JP2018147244A - Information processing device, medical auditing device, and program - Google Patents

Abstract

PROBLEM TO BE SOLVED: To eliminate such a state in which no documents for recording practices of medical treatments physically exist in a system.SOLUTION: Provided is an information processing device that processes a practice record including a type of practice records which is prior associated with a type of medical treatments as an attribute, and when there is no existence of a practice record in which a practice of a medical treatment including the type of medical treatments as its attribute is recorded and the practice of the medical treatment is recorded in a first practice record excluding the type of practice records which is prior associated with the type of medical treatments as its attribute, a document generating part 24 generates a second practice record including the type of practice records which is prior associated with the type of medical treatments. The second practice record is registered as a practice record in which the practice of the medical treatment is recorded.SELECTED DRAWING: Figure 1

Description

  The present invention relates to an information processing apparatus, a medical audit apparatus, and a program.

  There is a system for recording and storing an execution of a medical practice in an implementation record document having as an attribute an implementation record document type associated in advance with the medical practice type that is the type of the medical practice.

  Patent Document 1 discloses a system that supports creation of medical plans and medical records by doctors and nurses.

JP 2001-52073 A

  By the way, an implementation of a certain medical practice may be recorded in an implementation record document having an implementation record document type that is different from an implementation record document type associated in advance with the medical practice type that is the type of the medical practice. In this case, there is actually no implementation record document having as an attribute the implementation record document type that is associated in advance with the medical practice type of the medical practice, but there is a record that the medical practice has been implemented. For this reason, it can be considered that processing is performed assuming that the execution record document does not exist in the system. However, if processing is performed in this way, the actual medical practice record document does not exist in the system, which may cause a problem when, for example, medical information is audited.

  An object of the present invention is to prevent a situation in which a document that records the implementation of a medical practice does not exist as an entity in the system.

  According to the first aspect of the present invention, a storage means for storing a medical practice type and an implementation record document type pre-associated with the medical practice type, and an implementation record document type pre-associated with the medical practice type as an attribute There is no implementation record document in which the implementation of a medical practice having the medical practice type as an attribute is recorded, and the implementation of the medical practice is associated with the medical practice type in advance Creating means for creating a second implementation record document having an implementation record document type associated in advance with the medical practice type as an attribute when recorded in a first implementation record document having no implementation record document type as an attribute; And a registration unit that registers the second implementation record document as an implementation record document in which the implementation of the medical practice is recorded.

  The invention according to claim 2 is characterized in that the second implementation record document is a dummy document having no description content or a document having information indicating a location of the implementation record of the medical practice. An information processing apparatus according to claim 1.

  The invention according to claim 3 is the information processing apparatus according to claim 2, wherein the registration unit registers the first execution record document in association with the second execution record document.

  The invention according to claim 4 is the information processing apparatus according to claim 1, wherein the second implementation record document is a copy of the first implementation record document.

  The invention according to claim 5 further includes an extracting means for extracting a portion where the medical practice is recorded from the first execution record document, and the creating means uses a copy of the extracted portion. The information processing apparatus according to claim 4, wherein the second execution record document is created.

  According to a sixth aspect of the present invention, the storage unit further stores one or a plurality of implementation record document type candidates that can be replaced by different implementation record document types, and the creation unit includes the first A document having, as an attribute, an execution record document type selected from the one or more execution record document type candidates when registering the execution record document is created as the second execution record document. An information processing apparatus according to any one of claims 1 to 5.

  The invention according to claim 7 is characterized in that the implementation record document type that can be replaced is an implementation record document type that is related to the different implementation record document type. The information processing apparatus described.

  According to an eighth aspect of the present invention, a storage means for storing a medical practice type and an implementation record document type pre-associated with the medical practice type, and an implementation record document type pre-associated with the medical practice type as an attribute. There is no implementation record document in which the implementation of a medical practice having the medical practice type as an attribute is recorded, and the implementation of the medical practice is associated with the medical practice type in advance Creating means for creating a second implementation record document having an implementation record document type associated in advance with the medical practice type as an attribute when recorded in a first implementation record document having no implementation record document type as an attribute; Registration means for registering the second implementation record document as an implementation record document in which the implementation of the medical practice is recorded, and registration of the second implementation record document when medical information is audited The information as to whether or not, and control means for displaying on the display means as the information used for the audit is a device for medical audit with.

  According to the ninth aspect of the present invention, the computer is associated with the medical practice type in advance, the storage control means for storing the medical practice type and the execution record document type previously associated with the medical practice type in the storage means. There is no implementation record document having an implementation record document type as an attribute, and there is no implementation record document in which the implementation of the medical activity having the medical practice type as an attribute exists, and the implementation of the medical practice is performed by the medical practice A second implementation record document having, as an attribute, an implementation record document type pre-associated with the medical practice type when recorded in a first implementation record document that does not have an implementation record document type associated with the species in advance as an attribute A program for causing the second implementation record document to function as a registration unit for registering the second implementation record document as an implementation record document in which the implementation of the medical practice is recorded. .

  According to the first, second, third, and ninth aspects of the present invention, it is possible to prevent a state in which a document that records the implementation of a medical practice does not exist as an entity in the system.

  According to the fourth and fifth aspects of the present invention, the second execution record document in which the practice of medical practice is actually recorded is registered.

  According to the sixth and seventh aspects of the present invention, it is easier for the operator to select an implementation record document type from among all implementation record document type candidates.

  According to the eighth aspect of the present invention, when medical information is audited, information indicating whether or not a medical practice has been performed is provided.

It is a figure which shows an example of the medical information management system which concerns on this embodiment. It is a figure which shows an example of the medical information management apparatus which concerns on this embodiment. It is a figure which shows a terminal device. It is a figure which shows an example of a document kind definition table. It is a figure which shows an example of a document management table. It is a figure which shows an example of the registration screen of a dummy document. It is a flowchart which shows an example of the registration process of a dummy document. It is a figure which shows an example of the registration screen of an implementation record document. It is a figure which shows an example of the registration status screen of an implementation record document.

  A medical information management system as an information processing system according to an embodiment of the present invention will be described with reference to FIG. FIG. 1 shows an example of a medical information management system according to the present embodiment.

  The medical information management system according to the present embodiment is a system for creating, registering, managing, etc., execution record document data in which medical practice is recorded. As an example, the medical information management system 10 as an information processing apparatus 1 or a plurality of terminal devices 12. The medical information management device 10 and the terminal device 12 have a function of communicating with each other via a communication path N such as a network, for example. The medical information management system may include other devices such as a server.

