JP2017136155A - Contrast examination support device, contrast examination support method, and contrast examination support program - Google Patents

Abstract

SOLUTION: A CPU provided to a contrast examination support device 12b detects a set of an examination name and a contrast medium name described in an examination order, and searches for a set of the examination name/contrast medium name that coincides with the detected set of the examination name/contrast medium name from one or two sets of the examination name/contrast medium name accumulated in an examination master database DB2. If the search result shows "detection," the CPU transfers image data indicating an examination execution screen to a modality 14. If the search result shows "non detection," on the other hand, the CPU displays a warning dialog on a viewer of the contrast examination support device 12b. If an "OK" button on the warning dialog is clicked, the CPU transfers the image data indicating the examination execution screen to the modality 14.EFFECT: A risk can be reduced that a medical worker performing a contrast examination uses a contrast medium erroneously.SELECTED DRAWING: Figure 1

Description

  The present invention relates to a contrast examination support apparatus, a contrast examination support method, and a contrast examination support program, and in particular, a contrast examination support apparatus, a contrast examination support method, and a contrast examination support program that support a patient's contrast examination performed according to an examination order. About.

  The contrast examination is an examination necessary for diagnosing the presence and shape of a lesion by using a contrast medium. However, the purpose of use of the contrast agent is originally defined, and if used for a purpose other than the intended purpose (misuse), the patient may die.

  Such an accident may occur when the doctor who has issued the examination order does not grasp the proper purpose of use of all the contrast agents and an incorrect contrast agent is described in the examination order. There is a possibility that an accident caused by a description mistake on the examination order can be prevented in advance by checking the examination order by the pharmacist before the contrast medium is administered. However, it is unlikely that the pharmacist will check the examination order during the contrast examination.

JP2013-148942A

  In most hospitals, the radiologist operating the modality checks side effect information in the patient's history of contrast agent use. As a result, if it is determined that the use of the contrast medium on the examination order is satisfactory for the patient, a contrast examination is performed.

  In this regard, in Patent Document 1, reference is made to the side effects of other patients having the same history as the patient to be examined, and if the patient to be examined has a similar history, the patient to be examined Is determined to have similar side effects, and an alert mark is displayed on the screen. However, in Patent Document 1, no alert is issued in relation to the purpose of use.

  Therefore, a main object of the present invention is to provide a contrast examination support apparatus, a contrast examination support method, and a contrast examination support program, which can reduce the concern that a medical worker performing a contrast examination mistakes the use of a contrast medium. That is.

  The contrast examination support apparatus according to the present invention (10: reference numeral corresponding to the embodiment; the same applies hereinafter) is detected by the detection means (S9) for detecting the set of the examination name and the contrast agent name described in the examination order. Search means (S11, S11 ') for searching for one or more sets stored in the database (DB1, DB3) for a set that matches the set, and inspection is performed when the search result of the search means indicates detection Output by the first transfer means (S15, S25) for transferring the screen information to the modality (14), warning output means (S13, S17) for outputting a warning when the search result of the search means indicates non-detection, and the warning output means The second transfer means (S21, S25) for transferring the inspection execution screen information to the modality in response to a predetermined operation for the warning.

  Preferably, the database is a database created with reference to a document attached to the contrast medium.

  Preferably, the database is a database created based on the inspection history.

  Preferably, each of the first transfer means and the second transfer means establishes modality and MWM cooperation and executes the transfer process.

  Preferably, information output means (S35 to S39, S45) for displaying the information of the contrast agent that is the target of the set detected by the detection means in relation to the processing of the first transfer means is further provided.

  More preferably, the information output means includes a contrast agent image display means (S35, S37) for displaying an image representing a contrast agent, and a document image display means (S45) for displaying an image representing a document attached to the contrast agent. Including.

