JP2018190260A - Medical information management apparatus and medical information sharing system - Google Patents

Abstract

PROBLEM TO BE SOLVED: To improve the efficiency of a system sharing medical information.SOLUTION: A medical information management apparatus 10 for storing medical information of patients stores, for each patient, consent form acquisition/non-existence information indicating whether a consent form relating to the sharing of medical information of the patient is already obtained in association with a medical personnel who should obtain the consent form. When the consent form corresponding to a target patient is already obtained, the medical information of the patient is disclosed to a facility terminal 20 with which data communication can be performed via a communication network N. When the consent form corresponding to the target patient is not yet obtained, reference to the medical information of the patient from the facility terminal 20 is disabled. With respect to the patient for whom the consent form is not yet obtained, the medical information management apparatus 10 issues a warning prompting obtaining the consent form to a notification destination of the medical personnel who should obtain the consent form corresponding to the patient at a predetermined timing.SELECTED DRAWING: Figure 1

Description

  The present invention relates to a medical information management apparatus and a medical information sharing system.

  In recent years, with the diversification of medical technology, medical cooperation in which a plurality of medical facilities such as hospitals and clinics having a specific function share medical information and perform examination and treatment of patients in cooperation is becoming widespread. In addition, the importance of home care and nursing care is increasing, and patient information is being shared among medical facilities such as hospitals, clinics, home-visit nursing stations, and nursing care offices. Specifically, a system is used in which medical information is uploaded from each medical facility to a medical information management apparatus connected via a communication network, and the medical information is downloaded from another medical facility with which it is linked.

Since medical information such as test results and medical records is personal information of the patient, in order to use the medical information in other medical facilities, it is necessary to obtain a consent form for information sharing from the patient.
For example, when the medical terminal requests the shared server device to provide the shared medical chart, the shared server apparatus checks the provision agreement information, and when the patient agrees to provide the shared medical chart, the shared medical chart is transferred to the medical terminal. A medical information system has been proposed that refuses to provide a shared chart when the patient does not agree to provide the shared chart (see Patent Document 1).

JP 2007-052815 A

  However, even if a system for sharing medical information via a communication network is introduced in each medical facility, there is a problem that it takes time to obtain the consent form itself in an actual medical field. Since the medical information is not disclosed while the consent form is not obtained, it is not possible to obtain merits such as the efficiency of medical care and nursing care and the reduction of the burden on patients by sharing information between medical facilities.

  The present invention has been made in view of the above problems in the prior art, and an object thereof is to improve the efficiency of a system for sharing medical information.

  In order to solve the above-mentioned problem, the invention described in claim 1 is a medical information management device having medical information storage means for storing medical information of a patient for each patient, and for each patient, A consent form information storage means for storing the consent form information indicating whether or not a consent form relating to sharing of medical information is obtained, and a medical person who should obtain the consent form, and a target The patient is judged whether or not a consent form corresponding to the patient is obtained based on the information on whether or not the consent form corresponding to the patient is obtained, and it is judged that the consent form corresponding to the patient is obtained. If the medical information of the patient is disclosed to a terminal device capable of data communication with the medical information management device via a communication network, and it is determined that the consent form corresponding to the patient is not obtained In addition, Based on the public control means for making it impossible to refer to the medical information of the patient from the terminal device and the consent form acquisition presence / absence information, the patient is determined to have received no consent form at a predetermined timing. And a warning means for notifying a medical person who should obtain a consent form corresponding to the patient of a warning prompting to obtain the consent form.

  The invention according to claim 2 is the medical information management device according to claim 1, wherein for each patient, a date for storing a date on which medical information sharing is explained to the patient or the patient's family Storage means, the warning means for the patient for whom it is determined that the consent form has not been obtained, when the predetermined time has passed since the date corresponding to the patient stored in the date storage means Send a warning prompting you to obtain the certificate.

  The invention according to claim 3 is the medical information management device according to claim 1 or 2, further comprising interval day storage means for storing predetermined interval days, wherein the warning means is stored in the interval days storage means. A warning prompting to obtain the consent form is notified at the stored interval days.

  The invention according to claim 4 is the medical information management device according to any one of claims 1 to 3, wherein the patient is determined not to obtain a consent form based on the consent form availability information. Is provided with a second warning means for notifying the patient's notification destination of a warning prompting the submission of the consent form at a predetermined timing.

  The invention described in claim 5 is the medical information management device according to any one of claims 1 to 4, wherein the patient is determined not to obtain a consent document based on the consent document acquisition information. Is provided with upload control means for disabling uploading of the patient's medical information from the terminal device.

  The invention according to claim 6 is the medical information management device according to any one of claims 1 to 4, wherein when a request for uploading medical information is received from the terminal device, When it is determined that the consent form corresponding to the patient has not been obtained based on the corresponding consent form availability information, the medical information to be uploaded is stored in the holding area, and the consent form corresponding to the patient is obtained. And upload control means for storing the medical information stored in the reserved area in the medical information storage means after it is determined that the medical information is stored.

  The invention according to claim 7 is a medical information management device having medical information storage means for storing medical information of the patient for each patient, and a terminal device capable of data communication with the medical information management device via a communication network A medical information sharing system comprising: the medical information management device, for each patient, consent form acquisition presence / absence information indicating whether or not a consent form related to sharing of the patient's medical information is obtained; A consent form corresponding to the patient based on the consent form acquisition information corresponding to the patient for the target patient and the consent form information storage means for storing the medical person who should obtain the consent form in association with each other If it is determined that the consent form corresponding to the patient is obtained, the patient's medical information is disclosed to the terminal device, and the patient is dealt with. When it is determined that the consent form has not been obtained, the consent form is obtained based on the public control means for prohibiting reference to the patient's medical information from the terminal device and the consent form availability information. A warning means for notifying a medical person who should obtain a consent form corresponding to the patient at a predetermined timing for a patient determined not to receive a warning prompting the acquisition of the consent form. .

  According to the present invention, it is possible to improve the efficiency of a system for sharing medical information.

It is a system configuration figure of a medical information sharing system in an embodiment of the invention. It is a block diagram which shows the functional structure of a medical information management apparatus. It is a figure which shows the example of a facility information table, a user information table, a patient information table, an agreement information table, a name collation information table, and a file information table. It is a figure which shows the folder structure in a file storage part. It is a block diagram which shows the functional structure of a facility terminal. It is a flowchart which shows the patient registration process performed by a medical information management apparatus. It is a flowchart which shows the patient registration process performed by a medical information management apparatus. It is a ladder chart which shows the consent document information registration process at the time of consent document acquisition performed with a medical information management apparatus and a facility terminal. It is a ladder chart which shows consent form information registration processing at the time of consent withdrawal performed by a medical information management device and a facility terminal. It is a flowchart which shows the consent form unacquisition remind process performed by the medical information management apparatus. It is a flowchart which shows the consent form unacquisition remind process performed by the medical information management apparatus. It is a ladder chart which shows the upload process performed by a medical information management apparatus and a facility terminal. It is an example of a patient list screen. It is an example of an upload screen. It is a ladder chart which shows the information reference process performed by a medical information management apparatus and a facility terminal. It is an example of the reference screen of the patient from whom consent form is not acquired. It is an example of the reference screen of the patient from whom consent form is obtained. It is an example of a visit record display screen. It is a ladder chart which shows the 2nd upload process performed by the medical information management apparatus and facility terminal in the modification 2.

  Hereinafter, an embodiment of a medical information sharing system according to the present invention will be described with reference to the drawings. However, the scope of the invention is not limited to the illustrated examples.