  The medical information management apparatus 10 has a function of creating, registering, managing, etc., execution record document data in which the execution of a medical practice is recorded. An instruction to create the execution record document data may be given by the medical information management apparatus 10 or may be given by the terminal apparatus 12. Further, the implementation record document data may be stored in the medical information management apparatus 10, may be transmitted to the terminal apparatus 12, and stored in the terminal apparatus 12, or may be transmitted to another apparatus such as a server and It may be stored in another device. Further, the implementation record document may be displayed on the medical information management device 10, the terminal device 12, other devices, or the like.

  The terminal device 12 is a device such as a personal computer (PC), a tablet PC, a smartphone, or a mobile phone.

  Here, the medical practice and the implementation record document will be described. A medical practice is an action performed by a medical worker such as a doctor or nurse, for example, registration of a referral letter of a patient from another hospital, return of the referral letter, reporting of a patient's visit, in-patient treatment It is an act of making a plan, operation record, operation site check, etc. Usually, when a medical practice is performed in a hospital, the implementation of the medical practice is recorded in an implementation record document by a worker such as a healthcare worker. For example, an implementation record document as a sheet or digitized implementation record document data is used, and the implementation of a medical practice is recorded in the implementation record document. The implementation record document is a document related to medical practice, such as a letter of return for a referral letter, a visit report, a hospitalization plan, a surgical record, a surgical site check, and the like.

  In the present embodiment, a medical practice type that is an attribute (for example, type) of a medical practice and an implementation record document type that is an attribute (for example, a type) of an implementation record document in which the implementation of the medical practice is to be recorded. Associated. Usually, when a certain medical practice (for example, “surgery record”) is performed by a worker such as a healthcare worker, the practice is associated with a medical practice type (for example, “surgery record”) that is an attribute of the medical practice in advance. The implementation of the medical practice is recorded in an implementation record document having a record document type (for example, “surgery record”) as an attribute. In the above example, the operation record is described in the operation record. For example, an operator such as a medical worker describes the implementation of a medical practice in an implementation record document as a form, or describes the implementation of a medical practice in data of the implementation record document.

  On the other hand, the implementation of a certain medical practice is an implementation record document having an implementation record document type as an attribute that is different from the implementation record document type previously associated with the medical practice type that is the attribute of the medical practice, or an implementation record document type in the first place. There is a case where it is recorded in an implementation record document that does not have an attribute (that is, an implementation record document that does not have an implementation record document type associated with the medical practice type in advance). For example, an implementation record document type (for example, “surgical site check form”) in which execution of a medical procedure “surgical site check” is pre-associated with a medical activity type (for example, “surgical site check”) that is an attribute of the medical activity. May be recorded in an implementation record document having an attribute of an implementation record document type (for example, “surgery record”) that is different from the above. In other words, the medical practice of “surgical site check” should be recorded in the “surgical site check form”. It may be recorded together with the implementation of a medical procedure called “surgery record”. For example, it is assumed that a medical worker records the implementation of medical actions “operation record” and “operation site check” in one “operation record”. In this case, there is actually no implementation record document (for example, “surgical site check form”) having as an attribute the implementation record document type previously associated with the medical practice type “surgical site check”. In this embodiment, in such a case, the medical information management apparatus 10 uses an execution record document type (for example, “surgical site check form”) previously associated with the medical practice type (for example, “surgical site check”) as an attribute. An implementation record document is created and the implementation record document is registered. This registration is “deemed registration”, and the implementation record document registered in this way is “deemed registration document”. Deemed registration will be described in detail later.

  As described above, in medical practice, the implementation of all medical practices is to be recorded as a regular implementation record document to be recorded (an implementation record document type previously associated with a medical practice type as an attribute of the medical practice). Recorded at an implementation record document having an attribute as an attribute of an implementation record document type previously associated with another medical practice type. There is a case.

  The implementation record document is used for medical audit, for example. In the audit, for example, an audit for evaluating whether or not a medical practice is properly performed, an audit for evaluating whether or not a predetermined medical practice is actually performed, and a predetermined order Audits to evaluate whether or not each medical practice has been implemented are conducted. The audit is performed by an auditor, for example. For example, when there is an entity (for example, paper or data) of an implementation record document in which an implementation of a certain medical practice is recorded, it is determined that the medical practice has actually been performed. As described above, the existence of the entity of the implementation record document may prove that the medical practice has been appropriately implemented. At the time of an audit, for example, information indicating the presence or absence of the actual record document or the actual record document itself is displayed on the display device, and the auditor performs an audit based on the information displayed there. In order to evaluate whether or not the audit has been properly performed, an audit may be performed on an audit performed by an auditor. Even in this case, the audit may be performed by confirming the existence of the entity of the execution record document.

  Hereinafter, each device included in the medical information management system according to the present embodiment will be described in detail.

  The medical information management apparatus 10 will be described in detail with reference to FIG. FIG. 2 shows the configuration of the medical information management apparatus 10.

  The communication unit 14 is a communication interface, and has a function of transmitting data to another device and a function of receiving data from another device. The communication unit 14 may be a communication interface having a wireless communication function or a communication interface having a wired communication function.

  The storage unit 16 is a storage device such as a hard disk or a memory, and stores various programs, various data, address information of an external device (for example, address information of the terminal device 12), and the like. The storage unit 16 includes a document storage unit 18, a document type definition storage unit 20, and a management information storage unit 22.

  The document storage unit 18 stores data of an implementation record document that records the implementation of medical practice. The data of the execution record document is created by the document creation unit 24 described later. Note that the data of the implementation record document itself may be stored in another storage device (for example, a server) without being stored in the document storage unit 18.

  The document type definition storage unit 20 stores document type definition information. The document type definition information is information indicating an association between a medical practice type that is an attribute of a medical practice and an implementation record document type that is an attribute of an implementation record document in which the implementation of the medical practice is to be recorded. For example, the document type definition information is created in advance and stored in the document type definition storage unit 20.

