JP2019118651A - Ophthalmologic information processing program, and ophthalmologic information processing method - Google Patents

Abstract

To provide an ophthalmologic information processing program and an ophthalmologic information processing method that can properly process ophthalmologic information and improve accuracy of diagnosis, etc.SOLUTION: An ophthalmologic information processing system comprises a server 10, and a plurality of terminal devices 20. The ophthalmologic information processing system executes a first transmission step (S32), a second transmission step (S35), an additional data preparation step (S36), a third transmission step (S37), and a fourth transmission step (S38). In the first transmission step, a terminal device 20A transmits subject data to the server 10. In the second transmission step, the server 10 transmits the subject data to a terminal device 20C. In the additional data preparation step, the terminal device 20C prepares additional data to be added to the subject data. In the third transmission step and the fourth transmission step, the additional data is transmitted to the terminal device 20A via the server 10.SELECTED DRAWING: Figure 4

Description

  The present disclosure relates to an ophthalmologic information processing program for processing ophthalmologic information including data of test results of an eye to be examined, and an ophthalmologic information processing method.

  Heretofore, various techniques for processing ophthalmologic information have been proposed. For example, the ophthalmologic information processing apparatus disclosed in Patent Document 1 attempts to facilitate follow-up observation of an eye to be examined by matching layer thickness information based on a plurality of OCT data obtained on different days.

Unexamined-Japanese-Patent No. 2017-104535

  In order to make a diagnosis and the like based on test results more accurately, it is desirable to appropriately process ophthalmologic information. For example, a doctor at a facility different from the facility where the test was performed may want to have a diagnosis based on the test result. In addition, if you want a doctor or the like of a facility different from the facility where the examination was performed to supplement the data of the examination result (for example, complement the boundary of each layer in the tomographic image (so-called “complementation of segmentation”) There is also. There are also cases where it is desirable to change the display of test result data in order to make a more accurate diagnosis. Properly processing ophthalmologic information in such a case has been difficult in the prior art.

  The present disclosure is to provide an ophthalmologic information processing program and an ophthalmologic information processing method capable of appropriately processing ophthalmologic information to improve accuracy such as diagnosis.

  An ophthalmologic information processing program provided by an exemplary embodiment of the present disclosure is executed in an ophthalmologic information processing system including a server and a plurality of terminal devices capable of communicating with the server. An information processing program, wherein an eye information processing program is executed by a controller of the eye information processing system, whereby a first terminal device among the plurality of terminal devices is acquired by the eye examination apparatus. A first transmission step of transmitting subject data including examination result data to the server, and the server browsing the subject data transmitted from the first terminal device among the plurality of terminal devices A second transmission step of transmitting the subject data to a second terminal device, which is a terminal device permitted to be Data generation step of generating additional data for the subject data by receiving an instruction from the user in a state in which at least a part of the data is displayed on the display unit, and the second terminal device A third transmission step of transmitting data to the server, and a fourth transmission step of the server transmitting the additional data to the first terminal device are executed by the ophthalmologic information processing system.

  An ophthalmologic information processing method provided by an exemplary embodiment of the present disclosure is performed in an ophthalmologic information processing system including a server and a plurality of terminal devices capable of communicating with the server. An information processing method, wherein a first terminal device among the plurality of terminal devices transmits subject data including data of examination results of an eye to be examined acquired by an ophthalmologic examination apparatus to the server. The subject data is transmitted to the second terminal device, which is a terminal device in which the server is permitted to browse the subject data transmitted from the first terminal device among the plurality of terminal devices. In the second transmission step of transmitting, the second terminal apparatus receives an instruction from the user in a state in which at least a part of the subject data is displayed on the display unit, and the second subject transmits the subject data. An additional data generation step for generating additional data, a third transmission step for the second terminal device to transmit the additional data to the server, and the server to transmit the additional data to the first terminal device And a fourth transmitting step.

  According to the ophthalmologic information processing program and the ophthalmologic information processing method in the present disclosure, the ophthalmologic information is appropriately processed to improve the accuracy of diagnosis and the like.

FIG. 1 is a block diagram showing a schematic configuration of an ophthalmologic information processing system 1; It is a sequence diagram which shows the flow of the process at the time of the user of a request origin designating the user of a request destination. It is a figure which shows an example of the request destination candidate information displayed on monitor 26A of terminal device 20A of request origin. It is a sequence diagram which shows an example of the flow of a process at the time of the additional data being produced by the terminal device 20C of a request destination with respect to the subject data transmitted from the terminal device 20A of a request source. It is a flowchart of additional data creation processing (S36) shown in FIG. It is a figure which shows an example of the test result report used for macular disease diagnosis. FIG. 7 is a diagram showing a result of changing attention range data from the state shown in FIG. 6; It is a figure which shows an example of the test result report used for tomographic image diagnosis. It is a sequence diagram which shows an example of the flow of a process when the additional data based on progress of the medical condition of a to-be-tested eye, etc. are produced. It is a sequence diagram which shows an example of the flow of a process in case transmission of patient data is started before a scheduled date which a user produces additional data. It is a flowchart which shows an example of a maintenance notification process. It is a flow chart which shows an example of operation prediction processing. FIG. 10 is a sequence diagram showing an example of a process flow of setting an examination condition of the ophthalmologic examination apparatus 30 based on a use status of the ophthalmologic examination apparatus 30.

<Overview>
An ophthalmologic information processing program exemplified in the present disclosure is executed in an ophthalmologic information processing system including a server and a plurality of terminal devices. The ophthalmologic information processing system executes a first transmission step, a second transmission step, an additional data creation step, a third transmission step, and a fourth transmission step. In the first transmission step, subject data including the data of the examination result of the subject eye acquired by the ophthalmologic examination apparatus is transmitted from the first terminal apparatus of the plurality of terminal apparatuses to the server. In the second transmission step, the subject data is transmitted from the server to the second terminal device. The second terminal device is a terminal device of a user authorized to view the subject data transmitted from the first terminal device among the plurality of terminal devices. In the additional data creation step, the second terminal device creates additional data to be added to the subject data by receiving an instruction from the user while the subject data is displayed on the display unit. In the third transmission step, the additional data is transmitted from the second terminal device to the server. In the fourth transmission step, the additional data is transmitted from the server to the first terminal device.