  The contrast examination support method according to the present invention is a contrast examination support method executed by the processor (24) of the contrast examination support apparatus (12b), and detects a set of examination names and contrast agent names described in the examination order. Detection step (S9), Search step (S11, S11 ') for searching a set that matches the set detected by the detection step from one or more sets stored in the database (DB1, DB3), Search step The first transfer step (S15, S25) for transferring the examination execution screen information to the modality (14) when the search result of the search indicates detection, and the warning output step (S13) for outputting a warning when the search result of the search step indicates non-detection , S17), and a second transfer step (S21, S25) for transferring the examination execution screen information to the modality in response to a predetermined operation for the warning output by the warning output step.

  The contrast examination support program according to the present invention is detected by the detection step (S9), which detects the set of examination name and contrast agent name described in the examination order in the processor (24) of the contrast examination support apparatus (12b). A search step (S11, S11 ') that searches the set (1 or 2) stored in the database (DB1, DB3) for a set that matches the set, and when the search result of the search step indicates detection Output by the first transfer step (S15, S25) for transferring screen information to the modality (14), the warning output step (S13, S17) for outputting a warning when the search result of the search step indicates non-detection, and the warning output step This is a contrast examination support program for executing the second transfer step (S21, S25) for transferring the examination execution screen information to the modality in response to a predetermined operation for the given warning.

  If the set of examination name and contrast agent name described in the examination order does not match any of one or more sets stored in the database, a warning is output. The inspection execution screen information is transferred to the modality in response to a predetermined operation for the warning. As a result, it is possible to reduce a concern that a medical worker who performs a contrast examination mistakes the use of a contrast medium.

  The above object, other objects, features and advantages of the present invention will become more apparent from the following detailed description of embodiments with reference to the drawings.

It is a block diagram which shows the structure of the medical system of this Example. It is a block diagram which shows an example of the RIS terminal which comprises a medical system. It is an illustration figure which shows an example of the test | inspection master database provided in the RIS server which comprises a medical system. It is an illustration figure which shows an example of the RIS test | inspection database provided in the RIS server which comprises a medical system. It is an illustration figure which shows an example of the test | inspection list screen displayed on the viewer which comprises a contrast test support apparatus. It is an illustration figure which shows an example of the test | inspection implementation screen displayed on the viewer which comprises a contrast test support apparatus. It is an illustration figure which shows an example of the warning dialog multiplexedly displayed on a test | inspection list screen. It is a flowchart which shows a part of operation | movement of CPU which comprises a contrast examination support apparatus. It is a flowchart which shows a part of other operation | movement of CPU which comprises a contrast examination assistance apparatus. It is a flowchart which shows a part of other operation | movement of CPU which comprises a contrast examination assistance apparatus. It is an illustration figure which shows an example of the test | inspection log | history database provided in the RIS server of the other Example. It is a flowchart which shows a part of operation | movement of CPU which comprises the contrast examination assistance apparatus of another Example. It is an illustration figure which shows an example of the warning dialog multiplexedly displayed on the test | inspection list screen in another Example. It is a flowchart which shows a part of operation | movement of CPU which comprises the contrast examination assistance apparatus of another Example. It is an illustration figure which shows another example of the examination implementation screen displayed on the viewer which comprises a contrast examination support apparatus. It is an illustration figure which shows an example of the confirmation dialog multiplexedly displayed on the test | inspection list screen in another Example. It is an illustration figure which shows an example of the attached document image multiplexedly displayed on the test | inspection list screen in another Example.

[Example 1]
Referring to FIG. 1, the medical system of this embodiment is referred to as a hospital information system (hereinafter referred to as “HIS”) 10 and a radiology information system (hereinafter referred to as “RIS”) connected to each other by a hospital LAN 18. ) 12, modality 14 and image storage communication system (hereinafter referred to as “PACS”) 16.

  Here, the RIS 12 includes an RIS server 12a connected to the in-hospital LAN 18 and an RIS terminal (contrast examination support apparatus) 12b connected to the RIS server 12a. The modality 14 includes a console 14a connected to the in-hospital LAN 18 and a radiation imaging apparatus 14b operated by the console 14a.

