JP2016126571A - Diagnosis treatment support device and diagnosis treatment support system - Google Patents

Abstract

PROBLEM TO BE SOLVED: To improve efficiency of inspection operations management related to medical treatment.SOLUTION: A diagnosis tree storage part 13A stores a diagnosis tree formed of plural inspection stages which are selectively associated according to a standard transition order and execution requirements, for each of plural diseases. A diagnosis tree determination part 17B determines an object diagnosis tree related to a disease of an inspection object, out of the plural diagnosis trees stored in the diagnosis tree storage part 13A. A next time stage determination part 17D uses the inspection stage of a current inspection, and execution requirement determination information for determining whether or not, any execution requirement for a next time inspection is satisfied, to determine an inspection stage of the next time inspection, out of the plural inspection stages included in the object diagnosis tree.SELECTED DRAWING: Figure 3

Description

  Embodiments described herein relate generally to a diagnostic treatment support apparatus and a diagnostic treatment support system.

  There is a medical critical path as a method of inspection work management aimed at improving quality and efficiency in medical care. In the medical critical path, prescription items and inspection nursing care items are set in advance along the time axis. The medical staff can appropriately proceed with the examination by checking the medical critical path. In addition, the effectiveness of informed consent has been demonstrated because it is possible to schedule a discharge schedule.

  In Patent Document 1, the entire critical path is divided into several steps for each purpose, and “condition item to move to next step” is set in each step. Once it is confirmed that the condition is met, the next step can be taken. This makes it possible to clearly determine whether the treatment schedule will be advanced as scheduled, or will be extended or stopped.

  However, in the inspection work management using the critical path, the following inconvenience occurs. That is, when there are a plurality of critical paths, it is not possible to automatically associate the inspection that has already been performed with the critical path. It is necessary to manually determine whether or not to move to the next step. Since the critical path is not assumed to be branched, it cannot cope with changes in examination, diagnosis, and treatment.

JP 2004-13219 A

  An object is to provide a diagnostic treatment support apparatus and a diagnostic treatment support system that can improve the efficiency of medical examination management.

  The diagnostic treatment support apparatus according to the present embodiment stores a file configured by a plurality of examination stages selectively associated with each of a plurality of lesions according to a standard transition order and implementation requirements. A file determination unit for determining a target file related to a lesion to be examined among a plurality of files stored in the file storage unit, and an examination of a current examination from among a plurality of examination stages included in the target file And a next stage determination unit that determines an inspection stage for the next inspection using the stage and determination information for determining whether or not the requirements for performing the next inspection are satisfied.

The figure which shows the structure of the diagnostic treatment assistance system containing the diagnostic treatment assistance apparatus which concerns on this embodiment. The figure which shows the guideline of the diagnosis of stable angina when a patient can exercise. The figure which shows the guideline of the diagnosis of stable angina when a patient cannot move. The figure which shows the structure of the diagnostic treatment assistance apparatus of FIG. The figure which shows an example of the lesion-diagnosis tree database managed by the diagnostic tree memory | storage part of FIG. The figure which expressed typically the typical example of the diagnostic tree about the stable angina managed by the diagnostic tree memory | storage part of FIG. The figure which shows an example of the test | inspection stage database managed by the diagnostic tree memory | storage part of FIG. The figure which shows an example of the database between stators managed by the diagnostic tree memory | storage part of FIG. The figure which shows an example of the lesion information database managed by the lesion information storage part of FIG. The figure which shows an example of the facility requirement judgment information database managed by the facility requirement judgment information storage part of FIG. The figure which shows an example of the patient requirement judgment information database managed by the patient requirement judgment information storage part of FIG. The figure which shows the typical flow of the diagnostic treatment assistance process performed under control of the control part of FIG. It is a figure for demonstrating the extraction method of the lesion name character string performed by the character string extraction part in FIG.11 S1, and is the figure which represented the description content of the medical report according to the item by the table form. FIG. 12 is another view for explaining the lesion name character string extraction method performed by the character string extraction unit in step S <b> 1 of FIG. 11, and shows the description content of the medical report in a tabular format for each item. It is a figure for demonstrating the process which determines the test | inspection stage of a present test | inspection from the character string described in the electronic medical record and a medical report performed by the present stage determination part in step S3 of FIG. The figure displayed in tabular form by item. It is a figure for demonstrating the specific process of the requirement judgment information performed by the next stage determination part in FIG.11 S4, and the figure which represented the description content of the medical report according to the item by the table form. The figure which shows the example of a display of the examination stage of the present test | inspection regarding the patient name "A" of age "**" displayed by the display part in FIG.11 S5, and the examination stage of the next examination. The figure which shows the example of a display of the test | inspection stage of a present test | inspection and the test | inspection stage of a next test | inspection which distinguish a new lesion and the existing lesion | pathology displayed by the display part in FIG.11 S5. The figure which shows the example of a display of the inspection stage of the next inspection which concerns on the application example 1. FIG. It is a figure which shows the example of a display of the test | inspection stage of the next test | inspection which concerns on the application example 2, Comprising: The figure which shows the example of warning display in the mode which sets a warning due date on the day before an implementation deadline. It is a figure which shows the example of a display of the test | inspection stage of the next test | inspection which concerns on the application example 3, Comprising: The figure which shows the parallel display example of the table image and the issuance screen of an inspection request.

  Hereinafter, a diagnostic treatment support apparatus and a diagnostic treatment support system according to the present embodiment will be described with reference to the drawings.

  The diagnostic treatment support apparatus according to the present embodiment is a computer device included in the diagnostic treatment support system.

  FIG. 1 is a diagram illustrating a configuration of a diagnostic treatment support system 100 including a diagnostic treatment support device 1 according to the present embodiment. As shown in FIG. 1, the diagnostic treatment support system 100 includes a diagnostic treatment support apparatus 1, an electronic medical record system 200, and a medical report system 300 that are connected to each other via a network. As image communication between the devices included in the diagnostic treatment support system 100, any existing standard such as DICOM standard which is a standard for medical images may be used. As information communication, industry standard TCP / IP (Transmission Control Protocol / Internet Protocol) communication is typically employed. Information is transmitted and received in units of packets (basic unit of information to be transferred) via the network. The diagnostic treatment support system 100 may include other devices such as a medical image photographing device and a medical image storage device.

  The electronic medical record system 200 is a system for creating, storing, and browsing an electronic medical record in accordance with instructions from a doctor via an input device. Electronic medical records are created by medical personnel such as doctors when medical examinations and examinations are performed. The electronic medical record system 200 may be a system composed of a plurality of computers or a system composed of a single computer. The electronic medical record is supplied to the diagnostic treatment support apparatus 1 via a network.