  According to the technique exemplified in the present disclosure, the additional data to the subject data transmitted from the first terminal device is created in the second terminal device of the user permitted to view, and transmitted to the first terminal device. Therefore, for example, a doctor or the like at a facility different from the facility where the examination was performed easily creates additional data with reference to the subject data. Therefore, the accuracy of diagnosis etc. is improved.

  Note that the server may execute a first saving step of saving subject data received from the first terminal device. The second terminal device may execute a second saving step of saving subject data received from the server. The server may execute a third saving step of saving the additional data received from the second terminal device. The first terminal device may execute a fourth saving step of saving the additional data received from the server.

  Moreover, the specific aspect of additional data can be selected suitably. For example, the additional data may be data indicating the result of a diagnosis made by the doctor referring to the subject data. Further, the additional data may be data that supplements the data of the inspection result. As an example, if the subject data is a tomographic image of the tissue of the eye to be examined (for example, the fundus), the additional data is data that complements the boundary of each layer in the tomographic image (so-called complementary data of "segmentation") Good.

  In the additional data creation step, the additional data may be created in a state where the inspection result report is displayed on the display unit. The examination result report includes an examination result image which is an image based on the examination result acquired by the ophthalmologic examination apparatus, and attention range data which is data based on an examination result of a part of the attention range in the range of the examination result image. May be included. The second terminal device may perform the report change step. In the report changing step, the attention range of the inspection result image in the inspection result report is changed according to the instruction from the user, and the attention range data is changed to data in the changed attention range based on the subject data. It may be done.

  In this case, the user using the second terminal device can appropriately create the additional data by confirming the inspection result report including the inspection result image and the attention range data. Furthermore, when the attention range set in the examination result image is inappropriate, the user who uses the second terminal changes the attention range and displays the inspection result report including the data in the changed attention range. be able to. Therefore, additional data is created more appropriately.

  Here, the examination result report is a report in which a part of data extracted according to the user's instruction among the data of the examination result acquired by the ophthalmologic examination apparatus is arranged in a report format so that the user can easily read it. It may be That is, the inspection result report is different from the viewer for viewing and analyzing the inspection result data itself. The user using the first terminal may select a desired template from a plurality of templates different from each other, for example, the type of data to be extracted and / or the arrangement of the extracted data. The first terminal, the server, or the second terminal extracts the data defined by the selected template from the data of the inspection result, and arranges the data at the position defined by the selected template. You may create data. In this case, the user of the first terminal can efficiently cause the user of the second terminal to browse the data necessary for creating the additional data out of the entire data of the inspection result. However, the test result report may be automatically generated by the controller based on no instruction from the user. Also, the background color of the test result report may be white. In this case, for example, even when printing an inspection result report, the user can appropriately browse the inspection results.

  In addition, various images can be adopted as the inspection result image. For example, when the data of the test result is acquired by the OCT apparatus for ophthalmology, the test result image may be a two-dimensional map image showing a two-dimensional distribution of the thickness of a specific layer in the fundus of the subject's eye The three-dimensional tomographic image of the tissue of the eye to be examined may be used. In addition, the inspection result image may be a front image of the fundus photographed by a fundus photographing apparatus (for example, an OCT apparatus, a fundus camera, a laser scanning fundus photographing apparatus (SLO), an infrared camera, etc.).

  Moreover, the specific aspect of attention range data can also be selected suitably. For example, the attention range data may be a chart showing an average value of the thickness of a specific layer in each of a plurality of regions within the attention range. Further, the area of interest data may be data of a two-dimensional or three-dimensional tomographic image in the area of interest.

  The first terminal device may execute the designated information transmission step. In the designation information transmission step, the designation information for designating one or more second terminal devices for permitting browsing of the subject data among the plurality of terminal devices for which the account is registered in the ophthalmologic information processing system is a server Sent to In the second transmission step, the subject data may be transmitted to the second terminal device designated by the designation information. In this case, a requesting user who wants to request the creation of additional data to another user can request the creation of additional data by specifying an appropriate user.

  The designation information may be transmitted in advance from the first terminal device to the server before the subject data is transmitted. In this case, the server registers the second terminal device designated by the first terminal device, and is designated by the designation information received in advance after receiving the subject data from the first terminal device. The subject data may be transmitted to the second terminal device. Also, the designation information may be transmitted to the server together with the subject data.

  The server may execute a user information transmission step of transmitting, to each of the terminal devices, user information on the user of the terminal device whose account is registered. The terminal device may execute a designated information creation step of creating designated information by receiving an instruction from the user in a state where the user information is displayed on the display unit. In this case, the request source user can appropriately specify the request destination user while confirming the user information.

  The terminal apparatus may execute a search step of searching for user information including specified information from a plurality of pieces of user information. In this case, the requesting user can more easily find out the appropriate requesting user.

  The user information may include information indicating the number of times additional data has been created in the past by the user of each terminal device. In this case, the request source user can appropriately specify the request destination user after grasping the number of times each user created the additional data in the past (that is, the user's experience).

  The first terminal device may execute the evaluation value transmission step of creating the evaluation value of the user of the second terminal device that created the additional data according to the instruction from the user, and transmitting the evaluation value to the server. The user information may include an evaluation value. In this case, the request source user can appropriately specify the request destination user after grasping the past evaluations assigned to the respective users.

  The first terminal device may execute the browsing range information transmission step. In the browsing range information transmission step, browsing range information indicating the range of data browsable in the second terminal device among the subject data transmitted to the server in the first transmission step is created according to the user's instruction, Sent to the server. In the second transmission step, data of the range indicated by the browsing range information in the subject data is transmitted to the second terminal device. In this case, the requesting user can appropriately specify data to be browsed by the requesting user.

  An identification information creation step may be performed to create identification information for identifying each subject. In the second transmitting step, subject data including no identification name of the subject and including identification information may be sent to the second terminal device. In this case, the requesting user can cause the requesting user to create additional data for the subject data without informing the requesting user of the subject's personal information.