[Configuration of medical information sharing system]
FIG. 1 shows a system configuration of a medical information sharing system 100 in the present embodiment.
As shown in FIG. 1, a medical information sharing system 100 includes a medical information management device 10, a facility terminal 20 as a terminal device used by medical personnel belonging to each medical facility, and a patient terminal 30 used by a patient. , And is configured. The medical information management device 10, the facility terminal 20, and the patient terminal 30 are connected via a communication network N so that data communication is possible.

  The medical information management apparatus 10 accumulates and manages medical information registered from the facility terminal 20. The medical information management apparatus 10 may be a cloud server provided in a cloud environment.

The facility terminal 20 is a computer device such as a PC (Personal Computer), a tablet terminal, or a smartphone used by medical personnel belonging to each medical facility. Medical facilities include hospitals and clinics to which the attending physician belongs, visiting nursing stations to which nurses who perform patient home-visiting care, care managers to create patient care plans, and visiting caregivers to provide patient home-care Examples include nursing care offices to which they belong and dispensing pharmacies to which pharmacists belong.
Medical personnel involved in patient examination, treatment, home care / care, etc. register medical information about the patient from the facility terminal 20. The registered medical information is stored in the medical information management apparatus 10.

  The patient terminal 30 is a computer device such as a PC, a tablet terminal, or a smartphone used by a patient.

[Configuration of medical information management device]
FIG. 2 shows a functional configuration of the medical information management apparatus 10.
As shown in FIG. 2, the medical information management apparatus 10 includes a control unit 11, an operation unit 12, a display unit 13, a communication unit 14, a RAM 15, a storage unit 16, a time measuring unit 17, and the like. They are connected by a bus 18.

  The control unit 11 is configured by a CPU (Central Processing Unit) and the like, and comprehensively controls the processing operation of each unit of the medical information management apparatus 10. Specifically, the CPU reads out various processing programs stored in the storage unit 16 in accordance with an operation signal input from the operation unit 12 or an instruction signal received by the communication unit 14, and expands it in the RAM 15. Various processes are performed in cooperation with the program.

  The operation unit 12 includes a keyboard having a cursor key, a character input key, various function keys, and the like, and a pointing device such as a mouse. The control unit 11 receives an operation signal input by a key operation or a mouse operation on the keyboard. Output to.

The display unit 13 includes a monitor such as an LCD (Liquid Crystal Display), and displays various screens according to instructions of a display signal input from the control unit 11.
Note that the operation unit 12 and the display unit 13 are not essential components of the medical information management apparatus 10.

  The communication unit 14 includes a network interface and the like, and transmits and receives data to and from an external device connected via a communication network N such as a LAN (Local Area Network), a WAN (Wide Area Network), and the Internet.

  The RAM 15 forms a work area that temporarily stores various programs, input or output data, parameters, and the like read from the storage unit 16 in various processes that are executed and controlled by the control unit 11.

  The storage unit 16 includes an HDD (Hard Disk Drive), a non-volatile semiconductor memory, and the like, and stores various processing programs, parameters and files necessary for executing the programs, and the like. For example, the storage unit 16 includes a web server program for realizing a function as a web server that provides various web screens to the web browser by communicating with a web browser mounted on an external device using the HTTP protocol, The application program etc. which operate | move above and provide a medical information sharing service to the user of an external apparatus via a web browser are memorize | stored.

  The storage unit 16 stores a facility information table T1, a user information table T2, a patient information table T3, a consent form information table T4, a name identification information table T5, a file information table T6, and a remind control information 161.

  FIG. 3 shows examples of the facility information table T1, the user information table T2, the patient information table T3, the consent form information table T4, the name identification information table T5, and the file information table T6.

The facility information table T1 is a table for managing facility information related to a medical facility for each medical facility involved in treatment of a patient, home care / care, and the like. In the facility information table T1, a facility ID, a business type, a name, an address, a telephone number, a FAX number, and the like are stored in association with each medical facility.
The facility ID is medical facility identification information.
The business type is the business type of the medical facility (clinic clinic, home-visit nursing station, pharmacy, care support center, care establishment, etc.).
The name is the name of the medical facility.
The address is the address of the medical facility.
The telephone number is the telephone number of the medical facility.
The FAX number is a FAX number of a medical facility.

  The facility information included in the facility information table T1 is registered by the secretariat that manages and manages the system.

The user information table T2 is a table for managing user information regarding users for each user (medical personnel) who uses the medical information sharing system 100. In the user information table T2, for each user, a user ID, password, authority, name, telephone number, mail address, facility ID, job type, and the like are stored in association with each other.
The user ID is user identification information.
The password is used for user authentication when the user logs in to the system.
The authority is information indicating a user's authority (system administrator, facility administrator, general).
The name is the name of the user.
The telephone number is the user's telephone number.
The e-mail address is the user's e-mail address.
The facility ID is a facility ID of a medical facility to which the user belongs.
The job type is the job type of the user (doctor, nurse, pharmacist, care manager, rehabilitation specialist, helper, etc.).

  The user information included in the user information table T2 is registered by an administrator in each medical facility.

The patient information table T3 is a table for managing patient information regarding a patient for each patient. In the patient information table T3, for each patient, patient ID, name, gender, date of birth, address, telephone number, e-mail address, contraindications, allergies, medical insurance number, medical insurance number registration date, long-term care insurance number, long-term care insurance The number registration date and the like are stored in association with each other.
The patient ID is patient identification information common in the system.
The name is the name of the patient.
The gender is the gender of the patient.
The date of birth is the date of birth of the patient.
The address is the patient's address.
The phone number is the patient's phone number.
The e-mail address is the patient's e-mail address.
Contraindications are contraindications for patients, such as contraindications.
Allergy is information about the patient's allergies.
The medical insurance number is a patient's medical insurance number.
The medical insurance number registration date is the date when the medical insurance number of the patient is registered in the patient information table T3.
The care insurance number is a patient's care insurance number.
The care insurance number registration date is a date when the care insurance number of the patient is registered in the patient information table T3.

The consent form information table T4 is a table for managing consent form information regarding the consent form for each patient. In the consent form information table T4, for each patient, the patient ID, explanation presence / absence flag, explainer, explanation date, consent status, consent form acquisition presence / absence flag, consent form signature / stamping date, number of reminders, etc. are stored in association with each other. Is done.
The patient ID is a patient ID of a patient whose medical information is shared.
The description presence / absence flag is a flag (presence / absence) indicating whether or not an explanation of the consent form (shared contents) has been implemented for a patient or patient family whose medical information is shared.
The explainer is a user ID of a medical person who explained the consent form (shared contents) to a patient or patient family whose medical information is shared.
The explanation date is a date when the consent form (shared contents) is explained to the patient or patient family to whom the medical information is shared.
The consent status is the consent status (consent / disagree / hold / retract) of the patient or patient family.
The consent form availability flag is a flag (obtained / not obtained) indicating whether or not a consent form has been obtained from a patient or a patient family.
The consent form signing / stamping date is the date on which the patient or the patient's family signed / stamped the consent form.
The number of reminds is the number of times a reminder has been executed to notify that the consent form has not been obtained.

The storage unit 16 that stores the consent form information table T4 includes, for each patient, consent form acquisition presence / absence information (consent form acquisition presence / absence flag) that indicates whether or not the consent form relating to the sharing of the patient's medical information is obtained. This is a consent form information storage means for storing a medical person (explanator) who should obtain the consent form in association with each other.
Moreover, the memory | storage part 16 which memorize | stores consent form information table T4 memorize | stores the date (description date) by which the description about sharing of medical information was performed with respect to the said patient or the said patient's family for every patient. It is.

The name identification information table T5 is a table for managing patient identification information in each medical facility of each patient. The name identification information table T5 stores a patient ID, a facility ID, and an in-facility patient ID in association with each other.
The patient ID is a common patient ID in the system.
The facility ID is a facility ID of a medical facility involved in patient treatment, home medical treatment, nursing care, or the like.
The in-facility patient ID is identification information given to the patient in the medical facility.

