in the laboratory is displayed in a tabular form in the lowest level, and the time on the time axis and the time at which each inspection data is acquired are displayed so as to match.

  If necessary, the doctor changes the set value of the ventilator 4 according to the condition of the patient.

  The change information receiving means 29 receives change information indicating that the setting value or mode has been changed from the ventilator 4 connected to the connecting means 27 (S29-YES). When the treatment is performed by the medical device, the condition to be changed includes a setting value and a mode of the medical device, and the change information includes information related to a mode change of the ventilator, a change of the setting value, and the like.

  Further, the condition change accepting unit 25a accepts the condition changed from the change information and accepts the time when the change information is received as the designated time (S30).

  Subsequently, the timeline display changing means 26 displays the timeline when the change information is received, changing the color of the timeline selected before and after that time (S31). Further, the changed condition such as the set value changed near the place where the color of the timeline has changed is displayed (S32). Also, since it is not possible to display all the current modes and settings near the timeline, selecting a timeline with the mouse etc. will open a window and display all the modes and settings set on the ventilator You may make it do.

  Until the next change information is received (S29-NO), the timeline continues to display the current color as it is (S32).

  Here, the timeline of FIG. 10 will be specifically described. FIG. 10 shows that the color changes when the hatching is changed for convenience. At 0:30, the mode of the ventilator 4 is not changed, the setting values of FiO2 (0.4-> 0.5), PS (15-> 12), PC (15-> 13) are changed, and time 7:00 The mode (SIMV-> PVS) and FiO2 (0.5-> 0.3) settings have been changed. Furthermore, the set value of PS (12-> 11) is changed at time 9:50.

  In the above description, the case where the signal is received from the ventilator connected to the connection part of the bedside terminal 2A and the display of the timeline is changed has been described. However, the setting value of the ventilator is input from the input screen. May be.

  FIG. 11 is a flowchart showing a processing flow of the medical information system 10a and the clinical information display device 1a when the set value of the ventilator is input from the input screen.

  S21 to S28 perform the same processing as described above. When the timeline is selected with a mouse or the like, a pull-down menu is displayed as shown in FIG. 12 (S33). Further, when “setting change” is selected from the pull-down menu of FIG. 12, a setting value change input screen D2 is displayed, and the ventilator mode and the setting value can be input. Further, the change time is input on the set value change input screen D2.

  The time input accepting unit 24 accepts an input of the time to be changed from the set value change input screen D2. Further, the condition change accepting means 25 accepts the time input on the set value change input screen D2 and the input mode and set value as change conditions (S34).

  Further, the timeline display changing means 26 displays the timeline input on the set value change input screen D2 with the color of the timeline selected before and after that time changed (S35).

  If the timeline is not selected (S33-NO), the display continues as it is with the currently designated color (S36).

  As described above in detail, at the bedside terminal 2A, it is possible to confirm the time when the setting conditions of the medical device such as a ventilator are changed along with the change of vital sign data and other examination data. Thereby, it becomes easy to recognize the relationship between the change in the patient's condition and the setting of the medical device, which can lead to an appropriate treatment.

  Also in the second embodiment, the clinical department terminal 2C and the nurse station terminal 2B receive vital sign data, examination data, treatment information, etc. from the medical information management server 5 via the network 8, The progress table may be displayed on the medical department terminal 2C or the nurse station terminal 2B. Thereby, it becomes possible to grasp the patient's condition even at a terminal remote from the patient.

  In the above, the case where the vital sign data is represented by a line graph and the numerical value of the examination data of the examination performed in the laboratory is represented in a tabular form has been described. However, the vital sign data is represented in a table form and the examination performed in the laboratory. The inspection data may be represented by a line graph. The display of the line graph and the table format may be any combination, and the display of the line graph and the table format may be switched as necessary.

  In the above, the case of displaying the value of vital sign data along with the timeline, the value of the examination data of the examination conducted in the laboratory, and the setting value of the ventilator has been explained, but special treatment, nursing article, nurse The observation items observed by the user, the treatment performed by the nurse, and the like may be input in accordance with the time axis and displayed together with the timeline on the progress table. These combinations can be displayed together with the timeline in various combinations depending on the setting.