  The identification information creating step may be executed in the first terminal device or may be executed by the server. In addition, whether or not to create identification information may be determined according to an instruction from the user of the first terminal device.

  In the second transmission step, subject data including data of a plurality of examination results acquired at different times from the subject's eye of the same subject may be transmitted from the server to the second terminal device. In the additional data creation step, additional data may be created for subject data including data of a plurality of examination results acquired at different times. In this case, the requesting user can appropriately request the other user to create additional data based on the progress of the medical condition of the eye to be examined.

  By performing the first transmission step, each of the plurality of first terminal devices transmits, to the server, subject data including data of a plurality of examination results acquired at different times from the subject's eye of the same subject It may be done. The server may execute a saving step of saving subject data received from each of the plurality of first terminals. In this case, for example, even when the examination is performed at different facilities at different times with respect to the same subject eye, additional data is appropriately created based on the progress of the medical condition of the subject eye and the like.

Embodiment
Hereinafter, one of the typical embodiments of the present disclosure will be described with reference to the drawings. In the present embodiment, an ophthalmologic information processing system 1 including a server 10 and a plurality of terminal devices 20 is illustrated.

  The system configuration of the ophthalmologic information processing system 1 in the present embodiment will be described with reference to FIG. The ophthalmologic information processing system 1 includes a server 10 and a plurality of terminal devices 20 used in each base (for example, a hospital, a medical checkup facility, etc.). In FIG. 1, the terminal device 20A used at the site A and the terminal device 20B used at the site B are illustrated.

  The server 10 provides various data and the like to the connected device (the terminal device 20 in the present embodiment). In the present embodiment, a server of a maker that provides a cloud service (a so-called cloud server) is used as the server 10. However, it goes without saying that servers other than the cloud server may be used. The server 10 includes a control unit 11 that performs various processing control, and a communication I / F 14. The control unit 11 includes a CPU 12 which is a controller in charge of control, and a storage device 13 capable of storing programs, data, and the like. The storage device 13 stores an ophthalmologic information processing program for executing various processes described later. The communication I / F 14 connects the server 10 to an external device (for example, the terminal device 20) via the network 5 (for example, the Internet).

  The terminal device 20 is used by a user at each site (e.g., a doctor and an inspection technician). The terminal device 20 of the present embodiment is a personal computer, but may be a portable terminal such as a smartphone or a tablet terminal. The terminal device 20 includes a control unit 21 that performs various control processes, and a communication I / F 24. The control unit 21 includes a CPU 22 which is a controller in charge of control, and a storage device 23 capable of storing programs, data, and the like. The storage device 23 stores an ophthalmologic information processing program for executing various processes described later. The communication I / F 24 connects the terminal device 20 to an external device (for example, the server 10) via the network 5.

  The terminal device 20 is connected to the operation unit 25 and the monitor 26. The operation unit 25 is operated by the user in order for the user to input various instructions to the terminal device 20. For the operation unit 25, for example, at least one of a keyboard, a mouse, and a touch panel can be used. A microphone or the like for inputting various instructions may be used together with the operation unit 25 or in place of the operation unit 25. The monitor 26 is an example of a display unit capable of displaying various images.

  At least any one of the plurality of terminal devices 20 can exchange data and the like with one or more ophthalmologic examination apparatuses 30 that examine the subject's eye. A method for the terminal device 20 to exchange data etc. with the ophthalmologic examination apparatus 30 can be selected as appropriate. For example, the terminal device 20 may exchange data and control signals with the ophthalmic examination apparatus 20 by at least one of wired communication, wireless communication, a removable storage medium (for example, USB memory), and the like.

  Various devices can be used for the ophthalmologic examination device 30. As an example, the ophthalmologic examination apparatus 30 used in the present embodiment includes an OCT apparatus capable of acquiring a tomographic image of a tissue of an eye to be examined. However, the ophthalmologic examination apparatus 30 other than the OCT apparatus (for example, at least one of the fundus camera, scanning laser ophthalmoscope (SLO), axial length measurement apparatus, corneal shape measurement apparatus, intraocular pressure measurement apparatus, and eye refractive power measurement apparatus) Or) may be used.

  The ophthalmologic examination apparatus 30 includes a control unit 31 that performs various control processes, and an examination unit 35. The control unit 31 includes a CPU 32 which is a controller in charge of control, and a storage device 33 capable of storing programs, data, and the like. The examination unit 35 includes various components necessary for the ophthalmologic examination apparatus 30 to examine the eye to be examined. For example, when an OCT apparatus is used as the ophthalmologic examination apparatus 30, the examination unit 35 includes an OCT light source, a scanning unit for scanning the OCT light, an optical system for irradiating the OCT light to the eye, and a tissue of the eye And a light receiving element for receiving the light reflected by the light source.

  Here, an outline of processing that can be executed by the ophthalmologic information processing system 1 according to the present embodiment will be described. The ophthalmologic information processing system 1 of the present embodiment can execute a plurality of processes for enhancing the convenience of the user. However, it goes without saying that only a part of the plurality of processes described below may be executed by the ophthalmologic information processing system 1.

  First, in the ophthalmologic information processing system 1, another terminal device 20 can create additional data for subject data acquired by a plurality of terminal devices 20. The subject data includes data of the examination result performed by the ophthalmologic examination apparatus 30. The additional data may be, for example, data of a diagnosis result created by the user (doctor) referring to the subject data, or may be data that complements an image or the like. In the ophthalmologic information processing system 1 according to the present embodiment, a request source user who requests the creation of additional data to another user can appropriately specify a request destination user from among a plurality of users. Further, when the additional data is data of a diagnosis result, the user who creates the additional data can appropriately diagnose while referring to the inspection result report in which the images of the inspection result are arranged. In addition, the user who creates additional data can also change the content of the inspection result report to an appropriate content. Furthermore, in the present embodiment, the user can request another user to follow up the eye to be examined.

