JP2015197733A - Clinical path creation support device, method, and program - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a clinical path creation support device capable of quickly contributing to the creation of a clinical path.SOLUTION: A clinical path creation support device performs the primary narrowing-down processing of events executable on a clinical path to be newly created on the basis of the disease/injury name of a patient, and performs secondary narrowing-down processing for further narrowing down the events narrowed down by the primary narrowing-down processing on the basis of patient attribute information indicating patient-specific attributes. The events left behind after the two-stage narrowing-down based on the disease/injury name and the patient attribute information are displayed on a clinical path creation screen as the candidates of the events configuring the clinical path to be newly created, and the new clinical path is created by selecting any of those candidates.

Description

  The present invention relates to a clinical path creation support apparatus, method, and program for supporting creation of a clinical path.

  In recent years, clinical institutions have been introducing clinical paths. The clinical path indicates a medical plan until reaching the target state. By performing medical treatment according to the clinical path, the medical treatment contents are standardized, and the understanding level of medical staff and patients can be increased. Thereby, in a medical institution, the stable high quality medical treatment becomes possible. In addition, patients can receive medical care with peace of mind.

  On the other hand, there are various forms of clinical paths, such as those composed of only one medical practice and those including a combination of a plurality of medical practice. In addition, there are many candidates for each medical practice. For this reason, when generating a clinical path, it is necessary to appropriately select one or a plurality of candidates from an enormous number of candidates, which is troublesome.

  As a configuration for reducing such labor, for example, Patent Document 1 below describes a configuration in which when a disease name is input, a plurality of types of action plans (clinical paths) corresponding to the disease name are output. In this way, if the candidates to be selected when creating the clinical path are narrowed down by the disease name, the labor for creating the clinical path can be reduced.

JP 2009-076102 A

  However, in Patent Document 1, it is difficult to say that the candidates are sufficiently narrowed down. In other words, even if the disease name is the same, the treatment plan will differ depending on the patient's age, gender, pre-existing condition, and health condition (current disease, vital information, etc.), so select when creating a clinical path The candidates to be targeted also differ. Furthermore, the treatment plan will differ depending on whether advanced medical methods are used, whether generic drugs are used, whether or not a medical method that has a large expected effect but a high risk is used, and is the same as described above. The candidates to be selected when creating a clinical path are different. Thus, even if the disease names are the same, the forms of clinical paths are diverse, and the number of individual medical practice candidates that cover all of these is still enormous. That is, if a candidate to be selected is narrowed down by disease name when creating a clinical path, an enormous number of candidates still remain.

  The present invention has been made in view of the above background, and patient-specific attributes (age and sex, pre-existing condition, health condition, propensity (whether advanced medical methods are preferred, generic drugs are preferred, Contributes to the speed of clinical path creation by narrowing down candidates to be selected when creating a clinical path based on patient attribute information that represents the degree of resistance to high-risk medical treatment methods))) It is an object of the present invention to provide a clinical path creation support apparatus, method, and program that can be used.

  In order to achieve the above object, a clinical path creation support apparatus according to the present invention is a candidate that stores a plurality of candidate components constituting a clinical path in the clinical path creation support apparatus that supports the creation of a clinical path indicating a medical plan. A first narrowing-down unit that narrows down candidates by extracting candidates that match a condition from candidates stored in the candidate storage unit, based on injury and illness information that represents the patient's injury and disease, and patient-specific A second refinement unit that refines candidates by extracting candidates that match the conditions from candidates extracted by the primary refinement unit based on patient attribute information representing the attributes of the second refinement unit, and a second refinement unit And an output unit that outputs the extracted candidates.

  The patient attribute information may include at least one of the patient's age, sex, pre-existing condition, health condition, and propensity.

  The health condition may include at least one of a wound currently affected by the patient and vital information of the patient.

  The propensity may include at least one of a degree of interest regarding advanced medical care, a degree of avoidance regarding risks associated with medical care, and a degree of interest regarding the use of generic drugs.

  The patient attribute information may include kinship attribute information indicating attributes specific to the kinship of the patient.

  The output unit may be a distribution unit that distributes candidates to a terminal via a network, or a display unit that displays candidates on a screen.