  Note that the present invention is not limited to this embodiment, and some or all of the constituent elements of the clinical information display device may be configured by one computer, and may be one or more connected via a network. It may be constituted by a computer, a server, and a storage device. Each device is controlled by a program for creating a graph according to the present specification installed from a recording medium such as a CD-ROM. The program may be installed after being downloaded from a storage device of a server connected via a network.

DESCRIPTION OF SYMBOLS 1, 1a Clinical information display apparatus 2A Bedside terminal 2B Nurse station terminal 2C Medical department terminal 3 Biological information monitor 4 Medical equipment 5 Medical information management server 6 Electronic medical record management server 7 Examination room terminal 8 Network 10, 10a Medical information system 21 Patient Designation receiving means 22, 22a Graph display means 23 Timeline selection receiving means 24, 24a Time input receiving means 25, 25a Condition change receiving means 26 Timeline display changing means 27 Connection means 28 Detection means 29 Change information receiving means 31 Biological information monitor Interface device 51 Medical information database

Claims (8)

One or more vital sign data of the patient is displayed along the time axis in the order of the monitored time, and the test data of the one or more examination items of the patient is displayed along the time axis in the order of the examined time. Graph display means for displaying at least one of the above and displaying a period in which medical treatment is continuously performed on the patient on a timeline along the time axis;
Condition change accepting means for accepting designation of time on the timeline and accepting that the condition of the treatment is changed from the designated time;
Clinical information comprising timeline display changing means for changing the display of the timeline so that the display after the specified time differs from the display before the specified time in response to acceptance of the change of the condition Display device.   The clinical information display apparatus according to claim 1, wherein the condition change accepting unit accepts a time corresponding to a position indicated on the displayed timeline as the designated time. A time input receiving means for receiving time input;
The clinical information display apparatus according to claim 1, wherein the condition change accepting unit accepts the input time as the designated time. Connection means for connecting to a medical device on which the treatment is performed;
And further comprising detection means for detecting that the treatment is started using the connected medical device,
The said graph display means detects that the said treatment was started by the said detection means, and starts the display of the timeline corresponding to this treatment, The Claim 1 characterized by the above-mentioned. Clinical information display device. Further comprising change information receiving means for receiving change information representing a change in conditions relating to the treatment from the medical device,
The clinical information display apparatus according to claim 4, wherein the condition change accepting unit accepts the time when the change information is received by the change information receiving unit as the designated time. The graph display means displays a plurality of timelines corresponding to each of a plurality of different treatments performed on the patient;
A timeline selection accepting unit for accepting selection of one timeline among the plurality of displayed timelines;
The condition change accepting means accepts designation of a time on the timeline selected by the timeline selection accepting means, and accepts changing a treatment condition corresponding to the selected timeline. The clinical information display device according to any one of claims 1 to 5, wherein A method for operating a clinical information display device comprising a graph display means, a condition change accepting means, and a timeline display change means,
The graph display means displays one or more vital sign data of the patient along the time axis in the order of the monitored time, and the time axis in the order of the time of the examination data of the one or more examination items of the patient. A graph display that displays at least one of the displays along the line and displays a timeline along the time axis during which medical treatment is continuously performed on the patient Steps,
A condition change accepting step, wherein the condition change accepting unit accepts designation of a time on the timeline, and accepts that the condition of the treatment is changed from the designated time;
A timeline display in which the timeline display changing unit changes the display of the timeline so that the display after the specified time and the display before the specified time differ depending on acceptance of the change of the condition A method for operating a clinical information display device comprising a change step. Computer
One or more vital sign data of the patient is displayed along the time axis in the order of the monitored time, and the test data of the one or more examination items of the patient is displayed along the time axis in the order of the examined time. Graph display means for displaying at least one of the above and displaying a period in which medical treatment is continuously performed on the patient on a timeline along the time axis;
Condition change accepting means for accepting designation of time on the timeline and accepting that the condition of the treatment is changed from the designated time;
Clinical function for functioning as timeline display changing means for changing the display of the timeline so that the display after the specified time is different from the display before the specified time in response to acceptance of the change of the condition Information display program.