  In addition, the ophthalmologic information processing system 1 according to the present embodiment can perform processing according to the use status of at least one of the terminal device 20 and the ophthalmologic examination apparatus 30 (hereinafter, also simply referred to as “apparatus”). For example, the ophthalmologic information processing system 1 can set a scheduled date and time for the user to create additional data, based on the use status of the terminal device 20. The ophthalmologic information processing system 1 can start transmission of the subject data before the set scheduled date and time to the terminal device 20 of the user who creates the additional data. The ophthalmologic information processing system 1 can also notify the user of information on part replacement, maintenance, inspection, repair, and the like of the apparatus based on the use status of the apparatus. The ophthalmologic information processing system 1 can also predict the operation that the user is performing as a routine work based on the usage status of the device, and perform processing based on the prediction result. Further, the ophthalmologic information processing system 1 can appropriately set the examination conditions of the ophthalmologic examination apparatus 30 based on the use situation of the ophthalmologic examination apparatus 30. Each process will be described in detail below.

  An example of processing for causing the requesting user to specify the requesting user will be described with reference to FIGS. 2 and 3. In the example illustrated in FIG. 2, the terminal device 20 </ b> A is the terminal device 20 of the request source user who designates the request destination user from now. The terminal device 20B is a terminal device 20 of a request source user who has requested another user to create additional data in the past. The terminal device 20C and the terminal device 20D are terminal devices 20 of users who are candidates for the request destination. In the ophthalmologic information processing system 1, the accounts of the terminal devices 20A, 20B, 20C, and 20D are already registered.

  First, the terminal device 20B of the user who has requested another user to create additional data in the past evaluates the user of the terminal device 20 (in the example shown in FIG. 2, the terminal device 20C and the terminal device 20D) which created the additional data. A value is created in accordance with an instruction from the user (S11). The terminal device 20B transmits the created evaluation value to the server 10 (S12). The server 10 stores the received evaluation value.

  In addition, the terminal device 20C of the user who is the request candidate creates user information on the user of the terminal device 20C according to an instruction from the user (S14). The terminal device 20C transmits the created user information to the server 10 (S15). The server 10 stores user information of the user of the terminal device 20C. Similarly, the terminal device 20D also creates user information (S16) and transmits it to the server 10 (S17).

  Further, although not shown in FIG. 2, the server 10 stores information on the number of times each terminal device 20 has created additional data in the past.

  When the terminal device 20A of the user who designates the request destination inputs an instruction to start the request destination specification process, the terminal device 20A transmits a request signal of request destination candidate information to the server 10 (S19). When receiving the request signal, the server 10 transmits request destination candidate information to the terminal device 20A that has transmitted the request signal (S20). The terminal device 20A accepts the instruction from the user in a state where the received request destination candidate information is displayed on the monitor 26A, thereby permitting the terminal device 20 to permit inspection of the subject data (that is, the terminal device 20 of the request destination. The designation information for designating) is created (S21). The number of terminal devices 20 to be specified may be one or more.

  FIG. 3 shows an example of request destination candidate information displayed on the monitor 26A of the terminal device 20A. The request destination candidate information of the present embodiment includes information on each user name, facility name, area, number of diagnostic readings (diagnostic agent), number of OCT boundary complementing agents, and evaluation value of each of the terminal devices 20 of the request candidate. The information on the user name, the facility name, and the area is included in the user information transmitted in S15 and S17. The number of interpretations (diagnostic agent substitution) and the OCT boundary complementation agent number are examples of information on the number of times additional data has been created in the past. The number of interpretations (diagnostic agency) is the number of times the user has created diagnostic result data in response to another user's request. The OCT boundary complementing proxy number is the number of times the user has created data (so-called "segmentation data") that complements the boundary of each layer in the tomographic image in response to another user's request. The evaluation value is the evaluation value transmitted in S12. The user of the terminal device 20A can appropriately select the request destination by referring to the request destination candidate information.

  The terminal device 20A according to the present embodiment can search for a terminal device 20 of a request candidate including information specified by the user based on the request destination candidate information. For example, in the example illustrated in FIG. 3, when the user designates “Aichi prefecture” and inputs a search instruction, the terminal device 20A causes the monitor 26A to display only users whose area is “Aichi prefecture”. Moreover, in the present embodiment, it is also possible to transmit and receive a message via the server 10 between the request source terminal device 20A and the request candidate terminal devices 20C and 20D.

  Further, the terminal device 20A of the user who designates the request destination creates, in accordance with an instruction from the user, browsing range information indicating the range of data that can be browsed by the terminal device 20 of the request destination among the subject data. (S22). The user can appropriately set the range of data to be browsed by the requested user.

  The terminal device 20A transmits the designation information generated in S21 and the browsing range information generated in S22 to the server 10 (S23, S24). FIG. 2 exemplifies a case where the user of the terminal device 20A designates the user of the terminal device 20C as the request destination. The server 10 stores the received designation information and the browsing range information. Further, the server 10 transmits, to the terminal device 20C, application request information for notifying that the user of the terminal device 20A has made a request for creating additional data (S25). When the user of the terminal device 20C performs an operation of accepting the application, the terminal device 20C transmits acceptance response information to the server 10 (S26). The server 10 registers the terminal device 20A and the terminal device 20C as the same group (S28), and transmits a notification indicating the registration to the terminal device 20A (S29).

  An example of processing when additional data is created by the terminal device 20C of the request destination with respect to the subject data transmitted from the terminal device 20A of the request source will be described with reference to FIGS. 4 to 8. First, the terminal device 20A of the request source acquires the data of the examination result of the eye to be examined performed by the ophthalmologic examination apparatus 30A (S31). The terminal device 20A transmits subject data including test result data to the server 10 (S32). As an example, the subject data includes, in addition to the test result data, patient name of the subject, gender, information of right and left eyes, test date, and focus value at the test. The terminal device 20A can also transmit subject data of a plurality of subjects to the server 10. The server 10 stores the received subject data.

  When the terminal device 20C of the request destination inputs an instruction to start the creation (substitution) of the additional data, the terminal device 20C transmits a signal to notify the proxy start to the server 10 (S33). In response to receiving the signal, the server 10 creates identification information (ID) for identifying the subject and adds it to the respective subject data, and personal information of the subject (an example of the personal name of the subject) The information of (1) is deleted from the subject data (S34), and transmitted to the terminal device 20C (S35). As a result, the possibility of leaking personal information of the subject is reduced. The step of S34 may be executed by the request source terminal device 20A instead of the server 10. Further, whether or not to execute step S34 may be determined according to an operation instruction from the user of the terminal device 20A of the request source. Further, the server 10 transmits only the subject data within the range that can be browsed by the browsing range information (see S22 and S24 in FIG. 2) to the terminal device 20C in S35.