The file information table T6 is a table for managing file information related to medical information files stored in the file storage unit 162. In the file information table T6, for each medical information file, a registration date, a registrant, a type, a storage location, a name, and the like are associated and stored.
The registration date and time is the date and time when the medical information file is registered in the file storage unit 162.
The registrant is a user ID of a medical person who registered a medical information file in the file storage unit 162.
The type is the type of medical information file.
The storage destination is a file storage destination in the file storage unit 162.
The name is the name of a medical information file.

The remind control information 161 is information indicating a condition when notifying that the consent form has not been obtained, and includes the number of remind days and the remind interval.
The number of days of reminding is the number of days from the date when the consent form is explained (the explanation date) until the first reminding is conducted.
The remind interval is the number of days for performing the second and subsequent reminds after the number of remind days has elapsed from the explanation date. In other words, the storage unit 16 that stores the remind control information 161 is an interval days storage unit that stores predetermined interval days.

  The storage unit 16 includes a file storage unit 162. The file storage unit 162 stores medical information shared in the system.

FIG. 4 shows a folder structure in the file storage unit 162.
A folder (patient ID folder) having a name that matches the patient ID of each patient is created in the lower hierarchy of the root folder.
A folder (facility ID folder) having a name that matches the facility ID for each medical facility is created in a lower hierarchy of the patient ID folder.
In the lower hierarchy of the facility ID folder, a medical information file related to the patient corresponding to the upper patient ID folder registered from the medical facility corresponding to the facility ID folder is stored. A folder may be created for each type of medical information in a lower hierarchy of the facility ID folder, and medical information may be classified and stored in this folder.
The file storage unit 162 of the storage unit 16 is a medical information storage unit that stores medical information of the patient for each patient.

  The timer unit 17 has a timer circuit (RTC: Real Time Clock). The timer circuit measures the current date and time and outputs it to the controller 11.

  When the facility information is accessed from the login account (user ID / password) corresponding to each user in the facility terminal 20, the control unit 11 refers to the user information table T2 in the storage unit 16, and It is determined whether or not the user is registered in advance. When the combination of the user ID and password input at the facility terminal 20 is registered in the user information table T2, the control unit 11 determines that the user corresponding to this user ID is a valid user.

In response to the information acquisition request from the facility terminal 20, the control unit 11 provides the requested information to the facility terminal 20.
The control unit 11 determines whether or not a consent form corresponding to the patient has been obtained for the target patient based on the consent form availability flag corresponding to the patient, and the consent form corresponding to the patient is obtained. If it is determined that the patient's medical information is disclosed to the facility terminal 20 and the consent form corresponding to the patient is determined not to be obtained, the facility terminal 20 The patient's medical information cannot be referred to. That is, the control unit 11 functions as a public control unit.

  In addition to the above principle, in this embodiment, as an exception, medical information registered by medical personnel belonging to the same medical facility as the medical personnel using the facility terminal 20 is related to the medical information. Regardless of whether or not a consent form corresponding to the patient has been obtained, it shall be made public.

Based on the consent document acquisition presence / absence flag, the control unit 11 provides a notification to a medical person who should obtain an agreement corresponding to the patient at a predetermined timing with respect to a patient for which it has been determined that the agreement has not been obtained. A warning prompting the user to obtain the consent form is notified. That is, the control unit 11 functions as a warning unit.
Specifically, the control unit 11 determines a certain period of time from the explanation date corresponding to the patient (patient ID) in the consent form information table T4 (for the remind control information 161) for the patient for which it is determined that the consent form has not been obtained. When the reminder days have passed, a warning is issued to prompt you to obtain a consent form.
In addition, the control unit 11 notifies a warning that prompts the user to obtain a consent form at a predetermined interval (remind interval of the remind control information 161).

  Based on the consent form acquisition flag, the control unit 11 notifies a warning prompting the patient's notification destination to submit the consent form at a predetermined timing for a patient who has been determined that the consent form has not been obtained. To do. That is, the control unit 11 functions as a second warning unit.

[Configuration of facility terminals]
FIG. 5 shows a functional configuration of the facility terminal 20.
As shown in FIG. 5, the facility terminal 20 includes a control unit 21, an operation unit 22, a display unit 23, a communication unit 24, a RAM 25, a storage unit 26, and the like, and each unit is connected by a bus 27. Yes.

  The control unit 21 includes a CPU and the like, and comprehensively controls processing operations of the respective units of the facility terminal 20. Specifically, the CPU reads various processing programs stored in the storage unit 26 in accordance with an operation signal input from the operation unit 22 or an instruction signal received by the communication unit 24, expands the program in the RAM 25, and Various processes are performed in cooperation with the program.

The operation unit 22 includes a keyboard having cursor keys, character input keys, various function keys, and the like, and a pointing device such as a mouse. The control unit 21 receives operation signals input by keyboard operations or mouse operations. Output to.
When the facility terminal 20 is a tablet terminal, a smartphone, or the like, the operation unit 22 includes operation keys such as a power key for turning on / off the power, and a touch panel stacked on the display unit 23, and corresponds to each operation key. The operation signal corresponding to the position of the touch operation by the user's finger or the like is output to the control unit 21.

  The display unit 23 includes a monitor such as an LCD, and displays various screens according to instructions of display signals input from the control unit 21. For example, the display unit 23 displays various Web screens based on display data for various Web screens received from the medical information management apparatus 10.

  The communication unit 24 includes a network interface and the like, and transmits and receives data to and from an external device connected via a communication network N such as a LAN, WAN, or the Internet. The communication unit 24 performs wireless communication using a mobile phone line or the like, and transmits / receives data to / from an external device such as the medical information management apparatus 10 connected via the communication network N.

  The RAM 25 forms a work area that temporarily stores various programs, input or output data, parameters, and the like read from the storage unit 26 in various processes that are executed and controlled by the control unit 21.

  The storage unit 26 includes an HDD, a nonvolatile semiconductor memory, and the like, and stores various processing programs, parameters and files necessary for executing the programs, and the like. For example, the storage unit 26 stores a Web browser program and the like for realizing a Web browser.

  The facility terminal 20 is used when registering medical information in the medical information management apparatus 10, referring to medical information managed by the medical information management apparatus 10, and the like.

[Operation in medical information sharing system]
Next, the operation in the medical information sharing system 100 will be described.

6 and 7 are flowcharts showing patient registration processing executed by the medical information management apparatus 10. This process is a process of registering a patient based on information input from the facility terminal 20 and is realized by a software process in cooperation with the program stored in the control unit 11 and the storage unit 16.
In a medical facility, patient information (name, sex, date of birth, address, telephone number, e-mail address, contraindications, allergies, medical insurance number, nursing insurance number, etc.) is obtained from the patient and their family.

  First, in the facility terminal 20, when a URL for accessing the medical information management apparatus 10 from the web browser is input by the operation unit 22, the control unit 21 passes the communication unit 24 based on the input URL. Then, the medical information management apparatus 10 is accessed.

  In the medical information management apparatus 10, display data for displaying a login screen is transmitted from the control unit 11 to the facility terminal 20 via the communication unit 14. The display data of various Web screens including the login screen transmitted to the facility terminal 20 by the Web server function of the medical information management apparatus 10 includes HTML, style sheets, image data, and predetermined processing in the facility terminal 20 Includes a script for executing.

  In the facility terminal 20, when the login screen display data is received by the communication unit 24, the control unit 21 displays the login screen on the display unit 23. The login screen includes input fields for user ID and password. When a user ID and a password are input by an operation from the operation unit 22 on the login screen, the control unit 21 transmits the input user ID and password to the medical information management apparatus 10 via the communication unit 24. .