  The management information storage unit 22 stores management information for managing the data of the implementation record document. The management information includes, for example, patient identification information for identifying a patient (for example, patient name, patient ID, etc.), information indicating a medical practice type as an attribute of the medical practice performed on the patient, and the medical practice This is information indicating an association with information indicating an execution record document type as an attribute of the execution record document in which the execution is recorded. Further, the deemed registration information may be associated with information indicating an implementation record document type as an attribute of the deemed registered implementation record document (deemed registration document). The deemed registration information is information indicating that the implementation record document having the implementation record document type associated with the deemed registration information as an attribute is a deemed registered document (deemed registration document). The management information includes, as other information, document identification information for identifying the data of the implementation record document, information indicating the location where the data of the implementation record document is stored (for example, a URL indicating the storage location of the data) Address information) and the like. For example, the management information is updated every time data of an implementation record document is created.

  The document creation unit 24 has a function of creating data of an implementation record document. The data of the execution record document is stored in the document storage unit 18. For example, an implementation record document as a sheet describing the implementation of a medical practice is read by a scanner, and the document creation unit 24 creates implementation record document data (for example, image data) based on the read result. The implementation record document as a sheet includes, for example, patient identification information (for example, patient name and patient ID) for identifying a patient, information indicating the implementation record document type of the implementation record document, etc., as code information (for example, 1 (Dimensional barcode, two-dimensional barcode, etc.). When the execution record document as the paper is read by the scanner, the code information is also read. The document creation unit 24 analyzes the code information to acquire patient identification information, information indicating the execution record document type, and the like, and associates them with the execution record document data as management information of the execution record document. The management information is stored in the management information storage unit 22. Of course, the implementation record document data may be used without using the implementation record document as paper. The document creation unit 24 may acquire information indicating patient identification information and an execution record document type without using the code information. For example, patient identification information may be input by an operator, or may be input to the medical information management apparatus 10 from another device.

  The document management unit 26 has a function of performing processing such as registration, update, and reference of data of an implementation record document. For example, at the time of registration of the implementation record document, the document management unit 26 stores the data of the implementation record document in which the medical practice has been recorded in the document storage unit 18, and the management information of the implementation record document is stored in the management information storage unit 22. Remember me. As a result, the execution record document is registered. The document management unit 26 corresponds to an example of a registration unit.

  The control unit 28 has a function of controlling the operation of each unit of the medical information management apparatus 10. The control unit 28 includes a display control unit 30.

  The display control unit 30 has a function of controlling the display of the execution record document and other information. For example, the display control unit 30 may cause the UI unit 32 (user interface unit) or the terminal device 12 of the medical information management apparatus 10 to display an implementation record document, an implementation record document registration screen, and the like.

  The UI unit 32 is a user interface unit and includes a display unit and an operation unit. The display unit is a display device such as a liquid crystal display. The operation unit is an input device such as a touch panel or a keyboard. Of course, the UI unit 32 may be a user interface that serves as both a display unit and an operation unit (for example, a touch-type display). The medical information management apparatus 10 may not include the UI unit 32.

  In this embodiment, a medical practice type (hereinafter referred to as “target medical practice type”) as an attribute of a medical practice (hereinafter referred to as “target medical practice”) that is a target of processing such as registration processing is associated in advance. An implementation record document having the implementation record document type as an attribute, and data of the implementation record document in which the implementation of the target medical practice is recorded is not registered (for example, the data is stored in the document storage unit 18) And an implementation record document type (hereinafter referred to as “first implementation record document type”) that is different from the implementation record document type previously associated with the target medical practice type is an attribute. If it is recorded in an implementation record document or an implementation record document that does not have the implementation record document type as an attribute (hereinafter referred to as “first implementation record document”) (that is, the implementation of the target medical practice is the target physician) The document creation unit 24, the execution record document type (in the case of being recorded in the first execution record document not having the attribute of the execution record document type previously associated with the action type) ( Hereinafter, an implementation record document (hereinafter referred to as “second implementation record document”) having “second implementation record document type” as an attribute is created. The second implementation record document corresponds to a document that is regarded as being registered.

  When the data of the second implementation record document is created, the document management unit 26 stores the data of the second implementation record document in the document storage unit 18 as the implementation record document data in which the implementation of the target medical practice is recorded. The management information of the second execution record document is stored in the management information storage unit 22. Thereby, the second execution record document is regarded as being registered. In the management information of the second implementation record document, for example, the deemed registration information indicating that the second implementation record document is a registered document is the implementation record document type as the attribute of the second implementation record document. Associated with the information shown. Based on the presence / absence of association of the deemed registration information, it is determined whether or not the registered implementation record document corresponds to the deemed registered document. The document management unit 26 may store the data of the first implementation record document and the data of the second implementation record document in the document storage unit 18 in association with each other.

  Hereinafter, the process performed by the document creation unit 24 will be described in more detail.

  For example, the document creation unit 24 may create data of the second implementation record document as a dummy document, or the location of the implementation record of the target medical practice (the first implementation in which the implementation of the target medical practice is actually recorded). Data of a document having information indicating the location of the recorded document) may be created as data of the second embodiment recorded document. The dummy document may be a document having no description content, that is, a document in which no information such as a character string or an image is described, or a predetermined character string (for example, a medical practice performed). The document may be a document in which a record is not described and a character string indicating a dummy document) is described. The information indicating the location of the implementation record of the target medical practice is, for example, address information such as a URL indicating the data storage location of the first implementation record document in which the implementation of the target medical practice is actually recorded, or the first implementation record. Document identification information for identifying the document (for example, the name of the first execution record document, document ID, etc.).

  As another example, the document creation unit 24 may create a copy of at least a part of the first implementation record document as data of the second implementation record document. That is, the data of the second working record document may be data representing a copy of the whole or part of the first working record document. The document creation unit 24 functions as an example of an extraction unit, extracts a part in which the implementation of the target medical practice is recorded from the first implementation record document, and extracts a second implementation record document including a copy of the extracted part. Data may be created.

  For example, the operator manually designates a portion of the data of the first implementation record document where the implementation of the target medical practice is recorded, and the document creation unit 24 records a copy of the designated portion in the second implementation record. It may be created as document data. In this case, in the management information of the second execution record document, the information indicating that the copy portion is designated by the manual operation of the operator is associated with the information indicating the execution record document type as the attribute of the second execution record document. May be. Based on the associated information, it is determined whether or not the second execution record document has been created by a manual operation copy.

  The document creation unit 24 automatically extracts a portion where the target medical practice is recorded in the data of the first implementation record document, and creates data of the second implementation record document including a copy of the extracted portion. May be. In this case, in the management information of the second execution record document, information indicating that the copy part has been automatically specified may be associated with information indicating the execution record document type as the attribute of the second execution record document. . Based on the associated information, it is determined whether or not the second execution record document has been created by automatic copying.