  The requested terminal device 20C executes additional data creation processing (S36). The requested terminal device 20C transmits the additional data created in S36 to the server 10. The server 10 stores the received additional data and transmits it to the request source terminal device 20A.

  The additional data creation process (S36) will be described with reference to FIG. The CPU 22 of the terminal device 20C selects the test result report of the N-th (the first N value is “1”) subject data among one or more subject data for which additional data is to be created. It is created and displayed on the monitor 26 (S41). The inspection result report may be created by the requesting terminal device 20A, or may be created by the server 10. In this case, the test result report is transmitted from the server 10 to the terminal device 20C.

  An example of the inspection result report will be described with reference to FIGS. 6 and 7. The examination result report 50 is a report format so that a part of data extracted according to the instruction of the user of the terminal device 20A among the data of the examination result acquired by the ophthalmologic examination apparatus 30A can be easily viewed by the user It is arranged. Therefore, the inspection result report 50 is different from the viewer displayed for the user to view, analyze, etc. the data of the inspection result. In the present embodiment, the terminal device 20C of the request source determines which template to use from any of the plurality of templates related to the inspection result report in accordance with the selection instruction from the user. Each template defines the type of data to be extracted, the arrangement of the extracted data on a report, and the like. The terminal device 20A, the server 10, or the terminal device 20C (in the present embodiment, the terminal device 20C) extracts the data defined by the selected template from the inspection result data, and arranges the data at the position defined by the template Then, the inspection result data 50 is created. The background color of the inspection result data 50 is white.

  The test result report 50 illustrated in FIGS. 6 and 7 is used for diagnosis of macular disease. The examination result report 50 includes a bibliographic item display unit 51, an examination result image 53, a focused range data 55, a normal eye database image 57, and a deviation map image 58. The bibliographic items (for example, identification information (ID), gender, right and left eyes, examination date, and focus value) included in the subject data are displayed on the bibliographic items display unit 51.

  The examination result image 53 is an image based on the data of the examination result acquired by the ophthalmologic examination apparatus 30. As an example, the inspection result image 53 shown in FIGS. 6 and 7 is a two-dimensional map image showing the two-dimensional distribution of the thickness of a specific layer (ILM-RPE / BM in FIGS. 6 and 7) in the fundus of the subject's eye is there. Although not shown in FIGS. 6 and 7, in the inspection result image 53, the thickness of a specific layer is represented in a two-dimensional manner by the change in color. The distribution of thickness of a specific layer can be obtained by analyzing a three-dimensional image of the fundus. Further, on the examination result image 53, a marker 54 indicating a part of the range of interest in the range of the examination result image 53 is displayed. The outline of the marker 54 shown in FIG. 6 and FIG. 7 is circular, and the inside of the marker 54 is the attention range. The range of interest may not be circular, and may be linear or dotted.

  The attention range data 55 is data based on the inspection result of the attention range. As one example, attention range data 55 shown in FIGS. 6 and 7 is a chart showing an average value of thickness of a specific layer in each of a plurality of regions within the attention range. When at least one of the position, size, and shape of the target range is changed, the target range data 55 is also changed. The user can appropriately create the additional data by confirming the inspection result report 50 including the inspection result image 53 and the attention range data 55.

  The normal eye database image 57 is an image based on a database of normal eyes with no disease. The user can perform more appropriate diagnosis by comparing the subject data with the normal eye database image 57. The deviation map image 58 is an image showing the difference between the subject data and the normal eye database. In the examination result report 50 of the present embodiment, there is an abnormality free button operated when it is determined that there is no abnormality in the eye to be examined, an abnormality present button which is operated when it is determined that there is an abnormality, There is also a comment field in which comments are entered.

  It returns to the explanation of FIG. The CPU 22 determines whether an instruction to change the attention range is input by the user (S43). In the present embodiment, the user operates the pointer 59 (see FIG. 7) with the operation unit 25 (for example, a mouse or the like) to change at least one of the position, size, and shape of the marker 54 indicating the attention range. Then, it is possible to input an instruction to change the attention range. When an instruction to change the attention range is input (S43: YES), the CPU 22 changes the attention range according to the input instruction (S44). Further, the CPU 22 changes the attention range data 55 to data in the changed attention range based on the subject data (S45). Thereafter, the process returns to S43. In the example shown in FIG. 7, the position of the attention range is moved from the state shown in FIG. 6 to the lower right side. As a result, the attention range data 55 is also changed to data based on the moved attention range. The user can create additional data in a state where the appropriate inspection result report 50 is displayed by changing the attention range.

  If the change instruction of the attention range has not been input (S43: NO), the CPU 22 determines whether the additional data generation instruction has been input (S46). In the present embodiment, the user can input an instruction to create additional data including the presence or absence of a disease and a comment by operating the operation unit 25. If the instruction to create additional data has not been input (S46: NO), the process returns to S43. When an instruction to create additional data is input (S46: YES), the CPU 22 creates additional data according to the input instruction (S47). Next, the CPU 22 determines whether or not the additional data creation process for all the subject data has been completed (S48). If it has not completed (S48: NO), the process with respect to the following test subject data will be performed (S49, S41-S47). When the process for all the subject data is completed (S48: YES), the additional data creation process ends.

  In addition, it is also possible to change the contents of the processing and data described above. For example, it is also possible to change the content of the inspection result report. The examination result report 60 illustrated in FIG. 8 includes an examination result image 63 and attention range data 65A, 65B. The examination result image 63 is a front image of the fundus taken by the fundus imaging apparatus. In the inspection result image 63, two types of markers 63A and 63B indicating a focused range are displayed. The attention range data 65A is data of a three-dimensional tomographic image in a region indicated by the marker 63A in the fundus. The attention range data 65B is data of a two-dimensional tomographic image in a region indicated by the marker 63B in the fundus. In this case, when the markers 63A and 63B are changed, tomographic image data of the positions of the changed markers 63A and 63B are displayed.