  Further, the RIS terminal 12b is configured as shown in FIG. As shown in FIG. 2, a communication I / F 22, a CPU 24, a keyboard / mouse 26, an HDD 28, a viewer 30 and a DRAM 32 are connected to the bus BS1.

  The RIS terminal 12b is operated by a pharmacist in the preparation stage of the contrast examination. The pharmacist reads the examination name (purpose of use) that can use the contrast medium from the attached document of the contrast medium used in the hospital, and inputs the read examination name and the name of the contrast medium through the keyboard / mouse 26. The set of the entered examination name and contrast agent name is given to the RIS server 12a through the communication I / F 22, and is stored in the examination master database DB1 (see FIG. 3) together with the examination ID and the contrast agent ID. Accordingly, when the pharmacist repeats the above-described operation for a plurality of contrast agents, a plurality of examination name / contrast agent name sets are registered in the examination master database DB1.

  The examination ID is identification information assigned to the examination specified by the examination name, and the contrast agent ID is identification information assigned to the contrast agent specified by the contrast agent name. The “examination master” means master information indicating a contrast medium permitted to be used for a specific examination, and may be called an “examination contrast medium permission master”.

  A HIS terminal (not shown) constituting the HIS 10 is operated by the attending physician. When the attending physician creates an examination order by operating the HIS terminal, an HIS server (not shown) constituting the HIS 10 notifies the RIS server 12a of the created examination order via the in-hospital LAN 18. In the examination order, examination date, patient ID, patient name, examination ID, examination name, contrast agent ID and contrast agent name are described as examination information, and the examination information is stored in the RIS examination database DB2 shown in FIG. .

  The status information is information for identifying whether or not the examination has been performed, the examination date is the examination date, and the patient ID is identification information assigned to the patient specified by the patient name. The examination ID and contrast medium ID are as described above.

  The RIS terminal 12b is operated by a radiologist at the contrast examination stage. At this time, the CPU 24 executes processing according to the flowcharts shown in FIGS. A control program (contrast examination support program) corresponding to these flowcharts is stored in the HDD 28.

  Referring to FIG. 8, in step S1, the RIS server 12a is accessed through the communication I / F 22, and the examination information whose status information indicates “not implemented” is acquired from the RIS examination database DB2. The acquired inspection information is held in the DRAM 32. In step S3, an inspection list screen is drawn on the DRAM 32 based on the acquired inspection information, and the viewer 30 is instructed to display the drawn inspection list screen. When the inspection information is stored in the RIS inspection database DB2 as shown in FIG. 4, the inspection list screen is output from the viewer 30 as shown in FIG.

  In step S5, it is determined whether or not an inspection order selection operation (an operation for clicking a desired inspection item on the inspection list screen) has been performed with the keyboard / mouse 26. If the determination result is updated from NO to YES, step S5 is performed. Proceed to S7. In step S7, an inspection execution screen corresponding to the selected inspection item is drawn on the DRAM 32, and the viewer 30 is instructed to display the drawn inspection execution screen. When the inspection item at the top of the inspection list screen shown in FIG. 5 is clicked, the inspection execution screen is output from the viewer 30 in the manner shown in FIG.

  In step S9, an examination name and a contrast agent name are extracted from examination information corresponding to the clicked examination item, and an examination name / contrast agent name set is created. In step S11, the RIS server 12a is accessed through the communication I / F 22, and the RIS server 12a is requested to search for an examination name / contrast medium name set that matches the examination name / contrast medium name set created in step S9.

  When the inspection item at the top of the examination list screen shown in FIG. 5 is clicked, a set of “chest CT” and “urogura fin” is created in step S9, and “chest CT” and “urogura fin” are set in step S11. A search for a set is requested.

  Upon receiving the request, the RIS server 12a searches the examination master database DB1 for a desired examination name / contrast agent name set, and returns the search result to the RIS terminal 12b. The returned search result is received by the communication I / F 22 and notified to the CPU 24.