  For example, the document creation unit 24 identifies the character string described as the implementation record of the target medical practice by analyzing the character string described in the first implementation record document, and includes the identified character string Data of the second implementation record document may be created.

  As another example of the automatic extraction, the document creation unit 24 selects a portion in which the implementation of the target medical practice is recorded in the data of the first implementation record document based on the relationship between the medical practice type and the implementation record document type. Data of the second implementation record document that includes a copy of the extracted part that is automatically extracted may be created. The presence / absence of relevance is determined in advance based on, for example, the actual history of medical practice records and statistical data.

  For example, the implementation of the medical practice B having the medical practice type B as an attribute is recorded in a specific portion of the implementation record document A having the implementation record document type A previously associated with the medical practice type A as an attribute. Shall be accepted. In this case, the medical practice type B is recognized in advance as a medical practice having a relationship with the implementation record document type A. For example, when the frequency at which the execution of the medical practice B is recorded in a specific part of the implementation record document A is equal to or higher than a predetermined threshold, the medical practice type B is related to the implementation record document type A. It is recognized in advance as having a medical practice. In this case, the document creation unit 24 extracts a specific part of the implementation record document A, and uses the data of the second implementation record document including a copy of the specific part as the data of the implementation record document associated with the medical practice type B. create.

  A specific example will be described. The medical action B “surgical site check” is a medical action related to the medical action A “surgical record”, and the execution record document A “surgery record” to be recorded is specified. In the portion, the implementation of the medical practice B called “surgical site check” may be recorded together with the implementation of the medical practice A “surgical record”. When creating the data of the implementation record document for the medical practice “surgical site check”, the document creation unit 24 extracts a specific part of the first implementation record document “surgical record” and copies the specific part. The data of the 2nd execution record document containing is produced as data of the 2nd execution record document about the medical practice of "surgical site check".

  When creating data of the second implementation record document using a copy of the first implementation record document, the document creation unit 24 selects a portion other than the portion where the target medical practice is recorded in the second implementation record document (second implementation record). By applying invisibility processing (for example, filling the part) to a part unrelated to the part where the target medical action is recorded in the document, the unrelated part is made invisible to the user. Also good. For example, when the data of the second implementation record document is created using the entire copy of the first implementation record document, the document creation unit 24 performs the invisible process on the portion other than the portion where the target medical practice is recorded. Apply.

  When the data of the second execution record document is generated using the copy of the first execution record document, the document creation unit 24 displays information such as a mark indicating that the data of the second execution record document is a copy. You may record in an implementation record document.

  Copying of the first implementation record document may be prohibited according to the first implementation record document type as the attribute of the first implementation record document and the second implementation record document type as the attribute of the second implementation record document. Only partial copy may be permitted. For example, when the implementation of the target medical practice is recorded in the first implementation record document prohibited from copying, or when creating the data of the second implementation record document prohibited from copying, the document creation unit 24 The dummy document data and the like are created as the second execution record document data without using the copy of the first execution record document. When the implementation of the target medical practice is recorded in the first implementation record document for which partial copy is permitted, or when the data of the second implementation record document for which creation by partial copy is permitted is created, the document creation unit 24 The data of the second implementation record document may be created using a copy of the portion of the first implementation record document where the implementation of the target medical practice is recorded.

  As another example, it is an essential condition that the data of the second implementation record document is created using a copy of the entire first implementation record document according to the first implementation record document type and the second implementation record document type. Alternatively, it may be an indispensable condition to create data of the second implementation record document using a partial copy of the first implementation record document.

  As another example, copying of the first implementation record document may be prohibited or only partial copying may be permitted depending on the target medical practice type. For example, when the target medical practice type corresponds to a copy-prohibited medical practice type, the document creation unit 24 uses the dummy document data as the second implementation record document data without using a copy of the first implementation record document. create. If the target medical practice type corresponds to a medical practice type with partial copy permission, the document creation unit 24 performs the second implementation using a copy of the portion in which the implementation of the target medical practice is recorded in the data of the first implementation record document. Create recorded document data.

  Hereinafter, the terminal device 12 will be described in detail with reference to FIG. FIG. 3 shows the configuration of the terminal device 12.

  The communication unit 34 is a communication interface and has a function of transmitting data to other devices and a function of receiving data from other devices. The communication unit 34 may be a communication interface having a wireless communication function or a communication interface having a wired communication function.

  The storage unit 36 is a storage device such as a hard disk or a memory, and stores various programs, various data, address information of external devices (for example, address information of the medical information management device 10), and the like.

  The UI unit 38 is a user interface unit and includes a display unit and an operation unit. The display unit is a display device such as a liquid crystal display. The operation unit is an input device such as a touch panel or a keyboard. Of course, the UI unit 38 may be a user interface that serves as both a display unit and an operation unit (for example, a touch-type display).

  The control unit 40 has a function of controlling the operation of each unit of the terminal device 12. The control unit 40 functions as, for example, a display control unit, and displays various types of information on the display of the UI unit 38.

  The terminal device 12 is used, for example, when registering an implementation record document. For example, when registering an implementation record document, an implementation record document registration screen is displayed on the UI unit 38 of the terminal device 12, and an operator such as a medical worker performs an operation record document registration operation using the terminal device 12. . In addition, when the second execution record document is registered, a second execution record document registration screen is displayed on the UI unit 38 of the terminal device 12, and the operator performs a second operation record document registration operation using the terminal device 12. Do. Of course, the operator may perform the registration operation using the medical information management device 10 without using the terminal device 12.

  Note that the terminal device 12 may include the document creation unit 24 and the document management unit 26, and may perform creation and registration processing of an implementation record document. Further, the terminal device 12 includes a document storage unit 18, a document type definition storage unit 20, and a management information storage unit 22, and stores data of the implementation record document, stores document type definition information, and stores management information. It may be memorized.

  Hereinafter, the document type definition information will be described in detail with reference to FIG. FIG. 4 shows an example of a document type definition table as document type definition information. The data of the document type definition table is created in advance and stored in the document type definition storage unit 20.