  In the above process, the transmission process (S23 in FIG. 2) of the designation information for designating the requested terminal device 20 and the transmission process (S32 in FIG. 4) of the subject data are performed at different timings. However, the designation information and the subject data may be transmitted to the server 10 simultaneously. In addition, the server 10 may appropriately combine data of a plurality of types of examination results acquired by different types of ophthalmologic examination apparatuses 30 for the same eye to be examined and transmit the data to the terminal apparatus 20 of the request destination. For example, the server 10 may transmit the inspection result of the perimeter at each of a plurality of positions on the fundus and the image of the thickness map of a specific layer of the fundus in advance to the requested terminal device 20. Good.

  An example of processing when additional data (that is, additional data based on the result of follow-up observation) based on the progress of the medical condition of the eye to be examined is created will be described with reference to FIG. In the example illustrated in FIG. 9, subject data including data of a plurality of examination results acquired at different times from the same subject eye is transmitted to the requested terminal device 20 </ b> C via the server 10. The requested terminal device 20C creates additional data for subject data including data of a plurality of examination results. The details will be described below.

  In the example shown in FIG. 9, first, the terminal device 20A of the request source acquires examination result data (S51), and transmits subject data including the acquired examination result data to the server 10 (S52). The server 10 stores the subject data transmitted in S54. Furthermore, the terminal device 20B different from the terminal device 20A acquires the test result data obtained at the different time from the same eye to be examined (S53), and transmits the subject data including the acquired test result data to the server 10 (S54). The server 10 stores the subject data transmitted in S54. When the server 10 receives a signal notifying of the proxy start from the requested terminal device 20C (S55), the server 10 creates identification information of the subject and deletes the personal information (S56). In addition, the server 10 transmits the test subject data to the terminal device 20C of the request destination (S58) after associating a plurality of test result data for the same subject eye (S57). The terminal device 20C of the request destination creates additional data for subject data including data of a plurality of examination results acquired at different times from the same subject eye (S59). The created additional data is transmitted from the requested terminal device 20C to the server 10 (S60), and further transmitted to at least one of the requested terminal devices 20A and 20B (the terminal device 20A in FIG. 9).

  In this case, the requesting user can appropriately request the other user to create additional data based on the progress of the medical condition of the eye to be examined. In the example shown in FIG. 9, the subject data of the same subject's eye is transmitted to the server 10 from the terminal device 20A and the terminal device 20B different from each other. Therefore, even if the same subject's eye is examined at different times at different times, additional data is appropriately created based on the results of the medical condition of the subject's eye and the like. However, it goes without saying that a plurality of test subject data for the same subject eye may be transmitted from the same terminal device 20 to the server 10.

  With reference to FIG. 10, an example of processing in the case where transmission of subject data is started before the scheduled date and time when the user creates additional data will be described. In the example shown in FIG. 10, the terminal apparatus 20A of the request source acquires examination result data (S70), and transmits subject data including the acquired examination result data to the server 10 (S71). The requested terminal device 20C transmits, to the server 10, use status information including the operation log of the terminal device 20C (S72). The server 10 sets a scheduled date and time when the operation to create additional data for the subject data is performed next in the terminal device 20C that is the transmission source of the usage status information (S73). Specifically, in the example illustrated in FIG. 10, the scheduled date and time is automatically set by the server 10 based on the operation log included in the usage status information. Therefore, the user of the terminal device 20C does not have to perform an operation for setting the scheduled date and time. The processing of S72 and S73 may be performed after the processing of S70 and S71.

  When a predetermined time before the set scheduled date and time arrives, the server 10 transmits subject data to the requested terminal device 20C (S74). The terminal device 20C creates additional data (S75), and transmits the created additional data to the server 10 (S76). The server 10 transmits the received additional data to the requesting terminal device 20A (S77).

  When the process shown in FIG. 10 is performed, in the terminal device 20C that creates additional data, reception of the additional data is started even if an operation or the like for receiving the subject data is not performed. Thus, the work efficiency is improved. In addition, it is also possible to change the process illustrated in FIG. For example, the usage status information transmitted in S72 may include information indicating a scheduled date and time. The information indicating the scheduled date and time may be created by the user inputting an instruction to the terminal device 20C. The server 10 may set the scheduled date and time based on the information indicating the scheduled date and time in the use status information.

  With reference to FIG. 11, an example of processing (hereinafter referred to as "maintenance notification processing") of notifying the user of information on component replacement, maintenance, inspection, repair, etc. of the device based on the usage status of the device will be described. Do. The maintenance notification process shown in FIG. 11 is executed by the CPU 12 of the server 10.

  First, the CPU 12 receives the use status information of the terminal device 20 and the ophthalmologic examination device 30 from the respective terminal devices 20 (S81). The process of S81 may be performed at any timing. The CPU 12 determines whether the number of operations in the ophthalmologic examination apparatus 30 (that is, the number of examinations) is equal to or more than a threshold (S82). The number of operations may be determined, for example, based on the operation log of the ophthalmologic examination apparatus 30 included in the use status information. If the number of times of operation is less than the threshold (S 82: NO), the process proceeds directly to S 84. If the number of operations is equal to or greater than the threshold (S82: YES), the CPU 12 transmits a control signal for notifying the user of the component replacement recommendation of the ophthalmologic examination apparatus 30 to the terminal device 20 of the transmission source of usage information. (S83). For parts for which replacement is recommended, the threshold used in S82 may be set in advance according to the type of the part (for example, a light source). When the terminal device 20 receives the control signal transmitted in S83, the terminal device 20 causes the monitor 26 to display a message for recommending component replacement.