  In step S13, it is determined whether or not a search result indicating “non-detection” has been returned. In step S15, it is determined whether or not a search result indicating “detection” has been returned. If both the determination result in step S13 and the determination result in step S15 are NO, the process returns to step S13. If the determination result in step S15 is YES, the process proceeds to step S25. If the determination result in step S13 is YES, the process proceeds to step S13. Proceed to S17.

  In step S17, a warning dialog reflecting the examination name and the contrast agent name extracted in step S9 is created on the DRAM 32, and the viewer 30 is instructed to display the created warning dialog multiple times. When the top inspection item on the inspection list screen shown in FIG. 5 is clicked, the search result indicates “non-detection”, and a warning dialog is multiplexed on the inspection execution screen. The warning dialog has the form shown in FIG.

  According to Figure 7, “The contrast medium used is not set in the inspection contrast medium permission master. The contrast medium used for the inspection may not be appropriate. Check the information on the contrast medium package insert. "" Is displayed in the middle of the warning dialog, and the words "Examination name: [CT] chest" and "Contrast used: urografin" are displayed in the middle of the warning dialog, and the "OK" button. Is displayed in the lower center of the warning dialog. An “X” button is displayed at the upper right corner of the warning dialog.

  In step S19, it is determined whether or not the “X” button is clicked by the keyboard / mouse 26. In step S21, it is determined whether or not the “OK” button is clicked by the keyboard / mouse 26.

  If both the determination result in step S19 and the determination result in step S21 are NO, the process returns to step S19. If the determination result in step S19 is YES, the process returns to step S3. If the determination result in step S21 is YES, the process returns to step S19. After instructing the viewer 30 not to display the warning dialog in S23, the process proceeds to step S25. The output of the viewer 30 returns to the display state shown in FIG. 5 when YES is determined in step S19, and returns to the display state shown in FIG. 6 when YES is determined in step S21.

  In step S25, the MWM cooperation with the console 14a constituting the modality 14 is established via the RIS server 12a. Image data (examination execution screen information) representing the examination execution screen shown in FIG. 6 is transferred to the console 14a via the RIS server 12a and the in-hospital LAN 18. As a result, the examination execution screen is displayed on both the viewer 30 and the monitor (not shown) of the console 14a.

  The radiologist selects a contrast agent with reference to the examination execution screen, and administers the selected contrast agent to the patient placed on the radiation imaging apparatus 14b. The radiologist then operates the console 14a to perform a contrast examination (radiography). The tomographic image obtained in this way is given from the radiation imaging apparatus 14b to the console 14a and is made into a DICOM file. The DICOM file created in this way is stored in the PACS 16 via the hospital LAN 18.

  When the contrast examination is completed, the radiologist performs an end operation on the console 14a. The console 14a issues a test end notification to the RIS terminal 12b. The issued examination end notification is given to the RIS terminal 12b via the hospital LAN 18 and the RIS server 12a.

  In step S27, it is repeatedly determined whether or not an inspection end notification has been given. If the determination result is updated from NO to YES, the process proceeds to step S29. In step S29, the examination information corresponding to the current contrast examination is identified from the RIS examination database DB2, and the status information constituting the identified examination information is updated from “not implemented” to “completed”.

  In step S31, it is repeatedly determined whether or not the test end operation has been performed by the keyboard / mouse 26. When the determination result is updated from NO to YES, the process ends after releasing the MWM cooperation with the console 14a in step S33. To do.

  As can be understood from the above description, the CPU 24 provided in the contrast examination support device 12b detects the set of examination name and contrast medium name described in the examination order (S9), and the detected examination name / contrast medium name is detected. The examination name / contrast medium name set that matches the set is searched from one or more examination name / contrast medium name sets stored in the examination master database DB1 (S11). If the search result indicates “detect”, the CPU 24 transfers the image data representing the examination execution screen to the modality 14 (S15, S25). On the other hand, if the search result indicates “not detected”, the CPU 24 displays a warning dialog on the viewer 30 (S13, S17). When the “OK” button on the warning dialog is clicked, the CPU 24 transfers the image data representing the inspection execution screen to the modality 14 (S21, S25).