  The medical report system 300 is a system for creating, storing, and browsing a medical report according to instructions from a doctor via an input device. A medical report is created by a medical staff such as a doctor when a medical image is interpreted. The medical report system 300 may be a system composed of a plurality of computers or a system composed of a single computer. The medical report is supplied to the diagnostic treatment support apparatus 1 via the network.

  The diagnosis and treatment support device 1 is a computer device for supporting diagnosis, treatment, examination, and the like. The diagnostic treatment support apparatus 1 determines the examination stage of the current examination of the patient and the examination stage of the next examination using a diagnosis tree, which will be described later, and provides it to medical personnel such as doctors and nurses. The diagnosis tree is generated based on a guideline indicating a standard examination flow of diagnosis for a certain lesion.

  2A and 2B are diagrams showing guidelines for diagnosis of stable angina (Akira Yamashina et al., 2009, “Guidelines on Noninvasive Diagnosis of Coronary Artery Lesions”, Circulation Journal Vol.73, Suppl. III.). is there. FIG. 2A is a guideline when the patient can exercise, and FIG. 2B is a guideline when the patient cannot exercise. As shown in FIGS. 2A and 2B, guidelines are defined for each lesion. The diagnostic treatment support apparatus 1 according to the present embodiment determines the inspection stage of the current inspection and the inspection stage of the next inspection using a diagnosis tree generated in advance based on this guideline.

  FIG. 3 is a diagram illustrating a configuration of the diagnostic treatment support apparatus 1. As illustrated in FIG. 3, the diagnostic treatment support apparatus 1 includes a storage unit 13, a read / write unit 15, an information processing unit 17, a communication unit 19, an operation unit 21, and a display unit 23 with the control unit 11 as a center.

  The storage unit 13 is a storage device such as a semiconductor storage device or an HDD (hard disk drive). The storage unit 13 stores various information. For example, the storage unit 13 includes a diagnostic tree storage unit 13A, a lesion information storage unit 13B, a facility requirement determination information storage unit 13C, and a patient requirement determination information storage unit 13D.

  The diagnostic tree storage unit 13A stores information regarding the diagnostic tree for each lesion. A diagnosis tree basically has a one-to-one correspondence with a lesion. However, when multiple types of diagnosis trees are established for one lesion or when a single diagnosis tree common to a plurality of lesions is used, there are many pairs. You may support many. The identifier of the lesion and the identifier of the diagnosis tree may be associated with each other in a known form such as a database or a table, or are associated with a description language such as XML (extensible markup language) or HTML (hypertext markup language). May be. Hereinafter, it is assumed that the identifier of the lesion and the identifier of the diagnosis tree are associated by a database. This database will be called a lesion-diagnosis tree DB. As the lesion identifier, for example, a lesion name or ID is used. As the diagnosis tree identifier, for example, a diagnosis tree name or ID is used. Hereinafter, it is assumed that the identifier of a lesion in the lesion-diagnostic tree DB is a lesion ID, and the identifier of the diagnostic tree is a diagnostic tree ID. The lesion-diagnostic tree DB may be associated with other information in addition to the lesion ID and the diagnostic tree ID.

  FIG. 4 is a diagram showing a lesion-diagnosis tree DB. As shown in FIG. 4, a plurality of lesion IDs and a plurality of diagnosis tree IDs are associated in the lesion-diagnosis tree DB. For example, the lesion ID “1” corresponds to stable angina and is associated with the diagnosis tree of the diagnosis tree ID “1”, that is, the diagnosis tree for stable angina. The lesion ID “101” corresponds to the lung cancer, the diagnosis tree with the diagnosis tree ID “101”, that is, the diagnosis tree regarding the diagnosis tree of the lung cancer, and the diagnosis tree ID “102”, that is, another diagnosis tree of the lung cancer. It is attached as a diagnosis tree.

  The diagnosis tree is a file composed of a plurality of inspection stages selectively associated according to a standard transition order and execution requirements. The examination stage indicates one examination stage in a series of examinations performed for diagnosis and treatment of the lesion. The series of inspection stages is not a single road. Following one inspection, there are a plurality of inspection candidates, and each candidate has an implementation requirement. After the one inspection is performed, a candidate that satisfies the execution requirement among the plurality of candidates is determined as the next inspection. A single inspection stage is associated with a plurality of inspection stages along with performance requirements. In addition, a standard execution time limit is set for one inspection after the previous inspection is performed until the one inspection is performed. Each inspection stage is associated with a standard implementation deadline.

  FIG. 5 is a diagram schematically representing a typical example of a diagnostic tree for stable angina. As shown in FIG. 5, a plurality of examination stages are defined in the diagnostic tree for stable angina. An identifier is associated with each inspection stage. A stage ID is adopted as an identifier for the inspection stage. For example, the inspection stage with stage ID “5” is “load SPECT”. Implementation requirements are associated with each inspection stage, and a plurality of subsequent inspection stages are associated with each inspection stage. For example, the inspection stage with stage ID “5” includes the inspection stage “follow-up” with stage ID “6”, the inspection stage “coronary angiography” with stage ID “7”, and the inspection stage “coronary artery CT” with stage ID “8”. ". The execution requirement “normal inspection result” is associated with the inspection stage “follow-up” of the stage ID “6”, and the execution requirement “inspection result is not normal” for the inspection stage “coronary angiography” of the stage ID “7”. “Examination results are mildly perfusion abnormal or test results are not difficult to determine” are associated with the implementation requirements “Examination results are not normal” and “Inspection results are mild perfusion” "Abnormality or test results are difficult to determine". Each inspection stage is associated with an execution deadline, as indicated by [•] in FIG. For example, it is recommended that the inspection corresponding to the inspection stage with the stage ID “9” be performed within two weeks from the load SPECT. Therefore, the inspection deadline “within 2 weeks” is associated with the inspection stage with the stage ID “8”.

  The diagnosis tree may be stored in a schematic form as shown in FIG. 4, but may be associated in a known form such as a database or a table, or may be associated with a description language such as XML or HTML. It may be done. For example, diagnostic trees are stored separately in an inspection stage database (hereinafter referred to as an inspection stage DB) and an interstage database (hereinafter referred to as an interstage DB).

  FIG. 6 is a diagram illustrating an example of the inspection stage DB. As shown in FIG. 6, the examination stage DB has items such as a stage ID, contents, examination ID, and treatment ID associated with each other for each of a plurality of examination stages. The stage ID indicates an identifier of the inspection stage. The content indicates the content of the inspection stage. The inspection ID is an identifier of an existing inspection content associated with the inspection stage. The treatment ID is an identifier of existing treatment contents linked to the examination stage. For example, the content of the examination stage of stage ID: 1 is “estimation of the pre-test probability of CAD”, and the identifier of the existing examination content and the identifier of the existing treatment content of stage ID: 1 are “NULL”. “NULL” is a code meaning “no value”.