  Next, the CPU 12 determines whether the use period of the ophthalmologic examination apparatus 30 is equal to or more than the threshold value based on the use status information of the ophthalmologic examination apparatus 30 (S84). If the usage period is less than the threshold (S84: NO), the process proceeds directly to S86. If the usage period is equal to or more than the threshold (S84: YES), the CPU 12 transmits a control signal for notifying the user of the recommendation for the inspection of the ophthalmologic examination apparatus 30 to the terminal device 20 of the transmission source of the usage status information ( S85). When the terminal device 20 receives the control signal transmitted in S85, the terminal device 20 causes the monitor 26 to display a message for recommending the inspection of the ophthalmic examination apparatus 30.

  Next, based on the use status information of each of the ophthalmologic examination apparatus 30 and the terminal device 20, the CPU 12 determines whether the remaining capacity of the storage device of at least one of the ophthalmologic examination device 30 and the terminal device 20 is less than a threshold It judges (S86). If the remaining capacity is equal to or more than the threshold (S86: NO), the maintenance notification process ends. If the remaining capacity is less than the threshold (S86: YES), the CPU 12 transmits a control signal for notifying the user of the decrease in the remaining capacity to the terminal device 20 that is the transmission source of the usage status information (S87). When the terminal device 20 receives the control signal transmitted in S87, the terminal device 20 causes the monitor 26 to display a message notifying that the remaining capacity of the storage device has decreased.

  In addition, the process illustrated in FIG. 11 can also be changed. For example, based on the remaining capacity of the storage capacity allocated to each of the terminal devices 20, the server 10 predicts a time when the remaining capacity will be lost, and a control signal or data for notifying the user of the predicted time. May be transmitted to the terminal device 20. In this case, the user can appropriately perform a procedure for increasing the remaining capacity (for example, a procedure for increasing the allocated storage capacity). Also, the server 10 may determine whether the version is the latest based on the information indicating the version of the software installed in the terminal device 20 among the usage status information. The server 10 may execute processing for updating the software version of the terminal device 20 when the version is not the latest.

  With reference to FIG. 12, an example of a method of predicting an operation that the user is performing as a routine work and performing processing based on the prediction result will be described. The operation prediction process illustrated in FIG. 12 is executed by the CPU 12 of the server 10.

  First, the CPU 12 receives the use status information of the terminal device 20 and the ophthalmologic examination device 30 from the respective terminal devices 20 (S91). The process of S91 may be performed at any timing. The use status information received in S91 includes an operation log of at least one of the terminal device 20 and the ophthalmologic examination apparatus 30. The CPU 12 extracts, from the operation log, at least two operations which are frequently and continuously executed based on the past operation log included in the usage status information (S92). The CPU 12 sets the extracted continuous operation as a prediction operation (S93). That is, in S92 and S93, the second operation continuously executed after the first operation in at least one of the terminal device 20 and the ophthalmologic examination apparatus 30 is predicted based on the operation log.

  Next, the CPU 12 determines, based on the operation signal transmitted from the terminal device 20 to the server, whether the first operation performed first among the set prediction operations is performed (S94). When the first operation is executed (S94: YES), the CPU 12 automatically transmits at least one of the control signal and the data to the terminal device 20 based on the prediction operation (S95). For example, it may be set as prediction operation that operation which performs analysis of a test result is performed after operation which performs a test by ophthalmologic examination apparatus 30. In this case, when the CPU 12 determines that the operation to execute the test has been performed (S94: YES), it transmits a control signal for automatically executing the analysis of the test result to the terminal device 20 (S95). . In addition, for example, after the operation of adding feature points on the inspection result image 53, an operation of requesting the server 10 to transmit the inspection result image 53 to which the same feature points are added is set as the prediction operation It may have been. In this case, when the CPU 12 determines that the operation of adding feature points has been performed (S94: YES), it automatically transmits the inspection result image 53 to which the same feature points are added to the terminal device 20 (S95) ). When an instruction to end the process is input (S96: YES), the operation prediction process ends.

  With reference to FIG. 13, an example of a process of setting inspection conditions of the ophthalmologic examination apparatus 30 based on the use status of the ophthalmologic examination apparatus 30 will be described. In the example illustrated in FIG. 13, first, the terminal device 20A sets the examination conditions of the ophthalmologic examination apparatus 30 based on an instruction from the user (S101). The terminal device 20A transmits, to the server 10, use status information including data of the set inspection condition (S102). The server 10 stores (registers) the received data of the inspection condition in association with the identification information (ID) of the user who uses the terminal device 20A that is the data transmission source (S103).

  Further, in the example illustrated in FIG. 13, the user inputs his / her identification information to the terminal device 20B different from the terminal device 20A for which the inspection condition is set, and also inputs an operation instruction for calling the inspection condition ( S104). The terminal device 20B transmits a signal for requesting inspection condition data to the server 10 together with the input identification number (S105). The server 10 transmits the data of the inspection result stored in association with the identification number to the terminal device 20B of the transmission source of the request signal (S106).

  In the example illustrated in FIG. 13, the user can perform the examination under the same examination condition even when the ophthalmologic examination apparatus 30 is used at a plurality of different facilities. However, it is also possible to change the process illustrated in FIG. For example, the terminal device 20 for setting the inspection condition and the terminal device 20 for calling the inspection condition may be the same device. In addition, in the case where a plurality of examinations are performed on the same subject eye at different times, data of examination conditions at the time when the examination is performed in the past may be used. In this case, the data of the examination condition may be included in the subject data. In addition, there are cases where the first ophthalmologic examination apparatus 30 that has conducted an examination in the past is different from the manufacturer of the second ophthalmologic examination apparatus 30 that performs an examination thereafter. In this case, the server 10 sets the examination condition of the second ophthalmologic examination device 30 which is the same examination condition as the examination performed in the past by the first ophthalmologic examination device 30 and transmits it to the terminal device 20. Good.

  In the embodiment, the request source terminal devices 20A and 20B are an example of the first terminal device, and the request destination terminal device 20C is an example of the second terminal device. The terminal device 20 may function as both a request source and a request destination, or may function as only one of the request source and the request destination. The processes of S32, S52, S54, and S71 are an example of the first transmission step. The processes of S35, S58, and S74 are an example of the second transmission step. The processes of S36 (FIG. 5), S59, and S75 are an example of the additional data creation step. The processes of S37, S60, and S76 are an example of the third transmission step. The processes of S38, S61, and S77 are an example of the fourth transmission step. The processes of S43 to S45 are an example of the report change step. The process of S23 is an example of the designation information transmission step. The process of S20 is an example of the user information transmission step. The process of S21 is an example of the designation information creation step. The processes of S11 and S12 are an example of the evaluation value transmission step. The processes of S22 and S24 are an example of the browsing range information transmission step. The processes of S34 and S56 are an example of the identification information creating step. The process of saving the subject data transmitted in S52 and S54 is an example of the saving step.