  The candidate output from the output unit may be displayed on a clinical path creation screen for creating a clinical path.

  The candidate corresponds to the medical practice, and the clinical path creation screen includes a medical practice input area for inputting the medical practice, and the candidate output from the output unit is displayed in the medical practice input area. It may be a thing.

  The medical practice and the candidates corresponding to each medical practice are classified into a plurality of types of categories, a plurality of clinical practice input areas are provided according to the categories, and the candidates output from the output unit correspond to the types of categories. It may be displayed in a menu format in the medical practice input area.

  The category may include at least one of diagnosis, examination, treatment, and aftercare.

  A patient attribute information storage unit that stores patient attribute information may be provided.

  In order to achieve the above object, the clinical path creation support method according to the present invention includes a candidate path storing apparatus that stores a plurality of candidate constituent elements that constitute a clinical path indicating a medical plan. In the clinical path creation support method for supporting the creation of the clinical path based on the components stored in the unit, the first narrowing unit provided in the clinical path creation device is a candidate based on the wound information representing the patient's wound A primary narrowing step for narrowing candidates by extracting candidates that match a condition from candidates stored in the storage unit, and a second narrowing unit provided in the clinical path creation support device include patient-specific Based on patient attribute information that represents attributes, candidates that match the conditions are extracted from the candidates extracted in the first refinement step. A second narrowing step for narrowing down candidates, and an output unit provided in the clinical path creation support apparatus includes an output step for outputting candidates extracted in the secondary narrowing step It is said.

  In order to achieve the above object, the clinical path creation support program of the present invention provides a clinical path based on components stored in a candidate storage unit that stores a plurality of candidates for components constituting a clinical path indicating a medical plan. In the clinical path creation support program that supports path creation, candidates are narrowed down by extracting candidates that match the conditions from candidates stored in the candidate storage unit based on the wound information indicating the patient's wounds and sickness. Based on the primary narrowing-down step and patient attribute information representing patient-specific attributes, the candidates are narrowed down by extracting candidates that match the conditions from the candidates extracted in the primary narrowing-down step. The next narrowing step and an output step for outputting the candidates extracted in the second narrowing step are sent to the computer. It is characterized in that to the row.

  Since the present invention narrows down candidates to be selected when creating a clinical path based on patient attribute information representing patient-specific attributes, it can contribute to speeding up the creation of a clinical path.

It is the schematic which shows the structure of a medical assistance system. It is explanatory drawing which shows the data system of a clinical path. It is explanatory drawing which shows the state by which the clinical path | pass was displayed. It is explanatory drawing which shows patient information. It is explanatory drawing which shows an event list. It is a block diagram which shows the structure of an application server. It is a functional block diagram of an application server. It is explanatory drawing which shows a clinical path creation screen. It is explanatory drawing which shows a clinical path creation screen. It is a flowchart which shows the narrowing-down procedure of an event. It is explanatory drawing which shows the candidate narrowed down by the primary narrowing down by a wound disease name.

  In FIG. 1, the medical support system 10 includes a clinical path creation support device 12 that supports creation of a clinical path 26 (see FIGS. 2 and 3) indicating a medical treatment plan until reaching a target state. Medical treatment includes examination, examination, treatment (surgery, medication), aftercare (postoperative examination, rehabilitation), etc. (clinical examination, examination, treatment (surgery, medication), aftercare ( Categorized into multiple categories such as postoperative examination, rehabilitation)).

  A terminal 16 of a user of the medical support system 10 is connected to the clinical path creation support apparatus 12 via a network 14 such as the Internet. The clinical path creation support apparatus 12 distributes (outputs) an operation screen such as a GUI (Graphical User Interface) to the terminal 16 via the network 14, and creates the clinical path 26 according to the operation instruction input from the terminal 16 through the operation screen. To help.

  The terminal 16 has a function of connecting to the network 14, an input unit such as a keyboard and a mouse, and a display unit such as a liquid crystal display (or a touch panel type display that serves as both the input unit and the display unit). And well-known electronic devices such as laptop computers, tablet terminals, mobile phones and smartphones. These terminals 16 are used by the user of the medical support system 10. Note that the users of the medical support system 10 are medical staffs such as doctors in charge of medical care for patients, nurses, laboratory technicians, and pharmacists.