  FIG. 7 is a diagram illustrating an example of an inter-stage DB. As illustrated in FIG. 7, the inter-stage DB includes a diagnosis tree ID, a stage ID, a start point flag, a next inspection stage, a requirement for performing the next inspection, and a period until the next inspection for each of the plurality of inspection stages. It has items such as. The diagnosis tree ID is an identifier of the diagnosis tree to which the examination stage belongs. The stage ID is an identifier of the inspection stage. The start point flag indicates whether or not the inspection stage is the first inspection stage in the diagnosis tree. Specifically, when the value of the start point flag is “1”, this indicates that the inspection stage is the first inspection stage. When the value of the start point flag is “0”, the inspection stage is not the first inspection stage. It shows that. The next inspection stage ID is an identifier of the inspection stage of the next inspection for the inspection stage. The requirement for performing the next inspection is a condition for performing the next inspection. In FIG. 7, information surrounded by $ indicates implementation requirement information, and information surrounded by double quotations indicates implementation requirement determination information. The implementation requirement information indicates character string information described in an observation item or an Impression item of an electronic medical record or a medical report, or a facility requirement or a patient requirement. Further, the implementation requirement determination information indicates character string information described in an electronic medical record or a finding item or an Impression item of a medical report, or facility requirement determination information or patient requirement determination information. The period until the next inspection indicates a recommended period from the execution date of the inspection corresponding to the inspection stage to the execution deadline of the next inspection. The recommended period may be expressed in units such as a predetermined year, month, or day, or may be described in units such as Y (Year), M (Month), and D (Day).

  The lesion information storage unit 13B stores lesion information generated for each patient lesion. The lesion information is information for managing patient lesions. The lesion information is managed in a record format. Hereinafter, the lesion information record is referred to as a lesion record. Various information in the lesion record may be associated in the form of a database or the like, or may be associated by a description language such as XML or HTML. Hereinafter, it is assumed that various types of information in the lesion record are related by a database. This database will be called a lesion information DB.

  FIG. 8 is a diagram illustrating an example of a lesion information DB. As shown in FIG. 8, the lesion information DB holds a plurality of lesion records related to a plurality of lesions. Each lesion record has items such as patient ID, lesion information ID, diagnosis tree ID, current examination stage ID, next examination stage ID, and execution deadline. The patient ID is a patient identifier. The current inspection stage ID is the stage ID of the inspection stage of the current inspection. The current inspection is an inspection performed most recently. The inspection stage of the current inspection is determined by the current stage determination unit 17C. The next inspection stage ID is the stage ID of the inspection stage of the next inspection. The next inspection is an inspection scheduled to be performed next time. The inspection stage for the next inspection is determined by the next stage determination unit 17D. The current examination and the next examination are set for each lesion. The implementation deadline represents the implementation deadline from the current inspection to the next inspection. When the next inspection is undecided or when the implementation deadline is undecided, the value of the implementation deadline may be set to NULL. For example, in the lesion record of the patient ID “1” and the lesion ID “1”, the diagnosis tree ID is “1”, the stage ID of the examination stage is “2”, and the ID of the next examination stage is “12”. And the implementation deadline is “2012/12/15”.

  The facility requirement determination information storage unit 13 </ b> C stores facility requirement determination information related to an inspection facility that performs a patient inspection in association with the facility requirement. Facility requirement determination information is managed for each inspection facility. The facility requirement and the facility requirement determination information may be associated with each other in the form of a table, a database, or the like, or may be associated with a description language such as XML or HTML. Hereinafter, it is assumed that the facility requirement and the facility requirement determination information are associated by a database. This database will be called a facility information DB.

  FIG. 9 is a diagram illustrating an example of the facility requirement determination information DB. As shown in FIG. 9, the facility requirement determination information DB has items such as a facility requirement ID and facility requirement determination information. The facility requirement ID is an identifier of the facility requirement. That is, the facility requirement ID corresponds to the content of the facility requirement. The facility requirement determination information is information for determining whether or not the facility requirement is satisfied. When the facility requirement is satisfied, the value of the facility requirement determination information is set to “1”. When the facility requirement is not satisfied, the value of the facility requirement determination information is preferably set to “0”. For example, in the facility requirement ID “1”, the facility requirement is “presence / absence of CT of 64 columns MDCT or more”, and the facility requirement determination information is “1 (present)”. Further, in the facility requirement ID “2”, the facility requirement is “whether or not the radiation dose reduction protocol is being tackled”, and the facility requirement determination information is “1 (working)”.

  The patient requirement determination information storage unit 13D stores the patient requirement determination information for each patient in association with the patient requirement. Patient requirement determination information is managed for each patient. The patient requirement and the patient requirement determination information may be associated with each other in the form of a table, a database, or the like, or may be associated with a description language such as XML or HTML. Hereinafter, it is assumed that patient requirements and patient requirement determination information are associated with each other by a database. The database will be referred to as patient requirement determination information DB.

  FIG. 10 is a diagram illustrating an example of the patient requirement determination information DB. As shown in FIG. 10, the patient requirement determination information DB includes items such as a patient ID, a patient requirement ID, and patient requirement determination information. The patient ID is a patient identifier. The patient requirement ID is an identifier of a patient requirement. That is, the patient requirement ID corresponds to the content of the patient requirement. The patient requirement determination information is information for determining whether or not the patient requirement is satisfied. When the patient requirement is satisfied, the value of the patient requirement determination information is set to “1”, and when the patient requirement is not satisfied, the value of the patient requirement determination information is preferably set to “0”. Moreover, when the patient requirement is calculating | requiring the numerical value of a target test | inspection item, the numerical value of a target test | inspection item may be set as patient requirement determination information. For example, the patient requirement of the patient requirement ID “1” is “serum creatine”, and the patient requirement determination information is “2.8 mg / dL”. Further, the patient requirement of the patient requirement ID “2” is “whether there is a contrast medium allergy”, the patient requirement judgment information is “1 (present)”, and the patient requirement of the patient requirement ID “3” is “whether there is asthma The patient requirement determination information is “0 (not present)”.

  The read / write unit 15 reads various information stored in the storage unit 13 and supplies the read information to the control unit 11. The read / write unit 15 updates various information stored in the storage unit 13 and writes new information.

  The information processing unit 17 executes information processing according to instructions from the control unit 11. Specifically, the information processing unit 17 includes a character string extraction unit 17A, a diagnostic tree determination unit 17B, a current stage determination unit 17C, and a next stage determination unit 17D. The character string extraction unit 17A extracts a specific character string from a plurality of characters described in an electronic medical record or a medical report. The diagnosis tree determination unit 17B specifies a diagnosis tree to be processed among the diagnosis trees stored in the diagnosis tree storage unit 13A. The current stage determination unit 17C determines the inspection stage of the current inspection from among a plurality of inspection stages in the diagnosis tree to be processed. The next stage determination unit 17D determines an inspection stage for the next inspection from a plurality of inspection stages in the diagnosis tree to be processed.