  In the medical information management device 10, the user ID and password are acquired from the facility terminal 20 via the communication unit 14 (step S <b> 1), and user authentication is performed by the control unit 11. Specifically, the control unit 11 searches the user information table T2 in the storage unit 16 for a record that matches the user ID input in the facility terminal 20, and the password included in the searched record and the facility terminal 20 If the entered passwords match, it is determined that the user authentication was successful.

  Next, in the facility terminal 20, when patient registration is instructed by an operation from the operation unit 22 and the patient's medical insurance number or care insurance number is input, the control unit 21 inputs the medical insurance number or The care insurance number is transmitted to the medical information management apparatus 10 via the communication unit 24.

  In the medical information management device 10, a medical insurance number or a long-term care insurance number is acquired from the facility terminal 20 via the communication unit 14 (step S2), and a patient corresponding to the medical insurance number or the long-term care insurance number is newly created by the control unit 11. It is determined whether or not the patient is a registered patient (step S3). Specifically, when the patient information table T3 in the storage unit 16 is referred to by the control unit 11 and there is a record including the medical insurance number or the care insurance number input at the facility terminal 20, a newly registered patient If there is no record including the medical insurance number or the care insurance number input at the facility terminal 20, it is determined that the patient is a newly registered patient.

If the target patient is a newly registered patient (step S3; YES), the control unit 11 transmits display data for displaying a patient registration screen to the facility terminal 20 via the communication unit 14. .
In the facility terminal 20, when a patient registration screen is displayed on the display unit 23 and patient information of the target patient is input by an operation from the operation unit 22, the input patient information is transmitted to the communication unit 24 by the control unit 21. To the medical information management apparatus 10 via The patient information of the target patient registered in advance in the medical facility may be transmitted to the medical information management apparatus 10.

In the medical information management apparatus 10, when patient information is received from the facility terminal 20 by the communication unit 14, a common patient ID is assigned to the target patient in the system by the control unit 11 and received from the facility terminal 20. The obtained patient information is associated with the patient ID and registered in the patient information table T3 of the storage unit 16 (step S4).
For the medical insurance number registration date and the care insurance number registration date in the patient information table T3, the control unit 11 registers the current date and time acquired from the timer unit 17.

  Next, the control unit 11 creates a folder (patient ID folder) having the same name as the patient ID of the target patient in the file storage unit 162 of the storage unit 16 immediately below the root folder (step S5).

  Next, the control unit 11 causes the file storage unit 162 of the storage unit 16 to have a folder (facility ID folder) having the same name as the facility ID of the medical facility to which the logged-in user belongs in the lower hierarchy of the patient ID folder of the target patient. It is created (step S6). Specifically, the control unit 11 refers to the user information table T2 in the storage unit 16, acquires the facility ID corresponding to the user ID of the login user, and creates a folder having the same name as the facility ID.

  Next, the control unit 11 adds the patient ID of the target patient, the facility ID of the medical facility to which the login user belongs, and the patient ID in the facility of the target patient in this medical facility as name identification information in the name identification information table T5 of the storage unit 16. Are registered in association with each other (step S7). The in-facility patient ID may be input from the operation unit 22 in the facility terminal 20 and transmitted to the medical information management apparatus 10 via the communication unit 24, or information registered in advance in the medical facility may be stored. It may be transmitted to the medical information management apparatus 10.

  Next, the control unit 11 determines whether or not information sharing has been described for the target patient (that medical information is to be shared among multiple occupations for the purpose of improving care and improving operational efficiency) (step). S8). Specifically, in the facility terminal 20, explanation presence / absence information indicating whether or not information sharing has been explained is input from the operation unit 22, and the explanation presence / absence information is input to the medical information management apparatus 10 via the communication unit 24. Sent. If the information sharing has been explained, the facility terminal 20 receives the explanation date from the operation unit 22 and transmits the explanation date to the medical information management apparatus 10 together with the explanation presence / absence information. In the medical information management apparatus 10, the control unit 11 determines whether or not information sharing has been described based on the description presence / absence information input at the facility terminal 20.

  When the information sharing has been described (step S8; YES), the control unit 11 registers the description presence flag “present”, the presenter, and the description date in the consent document information table T4 of the storage unit 16 ( Step S9). Specifically, the control unit 11 adds a new record in which the “patient ID” is the patient ID of the target patient to the consent form information table T4, sets the “explanation presence / absence flag” to “present”, “User ID of Login User” is stored in the “Person” field, and “Description Date” input at the facility terminal 20 is stored in the “Description Date” field.

  Next, moving to FIG. 7, the control unit 11 determines whether or not consent has been obtained (verbal) for information sharing (step S10). Specifically, in the facility terminal 20, an agreement status (consent / disagreement / hold) indicating whether or not consent is obtained from the operation unit 22 is input, and the agreement status is input via the communication unit 24. It is transmitted to the medical information management apparatus 10. In the medical information management apparatus 10, the control unit 11 determines whether or not consent has been obtained for information sharing based on the consent status input at the facility terminal 20.

  When consent is obtained for information sharing (step S10; YES), “consent” is registered in the “consent status” field of the target patient record in the consent form information table T4 of the storage unit 16 by the control unit 11. (Step S11). A patient who has obtained consent is requested to sign and seal a consent form for information sharing.

  Next, the control unit 11 determines whether or not a consent form signed and stamped for information sharing is obtained (step S12). Specifically, in the facility terminal 20, consent form acquisition presence / absence information indicating whether or not a consent form signed and sealed for information sharing has been obtained from the operation unit 22 is input. 24 to the medical information management apparatus 10. When the consent form is obtained, the facility terminal 20 receives the consent form signature / seal date from the operation unit 22 and transmits the consent form signature / seal date to the medical information management apparatus 10 together with the consent form availability information. Is done. In the medical information management device 10, the control unit 11 determines whether or not a consent form has been obtained based on the consent form availability information input at the facility terminal 20.

  If the consent form is obtained (step S12; YES), the control unit 11 causes the consent form information presence / absence flag “obtained” to the target patient record in the consent form information table T4 of the storage unit 16, and the consent form signature / The stamp date is registered (step S13). Specifically, in the consent form information table T4 of the storage unit 16, the "consent form acquisition presence / absence flag" of the target patient record is set to "acquired" by the control unit 11, and the "consent form signing / stamping date" field The “consent letter signature / sealing date” input at the facility terminal 20 is stored.

  In step S12, when the consent form has not been obtained (step S12; NO), the control unit 11 causes the consent form information presence / absence flag “unacquired” in the record of the target patient in the consent form information table T4 of the storage unit 16. "Is registered (step S14).

In step S10, when consent is not obtained for information sharing (step S10; NO), the control unit 11 adds the “consent status” field of the record of the target patient in the consent form information table T4 of the storage unit 16. “Disagree” is registered (step S15).
In step S10, when the consent for information sharing is put on hold (step S10; hold), the control unit 11 sets the “consent status” field of the target patient record in the consent form information table T4 of the storage unit 16. “Hold” is registered (step S16).

  If information sharing has not been described in step S8 (step S8; NO), the control unit 11 registers the description presence flag “none” in the consent form information table T4 of the storage unit 16 (step S17). . Specifically, the control unit 11 adds a new record whose “patient ID” is the patient ID of the target patient to the consent document information table T4, and sets the “explanation presence / absence flag” to “none”.

  In step S3, when the target patient is not a newly registered patient (step S3; NO), based on the medical insurance number or the long-term care insurance number acquired in step S2 by the control unit 11, the patient information table in the storage unit 16 Patient information (patient ID, etc.) of the target patient is read from T3 (step S18).