  In the document type definition table, for example, information indicating a medical practice type and an implementation record document type as an attribute of an implementation record document in which the implementation of the medical practice having the medical practice type as an attribute are associated with each other. It has been. For example, a medical practice type “surgery record” and an execution record document type “surgery record” are associated with each other. An implementation record document having an implementation record document type “surgery record” as an attribute is a document in which an implementation of a medical procedure having the medical operation type “operation record” as an attribute is recorded. By referring to the document type definition table, an implementation record document type associated with a medical practice type that is a target of processing such as registration processing is specified.

  Hereinafter, the management information will be described in detail with reference to FIG. FIG. 5 shows an example of a document management table as management information. Data of the document management table is stored in the management information storage unit 22.

  In the document management table, for example, a patient ID as patient identification information, information indicating a medical practice (or information indicating a medical practice type), information indicating an implementation record document (or information indicating an implementation record document type), and the like And information indicating the document update date and time are associated with each other. The medical practice associated with the patient ID is the medical practice performed on the patient having the patient ID, and the implementation record document associated with the medical practice is the medical practice performed on the patient. An implementation record document that records the practice of medical practice. The document update date / time is the creation date / time, reference date / time, update date / time, etc. of the corresponding execution record document. Further, information indicating deemed registration may be associated with the management information of the second execution record document. For example, each time an implementation record document is created, management information about the implementation record document is added to the document management table, thereby updating the document management table.

  Hereinafter, with reference to FIG. 6, the registration screen for the second embodiment recorded document will be described in detail. FIG. 6 shows an example of the registration screen. Here, as an example, an example in which a dummy document is registered as a second working record document will be described.

  For example, it is assumed that the worker performs a dummy document registration operation using the terminal device 12. In this case, when the worker accesses the medical information management device 10 using the terminal device 12, the data on the registration screen 42 is transmitted from the medical information management device 10 to the terminal device 12, and the registration screen 42 is displayed on the UI unit of the terminal device 12. 38. Of course, the operator may perform a dummy document registration operation using the UI unit 32 of the medical information management apparatus 10. In this case, a registration screen 42 is displayed on the UI unit 32 of the medical information management apparatus 10. In the following, a registration operation is performed using the terminal device 12.

  The registration screen 42 includes, for example, an ID input field, a name input field, a document type input field, and a comment field. A patient ID is entered in the ID input field. The name of the patient is entered in the name input field. In the document type input field, a second execution record document type as an attribute of the dummy document, that is, a second execution record document type as an attribute of the second execution record document to be created as a dummy document is input. In the example shown in FIG. 6, the document type input field has a pull-down format, and when the operator specifies the document type input field, a list of implementation record document types is displayed in the registration screen 42. From the list, the operator designates the second implementation record document type as the attribute of the second implementation record document for which the dummy document is to be created. Of course, the operator may designate the second implementation recorded document type by inputting a character string. Since the implementation record document type and the medical practice type are associated in advance, the medical practice type is designated by designating the implementation record document type. A comment is described by the operator in the comment column. For example, the name of the first implementation record document in which the implementation of the target medical practice is actually recorded, address information indicating the storage location of the first implementation record document, and the like are described.

  In the example shown in FIG. 6, “returned letter of introduction” is designated as the second implementation record document type as the attribute of the second implementation record document. That is, “return” is designated as the target medical practice type. In the comment section, “I also returned the letter of introduction” in the “Patient Report”. "Is entered. In other words, it is commented that the target medical action “Return” of the referral letter is not recorded in the implementation record document “Return letter of introduction” but is recorded in the implementation record document “Patient Visit Report”. It is described in the column. This implementation record document “patient visit report” corresponds to the first implementation record document. In the comment field, a URL indicating the storage location of the first implementation record document data is described.

  When the registration button image is displayed on the registration screen 42 and the operator presses the registration button image, the document creation unit 24 uses the recorded document type “returned introduction letter” as an attribute as a dummy document. Data of the second execution record document is created. As a result, data of the second implementation record document having the implementation record document type of “return of introduction” associated with the target medical practice type of “return” as an attribute is created. This dummy document may be a document having no description content or a document having information (for example, information indicating the location of the first execution record document) input in the comment field. When the data of the second execution record document is created, the document management unit 26 stores the data of the second execution record document in the document storage unit 18, and management information (for example, patient ID) of the second execution record document , Target medical practice type, implementation record document type as attributes of the second implementation record document) are added to the document management table shown in FIG. Thereby, the second execution record document is regarded and registered. Since the implementation record document type and the medical practice type are associated in advance, when the implementation record document type is designated on the registration screen 42, the target medical practice type associated with the implementation record document type is designated. Will be.

  As described above, data as the substance of the second execution record document is created, and the data and management information are stored.

  Hereinafter, with reference to the flowchart shown in FIG. 7, a process of registering a dummy document as the second execution record document will be described.

  First, when an operator accesses the medical information management device 10 using the terminal device 12 and requests registration of a dummy document, information indicating the request is transmitted from the terminal device 12 to the medical information management device 10 and medical information is displayed. The control unit 28 of the management apparatus 10 receives information indicating the request (S01). When the control unit 28 receives information indicating the request, the control unit 28 transmits data of a registration screen 42 (see FIG. 6) for registering the dummy document to the terminal device 12. As a result, the registration screen 42 is displayed on the UI unit 38 of the terminal device 12.

  Next, on the registration screen 42, the worker inputs a patient ID, a patient name, an implementation record document type as an attribute of the second implementation record document, a comment, and the like, and gives an instruction to register a dummy document. It can be said that the target medical practice type is designated by designating the implementation record document type. Information indicating the registration instruction is transmitted from the terminal device 12 to the medical information management apparatus 10, and when the document creation unit 24 of the medical information management apparatus 10 receives the information indicating the registration instruction, the information is displayed as a second implementation record document. Dummy document data is created (S02).

  Next, the document management unit 26 stores the data of the dummy document as the second implementation record document in the document storage unit 18, and management information (for example, patient ID, medical practice type, implementation record) of the second implementation record document Document type) is stored in the management information storage unit 22 (S03). Thereby, the second execution record document is regarded and registered.

  As described above, the second implementation record document is created and registered by creating and registering the data of the second implementation record document having the implementation record document type previously associated with the target medical practice type as the attribute of the target medical practice. Is not present in the medical information management system.

(Modification)
Hereinafter, modified examples will be described. In the above-described embodiment, the registration operation of the second execution record document is performed via the registration screen of the second execution record document. However, in the modification, the second operation is performed via the registration screen of the first execution record document. A registered document registration operation is performed. Hereinafter, the modification will be described in detail with reference to FIG. FIG. 8 shows an example of a registration screen for the first execution record document.