  The communication unit 19 communicates with the electronic medical record system 200 and the medical report system 300 included in the diagnostic treatment support system 100 via a network. For example, the communication unit 19 receives an electronic medical record from the electronic medical record system 200 or receives a medical report from the medical report creation apparatus 300. The received electronic medical record and medical report are supplied to the control unit 11. The communication partner by the communication unit 19 is not limited to the electronic medical record system 200 or the medical report system 300, and may communicate with other devices not shown.

  The operation unit 21 receives various instructions from the user via the input device. As the input device, a pointing device such as a mouse or a trackball, a selection device such as a mode switch, or an input device such as a keyboard can be used as appropriate.

  The display unit 23 displays the inspection stage of the next inspection on the display device in a predetermined layout. As the display device, for example, a CRT display, a liquid crystal display, an organic EL display, a plasma display, or the like can be used as appropriate.

  The control unit 11 functions as the center of the diagnostic treatment support apparatus 1. The control unit 11 stores an information processing program for determining the inspection stage of the next inspection in the memory. The control unit 11 receives the instruction to start the examination stage determination process for the next examination, reads the information processing program, controls each part according to the read information processing program, and executes the diagnostic treatment support process according to the present embodiment Let

  Hereinafter, the diagnostic treatment support process performed under the control of the control unit 11 will be described in detail. FIG. 11 is a diagram illustrating a typical flow of diagnostic treatment support processing performed under the control of the control unit. The diagnostic treatment support process is executed after the current examination for a certain lesion is completed and the creation of an electronic medical record or medical report is completed. The diagnosis and treatment support process is started by the control unit 11 when a start instruction is input through the operation unit 21 by a user such as a medical worker or a patient, for example. The user may input a start instruction at an arbitrary timing. For example, the user may input a start instruction when the communication unit 19 receives an electronic medical record or medical report of a patient to be processed in the diagnostic treatment support process. In addition, the diagnostic treatment support process may be automatically started when the electronic medical record or the medical report is received by the communication unit 19.

  As shown in FIG. 11, in the diagnostic treatment support process, the control unit 11 first causes the character string extraction unit 17A to perform an extraction process (step S1). In step S1, the character string extraction unit 17A extracts a character string representing a lesion name (hereinafter referred to as a lesion name character string) from an electronic medical record or a medical report regarding the patient to be processed. For example, the character string extraction unit 17A extracts a lesion name character string of a lesion to be examined from a character string described in an electronic medical record. Alternatively, the character string extraction unit 17A extracts the lesion name character string from the character string described in the finding item in the medical report or the character string described in the Impression item. The character string extraction unit 17A extracts a lesion name character string according to a predetermined extraction rule. Specifically, the character string extraction unit 17A determines whether or not to extract the lesion name character string according to the description of the character string around the lesion name character string. The character string extraction unit 17A may extract a character string representing a lesion name from both the electronic medical record and the medical report.

  FIG. 12 is a diagram for explaining a method of extracting a lesion name character string, and is a diagram showing the description contents of a medical report in a tabular format for each item. As shown in FIG. 12, the medical report includes items such as examination site, modality, finding, Impression, bed disease name, and examination purpose. Here, it is assumed that the observation item has a description of “** suspicion of stable angina is seen in **”. In this case, the character string extraction unit 17A first specifies a character string “stable angina” as a lesion name character string from the finding items. An existing identification method may be used for the lesion name character string. For example, the character string extraction unit 17A may specify a lesion name character string with reference to a table in which a plurality of lesion names are registered in advance, or a character that is lexically connected to the character “symptom”. The column may be specified as a lesion name character string. Next, the character string extraction unit 17A determines whether or not to extract the lesion name character string according to the character string around the specified lesion name character string. For example, the character string extraction unit 17A searches for a character string around the lesion name character string, and identifies a keyword corresponding to a preset extraction target. The keyword corresponding to the extraction target is, for example, “There is suspicion” or “There is suspicion”. As shown in FIG. 12, when the keyword corresponding to the extraction target is around the lesion name character string, the character string extraction unit 17A extracts the lesion name character string. Further, the character string extraction unit 17A may search for a character string around the lesion name character string and specify a keyword corresponding to a preset non-extraction target. Examples of the keyword corresponding to the non-extraction target include “no doubt” and “no doubt”. As shown in FIG. 13, when the keyword corresponding to the non-extraction target is around the lesion name character string, the character string extraction unit 17A does not extract the lesion name character string. The character string to be extracted and the character string to be extracted can be arbitrarily set by the user via the operation unit 21 or the like.

  If step S1 is performed, the control part 11 will make the diagnostic tree determination part 17B perform a determination process (step S2). In step S2, the diagnostic tree determination unit 17B determines a diagnostic tree that matches the lesion name character string extracted in step S1. In step S <b> 2, first, the lesion / diagnosis tree DB is read from the diagnosis tree storage unit 13 </ b> A by the read / write unit 15 and supplied to the information processing unit 17. The diagnosis tree determination unit 17B searches the lesion-diagnosis tree DB using the lesion ID corresponding to the lesion name character string as a keyword, and identifies the diagnosis tree ID associated with the keyword. Thereafter, the read / write unit 15 reads the diagnostic tree corresponding to the identified diagnostic tree ID from the diagnostic tree storage unit and supplies the diagnostic tree to the information processing unit 17. In this way, the diagnosis tree determination unit 17B determines a diagnosis tree corresponding to the lesion name represented by the lesion name character string extracted in step S1. Hereinafter, the determined diagnosis tree is referred to as a target diagnosis tree.

  When step S2 is performed, the control unit 11 causes the current stage determination unit 17C to perform determination processing (step S3). In step S3, the current stage determination unit 17C determines the inspection stage of the current inspection in the target diagnosis tree determined in step S2. Specifically, the current stage determination unit 17C determines the inspection stage of the current inspection from a plurality of inspection stages included in the target diagnosis tree according to a predetermined rule (hereinafter referred to as a current stage determination rule). . This stage decision rule is divided according to whether the lesion to be examined is new or existing. Note that a new lesion means a lesion newly found in the current examination of a certain lesion, and an existing lesion is another lesion that has already been examined in the patient's past examination. Means. Hereinafter, the method for determining the inspection stage of the current inspection will be described separately for a case where a lesion to be inspected is a new lesion and an existing lesion.

  (In the case of a new lesion) A lesion record corresponding to a new lesion is basically not stored in the lesion information storage unit 13B at the start of step S2. The current stage determination rule for a new lesion is, for example, “If there is no lesion record for a lesion to be processed (hereinafter referred to as a target lesion) in the lesion record, the first examination stage of the target diagnosis tree is the examination stage of the current examination. And so on. That is, the current stage determination unit 17C first determines whether there is a lesion record related to the target lesion in the lesion information storage unit 13B. If it is determined that there is no lesion record related to the target lesion, the current stage determination unit 17C determines the first inspection stage of the target diagnosis tree as the inspection stage of the current inspection.