  Next, the control unit 11 causes the file storage unit 162 of the storage unit 16 to have a folder (facility ID folder) having the same name as the facility ID of the medical facility to which the logged-in user belongs in the lower hierarchy of the patient ID folder of the target patient. It is created (step S19). Specifically, the control unit 11 refers to the user information table T2 in the storage unit 16, acquires the facility ID corresponding to the user ID of the login user, and creates a folder having the same name as the facility ID.

  Next, the control unit 11 adds the patient ID of the target patient, the facility ID of the medical facility to which the login user belongs, and the patient ID in the facility of the target patient in this medical facility as name identification information in the name identification information table T5 of the storage unit 16. Are registered in association with each other (step S20).

  After step S13, step S14, step S15, step S16, step S17 or step S20, the patient registration process ends.

  FIG. 8 is a ladder chart showing a consent form information registration process at the time of obtaining a consent form executed by the medical information management apparatus 10 and the facility terminal 20. This process is a process executed when a consent form signed / sealed from a patient who has obtained consent for information sharing or his / her family is obtained. The processing in the medical information management apparatus 10 is realized by software processing in cooperation with the program stored in the control unit 11 and the storage unit 16, and the processing in the facility terminal 20 is stored in the control unit 21 and the storage unit 26. It is realized by software processing in cooperation with a program.

First, the facility terminal 20 accesses the medical information management apparatus 10 via the communication unit 24 based on a URL for accessing the medical information management apparatus 10 from a Web browser.
In the medical information management apparatus 10, display data for displaying a login screen is transmitted from the control unit 11 to the facility terminal 20 via the communication unit 14.

In the facility terminal 20, when the user ID and password are input by the operation from the operation unit 22 on the login screen displayed on the display unit 23 (step S <b> 21), the input user ID and password are input by the control unit 21. Is transmitted to the medical information management apparatus 10 via the communication unit 24.
In the medical information management apparatus 10, when the user ID and the password are received by the communication unit 14, the control unit 11 performs user authentication (step S22).

Next, in the facility terminal 20, when a patient to register consent form information is selected by an operation from the operation unit 22 (step S <b> 23), the patient ID corresponding to the selected patient is set to the communication unit 24 by the control unit 21. To the medical information management apparatus 10 via
In the medical information management device 10, when the patient ID of the selected patient is received by the communication unit 14, the control unit 11 displays a consent form information change screen for the patient on the facility terminal 20 via the communication unit 14. Display data for transmission is transmitted.

  In the facility terminal 20, when the display data of the consent form information change screen is received by the communication unit 24, the control part 21 displays the consent form information change screen on the display unit 23. The consent form information change screen includes a selection field for selecting whether or not the consent form has been obtained, and an input field for entering the date on which the consent form was signed / sealed. When the consent form is obtained by the operation from the operation unit 22 and the consent form signature / seal date is input (step S24), the control unit 21 converts the input information into the medical information via the communication unit 24. It is transmitted to the management apparatus 10.

In the medical information management device 10, when information is received from the facility terminal 20 by the communication unit 14, the control unit 11 obtains the consent document acquisition presence / absence flag “acquired” in the record of the target patient in the consent document information table T 4 of the storage unit 16. "Agreement signing / stamping date is registered (step S25). Specifically, in the consent form information table T4 of the storage unit 16, the "consent form acquisition presence / absence flag" of the target patient record is set to "acquired" by the control unit 11, and the "consent form signing / stamping date" field The “consent letter signature / sealing date” input at the facility terminal 20 is stored.
This completes the agreement information registration process when obtaining the agreement.

  FIG. 9 is a ladder chart showing consent form information registration processing at the time of withdrawal of consent executed by the medical information management apparatus 10 and the facility terminal 20. This process is a process executed when consent is withdrawn from a patient who has obtained consent for information sharing or his / her family. The processing in the medical information management apparatus 10 is realized by software processing in cooperation with the program stored in the control unit 11 and the storage unit 16, and the processing in the facility terminal 20 is stored in the control unit 21 and the storage unit 26. It is realized by software processing in cooperation with a program.

  Since the process of step S31-step S33 is the same as the process of step S21-step S23 of the consent document information registration process (refer FIG. 8) at the time of consent document acquisition, description is abbreviate | omitted.

  In the facility terminal 20, when the display data of the consent form information change screen is received by the communication unit 24, the control part 21 displays the consent form information change screen on the display unit 23. The consent document information change screen further includes a selection field for selecting whether to withdraw the consent. When it is input by the operation from the operation unit 22 that the consent is withdrawn (step S <b> 34), the control unit 21 transmits the input information to the medical information management apparatus 10 via the communication unit 24.

In the medical information management device 10, when information is received from the facility terminal 20 by the communication unit 14, the control unit 11 sets “consent status” field of the target patient record in the consent form information table T 4 of the storage unit 16. "Withdrawal" is registered (step S35).
This completes the consent form information registration process when the consent is withdrawn.

  FIG. 10 and FIG. 11 are flowcharts showing the consent form unacquired remind process executed by the medical information management apparatus 10. This process is a process for giving a warning when the consent form is not yet obtained, and is realized by a software process in cooperation with the program stored in the control unit 11 and the storage unit 16.

First, the control unit 11 obtains the current date and time from the time measuring unit 17, and determines whether or not it is 3:00 am (step S41). If it is not 3 am (step S41; NO), the process returns to step S41 and the process is repeated.
Here, it is determined that 3:00 am is the time when the system operation is the lowest in one day and the subsequent processing is executed, but it may be set to another time.

If it is 3:00 am (step S41; YES), the controller 11 reads the consent document information one by one from the top of the consent document information table T4 in the storage unit 16 (step S42).
Here, it is judged by the control part 11 whether consent document information was able to be read from consent document information table T4 (step S43).

  When the consent document information can be read from the consent document information table T4 (step S43; YES), that is, when the next record exists in the consent document information table T4, the control unit 11 sets “ It is determined whether or not the “existence / non-existence flag” is “present” (step S44).

  When the “explanation presence / absence flag” is “present” (step S44; YES), the control unit 11 determines whether or not the “consent status” of the consent form information is “consent” (step S45). ).

  If the “consent status” is “consent” (step S45; YES), the control unit 11 determines whether or not the “consent document availability flag” of the consent document information is “unacquired”. (Step S46).

  If the “consent form acquisition flag” is “not yet acquired” (step S46; YES), the process proceeds to FIG. 11, and the control unit 11 determines whether the “remind count” of the consent form information is “0”. Is determined (step S47).

  If the “remind count” is “0” (step S47; YES), the control unit 11 causes the number of days from the “description date” to the present date of the consent form information to be equal to or greater than the number of remind days included in the remind control information 161. Is determined (step S48).

If the number of days from the “description date” to today is equal to or greater than the number of remind days (step S48; YES), the control unit 11 sets an “email address” corresponding to the “explainer (user ID)” of the consent form information. A remind mail is received from the user information table T2 and urged to obtain the consent form via the communication section 14 to the e-mail address of the presenter (step S49).
The medical staff (explainer) who should obtain the consent form confirms the remind mail at the facility terminal 20.

Next, the “mail address” corresponding to the “patient ID” of the consent form information is acquired from the patient information table T3 by the control part 11, and the consent form is submitted to the patient's mail address via the communication part 14. A reminding mail for prompting is transmitted (step S50).
The patient confirms the remind mail at the patient terminal 30.

  Next, the “remind count” of the corresponding record is set to “1” in the consent document information table T4 of the storage unit 16 by the control unit 11 (step S51).