  The processes of S32, S52, S54, and S71 are an example of the subject data transmission step. The processes of S72 and S102 are an example of the use status transmission step. The processes of S74, S83, S85, S87, S95, and S106 are an example of the situation-responsive transmission step. The process of S73 is an example of the scheduled date and time setting step. The processes of S92 and S93 are an example of the operation prediction step.

1 Ophthalmic Information Processing System 10 Server 12 CPU
20 terminal device 22 CPU
30 ophthalmic examination device 32 CPU
50, 60 Test result report 53, 63 Test result image 54, 64A, 64B Marker 55, 65A, 65B Attention range data

Claims (11)

An ophthalmologic information processing program executed in an ophthalmologic information processing system comprising a server and a plurality of terminal devices capable of communicating with the server, the ophthalmologic information processing program comprising:
The ophthalmic information processing program is executed by the controller of the ophthalmic information processing system,
A first transmission step in which a first terminal device of the plurality of terminal devices transmits subject data including data of examination results of the subject's eye acquired by the ophthalmologic examination device to the server;
The server transmits the subject data to a second terminal apparatus that is a terminal apparatus permitted to browse the subject data transmitted from the first terminal apparatus among the plurality of terminal apparatuses 2 transmission steps,
An additional data creation step of creating additional data for the subject data by receiving an instruction from the user while the second terminal device is displaying at least a part of the subject data on a display unit; ,
A third transmission step in which the second terminal device transmits the additional data to the server;
A fourth transmitting step of the server transmitting the additional data to the first terminal device;
An ophthalmologic information processing program executed by the ophthalmologic information processing system. It is an ophthalmologic information processing program of Claim 1, Comprising:
In the additional data creation step, an examination result image which is an image based on the examination result acquired by the ophthalmologic examination apparatus, and data based on the examination result of a part of the attention range in the range of the examination result image The additional data is created in a state where an inspection result report including certain attention range data is displayed on the display unit,
The second terminal device changes the attention range of the examination result image in the examination result report according to an instruction from the user, and changes the attention range data based on the subject data. An ophthalmologic information processing program, wherein a report change step of changing data in a focused range is executed by the ophthalmologic information processing system. It is an ophthalmologic information processing program of Claim 1 or 2, Comprising:
The first terminal device specifies one or more of the second terminal devices that allow browsing of the subject data among the plurality of terminal devices whose accounts are registered in the ophthalmologic information processing system The specified information transmitting step of transmitting specified information to the server is executed by the ophthalmologic information processing system.
In the second transmission step, the subject data is transmitted to the second terminal device designated by the designation information. It is an ophthalmologic information processing program of Claim 3, Comprising:
A user information transmission step in which the server transmits user information on a user of the terminal device whose account is registered in the ophthalmologic information processing system to each of the terminal devices;
A designation information creation step of creating the designation information by receiving an instruction from a user while the terminal device is displaying the user information on a display unit;
An ophthalmologic information processing program executed by the ophthalmologic information processing system. It is an ophthalmologic information processing program of Claim 4, Comprising:
An ophthalmologic information processing program, wherein the user information includes information indicating the number of times the additional data has been created in the past by the terminal device. It is an ophthalmologic information processing program of Claim 4 or 5, Comprising:
An evaluation value transmission step in which the first terminal device generates an evaluation value of the user of the second terminal device that has generated the additional data according to an instruction from the user, and transmits the evaluation value to the server As well as being executed
An ophthalmologic information processing program including the evaluation value in the user information. An ophthalmic information processing program according to any one of claims 1 to 6, wherein
The first terminal device generates browsing range information indicating a range of data browsable in the second terminal device among the subject data transmitted in the first transmission step, in accordance with an instruction from the user And the viewing range information transmission step of transmitting to the server is executed by the ophthalmologic information processing system;
In the second transmission step, data of a range indicated by the browsing range information in the subject data is transmitted to the second terminal device. An ophthalmic information processing program according to any one of claims 1 to 7, wherein
An identification information creation step of creating identification information for identifying each subject is executed by the ophthalmologic information processing system.
In the second transmission step, the subject data including no identification name of the subject and the identification information is sent to the second terminal apparatus. The ophthalmic information processing program according to any one of claims 1 to 8, wherein
In the second transmission step, subject data including data of a plurality of the examination results acquired at different times from the subject's eyes of the same subject is transmitted from the server to the second terminal device.
In the additional data creation step, the additional data is created for the subject data including the data of the plurality of examination results. It is an ophthalmologic information processing program of Claim 9, Comprising:
Subject data including data of a plurality of the examination results acquired at different times from the subject's eye of the same subject by each of the plurality of first terminal devices executing the first transmission step As well as being sent to the server
An ophthalmologic information processing program, wherein the storing step of storing the subject data of the same subject eye received from each of the plurality of first terminal apparatuses by the server is executed by the ophthalmologic information processing system. . An ophthalmologic information processing method executed in an ophthalmologic information processing system comprising a server and a plurality of terminal devices capable of communicating with the server,
A first transmission step in which a first terminal device of the plurality of terminal devices transmits subject data including data of examination results of the subject's eye acquired by the ophthalmologic examination device to the server;
The server transmits the subject data to a second terminal apparatus that is a terminal apparatus permitted to browse the subject data transmitted from the first terminal apparatus among the plurality of terminal apparatuses 2 transmission steps,
An additional data creation step of creating additional data for the subject data by receiving an instruction from the user while the second terminal device is displaying at least a part of the subject data on a display unit; ,
A third transmission step in which the second terminal device transmits the additional data to the server;
A fourth transmitting step of the server transmitting the additional data to the first terminal device;
An ophthalmologic information processing method comprising:

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