  Even in the case of a new lesion, the same lesion may have been examined in the past or a new lesion may be discovered in the course of examination of other lesions. In this case, the inspection stage in the middle of the target diagnosis tree corresponds to the inspection stage of the current inspection. For example, in the diagnosis tree of FIG. 5, when coronary angiography has been performed in the past and the current examination was a load SPECT, the examination stage of the current examination is not the examination stage “load SPECT” of the stage ID “5” The inspection stage “load SPECT” of the stage ID “15” is determined. When a plurality of inspection stage candidates follow one inspection stage in the target diagnosis tree, one candidate specified by the user via the operation unit 21 may be determined as the inspection stage of the current inspection.

  (In the case of existing lesion) The lesion record corresponding to the existing lesion is already stored in the lesion information storage unit 13B at the start time of step S2. The current examination stage ID of the lesion record stored at the start of step S2 is actually the stage ID of the examination stage of the previous examination, and the next examination stage ID is actually the stage ID of the examination stage of the current examination. It is. The current stage determination rule relating to an existing lesion is, for example, “if a lesion record relating to the target lesion exists in the lesion record, the inspection stage corresponding to the next inspection stage ID of the lesion record is determined as the inspection stage of the current inspection”. , Is defined as follows. That is, the current stage determination unit 17C first determines whether there is a lesion record related to the target lesion in the lesion information storage unit 13B. When it is determined that there is a lesion record related to the target lesion, the current stage determination unit 17C determines the inspection stage defined in the next inspection stage ID item of the lesion record as the inspection stage of the current inspection. For example, taking the diagnosis tree of stable angina in FIG. 5 as an example, the inspection stage of the current inspection at the end of the previous inspection is “load SPECT” of stage ID “5”, and the next time at the end of the previous inspection. When the inspection stage of the inspection is “coronary artery CT” of stage ID “8”, “coronary artery CT” of stage ID “8” is determined as the inspection stage of the current inspection at the end of the current inspection.

  When the inspection stage of the current inspection cannot be determined by the above method, the current stage determination unit 17C determines the current stage based on the character string described in the electronic medical record or the medical report and the inspection stage of the next inspection at the end of the previous inspection. The inspection stage of the current inspection at the end of the inspection may be determined. For example, when a load SPECT is performed in the previous examination and there is a description that the examination result is difficult to determine in the Impression item of the medical report of the previous examination, the current stage determination unit 17C, as shown in FIG. The examination stage “coronary artery CT” of “8” is determined as the examination stage of the current examination.

  In addition to the Impression item, the current stage may be determined using character strings described in the examination region item and the modality item. FIG. 14 is a diagram for explaining processing for determining the examination stage of the current examination from the character strings described in the examination part item and the modality item, and is a diagram showing the description contents of the medical report in a tabular format for each item. It is. As shown in FIG. 14, it is assumed that “heart” is described in the examination region item of the medical report, and “CT” is described in the modality item. Further, it is assumed that the inspection stage of the next inspection at the end of the previous inspection is the inspection stage “coronary artery CT” with ID “9”. The current stage determination unit 17C compares the combination of the description “cardio” of the examination site item and the description “CT” of the modality item with the examination stage “coronary artery CT” and determines whether or not they match. If it is determined that they match, the current stage determination unit 17C changes the inspection stage “coronary artery CT” whose ID is “9” as the inspection stage of the next inspection at the end of the previous inspection to the current inspection at the end of the current inspection. Decide on the inspection stage.

  When step S3 is performed, the control unit 11 causes the next stage determination unit 17D to perform determination processing (step S4). In step S4, the next stage determination unit 17D determines the inspection stage of the next inspection in the target diagnosis tree. The next stage determination unit 17D identifies candidates for the inspection stage for the next inspection that follows the inspection stage for the current inspection. Specifically, the read / write unit 15 first reads the inter-stage DB and the target diagnosis tree from the diagnosis tree storage unit 13A and supplies them to the next stage determination unit 17D. The next stage determination unit 17D searches the inter-stage DB and the target diagnosis tree, and specifies the inspection stage candidate for the next inspection subsequent to the inspection stage of the current inspection. When the candidates are specified, the next stage determination unit 17D searches the inter-stage DB and the target diagnosis tree, and specifies the implementation requirements for each of the candidates. When the execution requirement is specified, the next stage determination unit 17D extracts the execution requirement determination information for the specified execution requirement. Then, the next stage determination unit 17D determines a candidate that matches the execution requirement determination information as an inspection stage for the next inspection.

  Hereinafter, the determination process of the inspection stage of the next inspection will be described using a diagnosis tree of stable angina shown in FIG. 5 as a specific example. For example, it is assumed that the examination stage “coronary artery CT” is the examination stage item ID “8” of the current examination. In this case, as the examination stage candidates for the next examination, the examination stage “follow-up” with the examination stage item ID “9”, the examination stage “coronary angiography” with the examination stage item ID “10”, and the examination stage item ID “11”. The examination stage of "Medical treatment follow-up" is mentioned. The next stage determination unit 17D specifies the implementation requirements for each of the three candidates with reference to the diagnosis tree or the inter-stage DB. For example, the execution requirement of the inspection stage “follow-up” of the inspection stage item ID “9” is “normal inspection result”, and the execution requirement of the inspection stage “coronary angiography” of the inspection stage item ID “10” is “inspection result”. Is abnormal, and the implementation requirement of the inspection stage “medical treatment follow-up” of the inspection stage item ID “11” is “the test result is neither normal nor abnormal”. The next stage determination unit 17D identifies implementation requirement determination information for each implementation requirement. Implementation requirement judgment information for the implementation requirements related to the test results can be specified from the description items of the electronic medical record and medical report and the description of the Impression item.

  FIG. 15 is a diagram for explaining the processing for specifying the implementation requirement determination information, and is a diagram showing the description contents of the medical report in a table format for each item. As shown in FIG. 15, it is assumed that the finding item includes a character string “Indicating abnormalities in **” indicating an inspection result. In this case, the character string extraction unit 17A identifies the character string “abnormality was found” as the implementation requirement determination information. The next stage determination unit 17D determines candidates for requesting execution requirements that match the execution requirement determination information as inspection stages for the next inspection. For example, the implementation requirement determination information “abnormality was found” matches the implementation requirement “inspection result is abnormal”. Therefore, in this case, the next stage determination unit 17D determines the inspection stage “coronary angiography” of the stage ID “10” as the inspection stage of the next inspection.