  For example, it is assumed that an operator performs an operation for registering an implementation record document using the terminal device 12. In this case, when the worker accesses the medical information management device 10 using the terminal device 12, the data on the registration screen 44 is transmitted from the medical information management device 10 to the terminal device 12, and the registration screen 44 is displayed on the UI unit of the terminal device 12. 38. Of course, the operator may perform an operation for registering an execution record document using the medical information management apparatus 10. In this case, a registration screen 44 is displayed on the UI unit 32 of the medical information management apparatus 10. In the following, it is assumed that a registration operation is performed using the terminal device 12.

  The registration screen 44 includes a document display area 46, an attribute display area 48, and a document type selection field 50. In the document display area 46, an image of an implementation record document to be registered is displayed. For example, when registering an implementation record document as paper, the operator reads the implementation record document with a scanner, and the document creation unit 24 creates implementation record document data (image data) by reading the document. In the document display area 46, an image of the implementation record document created by the reading is displayed. In the implementation record document, patient identification information, information indicating an implementation record document type as an attribute of the implementation record document, and the like are described as code information. The code information is also read by reading the execution record document by the scanner, and the document creation unit 24 analyzes the code information to acquire patient identification information and information indicating the execution record document type. In the attribute display area 48, information indicating the type of recorded record document, patient identification information, and the like are displayed.

  The implementation record document as paper may not be used, and an electronic implementation record document may be used. In this case, when registering the data of the implementation record document, an image of the implementation record document is displayed in the document display area 46 and information indicating the implementation record document type is displayed in the attribute display area 48.

  When the registration button image is displayed on the registration screen 44 and the operator presses the registration button image, the document management unit 26 stores the data of the implementation record document to be registered in the document storage unit 18, and The management information of the implementation record document (for example, patient ID, target medical practice type, implementation record document type) is added to the document management table shown in FIG. As a result, the execution record document is registered.

  In the document type selection field 50, the second implementation record document type as an attribute of the second implementation record document is input. The document type selection field 50 has, for example, a pull-down format. When the operator designates the document type selection field 50, a list of second implementation recorded document types is displayed on the registration screen 44. Of course, the operator may designate the second implementation recorded document type by inputting a character string. When the operator selects the second implementation recording document type in the document type selection field 50 and presses the detailed button image, the screen changes, and the registration screen 42 shown in FIG. It is displayed on the part 38. Similar to the above-described embodiment, the registration operation of the second execution record document is performed on the registration screen 42.

  For example, the implementation record document displayed in the document display area 46 in the registration screen 44 corresponds to the first implementation record document, and the implementation of the target medical practice, that is, the first implementation record document is included in the first implementation record document. It is assumed that the implementation of a medical practice (target medical practice) other than the medical practice having as an attribute the medical practice type previously associated with the first implementation record document type as the attribute is recorded. Further, it is assumed that the target medical practice type as an attribute of the target medical practice is “return”, and the second implementation record document type pre-associated with the target medical practice type is “return letter of introduction”. In this case, as shown in FIG. 8, in the document type selection column 50, the user selects the second implementation recorded document type “return letter of introduction”, and then presses the detailed button image. When the operator inputs a comment or the like on the registration screen 42 shown in FIG. 6 and presses the registration button image, the document creation unit 24 has an implementation record document type “returned letter of introduction” as an attribute. Data of the second execution record document is created. The document creation unit 24 may create a dummy document as data of the second execution record document, or copy all or part of the first execution record document displayed in the document display area 46 in the second execution record. It may be created as document data. The operator designates a part to be copied in the image of the first execution record document displayed in the document display area 46, and the document creation unit 24 copies the designated part to the second execution record. It may be created as document data. The document management unit 26 stores the data of the second execution record document in the document storage unit 18, and stores the management information of the second execution record document in the management information storage unit 22. Thereby, the second execution record document is regarded and registered. After the registration screen 42 is displayed, when the second execution record document is regarded and registered, the screen transitions to the registration screen 44. When the user presses the registration button image on the registration screen 44, the first execution record document is registered. In addition, when an instruction for screen transition is given by the worker while the registration screen 42 is displayed (for example, when the screen transition button image is pressed by the worker), the screen returns to the registration screen 44.

  As described above, when the first implementation record document is registered, the second implementation record document is also registered, and a situation in which the entity of the second implementation record document does not exist in the medical information management system is prevented.

  Hereinafter, candidates for the second embodiment recording document type displayed in the document type selection field 50 will be described. In the document type selection field 50, all the implementation record document types registered in the document type definition table may be displayed as a list of candidates for the second implementation record document type.

  As another example, the document type selection field 50 relates to the first implementation record document type as the attribute of the first implementation record document displayed in the document display area 46 (between the first implementation record document). One or a plurality of implementation record document types (which have relevance) may be listed as candidates for the second implementation record document type. The implementation record document type having a relationship with the first implementation record document type can be replaced by the first implementation record document type (hereinafter referred to as “substitutable document type”). The implementation record document having the replaceable document type as an attribute is an implementation record document that can be replaced by the first implementation record document (hereinafter referred to as “substitutable document”). That is, the first implementation record document type can be replaced with the implementation record document type (substitutable document type) having a relationship with the first implementation record document type (substitution is possible). It is an implementation record document type that can be used instead of the document type, and the first implementation record document can be used instead of the replaceable document. Possible implementation record document).

  For example, in the document type definition table, for each implementation record document type, one or a plurality of implementation record document types (substitutable document types) having a relationship with the implementation record document type are associated in advance. . That is, for each medical practice type, one or a plurality of medical practice types having a relationship between the medical practice types are associated in advance. The presence / absence of the relevance is determined in advance based on, for example, the actual history of medical practice records and statistical materials.

  For example, an implementation record document A includes an implementation of a medical practice A having as an attribute a medical practice type A previously associated with the implementation record document type A as an attribute of the implementation record document A, and the medical practice type A It shall be generally accepted that the implementation of medical practice B having different medical practice types B as attributes is recorded. In this case, the medical practice type B is recognized as a medical practice having a relationship with the medical practice type A, and the implementation record document type B previously associated with the medical practice type B is the implementation record document type A. It is recognized in advance that it is an implementation record document type having a relationship with. That is, the implementation record document type B is an implementation record document type (substitutable document type) that can be replaced by the implementation record document type A, and the implementation record document B can be replaced by the implementation record document A. This is an implementation record document (substitutable document). In other words, the implementation record document type A is an implementation record document type that can be substituted for the implementation record document type B (an implementation record document that can be used in place of the implementation record document type B as an alternative document type). The implementation record document A is an implementation record document that can be substituted for the implementation record document B (an implementation record document that can be used in place of the implementation record document B as a substitutable document). .