In step S47, if the “remind count” is not “0” (step S47; NO), that is, if the “remind count” is 1 or more, the control unit 11 sets the number of days from the previous remind to the remind control. It is determined whether or not the reminder interval is included in the information 161 (step S52). The number of days since the previous remind is obtained by the following equation (1).
(Number of days since last reminder) = (Number of days from the explanation date of consent form information to today)
-(Remind days)-(Remind count-1) x (Remind interval) (1)

  If the number of days since the previous remind is equal to or greater than the remind interval (step S52; YES), the control unit 11 sets the “mail address” corresponding to the “explainer (user ID)” of the consent form information to the user information table T2. Is sent to the e-mail address of the explainer via the communication unit 14 to send a reminder mail that prompts the user to obtain the consent form (step S53).

  Next, the “mail address” corresponding to the “patient ID” of the consent form information is acquired from the patient information table T3 by the control part 11, and the consent form is submitted to the patient's mail address via the communication part 14. A reminder mail for prompting is transmitted (step S54).

  Next, the “remind count” of the corresponding record is counted up by the control unit 11 in the consent document information table T4 of the storage unit 16 (step S55).

  In step S44, when the “explanation presence / absence flag” is not “present” (step S44; NO), in step S45, when the “consent status” is not “consent” (step S45; NO), in step S46, “consent form” If the “presence / absence flag” is not “not available” (step S46; NO), in step S48, if the number of days from the “description date” to today is less than the number of remind days (step S48; NO), the previous time in step S52 When the number of days from the remind is less than the remind interval (step S52; NO), the process returns to step S42 after step S51 or after step S55, and the process is repeated.

  In step S43, if the consent document information cannot be read from the consent document information table T4 (step S43; NO), that is, if the processing is completed for all the records in the consent document information table T4, the consent document has not been received. The acquisition remind process ends.

  FIG. 12 is a ladder chart showing upload processing executed by the medical information management apparatus 10 and the facility terminal 20. The processing in the medical information management apparatus 10 is realized by software processing in cooperation with the program stored in the control unit 11 and the storage unit 16, and the processing in the facility terminal 20 is stored in the control unit 21 and the storage unit 26. It is realized by software processing in cooperation with a program.

  Since the processing of step S61 and step S62 is the same as the processing of step S21 and step S22 of the consent document information registration processing (see FIG. 8) when obtaining the consent document, description thereof is omitted.

  Next, in the facility terminal 20, when a patient list request is transmitted to the medical information management device 10 via the communication unit 24 based on an operation from the operation unit 22 (step S <b> 63), in the medical information management device 10, The control unit 11 transmits display data for displaying a patient list screen to the facility terminal 20 via the communication unit 14.

  In the facility terminal 20, when the display data of the patient list screen is received by the communication unit 24, the patient list screen is displayed on the display unit 23 by the control unit 21 (step S64).

FIG. 13 shows an example of a patient list screen 231 displayed on the display unit 23 of the facility terminal 20. On the patient list screen 231, a list of patients registered in the patient information table T3 of the medical information management apparatus 10 is displayed. The patient list screen 231 includes an upload button display field 40, a reference button display field 41, an in-facility patient ID display field 42, a name display field 43, a reading display field 44, a gender display field 45, an age display field 46, and the like. .
The upload buttons B1, B2, and B3 displayed in the upload button display field 40 are pressed when selecting a patient to upload medical information.
The reference buttons B4, B5, and B6 displayed in the reference button display field 41 are pressed when selecting a patient that refers to medical information.
The in-facility patient ID display field 42, the name display field 43, the reading display field 44, the gender display field 45, and the age display field 46 show the in-facility patient ID, name, name reading, gender, and age, respectively. Is displayed. For the in-facility patient ID, in the medical information management apparatus 10, the control unit 11 acquires the “facility ID” corresponding to the “user ID” of the logged-in user from the user information table T2, and lists the “facility ID” in the list. “In-facility patient ID” corresponding to the displayed combination of “patient ID” of the patient is acquired from the name identification information table T5.

  When a patient whose medical information is to be uploaded is selected by an operation from the operation unit 22 on the patient list screen (step S65), a patient ID corresponding to the selected patient is transmitted by the control unit 21 via the communication unit 24. It is transmitted to the medical information management apparatus 10.

For example, when the upload button B1 is pressed in the patient list screen 231 shown in FIG. 13, an upload screen 232 for uploading the patient's medical information “Tokyo Taro” is displayed on the display unit 23 as shown in FIG. Is displayed.
The upload screen 232 includes a folder selection field 50, a file display field 51, a file selection field 52, and the like.
The folder selection field 50 is created in the lower layer of the facility ID folder of the medical facility to which the logged-in user in the lower layer of the patient ID folder of the selected patient belongs in the file storage unit 162 of the medical information management apparatus 10. Folder is displayed. The user selects a folder as an upload destination in the folder selection field 50.
In the file display column 51, information (registration date, file name, size, etc.) of files stored in the folder selected in the folder selection column 50 in the file storage unit 162 of the medical information management apparatus 10 is displayed. Is done.
The file selection field 52 is an area for selecting a file to be uploaded. In the state where the file to be uploaded is displayed in the external area of the upload screen 232 of the display unit 23, by dragging and dropping the file to the file selection field 52 by the operation from the operation unit 22, the file becomes an upload target. You have selected a file.

  When a file (medical information) to be uploaded is selected by an operation from the operation unit 22 (step S66), the selected file is uploaded to the medical information management apparatus 10 by the control unit 21 via the communication unit 24. (Step S67).

In the medical information management apparatus 10, when the patient ID and file of the selected patient are received by the communication unit 14, the control unit 11 is in the lower hierarchy of the patient ID folder of the selected patient in the file storage unit 162 of the storage unit 16. The received file is stored in the facility ID folder of the medical facility to which the login user belongs (step S68).
In the folder selection field 50 on the upload screen 232 (see FIG. 14), when a folder lower than the facility ID folder is selected as the file upload destination, the file is saved in the selected folder. .

Further, the file information (registration date, registrant, type, storage location, name) of the uploaded file is stored in the file information table T6 of the storage unit 16 by the control unit 11 (step S69). Specifically, when the file is stored in the file storage unit 162 by the control unit 11, the current date and time is acquired from the time measuring unit 17, and this date and time is registered as “registration date and time”. Further, the control unit 11 registers the user ID of the login user who performed the file upload operation as “registrant”. Further, the control unit 11 registers the type of medical information corresponding to the folder selected in the folder selection field 50 of the upload screen 232 as “type”. Further, the control unit 11 registers the storage location where the file is stored in the file storage unit 162 as a “storage destination”. Further, the name of the uploaded file is registered as “name” by the control unit 11.
This completes the upload process.

  FIG. 15 is a ladder chart showing information reference processing executed by the medical information management apparatus 10 and the facility terminal 20. The processing in the medical information management apparatus 10 is realized by software processing in cooperation with the program stored in the control unit 11 and the storage unit 16, and the processing in the facility terminal 20 is stored in the control unit 21 and the storage unit 26. It is realized by software processing in cooperation with a program.

  Since the process of step S71-step S74 is the same as the process of step S61-step S64 of an upload process (refer FIG. 12), description is abbreviate | omitted.

  In the facility terminal 20, when a patient that refers to medical information is selected by an operation from the operation unit 22 on the patient list screen displayed on the display unit 23 (step S <b> 75), the selected patient is displayed by the control unit 21. Is transmitted to the medical information management apparatus 10 via the communication unit 24.

  In the medical information management apparatus 10, when the patient ID of the selected patient is received by the communication unit 14, the control unit 11 refers to the consent form information table T4 in the storage unit 16 and corresponds to the “patient ID” of the selected patient. It is determined whether or not the “consent form availability flag” is “acquired” (step S76).

  When the “consent form acquisition presence / absence flag” corresponding to the “patient ID” of the selected patient is “acquired” (step S76; YES), the control unit 11 causes the file storage unit 162 of the storage unit 16 to select the selected patient. The files stored in all the facility ID folders in the lower hierarchy of the patient ID folder are made public (step S77).