  Implementation requirements may include facility requirements and patient requirements in addition to requirements for test results. Implementation requirement determination information for facility requirements is specified from the facility requirement determination information storage unit 13C, and implementation requirement determination information for patient requirements can be specified from the patient requirement determination information storage unit 13D. For example, the inspection stage “load SPECT” of the stage ID “5” in FIG. 5 is required to satisfy “the condition for preferential execution of the coronary artery CT” as the execution requirement, and the inspection stage “coronary artery” of the stage ID “12”. “Contrast imaging” is required as an implementation requirement “satisfies the conditions for preferential implementation of coronary artery CT”. The conditions for priority implementation of coronary artery CT mean the following facility requirements and patient requirements.

  Facility requirements: 1. Have enough experience. 2. 64 or more MDCT models are available. 3. An appropriate reporting system is operating on a clear image. 4). CT characteristics are evaluated by comparison with coronary angiography. 5. We are working on a protocol to reduce exposure dose.

Patient requirements: Be careful of exposure in women under 1.50 years of age. 2. The patient is not expected to have significant coronary calcification (eg, a dialysis patient or the elderly). 3. Serum creatinine is not more than 2.0 mg / dL. 4). eGR is 60mL / min / 1.73m ² or less not be. 5). In diabetic patients, nephropathy including microalbuminuria should not be observed. 6). There is no contrast agent allergy. 7). No asthma.

  The next stage determination unit 17D searches the facility requirement determination information DB to identify facility requirement determination information for the facility requirement associated with the inspection stage candidate. Similarly, the next stage determination unit 17D searches the patient requirement determination information DB to identify the patient requirement determination information for the patient requirement associated with the candidate examination stage. The next stage determination unit 17D determines, as the inspection stage for the next inspection, the inspection stage associated with the implementation requirements that match both the specified facility requirement determination information and the patient requirement determination information.

  As described above, the next stage determination unit 17D obtains the execution requirement determination information corresponding to the type of the execution requirement associated with the examination stage candidate from the electronic medical record, the medical report, the facility requirement determination information DB, and the patient requirement determination information DB. The inspection stage associated with the execution requirement that matches the specified execution requirement determination information is determined as the inspection stage of the next inspection.

  The inspection stage of the current inspection determined in step S3 and the inspection stage of the next inspection determined in step S4 are written in the lesion record related to the target patient and the target lesion by the read / write unit 15.

  When step S4 is performed, the control unit 11 causes the display unit 23 to perform display processing (step S5). In step S5, the display unit 23 displays the inspection stage of the current inspection and the inspection stage of the next inspection on the display device with a predetermined layout.

  FIG. 16 is a diagram illustrating a display example of the examination stage of the current examination and the examination stage of the next examination regarding the patient name “A” of the age “**”. As shown in FIG. 16, the display unit 23 displays the inspection stage of the current inspection and the inspection stage of the next inspection in a tabular layout. Hereinafter, this tabular image is referred to as a table image IT. The table image IT1 shows a table in which the horizontal axis defines the examination date and the vertical axis defines the type of lesion. In the next inspection, since the inspection date is not fixed, “next inspection” is displayed instead of the next inspection date. An inspection stage is displayed in each cell of the table. The inspection stage may be simply displayed as a character string related to the contents of the inspection stage, or may be displayed as a mark STn including a character string related to the contents of the inspection stage, as shown in FIG. In order to easily distinguish between the current inspection and the next inspection, the mark ST1 related to the inspection stage of the current inspection and the mark ST2 related to the inspection stage of the next inspection may be visually distinguished and displayed. For example, in FIG. 16, the current examination for the lesion “lung cancer” is performed on “2012/05/01”, the current examination is performed on “2012/04/01” for the lesion “stable angina”, and “ The examination stage of the current examination for “stable angina” is “coronary artery CT”, the examination stage of the current examination for “lung cancer” is “CT”, and the examination stage of the next examination for “stable angina” Shows an example in which “coronary angiography” is “CT” and the examination stage of the next examination for “lung cancer” is “CT”.

  In each cell of the table image IT1, various types of information related to the inspection corresponding to the cell may be displayed. For example, as shown in FIG. 16, in each cell, a thumbnail image Is of a medical image generated in the examination, and an examination result such as “abnormal” are shown. The thumbnail image to be displayed may be a thumbnail image of any medical image, but in practice, a thumbnail image of a key image is preferable. In the thumbnail image, a hyper ring to the original image of the thumbnail image may be embedded. The inspection result may be simply displayed as a character string indicating the content of the inspection result, or may be displayed as a mark Er including a character string indicating the content of the inspection result, as shown in FIG. Further, an electronic medical record regarding the examination, a mark M1 in which a hyperlink to a medical report is embedded, or the like may be displayed.

  The content displayed by the display unit 23 can be arbitrarily changed by the user via the operation unit 21. For example, the read / write unit 15 corrects the lesion record related to the inspection stage to be corrected, which is stored in the lesion information storage unit 13B, according to the instruction for correcting the content of the inspection stage via the operation unit 21. The display unit 23 restricts the display to only the lesion or examination according to the restriction instruction for the lesion or examination via the operation unit 21 by the user, or sorts the lesion or examination or the like via the operation unit 21 by the user. You may rearrange according to.

  The display unit 23 may display the examination stage by distinguishing between a new lesion and an existing lesion. FIG. 17 is a diagram illustrating a display example of the inspection stage of the current inspection and the inspection stage of the next inspection, which distinguishes a new lesion from an existing lesion. It is possible that a lesion determined to be a new lesion is a really unrelated lesion. The display unit 23 may display an electronic interface Ib for determining a new lesion. As shown in FIG. 17, for example, it is assumed that “stable angina” and “lung cancer” are existing lesions, and “pneumonia” is a new lesion. In this case, the display unit 23 displays an electronic button Ib for confirming whether or not “pneumonia” is a new lesion superimposed on the table image IT2. At this stage, “pneumonia” is displayed as a lesion candidate. When it is determined by pressing the electronic button that “pneumonia” is a new lesion, the display unit 23 displays the examination stage of the new lesion “pneumonia”. For example, as shown in FIG. 17, the examination stage of the current examination of the lesion “lung cancer” is displayed in the cell corresponding to the examination date “12/05/01” of the lesion “lung cancer”. Further, the read / write unit 15 adds a lesion record related to the examination stage of the new lesion “pneumonia” to the lesion information DB.

  Although the examination stage is displayed when a new lesion is confirmed, the present embodiment is not limited to this. For example, the display unit 23 may display an examination stage related to the new lesion without confirming the new lesion. In addition, a new lesion may be displayed in the same manner as an existing lesion without being confirmed by an electronic interface.

  Further, it is not always necessary to display both the inspection stage of the next inspection and the inspection stage of the current inspection. That is, the display unit 23 may display the inspection stage of the next inspection without displaying the inspection stage of the current inspection.

  This is the end of the description of the diagnostic treatment support process performed under the control of the control unit 11.

  Next, an application example of displaying the inspection stage of the next inspection by the display unit 23 will be described.