As described above, if the examination name / contrast medium name set detected from the examination order does not match any one or more examination name / contrast medium name sets stored in the examination master database DB1, a warning dialog is output. The The image data of the inspection execution screen is transferred to the modality 14 in response to the click operation of the “OK” button for the warning dialog. As a result, it is possible to reduce a concern that a medical worker who performs a contrast examination mistakes the use of a contrast medium.
[Example 2]

  In this embodiment, instead of the inspection master database DB1 shown in FIG. 3, an inspection history database DB3 shown in FIG. 11 is provided in the RIS server 12a. The examination history database DB3 is a database that accumulates information on contrast examinations that have been appropriately performed in the past. The accumulated information is the examination ID, examination name, contrast agent ID, and contrast agent name as in the examination master database DB1. Further, the CPU 24 constituting the RIS terminal 12b executes the process of step S11 ′ shown in FIG. 12 instead of the process of step S11.

  In addition, since the medical system of this Example is the same as the medical system of Example 1 except these differences, the overlapping description regarding the same structure is abbreviate | omitted.

  In step S11 ′ shown in FIG. 12, the RIS server 12a is accessed through the communication I / F 22, and the RIS server 12a searches for the examination name / contrast medium name set that matches the examination name / contrast medium name set created in step S9. To ask.

  As described above, the RIS server 12a that has received the request searches the examination history database DB3 for a desired examination name / contrast agent name set, and returns the search result to the RIS terminal 12b. The returned search result is received by the communication I / F 22 and notified to the CPU 24.

  In this embodiment, the warning dialog displayed by the process of step S17 shown in FIG. 9 has the appearance shown in FIG. According to FIG. 13, the phrase “Contrast medium and test combination has not been used in the past. Check the appropriate contrast medium used for the test on the contrast medium package insert.” Is displayed.

According to this embodiment, since information on past contrast examinations is accumulated in the examination history database DB3, it is possible to reduce the labor necessary for constructing the database.
[Example 3]

  In this embodiment, a photographic image of a contrast medium used in the hospital and an attached document image are additionally stored in the RIS server 12a. The photographic image is accompanied by character information indicating the contrast agent name and content. Further, the CPU 24 constituting the RIS terminal 12b additionally executes the process shown in FIG. 14 when it is determined YES in step S15 shown in FIG.

  In addition, since the medical system of this Example is the same as the medical system of Example 1 except these differences, the overlapping description regarding the same structure is abbreviate | omitted.

  Referring to FIG. 14, in step S35, the RIS server 12a is accessed through the communication I / F 22, and a photographic image of the contrast agent corresponding to the contrast agent name extracted in step S9 is acquired. In step S37, a confirmation dialog in which the acquired photograph image appears is created on the DRAM 32, and the viewer 30 is instructed to display the created confirmation dialog multiple times.

  When the second inspection item on the inspection list screen shown in FIG. 5 is clicked, the inspection execution screen shown in FIG. 15 is displayed on the viewer 30 and the search result indicates “detection”. The confirmation dialog is superimposed on the inspection execution screen in the form shown in FIG. According to FIG. 16, a photographic image of the contrast medium is displayed on the left side of the confirmation dialog, characters indicating the contrast medium name and content are displayed on the right side of the confirmation dialog, and an “attached document” button is displayed on the lower right side of the confirmation dialog. Is displayed. The “X” button is displayed in the upper right corner of the confirmation dialog.

  In step S39, it is determined whether or not the “attached document” button is clicked by the keyboard / mouse 26. In step S41, it is determined whether or not the “X” button is clicked by the keyboard / mouse 26. If both the determination result in step S39 and the determination result in step S41 are NO, the process returns to step S39. If the determination result in step S39 is YES, the process proceeds to step S45. If the determination result in step S41 is YES, the process returns to step S39. Proceed to S43.

  In step S43, the viewer 30 is instructed not to display the confirmation dialog. As a result, the confirmation dialog disappears and only the inspection execution screen is output from the viewer 30. When the process of step S43 is completed, the process proceeds to step S25.

  In step S45, the attached document image of the contrast agent corresponding to the contrast agent name extracted in step S9 is acquired from the RIS server 12a, and an alternative display of the acquired attached document image is instructed to the viewer 30. As a result, the attached document image is displayed in multiple on the inspection execution screen instead of the confirmation dialog. The attached document image displayed when the “attached document” button is clicked on the confirmation dialog shown in FIG. 16 has the appearance shown in FIG.

  In step S47, it is repeatedly determined whether or not the “X” button displayed in the upper right corner of the attached document image has been clicked. When the determination result is updated from NO to YES, the process proceeds to step S49 to instruct the viewer 30 to hide the attached document image. As a result, the attached document image disappears and only the inspection execution screen is output from the viewer 30. When the process of step S49 is completed, the process proceeds to step S25.

  According to this embodiment, when the examination name / contrast agent name set that matches the examination name / contrast agent name set created in step S9 is detected from the examination master database DB1, a photographic image of the contrast agent appears. Confirmation dialogs are displayed in multiple on the inspection execution screen, and the attached document image is displayed as a substitute in response to a click operation of the “attached document” button. This can alleviate the concern of the radiologist picking up the wrong contrast agent and administering it to the patient.

  Needless to say, the first to third embodiments described above can be combined within a range that does not contradict each other.

10 ... HIS
12 RIS
12a ... RIS server 12b ... RIS terminal 14 ... modality 14a ... console 14b ... radiation imaging device 16 ... PACS
18 ... Hospital LAN

Claims (8)

Detection means for detecting a set of examination name and contrast medium name described in the examination order;
Search means for searching for a set that matches the set detected by the detection means from among one or more sets stored in a database;
First transfer means for transferring examination execution screen information to a modality when a search result of the search means indicates detection;
A warning output means for outputting a warning when the search result of the search means indicates non-detection; and a second for transferring the examination execution screen information to the modality in response to a predetermined operation for the warning output by the warning output means. A contrast examination support device comprising transfer means.   The contrast medium examination support apparatus according to claim 1, wherein the database is a database created with reference to a document attached to the contrast medium.   The contrast medium examination support device according to claim 1, wherein the database is a database created based on an examination history.   4. The contrast medium examination support device according to claim 1, wherein each of the first transfer unit and the second transfer unit establishes MWM cooperation with the modality and executes transfer processing. 5.   5. The contrast agent according to claim 1, further comprising an information output unit that displays information on a contrast agent that is a target of the set detected by the detection unit in relation to the processing of the first transfer unit. Inspection support device.   6. The contrast agent according to claim 5, wherein the information output unit includes a contrast agent image display unit that displays an image representing the contrast agent, and a document image display unit that displays an image representing a document attached to the contrast agent. Inspection support device. A contrast examination support method executed by a processor of a contrast examination support apparatus,
A detection step for detecting a set of examination names and contrast agent names described in the examination order;
A search step of searching for a set that matches the set detected by the detection step from one or more sets stored in a database;
A first transfer step of transferring the examination execution screen information to the modality when the search result of the search step indicates detection;
A warning output step for outputting a warning when the search result of the search step indicates non-detection; and a second operation for transferring the examination execution screen information to the modality in response to a predetermined operation for the warning output by the warning output step. A contrast examination support method comprising a transfer step. In the processor of the contrast examination support device,
A detection step for detecting a set of examination names and contrast agent names described in the examination order;
A search step of searching for a set that matches the set detected by the detection step from one or more sets stored in a database;
A first transfer step of transferring the examination execution screen information to the modality when the search result of the search step indicates detection;
A warning output step for outputting a warning when the search result of the search step indicates non-detection; and a second operation for transferring the examination execution screen information to the modality in response to a predetermined operation for the warning output by the warning output step. A contrast examination support program for executing a transfer step.

Images