  On the other hand, when the “consent document acquisition flag” corresponding to the “patient ID” of the selected patient is not “acquired” (step S76; NO), that is, when the consent document corresponding to the selected patient is not acquired, The file stored in the facility ID folder of the medical facility to which the login user in the lower hierarchy of the patient ID folder of the selected patient belongs is released in the file storage unit 162 of the storage unit 16 by the control unit 11 (step S78). ).

In the facility terminal 20, a reference screen is displayed on the display unit 23 according to the disclosure range (step S79).
This completes the information reference process.

  For example, when the reference button B4 is pressed on the patient list screen 231 shown in FIG. 13, a patient reference screen 233 “Taro Tokyo” is displayed on the display unit 23 as shown in FIG. FIG. 16 shows an example in which the consent form corresponding to the selected patient is not obtained, only the medical information of the own facility is disclosed, and the medical information of other facilities cannot be referred to. That is, in the consent form information table T4, the “consent form availability flag” corresponding to the patient ID of the selected patient is “not yet obtained”.

In the reference screen 233, the presence of medical information (file) stored in the facility ID folder of the medical facility to which the login user in the lower hierarchy of the patient ID folder of the selected patient belongs in the file storage unit 162 of the storage unit 16 Will be published.
In the reference screen 233, a medical information classification column 60 is provided in the vertical direction, and a date column 61 for one month is provided in the horizontal direction. On the reference screen 233, presence / absence of medical information classified into each of the classification categories is displayed in time series.

Here, the “type” of the medical information file is used as the major classification of the classification category in the classification category column 60. “Medical instruction request”, “visit record”, “document”, and “photograph” correspond to the “type” of the medical information file. The “type” of the medical information file is determined by the “type” of the target file in the file information table T6.
In addition, as the small classification of the classification category in the classification category column 60, the “registrant job type” in the medical information file is used. “Doctor”, “nurse”, “rehabilitation”, “pharmacist”, “care manager”, and “other” correspond to “job type of registrant” in the medical information file. In other words, “visit records” are further classified for each “registrant job”. Regarding the “registrant's job title” of the medical information file, first, the “registrant (user ID)” of the target file is acquired from the file information table T6, and the “job title” corresponding to this “user ID” is the user information. Obtained from table T2.

  The date on which the presence of medical information is displayed along the date field 61 of the reference screen 233 is determined by the “registration date” of the target file in the file information table T6.

On the reference screen 233, a mark M1 indicating the presence of medical information registered from the own facility for the login user is displayed in the area corresponding to the classification category to which the medical information belongs and the date on which the medical information is registered.
As a general rule, medical information of patients for whom consent forms have not been obtained cannot be referred from the facility terminal 20, but in the case of medical information registered from its own facility, it does not fall under information sharing between medical facilities. Can be referred to.

  FIG. 17 is an example of the reference screen 234 when the consent form corresponding to the selected patient has been obtained and not only the medical information of the own facility but also the medical information of other facilities is disclosed. That is, in the consent form information table T4, the “consent form availability flag” corresponding to the patient ID of the selected patient is “acquired”.

In the reference screen 234, the existence of medical information (file) stored in all the facility ID folders in the lower hierarchy of the patient ID folder of the selected patient in the file storage unit 162 of the storage unit 16 is disclosed.
On the reference screen 234, a medical information classification column 60 is provided in the vertical direction, and a date column 61 for one month is provided in the horizontal direction. The screen configuration of the reference screen 234 is the same as that of the reference screen 233.

  In the reference screen 234, a mark M1 indicating the presence of medical information registered from the own facility for the logged-in user in an area corresponding to the classification category to which the medical information belongs and the date on which the medical information is registered, and other facilities for the logged-in user A mark M2 indicating the presence of the registered medical information is displayed.

  In addition, when both medical information registered from the own facility and medical information registered from other facilities exist in the area corresponding to the classification category to which the medical information belongs and the date when the medical information was registered, A mark (mark different from marks M1 and M2) indicating the presence of medical information of both the own facility and the other facility is displayed.

  On the reference screens 233 and 234, when any of the marks M1 and M2 indicating the presence of medical information is pressed by an operation from the operation unit 22, the medical information corresponding to the pressed marks M1 and M2 is displayed on the display unit 23. Is displayed. That is, regarding the medical information whose presence is displayed on the reference screens 233 and 234, the contents of the medical information can also be referred from the facility terminal 20.

  For example, when the mark M2 in the area 62 corresponding to “visit record registered by the nurse” in the classification field 60 and “March 24, 2017” in the date field 61 is pressed on the reference screen 234, FIG. A visit record display screen 235 shown in FIG.

As described above, according to the present embodiment, the consent form is notified by notifying the medical personnel who should obtain the consent form corresponding to the patient whose consent form has not been obtained. Encourage medical personnel to obtain consent form. Since the medical information of the patient is disclosed by obtaining the consent form, the efficiency of the system for sharing the medical information can be improved.
For example, it is possible to notify a warning that prompts the user to obtain the consent form when a predetermined time has passed since the date when the medical information sharing was explained to the patient or the family of the patient, or at a predetermined interval.

  In addition, since a warning is sent to a notification destination of a patient who has not obtained a consent form, the patient can be prompted to submit a consent form.

[Modification 1]
Next, Modification 1 will be described. Note that illustration and description of the same configuration and processing as those in the above embodiment will be omitted, and description will be made centering on differences from the above embodiment.

  The control unit 11 of the medical information management device 10 prohibits uploading of the patient's medical information from the facility terminal 20 for a patient for which it is determined that the consent document has not been obtained based on the consent document availability flag. . That is, the control unit 11 functions as an upload control unit.

  Specifically, in step S64 of the upload process shown in FIG. 12, the control unit 11 of the medical information management apparatus 10 displays this patient list screen with respect to the patient list screen displayed on the display unit 23 of the facility terminal 20. When generating the display data to do so, the patient whose consent form has not been obtained is not displayed. That is, the control unit 11 generates display data for the patient list screen only for patients whose “consent form availability flag” in the consent form information table T4 is “acquired”.

  Alternatively, when generating the display data for displaying the patient list screen, the control unit 11 displays the patient for which the consent form is not obtained, but uploads corresponding to the patient for which the consent form is not obtained. Do not display the button (button for instructing upload).

  As another method, when a patient whose consent form is not obtained is selected as a patient to upload medical information in step S65 of the upload process shown in FIG. 12, the medical information of this patient cannot be uploaded. A warning to that effect may be displayed on the display unit 23 of the facility terminal 20.

  According to the first modification, in addition to the same effects as those of the above-described embodiment, it is impossible to upload medical information of a patient whose consent form has not been obtained. You can refuse to register.

[Modification 2]
Next, Modification 2 will be described. Note that illustration and description of the same configuration and processing as those in the above embodiment will be omitted, and description will be made centering on differences from the above embodiment.

  When there is a request for uploading medical information from the facility terminal 20, the control unit 11 of the medical information management apparatus 10 agrees corresponding to the patient based on the consent document acquisition presence / absence flag corresponding to the patient related to the medical information. When it is determined that the medical certificate has not been obtained, the medical information to be uploaded is stored in the holding area, and after it is determined that the consent form corresponding to the patient has been acquired, the medical information stored in the holding area is stored. It is stored in the file storage unit 162. That is, the control unit 11 functions as an upload control unit.

In the second modification, a second upload process shown in FIG. 19 is performed instead of the upload process shown in FIG.
About the process of step S81-step S87, it is the same as that of the process of step S61-step S67 of an upload process.

  In the medical information management apparatus 10, when a file (medical information) to be uploaded is received from the facility terminal 20 by the communication unit 14, the control unit 11 refers to the consent form information table T <b> 4 in the storage unit 16 and selects the selected patient. It is determined whether or not the “consent form acquisition presence / absence flag” corresponding to “patient ID” is “acquisition” (step S88).

  When the “consent form acquisition presence / absence flag” corresponding to the “patient ID” of the selected patient is not “acquired” (step S88; NO), that is, when the consent form corresponding to the selected patient is not obtained, the control unit 11, the upload target file is temporarily stored in the RAM 15 (holding area) (step S89). Further, the registrant (user ID of the login user) who instructed to upload the file at the facility terminal 20 in association with the file to be uploaded is also stored in the RAM 15.

  Thereafter, the control unit 11 determines whether or not the “consent form acquisition presence / absence flag” corresponding to the “patient ID” of the selected patient is “acquired” in the consent form information table T4 of the storage unit 16 (step). S90). If the “consent form availability flag” corresponding to the “patient ID” of the selected patient is not “acquired” (step S90; NO), the process returns to step S90.

  When the “consent document acquisition flag” corresponding to the “patient ID” of the selected patient is “acquired” (step S90; YES), that is, when the consent document corresponding to the patient is acquired, the control unit 11, the file temporarily stored in the RAM 15 is stored in a predetermined folder of the file storage unit 162 (step S91). Specifically, the file temporarily stored in the facility ID folder of the medical facility to which the registrant in the lower hierarchy of the patient ID folder of the selected patient belongs in the file storage unit 162 of the storage unit 16 by the control unit 11. Is saved.

  In step S88, if the “consent form availability flag” corresponding to the “patient ID” of the selected patient is “acquired” (step S88; YES), the control unit 11 stores the file to be uploaded as a file storage. The data is stored in the facility ID folder of the medical facility to which the login user in the lower hierarchy of the patient ID folder of the selected patient of the unit 162 belongs (step S92).

After step S91 or step S92, the control unit 11 stores the file information of the uploaded file in the file information table T6 of the storage unit 16 (step S93).
This completes the second upload process.

  According to the second modification, in addition to the same effects as those in the above embodiment, for medical information that cannot be disclosed because the consent form has not been obtained, storage in the file storage unit 162 is temporarily suspended, and the consent form is obtained. Can be stored in the file storage unit 162.

  In the second modification, the case where the medical information management apparatus 10 stores the medical information in the hold area when the consent form corresponding to the patient related to the medical information received from the facility terminal 20 has not been obtained has been described. The medical facility stores the medical information to be uploaded in the holding area of the local system, and after confirming that the consent form corresponding to the patient related to the medical information is obtained, the medical information management apparatus 10 It may be uploaded.

  Note that the descriptions in the above-described embodiments and modifications are examples of the medical information sharing system according to the present invention, and the present invention is not limited to this. The detailed configuration and detailed operation of each device constituting the system can be changed as appropriate without departing from the spirit of the present invention.

  For example, the timing for sending reminder emails to medical personnel and patients who should obtain consent forms is not limited to a certain period of time after explanation of sharing medical information, but the time limit for which consent forms are required In such a situation, a remind mail may be transmitted one week before, three days before, or the like. Moreover, it is good also as sending a remind mail according to the timing when a medical staff visits a patient next time.

  Also, in the email sent to the patient, a link to the same consent document as the consent document handed over to the patient is provided, and the patient who confirmed the email at the patient terminal 30 can register consent for information sharing from the Web screen It is good.

  In the above embodiment, a case has been described in which a reminder email is sent to a medical person who should obtain the consent form. However, the medical person who should obtain the consent form logs into the system from the facility terminal 20. At this time, a warning message that prompts the user to obtain the consent form may be displayed on the initial screen.

  As a computer-readable medium for storing a program for executing each process, a portable recording medium such as a CD-ROM can be applied in addition to an HDD and a nonvolatile semiconductor memory. A carrier wave may be applied as a medium for providing program data via a communication line.

DESCRIPTION OF SYMBOLS 10 Medical information management apparatus 11 Control part 14 Communication part 16 Storage part 17 Timekeeping part 20 Facility terminal 21 Control part 22 Operation part 23 Display part 24 Communication part 26 Storage part 30 Patient terminal 100 Medical information sharing system 161 Remind control information 162 File storage Unit 231 Patient list screen 232 Upload screen 233 Reference screen 234 Reference screen N Communication network T1 Facility information table T2 User information table T3 Patient information table T4 Consent form information table

Claims (7)

For each patient, a medical information management device having medical information storage means for storing medical information of the patient,
Consent for each patient to store the consent form information indicating whether or not the consent form for sharing the medical information of the patient is obtained and the medical personnel who should obtain the consent form in association with each other Book information storage means;
For the target patient, based on the consent form availability information corresponding to the patient, it is determined whether or not the consent form corresponding to the patient is obtained, and it is determined that the consent form corresponding to the patient is obtained. The medical information of the patient is disclosed to the terminal device capable of data communication with the medical information management device via the communication network, and it is determined that the consent form corresponding to the patient is not obtained. A public control means for disabling reference to the patient's medical information from the terminal device,
Based on the information on whether or not the consent form has been obtained, the consent of the medical personnel to whom the consent form corresponding to the patient should be obtained at a predetermined timing is agreed with the patient who has been determined that the consent form has not been obtained. A warning means for notifying the user of a warning,
A medical information management device comprising: For each patient, provided with a date storage means for storing a date on which sharing of medical information is explained to the patient or the family of the patient,
The warning means prompts the patient to obtain the consent form when a certain period of time has elapsed from the date corresponding to the patient stored in the date storage means for a patient for whom the consent form has not been obtained. The medical information management apparatus according to claim 1, which notifies a warning. An interval days storage means for storing a predetermined interval days;
The medical information management apparatus according to claim 1 or 2, wherein the warning means notifies a warning prompting to obtain the consent form with the interval days stored in the interval days storage means.   A second warning for notifying a patient who is notified that a consent form has not been obtained based on the consent form acquisition information to a notification destination of the patient at a predetermined timing. The medical information management apparatus according to any one of claims 1 to 3, further comprising means.   5. The apparatus according to claim 1, further comprising: an upload control unit that prohibits uploading of medical information of the patient from the terminal device for a patient for which it is determined that the consent form has not been obtained based on the consent form availability information. The medical information management device according to any one of the above.   When there is a request for uploading medical information from the terminal device, when it is determined that the consent document corresponding to the patient is not obtained based on the consent document availability information corresponding to the patient related to the medical information Upload control that stores medical information to be uploaded in a holding area, and stores medical information stored in the holding area in the medical information storage unit after it is determined that a consent form corresponding to the patient has been obtained. The medical information management apparatus according to any one of claims 1 to 4, further comprising means. A medical information sharing system comprising, for each patient, a medical information management device having medical information storage means for storing medical information of the patient, and a terminal device capable of data communication with the medical information management device via a communication network. There,
The medical information management device includes:
Consent for each patient to store the consent form information indicating whether or not the consent form for sharing the medical information of the patient is obtained and the medical personnel who should obtain the consent form in association with each other Book information storage means;
For the target patient, based on the consent form availability information corresponding to the patient, it is determined whether or not the consent form corresponding to the patient is obtained, and it is determined that the consent form corresponding to the patient is obtained. If the medical information of the patient is disclosed to the terminal device and it is determined that the consent form corresponding to the patient is not obtained, the medical information of the patient from the terminal device A public control means for disabling reference;
Based on the information on whether or not the consent form has been obtained, the consent of the medical personnel to whom the consent form corresponding to the patient should be obtained at a predetermined timing is agreed with the patient who has been determined that the consent form has not been obtained. A warning means for notifying the user of a warning,
Medical information sharing system with

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