(Application 1)
The display unit 23 according to the application example 1 displays the inspection stage and the diagnosis tree for the next inspection side by side.

  FIG. 18 is a diagram illustrating a display example of the inspection stage of the next inspection according to Application Example 1. As shown in FIG. 18, the display unit 23 displays a table image IT1 and an image (hereinafter referred to as a diagnostic tree image) Id that schematically represents a diagnostic tree side by side. The user can designate an examination stage to be displayed for a diagnostic tree among a plurality of examination stages displayed on the table image IT1 via the operation unit 21. The display unit 23 displays the diagnostic tree image ID whose display range is limited to the designated examination stage and the examination stage subsequent to the designated examination stage. For example, as shown in FIG. 18, when the examination stage “coronary artery CT” of the lesion “stable angina” is designated, the display unit 23 adds to the examination stage “coronary artery CT” and the subsequent examination stage “follow-up”. The diagnostic tree image Id having a limited display range is displayed on the examination stage “coronary angiography” and the examination stage “observation of medical treatment”. By displaying the table image IT1 and the diagnostic tree image Id side by side, the user can more easily and accurately grasp the relationship between the stages. When the diagnostic tree image Id includes the examination stage STp for the current examination and the examination stage STn for the next examination, the display unit 23 may emphasize the examination stages STp and STn in the diagnostic tree image Id. Thus, the user can clearly grasp the inspection stage STp of the current inspection and the inspection stage STn of the next inspection in the diagnosis tree image ID. The user can issue an instruction to correct the inspection stage STp for the current inspection or the inspection stage STn for the next inspection on the diagnostic tree image Id via the operation unit 21. The correction can be reflected in the lesion record by the read / write unit 15 using the method described above.

  In the above description, the diagnosis tree image is an image showing a part of the entire diagnosis tree. However, this embodiment is not limited to this. The display unit 23 may display a diagnostic tree image that schematically shows the entire diagnostic tree.

  In addition, the display unit 23 may display a mark M2 in which a hyperlink to literature data related to a diagnosis tree to be displayed is embedded. When the mark M2 is selected through the operation unit 21, the display unit 23 displays the document data associated with the hyperlink embedded in the selected mark M2. For example, when a medical staff such as a doctor presents a document to a patient or the like, the patient's understanding of the diagnosis tree can be further deepened. The literature may also be used for investigation of lesions by medical personnel. Thereby, the effort which a medical worker searches for literature, and the effort which refers can be reduced.

(Application example 2)
The display unit 23 according to the application example 2 displays a warning when the next inspection implementation deadline has passed or is approaching.

  Hereinafter, the warning process will be described. The next stage determination unit 17D compares the execution date of this display process with the warning deadline date, and determines whether or not the execution date of this display process has passed the warning deadline date. The warning expiration date can be set arbitrarily. For example, when it is desired to issue a warning when the execution deadline has passed, the warning deadline date is set to the execution deadline. When it is desired to issue a warning before the implementation deadline, the warning deadline date is set to a designated date that is a predetermined period before the implementation deadline.

  As described above, the implementation deadline is entered in the lesion information DB. The next stage determination unit 17D searches the lesion information DB, identifies the due date for the next examination for each of the plurality of lesions related to the target patient, and sets the warning due date based on the identified due date. For example, in the case of the mode in which the warning deadline date is set as the execution deadline, the next stage determination unit 17D sets the specified execution deadline as the warning deadline date. In the case of the mode in which the warning deadline date is set to a date before the execution deadline, the next stage determination unit 17D sets a day that is a predetermined period before the specified execution deadline as the warning deadline date. The predetermined period can be arbitrarily set by the user via the operation unit 21 such as 10 days, a month, or a week. If it is determined that the execution date of this display process has passed the warning deadline date, the next stage determination unit 17D supplies a warning signal to the display unit 23 via the control unit 11. Upon receiving the warning signal, the display unit 23 displays a warning that the warning deadline date has passed. When it is determined that the execution date of this display process has not passed the warning deadline date, the next stage determination unit 17D does not supply a warning signal.

  FIG. 19 is a diagram illustrating a display example of the inspection stage of the next inspection according to the application example 2, and is a diagram illustrating a warning display example in a mode in which the warning due date is set to a date before the execution deadline. As shown in FIG. 19, when the next stage determination unit 17D determines that the warning due date has passed, the display unit 23 is approaching the deadline for the next inspection, which also serves as a warning for prompting the creation of an order. A warning message Me is displayed. For example, as shown in FIG. 19, the display unit 23 may display a warning message Me such as “The implementation deadline is approaching. Please create an order”. By receiving the warning, the user can prevent the user from forgetting to perform the next inspection.

  In the above description, it is determined whether or not the warning due date has passed for the next examination regarding all diseases related to the target patient. However, this embodiment is not limited to this. For example, it may be determined whether the warning expiration date has passed for the next examination by limiting to the lesion designated by the user via the operation unit 21.

  In the above description, the warning is given by display on the display unit 23. However, this embodiment is not limited to this. For example, the control unit 11 issues a warning sound or a warning message from a speaker provided in the diagnostic treatment support apparatus 1 when a warning signal is supplied from the next stage determination unit 17D. Moreover, the control part 11 may notify a warning message by mail from the communication part 19 to the computer apparatus owned by the medical staff when the warning signal is supplied from the next stage determination part 17D.

(Application 3)
The display unit 23 according to the application example 3 displays an inspection request issuance screen together with the inspection stage of the next inspection.

  FIG. 20 is a diagram illustrating a display example of the inspection stage of the next inspection according to the application example 3, and illustrates a parallel display example of the table image IT1 and the inspection request issuance screen Io. The display unit 23 displays an inspection request issuance screen Io related to the designated inspection stage when the user designates the inspection stage for the next inspection through the operation unit 21. For example, as shown in FIG. 20, when the examination stage “coronary angiography” of the lesion “stable angina” is clicked by operating the mouse, the combination of the lesion “stable angina” and the examination stage “coronary angiography” is performed. An inspection request issuance screen Io corresponding to the above is displayed. On the issuance screen Io, an examination input field i1 and a lesion input field i2 are provided. In this way, the issue screen Io is provided with a plurality of input fields for inspection requests. When displaying the issuance screen Io, the display unit 23 may display the issuance screen Io in which initial values are automatically input in the input fields. For automatic input of initial values, or the display unit 23 may hold a table in which each input field is associated with an initial value for each combination of stage ID and lesion name. In this case, the display unit 23 searches the table using the stage ID and lesion name of the designated examination stage as keywords, specifies the initial value of each input field, and automatically specifies the specified initial value in the input field. input. For example, as shown in FIG. 20, “coronary angiography” is input as an initial value in the examination input field, and “stable angina” is input as an initial value in the lesion input field.

  As described above, by allowing the inspection request issuance screen to be displayed when the inspection stage is designated, the user can reduce the labor related to the inspection request. Also, by automatically inputting input items that can be determined according to the combination of the examination stage and the lesion name, the user's labor can be further reduced.