  The clinical path creation support device 12 is installed in, for example, an operating company that operates the medical support system 10. The clinical path creation support apparatus 12 includes an application server 17 that executes various functions such as operation screen distribution and clinical path 26 creation support in accordance with an application program (AP) 30 (see FIG. 6) described later, a clinical path DB 18, and a patient. An information DB (patient attribute information storage unit) 19 and an event DB (candidate storage unit) 20 are connected to each other via a network 22 such as a LAN.

  As shown in FIGS. 2 and 3, the clinical path DB 18 created by the clinical path creation support apparatus 12 is stored in the clinical path DB 18. The clinical path 26 includes patient identification information (patient name, patient ID, etc.) for identifying a patient to be treated, medical treatment contents (title) of the clinical path 26 as a whole, and individual medical treatments constituting the clinical path 26 ( (Event) contents, schedule, time, place, equipment used, person in charge, and various information such as event information indicating a target to be reached. 2 shows a system of data constituting the clinical path 26, and FIG. 3 shows a state displayed on the display in order to view the clinical path 26.

  As shown in FIG. 4, patient information 24 relating to a patient is stored in the patient information DB 19. The patient information 24 is associated with patient identification information for identifying a patient such as a patient name and patient ID, patient contact information (address, telephone number, e-mail address), and patient attribute information indicating patient-specific attributes. It has been done.

  As patient attribute information, patient age, sex, past illness, health condition, propensity, and relative attribute information indicating attributes specific to the patient's relative are stored. In addition to past illness history, allergy information indicating the presence or absence of various allergies and the like are stored as past illnesses. Further, as the health state, for example, the latest values such as body temperature, blood pressure, and pulse rate, average values, history, and the like are stored as vital information of the patient. Note that doctor evaluation information (for example, health status “good” or “bad”) based on the vital information described above may be stored as the health status. Moreover, you may memorize | store the information regarding the illness and illness which suffers now as a health condition.

  In addition, as for propensity, information indicating the degree of interest in advanced medical care (advanced medical interest), information indicating the degree of refrain from risk associated with medical treatment (risk refusal), and the use of generic drugs (generic drugs) Information indicating patient preferences, such as information indicating the degree of interest (degree of interest in generic drugs), is stored.

  In the present embodiment, “A” is stored as the advanced medical interest level when advanced medical treatment is desired, “B” when neither is desired, and “C” when neither is desired. Similarly, “A” is stored as the risk aversion, “B” when the risk is avoided, “B” when neither is stored, and “C” when not. In addition, “A” is stored as the generic drug interest level when the generic drug is desired, “B” when neither is desired, and “C” when not desired.

  In addition, relative attribute information includes past history of the patient's relatives (such as injury history and allergy information), propensity (information indicating the degree of interest in advanced medical care, information indicating the degree of refusal regarding risks associated with medical care, Information indicating the preference of the patient's relatives, such as information indicating the degree of interest regarding the use of generic drugs.

  The patient information 24 is distinguished for each patient, and patient information for one patient is generated in a patient registration process performed at the first use (at the first medical examination) of the medical support system 10 and stored in the patient information DB 20 (new). be registered. In the patient registration process, input of information necessary to generate the patient information 24 is requested. The information necessary for generating the patient information is obtained by, for example, performing a questionnaire to the patient and inputting the medical staff who collected the questionnaire by operating the terminal 16 or causing the patient to operate the terminal 16 by the medical staff. Entered.

  In addition, information that has not been input in the patient registration process and information obtained after the patient registration process can be input as soon as the information is obtained. When the information is input, the patient information 24 is updated accordingly. In addition, relative attribute information may be input automatically as relative attribute information by extracting relative information that matches the input name from patient information 24 by inputting a relative name or the like. The medical staff or the patient himself / herself may input based on the questionnaire to the patient.

  As shown in FIG. 5, the event DB 20 lists a plurality of events that are candidates for medical treatment (events) when a clinical path 26 is newly created (candidates of components constituting the newly created clinical path 26). A converted event list 28 is stored.

  In the event list 28, all events that can constitute the clinical path 26 are stored, and the names (contents) of the events and all the injuries and events in which the events may be implemented are stored in the respective events. Name (injury information), category to which each event belongs (diagnosis, examination, treatment (surgery, medication treatment), aftercare (postoperative examination, rehabilitation)), and patient attribute information The matching information for determination is associated.

  The conformance information defines conditions for a patient who can perform an event, and a plurality of conditions are defined corresponding to the type of patient attribute information. In the present embodiment, the patient attribute information includes age, sex, pre-existing disease, health condition, propensity, and relative attribute information, and the conformity information includes an age condition indicating a range of age, a sex condition indicating a gender, and a pre-existing condition indicating a pre-existing condition. , A health condition condition indicating a health condition, a tendency condition indicating a tendency, and a relative attribute condition indicating a relative attribute.

  Specifically, as the age condition, for example, any condition that can be performed on a patient who is 15 years old or older and less than 85 years old is defined. In addition, as sex conditions, for example, any conditions that can be implemented for male patients are defined. Further, as the pre-existing condition, for example, any condition that can be performed on a patient who has no history of the occurrence of a predetermined disease is defined. In addition, as the health condition, for example, any condition that can be performed on a patient having a predetermined blood pressure or less is defined. Furthermore, as the propensity condition, for example, any condition applicable to a patient whose advanced medical interest level is “A” is defined. In addition, as a relative attribute condition, for example, which condition is applicable to a patient who does not have a relative who has an allergic reaction to a specific drug.

  As shown in FIG. 6, the application server 17 is configured by installing a control program such as an operating system and an AP 30 for causing the computer to function as the application server 17 based on a computer such as a personal computer or a workstation.

  The application server 17 includes a storage device 32, a memory 34, a CPU 36, and a communication I / F 38, which are connected via a data bus 40. The storage device 32 is, for example, a hard disk drive, and is an internal storage built in the main body of the application server 17. The storage device 32 stores a control program, AP 30 such as application server software, images and messages displayed when the AP 30 is executed, display data 42 for displaying various operation screens, and the like. .

  The memory 34 is a work memory for the CPU 36 to execute processing. The CPU 36 centrally controls each part of the computer by loading a control program stored in the storage device 32 into the memory 34 and executing processing according to the program. The communication I / F 38 is provided with an interface for communicating with the networks 14 and 22, and the application server 17 is connected to the clinical path DB 18, the patient information DB 19, and the event via the networks 14 and 22 via the communication I / F 38. It communicates with the DB 20 and the terminal 16.

  The AP 30 is a program for causing a computer to execute various functions. The CPU 36 centrally controls each unit of the computer by loading the AP 30 stored in the storage device 32 into the memory 34 and executing processing according to the program.

  As shown in FIG. 7, when the AP 30 is activated, the CPU 36 cooperates with the memory 34 as a clinical path creation unit (output unit, distribution unit) 50, a primary narrowing unit 52, and a secondary narrowing unit 54. Function. The clinical path creation unit 50 delivers the clinical path creation screens 56 and 58 (see FIGS. 8 and 9) to the user terminal 16. The clinical path creation screens 56 and 58 are operation screens for newly generating a clinical path, and are sequentially distributed according to the progress of the clinical path creation work.

  The clinical path creation screen 56 shown in FIG. 8 is a clinical path creation screen that is initially distributed with the activation of the AP 30 (first output and displayed on the display of the terminal 16). A patient identification information input field 62 is provided.

  The wound name input field 60 is an input field for inputting a wound name to be treated by a newly generated clinical path, and the user can input the wound name into the wound name input field 60 by operating the terminal 16. . When the injury / illness name is input, the clinical path creation unit 50 operates the primary narrowing unit 52 to execute the primary narrowing process.

  In the primary narrowing process, the primary narrowing unit 52 accesses the event DB 20. Then, referring to the wound name of the event stored in the event list 28, an event that matches the wound name entered in the wound name input field 60 from the events stored in the event list 28 (ie, newly created) Event that can constitute a clinical path to be extracted) and stored in the memory 34. As described above, in the primary narrowing-down process, events are narrowed down based on the names of wounds.

  The patient identification information input field 62 is an input field for inputting patient identification information (patient name and patient ID) of a patient to be treated by a newly generated clinical path, and the user operates the terminal 16 to Patient identification information can be entered in the patient identification information input field 62. When the patient identification information is input, the clinical path creation unit 50 operates the secondary narrowing unit 54 to execute the secondary narrowing process.

  In the secondary narrowing process, the secondary narrowing unit 54 accesses the patient information DB 19 and the event DB 20. Then, the patient attribute information of the patient corresponding to the input patient identification information is compared with the matching information of the event narrowed down by the primary narrowing process (the event stored in the memory 34 by the primary narrowing unit 52). From the events narrowed down by the narrowing process, events that match the patient attribute information (that is, events that satisfy the age condition, gender condition, past illness condition, health condition condition, propensity condition, relative attribute attribute) are extracted, and the remaining events (Event not matching patient attribute information) is deleted from the memory 34. As described above, in the secondary narrowing process, the events narrowed down in the primary narrowing process are further narrowed down based on the patient attribute information.

  When the above-described primary narrowing process and secondary narrowing process are completed, the clinical path creation unit 50 displays a “next” button 56 a on the clinical path creation screen 56. The user can select the button 56 a by clicking the button 56 a via the terminal 16. When the button 56 a is selected, the clinical path creation unit 50 delivers a clinical path creation screen 58 shown in FIG. 9 to the terminal 16.

  In FIG. 9, the clinical path creation screen 58 is provided with an event input field (medical practice input area) 64. A plurality of event input fields 64 are provided corresponding to event categories such as diagnosis, examination, treatment (surgery, medication), aftercare (postoperative examination, rehabilitation), and the lower part of each event input field 64 Shows a list of events that match the category among the events remaining in the memory 34 after the primary narrowing process and the secondary narrowing process. The user can select an event from a list for each category by operating the terminal 16. When an event is selected, the selected event is displayed in the upper part of the event input field 64 and determined as an event to be executed.

  It should be noted that by operating an “add event” button 58a provided below the event input field 64 for each category, an event input field for the corresponding category is additionally displayed, and a plurality of events are selected for the same category. be able to. In this way, after determining one or a plurality of events (after determining all the events to be executed), when the “next” button 58b is operated, information indicating the determined event type is a clinical path creation unit. 50.

  Upon receiving this information, the clinical path creation unit 50 enters the detailed information of the determined event (contents, schedule, implementation time, implementation location, equipment used, person in charge, arrival target, etc.). A path creation screen (not shown) is distributed to the terminal 16. Then, the clinical path creation unit 50 creates a new clinical path based on the information input in accordance with this clinical path creation screen, and stores the created clinical path in the clinical path DB 18.

  The operation of the present invention having the above configuration will be described below with reference to the flowchart shown in FIG. As shown in FIG. 10, the clinical path creation support apparatus 12 performs a primary narrowing process when a wound name is input on the clinical path creation screen 56 (see FIG. 8). In the primary narrowing-down process, events that can be executed in the newly created clinical path are narrowed down based on the name of the patient's injury or illness.

  Further, in the clinical path creation support apparatus 12, when patient identification information is input on the clinical path creation screen 56 (see FIG. 8), secondary narrowing processing is performed. In the secondary narrowing-down process, the events narrowed down in the primary narrowing-down process are further narrowed down based on patient attribute information representing patient-specific attributes.

  Then, the events remaining after the two-stage narrowing based on the name of the wound and the patient attribute information are displayed on the clinical path creation screen 58 (see FIG. 9) as candidates for the events constituting the newly created clinical path (see FIG. 9). And a new clinical path can be created by selecting one of these candidates.

  As described above, according to the clinical path creation support device 12 of the present invention, event candidates are narrowed down based on patient attribute information in addition to the names of wounds. For this reason, the number of candidates to be selected is reduced compared to the case where event candidates are narrowed down only by the names of wounds and diseases, and it is possible to contribute to speeding up the creation of the clinical path.

  In addition, in the clinical path creation support device 12 of the present invention, it is possible to reduce the risk associated with medical care as compared with the case where event candidates are narrowed down only from the names of wounds. In other words, in the clinical path creation support device 12 of the present invention, an age condition capable of performing an event is provided, and an event that does not satisfy the age condition is excluded from the selection target. It is possible to exclude an event using an oral endoscope with a large burden from the selection target, and it is possible to prevent a risk that an event with a large burden is erroneously selected for an elderly person.

  In addition, since the health condition that can carry out the event is provided, and the event that does not satisfy the health condition is excluded from the selection target, for example, when the health condition is bad and the laparotomy cannot be performed, the laparotomy event is selected The risk that a dangerous event is erroneously selected for a patient with a poor health condition can be prevented.

  In addition, since the propensity conditions that allow the event to be implemented are set and events that do not satisfy the propensity condition are excluded from selection, for example, when prescribing a drug to a patient who intends to actively use the generic drug, The risk of prescribing the original drug and becoming the subject of claims despite the presence of the drug can be prevented. In addition, it is possible to prevent a risk that a patient who is cautious (resisting) in medical treatment in advanced medical care will be subjected to medical treatment in advanced medical care and become a subject of a complaint. Further, it is possible to prevent a risk that a patient who prefers medical treatment in advanced medical care will be subject to complaints without performing medical care in advanced medical care.

  In addition, since a relative attribute condition that allows the event to be performed is set and an event that does not satisfy the relative attribute condition is excluded from the selection target, for example, the drug has an allergic symptom in the patient's relative. The risk of inadvertently selecting drugs that may cause symptoms can be prevented. Furthermore, even if used for a patient's relatives, the expected effect is not obtained (or a side effect occurs), and a care method that cannot be expected for this patient (or an expected side effect) is inadvertently selected. Risk can also be prevented.

  In particular, by narrowing down events based on the propensity condition and relative attribute conditions, it is possible to narrow down more appropriately than when narrowing down events based on age conditions and sex conditions. In other words, when narrowing down events based on age and gender conditions, the number of data bases used for narrowing down is enormous, which is suitable for reflecting statistical information in narrowing down events, but for narrowing down events. It is difficult to reflect personality. On the other hand, when narrowing down events based on propensity conditions or relative attribute conditions, it is possible to narrow down events that reflect individuality, and the potential medical risks (preferences) due to patient preferences, relative attributes, etc. It is possible to prevent the risk of conducting a medical procedure contrary to the above, or performing a medical procedure for which no effect is expected (or a side effect occurs) from the results of the medical care for relatives.

  Hereinafter, a specific example of the secondary narrowing process when the name of the disease is “thyroid cancer” will be described with reference to FIG.

  In FIG. 11, when the wound name is “thyroid cancer”, the events remaining after the primary narrowing process with the wound name are “palpation”, “ultrasound examination”, “X-ray CT examination”, “ "MRI examination", "bone scintigraphy examination", "surgical therapy 1 (general surgery)", "surgical therapy 2 (endoscopic surgery)", "anticancer drug treatment 1 (using bleomycin)", "anticancer Drug treatment 2 (use of lenvatinib mesyl) ”,“ follow-up therapy ”,“ radiotherapy ”,“ pathological examination ”. “Radiotherapy” belongs to the treatment category, but is generally performed after surgery and is special among the treatment categories. For this reason, in this example, the treatment category is divided into treatment A and treatment B, “radiotherapy” is treated as a candidate for treatment B, and other treatment category candidates are treated as treatment A candidates. I do.

[Example 1] When the patient is a woman.
In this case, in the secondary refining process, “surgery therapy 1 (general surgery)” is excluded from the selection target (the gender condition of “surgery therapy 1 (general surgery)” in the event list is stored as not being performed on women. ) “Surgery 1 (general treatment)” may leave a surgical mark on the neck, and in many cases it is desired that a female does not leave such a surgical mark. On the other hand, there may be a promise not to leave a scar. Therefore, if “surgical treatment 1 (general treatment)” is excluded from selection for female patients, it is preferable for many women and hospitals that promise to leave no scars on women.

[Example 2] When liver dysfunction is recorded as a patient's past illness.
In this case, in the second narrowing-down process, “anticancer agent treatment 1 (use bleomycin)” is excluded from the selection target (as a past condition of “anticancer agent treatment 1 (use bleomycin)” in the event list, liver function Remember that people with disabilities will not do it). Bleomycin may cause side effects in those with liver dysfunction, those with pulmonary fibrosis, and those who are hypersensitive to this drug or pepromycin. For this reason, if "anticancer drug treatment 1 (use bleomycin)" is excluded from selection subjects for patients with hepatic dysfunction, the problem of side effects can be prevented. Of course, those who have pulmonary fibrosis and those who are hypersensitive to this drug or pepromycin may be excluded from the selection (pre-existing conditions of “anticancer drug treatment 1 (with bleomycin)” in the event list) It may be possible to memorize that it is not performed for those who have pulmonary fibrosis or who are hypersensitive to this drug or pepromycin).

[Example 3] When other than surgical therapy is selected as the treatment A.
In this case, in the secondary narrowing-down process, the “radiotherapy” of the treatment B is excluded from the selection target (the fact that the information other than the surgical therapy is not used as the matching information of the “radiotherapy” in the event list is stored). As described above, “radiotherapy” is often performed after surgery. Therefore, when “non-surgical therapy” is selected, “radiotherapy” is excluded from the selection target. Can prevent the problem.

  The specific content of the secondary narrowing process is not limited to the above-described example, and can be changed as appropriate. For example, for patients who do not want to be hospitalized, medical treatment with hospitalization may be excluded from the selection target. In this case, as patient attribute information, information on whether or not the patient wants to be hospitalized is stored, and for events that require hospitalization, the conformity information of the event is not implemented for patients who do not want to be hospitalized. Just remember.

  Also, if patient attribute information (patient preferences, etc.) is given priority more than necessary, there is a risk that the best medical care cannot be performed. In other words, even though it was originally necessary to be hospitalized as soon as possible and the patient did not like hospitalization or surgery, the medical condition involving hospitalization or surgery was excluded from the selection and the medical condition progressed. There is a fear that it will end. Therefore, for events that are excluded from selection based on patient attribute information, a warning message is displayed to indicate that this event has been excluded from selection, the reason, and the risk caused by this event being excluded. Etc. may be notified. Further, events that increase in risk if excluded from the selection target may not be excluded from the selection target regardless of the patient attribute information (may be excluded from the narrowing-down target of the secondary narrowing process).

  In addition, about the structure of the detail of this invention, it is not limited to the said embodiment, It can change suitably. For example, in the above embodiment, the example is described in which the clinical path creation support device is installed in the operating company of the medical support system. However, the clinical path creation support device may be installed in the medical institution to which the user of the medical support system belongs. Good.

  In the above embodiment, the clinical path creation screen is distributed from the clinical path creation support apparatus to the user's terminal, and the clinical path is created by performing an input operation from the user's terminal. Even if an input device (such as a mouse or a keyboard) or a display device (display unit such as a liquid crystal display) is provided in the clinical path creation support device, a clinical path creation screen is displayed on the display device, and an input operation is performed using the input device. It is good (it is good also as a structure which can provide a display part in a clinical path creation assistance apparatus, and can create a clinical path only by a clinical path).

  In the above-described embodiment, the example in which the present invention is applied to an apparatus that creates a new clinical path has been described. However, the present invention is applied to an apparatus that changes the contents of an existing clinical path, and the change is made. Selection targets that can be selected as events to be performed may be narrowed down based on patient attribute information. Also in this case, the same effect as the above embodiment can be obtained.

  In the above embodiment, the patient attribute information is described as an example of age, gender, pre-existing disease, health condition, propensity, and relative attribute information. However, the type and number of each information constituting the patient attribute information is changed as appropriate. it can. Moreover, the specific content of each information which comprises patient attribute information can also be changed suitably. For example, the advanced medical interest level, risk refusal level, and generic drug interest level are described as examples of the propensity. However, whether or not the above-described hospitalization is preferred may be stored as the propensity. Furthermore, in the above-described embodiment, each of the advanced medical interest level, the risk refusal degree, and the generic drug interest level has been described with three levels of A, B, and C, but may be expressed in two levels. It may be expressed in stages.

DESCRIPTION OF SYMBOLS 10 Medical assistance system 12 Clinical path creation assistance apparatus 16 Terminal 17 Application server 18 Clinical path DB
19 Patient information DB (patient attribute information storage unit)
20 Event DB (candidate storage unit)
24 Patient Information 26 Clinical Path 28 Event List 30 AP
32 Storage device 34 Memory 36 CPU
50 Clinical path creation part (output part, delivery part)
52 Primary Refinement Unit 54 Secondary Refinement Unit 56, 58 Clinical Path Creation Screen 60 Wound Name Input Field 62 Patient Identification Information Input Field 64 Event Input Field (Medical Action Input Area)

Claims (13)

In a clinical path creation support device that supports the creation of a clinical path indicating a medical plan,
A candidate storage unit that stores a plurality of candidate components constituting the clinical path;
A primary narrowing-down unit that narrows down candidates by extracting candidates that match conditions from candidates stored in the candidate storage unit, based on sickness and disease information that represents a patient's wound and sickness;
Based on patient attribute information representing patient-specific attributes, a secondary narrowing unit that narrows down the candidates by extracting candidates that match conditions from candidates extracted by the primary narrowing unit;
A clinical path creation support apparatus, comprising: an output unit that outputs the candidate extracted by the secondary narrowing-down unit.   The clinical path creation support apparatus according to claim 1, wherein the patient attribute information includes at least one of a patient's age, sex, medical history, health condition, and propensity.   The clinical path creation support apparatus according to claim 2, wherein the health condition includes at least one of an injury and illness that the patient is currently suffering from and vital information of the patient.   The clinical path according to claim 2, wherein the propensity includes at least one of a degree of interest in advanced medical care, a degree of refraining from risk associated with medical care, and a degree of interest in the use of generic drugs. Creation support device.   5. The clinical path creation support apparatus according to claim 1, wherein the patient attribute information includes kinship attribute information representing an attribute specific to a kinship of a patient.   The said output part is a delivery part which delivers the said candidate to a terminal via a network, or a display part which displays the said candidate on a screen, The any one of Claims 1-5 characterized by the above-mentioned. Clinical path creation support device.   The clinical path creation support apparatus according to claim 1, wherein the candidates output from the output unit are displayed on a clinical path creation screen for creating the clinical path. The candidate corresponds to a medical practice,
The clinical path creation screen is provided with a medical practice input area for inputting the medical practice,
The clinical path creation support apparatus according to claim 7, wherein the candidate output from the output unit is displayed in the medical practice input area. The medical practice and candidates corresponding to each medical practice are classified into a plurality of categories,
A plurality of the medical practice input areas are provided according to the category,
9. The clinical path creation support apparatus according to claim 8, wherein the candidates output from the output unit are displayed in a menu format in a medical practice input area corresponding to the type of the category.   The clinical path creation support apparatus according to claim 9, wherein the category includes at least one of diagnosis, examination, treatment, and aftercare.   The clinical path creation support apparatus according to any one of claims 1 to 10, further comprising a patient attribute information storage unit that stores the patient attribute information. A clinical path creation device having a candidate storage unit that stores a plurality of candidate component elements constituting a clinical path indicating a medical plan, and that supports creation of the clinical path based on the component elements stored in the candidate storage unit In the path creation support method,
The first narrowing-down unit provided in the clinical path creation device extracts the candidate that matches the condition from the candidates stored in the candidate storage unit based on the injury / illness information indicating the injury / illness of the patient. A first narrowing step for narrowing down,
The second narrowing unit provided in the clinical path creation support device extracts candidates that match the conditions from the candidates extracted in the primary narrowing step based on patient attribute information representing patient-specific attributes. A second narrowing step for narrowing down the candidates by:
An output unit provided in the clinical path creation support apparatus includes an output step of outputting the candidates extracted in the second narrowing-down step. In a clinical path creation support program that supports the creation of the clinical path based on the constituent elements stored in the candidate storage unit that stores a plurality of constituent element candidates constituting the clinical path indicating the medical plan,
A first narrowing-down step of narrowing down candidates by extracting candidates that match a condition from candidates stored in the candidate storage unit based on sickness and disease information representing a patient's wound and disease; and
Based on patient attribute information representing patient-specific attributes, a secondary narrowing step of narrowing down the candidates by extracting candidates that match conditions from the candidates extracted in the primary narrowing step;
A clinical path creation support program that causes a computer to execute an output step of outputting candidates extracted in the second narrowing-down step.

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