  For example, if the frequency at which the execution of the medical practice B is recorded in the implementation record document A is greater than or equal to a predetermined threshold based on the history of the implementation record, the medical practice B is related to the medical practice A. The implementation record document type B is certified as an implementation record document type that is related to the implementation record document type A. In this case, in the document type definition table, the implementation record document type B (substitutable document type) is associated in advance with the implementation record document type A as a candidate for the second implementation record document type. When the implementation record document A having the implementation record document type A as an attribute is registered as the first implementation record document, the implementation record document type B (substitutable document type) having a relationship with the implementation record document type A is set. In other words, the execution record document type B previously associated with the execution record document type A as the second execution record document type candidate in the document type definition table is displayed in the document type selection column 50 as the second execution record document type candidate. Is done. In this way, by displaying the second implementation record document type candidates (substitutable document types) having a relationship with the first implementation record document type, all the implementation record document types are displayed in the second implementation record document. Compared with the case of displaying as a seed candidate, the operator can easily select the second execution recorded document kind.

  In the document type definition table, one or a plurality of non-replaceable execution record document types (non-replaceable document types) may be associated in advance for each individual execution record document type. In this case, the non-substitutable document type is not displayed in the document type selection field 50 as a candidate for the second implementation recording document type, and is not selected by the operator.

  The non-substitutable document type is, for example, an implementation record document type that has no relationship between the non-substituting document type and the implementation record document type associated in advance. In the example described above, when the frequency at which the execution of the medical practice B is recorded in the implementation record document A is less than the threshold, the medical practice B is a medical practice that is not related to the medical practice A. The implementation record document type B is previously authorized as an implementation record document type that is not related to the implementation record document type A. In this case, in the document type definition table, the implementation record document type B is associated in advance with the implementation record document type A as an irreplaceable document type.

  As another example, the non-substitutable document type may be an implementation record document type that is prohibited from being replaced by an implementation record document type that is previously associated with the non-substituting document type. For example, non-substitutable document types are prohibited from being replaced by performance record document types for which deemed registration is prohibited (for example, document types that are more important than other performance record document types) or dummy documents. Document type.

  Further, the non-substitutable document type does not have to be displayed in the document type input column for designating the second execution recording document type in the registration screen 42 shown in FIG. May not be possible. As a result, since the non-substitutable document type is not selected by the operator, the second implementation record document having the non-substitutable document type as an attribute is not created, and only the second implementation record document is not registered.

  Hereinafter, a screen (hereinafter referred to as “registration status screen”) showing the registration status of the implementation record document will be described with reference to FIG. FIG. 9 shows an example of a registration status screen.

  For example, the registration status screen data is transmitted from the medical information management device 10 to the terminal device 12 and displayed on the UI unit 38 of the terminal device 12. Of course, the registration status screen may be displayed on the UI unit 32 of the medical information management apparatus 10. The registration status screen data is created by, for example, the display control unit 30 of the medical information management apparatus 10. The registration status screen is displayed, for example, when a medical audit is performed, and the audit is performed based on information displayed on the registration status screen.

  The registration status screen includes, for example, an entrance / exit attribute display area and a document classification display area.

  In the entrance / exit attribute display area, for example, for each patient, information indicating the patient ID, the patient name, information indicating the date of admission (date of entering a specific clinical department), date of dismissal (withdrawing from a specific clinical department) Information indicating the date of treatment) and information indicating the used medical department are displayed in association with each other.

  In the document classification display area, information indicating whether or not each execution record document is registered is displayed for each patient. Moreover, the classification of the implementation record document type is defined, and the implementation record document includes, for example, an implementation record document group relating to hospitalization, an implementation record document group relating to surgery, an implementation record document group relating to discharge, or other implementation record document groups. It is classified. For example, an implementation record document group relating to hospitalization includes an “entrance / exit medical plan”, an operation record document group relating to surgery includes an “operation record”, and an implementation record document group relating to discharge includes “ A “discharge certificate” is included, and other implementation record documents include an “introduction letter”.

  As information indicating the presence / absence of registration, for example, an image indicating the presence / absence of registration is displayed. For example, a registered image is displayed in a display column corresponding to an execution record document registered without being regarded as being registered. A deemed registered image is displayed in the display column corresponding to the deemed-registered implementation record document (that is, the implementation record document registered as the second implementation record document). An unregistered image is displayed in the display column corresponding to the execution record document that is not registered. Each image is created by, for example, the display control unit 30 of the medical information management apparatus 10.

  Whether or not the execution record document is registered is determined based on the management information stored in the management information storage unit 22.

  In the management information, an implementation record document having an implementation record document type that is not associated with deemed registration information as an attribute is an implementation record document registered without being deemed registered. Therefore, the registered image 52 is displayed in the display column corresponding to the implementation record document. An image having the same pattern as the registered image 52 is also a registered image. For example, a registered image is displayed in the display column corresponding to the “hospital care plan” for “general medicine” with the patient name “A river A male”. This indicates that the “hospital care plan” has been registered without being regarded as being registered.

  The implementation record document having the implementation record document type associated with the deemed registration information as an attribute is the implementation record document registered as the second implementation record document. Therefore, the deemed registered image 54 or the deemed registered image 56 is displayed in the display column corresponding to the implementation record document.

  The deemed registration image 54 is an image representing deemed registration by manual operation. The second execution record document created by manual operation is, for example, a dummy document created by an operator's instruction or a document created by copying by an operator's manual operation (created by the operator specifying a copy part) Document). The deemed registered image 54 is an image representing a document created in this way. An image having the same pattern as the deemed registration image 54 is also an image representing deemed registration by manual operation. For example, the deemed registration image 54 is displayed in the display column corresponding to the “medical information provision form” for “general medicine” with the patient name “A river A male”. This indicates that the “medical care information provision form” has been created and registered by manual operation.

  The deemed registration image 56 is an image representing deemed registration performed automatically. The automatically created second execution record document is, for example, a document created by automatic copying (a document created by automatically specifying the copy portion). The deemed registered image 56 is an image representing a document created in this way. An image having the same pattern as the deemed registration image 56 is also an image representing deemed registration that is automatically performed. For example, the deemed registration image 56 is displayed in the display column corresponding to the “medical information provision form” for “plastic surgery” with the patient name “B water B woman”. This indicates that the “medical care information provision form” has been created and registered by automatic copying.

  Of course, an image representing deemed registration may be displayed without distinguishing between manual operation and automatic deemed registration.

  An implementation record document that is not registered in the management information is an implementation record document that is not registered. Therefore, the unregistered image 58 is displayed in the display field corresponding to the implementation record document. An image having the same pattern as the unregistered image 58 is also an image representing unregistered. For example, an unregistered image 58 is displayed in the display column corresponding to “discharge certificate” for “general medicine” with the patient name “A river A male”. This indicates that the “discharge certificate” is not registered. The unregistered image 58 is an image indicating that an implementation record document that is required to be registered is not registered. In the above example, the “discharge certificate” that is required to be registered is not registered.

  A blank portion 60 represents unregistered. For example, the display column corresponding to the “patient questionnaire” for “general medicine” with the patient name “A river A male” is blank. This indicates that the “patient questionnaire” is not registered. The blank portion 60 indicates that any execution record document to be registered is not registered. In the above example, the “patient questionnaire” whose registration is arbitrary is not registered.

  Of course, an image indicating unregistered may be displayed without distinguishing between the implementation record document that must be registered and the implementation record document that has any registration.

  The unmanaged image 62 is an image representing an implementation record document that is not scheduled to be created. For example, for patients who are not scheduled to perform surgery, there is no plan to create an operation record document related to the operation, and therefore an unmanaged image 62 is displayed in the display column corresponding to such an operation record document. An image having the same pattern as the unmanaged image 62 is also an image representing an implementation record document that is not scheduled to be created.

  As described above, the registration status of each execution record document is presented. Compared to the case where the registration status is not presented, for example, at the time of auditing, it becomes easier for the auditor to determine the registration status of the implementation record document. Further, by distinguishing and displaying the registered image and the registered image, it is easier to determine whether or not the implementation record document is a registered document as compared with the case of displaying them without distinguishing them.

  In the embodiment and the modification described above, the data of the implementation record document corresponds to, for example, one document file. However, this is only an example, and the data of the implementation record document may be data including a plurality of document files. It may be information provided by an electronic medical record system or the like.

  Each of the medical information management device 10 and the terminal device 12 is realized by cooperation of hardware and software, for example. Specifically, each of the medical information management device 10 and the terminal device 12 includes one or more processors such as a CPU (not shown). The function of each part of the medical information management device 10 and the terminal device 12 is realized by the one or more processors reading and executing a program stored in a storage device (not shown). The program is stored in the storage device via a recording medium such as a CD or DVD, or via a communication path such as a network. As another example, the units of the medical information management apparatus 10 and the terminal apparatus 12 may be realized by hardware resources such as a processor, an electronic circuit, and an ASIC (Application Specific Integrated Circuit). In the realization, a device such as a memory may be used. As yet another example, each unit of the medical information management device 10 and the terminal device 12 may be realized by a DSP (Digital Signal Processor), an FPGA (Field Programmable Gate Array), or the like.

  DESCRIPTION OF SYMBOLS 10 Medical information management apparatus, 12 Terminal device, 18 Document storage part, 20 Document type definition storage part, 22 Management information storage part, 24 Document creation part, 26 Document management part, 28 Control part, 30 Display control part.

Claims (9)

Storage means for storing a medical practice type and an implementation record document type pre-associated with the medical practice type;
An implementation record document having an implementation record document type previously associated with the medical practice type as an attribute, and no implementation record document having an implementation of the medical practice type having the medical practice type as an attribute exists, and When the implementation of the medical practice is recorded in the first implementation record document that does not have the implementation record document type pre-associated with the medical practice type as an attribute, the implementation record document type pre-associated with the medical practice type Creating means for creating a second execution record document having as an attribute;
Registration means for registering the second implementation record document as an implementation record document in which the implementation of the medical practice is recorded;
An information processing apparatus. The second implementation record document is a dummy document having no description content, or a document having information indicating the location of the implementation record of the medical practice,
The information processing apparatus according to claim 1. The registration means registers the first implementation record document in association with the second implementation record document;
The information processing apparatus according to claim 2. The second implementation record document is a copy of the first implementation record document;
The information processing apparatus according to claim 1. And further comprising an extracting means for extracting a portion where the implementation of the medical practice is recorded from the first implementation record document,
The creating means creates the second implementation record document using a copy of the extracted portion;
The information processing apparatus according to claim 4. The storage means further stores one or a plurality of implementation record document type candidates that can be replaced by different implementation record document types,
The creation means creates a document having, as the second implementation record document, an implementation record document type selected from the one or more implementation record document type candidates when registering the first implementation record document. To
The information processing apparatus according to claim 1, wherein the information processing apparatus is an information processing apparatus. The implementation record document type that can be replaced is an implementation record document type that is related to the different implementation record document type.
The information processing apparatus according to claim 6. Storage means for storing a medical practice type and an implementation record document type pre-associated with the medical practice type;
An implementation record document having an implementation record document type previously associated with the medical practice type as an attribute, and no implementation record document having an implementation of the medical practice type having the medical practice type as an attribute exists, and When the implementation of the medical practice is recorded in the first implementation record document that does not have the implementation record document type pre-associated with the medical practice type as an attribute, the implementation record document type pre-associated with the medical practice type Creating means for creating a second execution record document having as an attribute;
Registration means for registering the second implementation record document as an implementation record document in which the implementation of the medical practice is recorded;
When medical information is audited, control means for displaying information on the presence or absence of registration of the second implementation record document on the display means as information used for the audit;
A medical auditing device. Computer
Storage control means for storing in the storage means a medical practice type and an execution record document type pre-associated with the medical practice type;
An implementation record document having an implementation record document type previously associated with the medical practice type as an attribute, and no implementation record document having an implementation of the medical practice type having the medical practice type as an attribute exists, and When the implementation of the medical practice is recorded in the first implementation record document that does not have the implementation record document type pre-associated with the medical practice type as an attribute, the implementation record document type pre-associated with the medical practice type Creating means for creating a second implementation record document having as an attribute,
Registration means for registering the second implementation record document as an implementation record document in which the implementation of the medical practice is recorded;
Program to function as.

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