[effect]
As described above, the diagnostic treatment support apparatus 1 according to the present embodiment includes at least the diagnostic tree storage unit 13A, the diagnostic tree determination unit 17B, and the next stage determination unit 17D. The diagnosis tree storage unit 13A stores a diagnosis tree constituted by a plurality of examination stages selectively associated with each of a plurality of lesions according to a standard transition order and execution requirements. The diagnosis tree determination unit 17B determines a target diagnosis tree related to a lesion to be examined among a plurality of diagnosis trees stored in the diagnosis tree storage unit 13A. The next stage determination unit 17D uses the inspection stage of the current inspection and the execution requirement determination information for determining whether or not the execution requirement of the next inspection is satisfied from the plurality of inspection stages included in the target diagnosis tree. Then, the inspection stage of the next inspection is determined.

  With the above configuration, the diagnostic treatment support apparatus 1 according to the present embodiment can automatically determine a diagnostic tree according to the contents of the performed examination even when there are a plurality of diagnostic trees. In addition, the next inspection after the current inspection can be automatically determined from a number of inspection stages included in the diagnosis tree. Therefore, it is possible to reduce time and labor for determining the inspection stage for the next inspection, as compared with the conventional case in which a transition to the next inspection stage is manually instructed. Moreover, the diagnostic tree according to the present embodiment has a branch according to the implementation requirements. Accordingly, it is possible to flexibly cope with changes in examination, diagnosis, and treatment as compared with the conventional case where no branching is assumed.

  Thus, according to the diagnostic treatment support apparatus 1 and the diagnostic treatment support system 100 according to the present embodiment, it is possible to improve the efficiency of medical examination management.

  Although several embodiments of the present invention have been described, these embodiments are presented by way of example and are not intended to limit the scope of the invention. These novel embodiments can be implemented in various other forms, and various omissions, replacements, and changes can be made without departing from the scope of the invention. These embodiments and modifications thereof are included in the scope and gist of the invention, and are included in the invention described in the claims and the equivalents thereof.

  DESCRIPTION OF SYMBOLS 1 ... Diagnostic treatment assistance apparatus, 11 ... Control part, 13 ... Memory | storage part, 13A ... Diagnostic tree memory | storage part, 13B ... Lesion information memory | storage part, 13C ... Facility requirement judgment information storage part, 13D ... Patient requirement judgment information memory part, 15 ... Read / write unit, 17 ... Information processing unit, 17A ... Character string extraction unit, 17B ... Diagnostic tree decision unit, 17C ... Current stage decision unit, 17D ... Next stage decision unit, 19 ... Communication unit, 21 ... Operation unit, 23 ... Display section

Claims (15)

For each of the plurality of lesions, a file storage unit that stores a file composed of a plurality of examination stages selectively associated according to a standard transition order and implementation requirements;
A file determination unit for determining a target file related to a lesion to be examined among a plurality of files stored in the file storage unit;
The inspection stage for the next inspection is determined using the inspection stage for the current inspection and the determination information for determining whether or not the requirements for the next inspection are satisfied from among the plurality of inspection stages included in the target file. The next stage decision section to
A diagnostic treatment support apparatus comprising:   The diagnostic treatment support apparatus according to claim 1, further comprising a current stage determination unit that determines an inspection stage of the current inspection from the plurality of inspection stages according to a predetermined rule. An extraction unit that extracts a character string related to the lesion to be examined from a character string included in at least one of an electronic medical record and a medical report;
The current stage determination unit determines a file corresponding to the extracted character string as the target file;
The diagnostic treatment support apparatus according to claim 2. The determination information includes a test result described in at least one of an electronic medical record and a medical report regarding the current test,
The next stage determination unit uses, as inspection stages for the next inspection, inspection stages of inspection candidates having implementation requirements that match the inspection results of the current inspection among inspection candidates associated with the inspection stage of the current inspection. decide,
The diagnostic treatment support apparatus according to claim 1. The determination information includes facility requirement determination information for determining whether or not a requirement required for a facility for performing an examination is satisfied and whether or not a requirement required for a patient is satisfied. Including at least one implementation requirement judgment information with patient requirement judgment information,
The next stage determination unit determines an inspection stage of the next inspection having an execution requirement that matches the execution requirement determination information among inspection candidates associated with the inspection stage of the current inspection. ,
The diagnostic treatment support apparatus according to claim 1. A storage unit that stores lesion information for each disease identifier, wherein the lesion information includes a disease identifier, an examination stage of a current examination, and an examination stage of a next examination;
An update unit that updates lesion information each time an examination stage is determined by the next stage determination unit;
The diagnostic treatment support apparatus according to claim 2, further comprising:   The diagnostic treatment support apparatus according to claim 6, wherein the update unit corrects the lesion information according to an instruction from a user.   The diagnostic treatment support apparatus according to claim 1, further comprising a display unit that displays an examination stage of the next examination.   The diagnostic treatment support apparatus according to claim 2, further comprising a display unit that displays an inspection stage of the next inspection and an inspection stage of the current inspection.   The diagnostic treatment support apparatus according to claim 9, wherein the display unit displays the examination stage of the next examination and the examination stage of the current examination in a table format arranged in time series for each disease.   The diagnostic treatment support apparatus according to claim 9, wherein the display unit displays the target file together with the inspection stage of the next inspection and the inspection stage of the current inspection.   12. The diagnostic treatment support apparatus according to claim 11, wherein the display unit displays the target file by visually enhancing the inspection stage of the next inspection and the inspection stage of the current inspection included in the target file. The file includes the second inspection stage from the inspection corresponding to the first inspection stage with respect to a first inspection stage of the plurality of inspection stages and a second inspection stage subsequent to the first inspection stage. Associating a standard execution deadline until the inspection corresponding to the inspection stage with the first inspection stage or the second inspection stage;
When the display unit displays the first inspection stage as the inspection stage of the current inspection and the second inspection stage as the inspection stage of the next inspection, the expiration date based on the execution deadline has passed. If so, display that effect,
The diagnostic treatment support apparatus according to claim 9.   The diagnostic treatment support apparatus according to claim 9, wherein the display unit displays a display window for requesting the next examination when the examination stage of the next examination is selected by a user. For each of the plurality of lesions, a file storage unit that stores a file composed of a plurality of examination stages selectively associated according to a standard transition order and implementation requirements;
A file determination unit for determining a target file related to a lesion to be examined among a plurality of files stored in the file storage unit;
The inspection stage for the next inspection is determined using the inspection stage for the current inspection and the determination information for determining whether or not the requirements for the next inspection are satisfied from among the plurality of inspection stages included in the target file. The next stage decision section to
A display unit for displaying an inspection stage of the next inspection;
A diagnostic treatment support system comprising: