JP2019160015A - Medical checkup support program, medical checkup support device and medical checkup support method - Google Patents

Abstract

To effectively suppress the spread of infectious disease.SOLUTION: A medical checkup support device 1 comprises a storage unit 10 and a processing unit 20. The storage unit 10 stores attribute information 12 of monitored objects P, Q and R. On the basis of the monitored objects P, Q and R and position history information 11 of the monitored object P to be an infection source detected from among them, the processing unit 20 specifies the monitored objects Q and R which have been in predetermined contact with the monitored object P to be an infection source. The processing unit 20 evaluates infection risk on the basis of the attribute information 12 of the specified monitored objects Q and R, and the monitored object Q which needs to be preferentially treated between the monitored objects Q and R is specified.SELECTED DRAWING: Figure 1

Description

  The present invention relates to a medical examination support program, a medical examination support apparatus, and a medical examination support method.

  There is known a system for identifying a user of a terminal that exists within a specified distance within the same space and notifying the terminal based on a history of position information of a terminal of an infected person such as influenza.

  In addition, a system is known that acquires position information of a plurality of terminals and health information of the users for each time, creates an infection risk map, and notifies a terminal of a user at risk of infection. In addition, when the identification information of an infectious disease patient is entered, the database that stores the ward or ward where the patient stayed and the stay period is searched, and the other stays in the same ward or ward during the same period as the patient. A system for displaying a list of patients is known.

JP 2012-198717 A JP2015-161987 JP 2005-25457 A

  In the conventional system, a terminal user or a patient who may be infected is specified from the positional relationship with the infected person for a certain time. However, there are individual differences in infection and subsequent symptoms, and the risk of onset, aggravation, and spread of infection will increase if the person who is relatively likely to develop and develop infection is not dealt with early.

  In one aspect, the present invention aims to effectively suppress the spread of the occurrence of infectious diseases.

  In one aspect, the first position history information indicating the history of the positions of the plurality of monitoring targets is acquired, and based on the first position history information, the infection source is detected from among the plurality of monitoring targets. The second position history information indicating the history of the position of the monitoring target is specified, and the monitoring target that is the infection source among the plurality of monitoring targets based on the first position history information and the second position history information The other monitoring target that has a predetermined contact with the other monitoring target is identified, the infection risk is evaluated based on the attribute information indicating the attribute of the other monitoring target, and the monitoring that should be preferentially dealt with among the other monitoring targets A medical examination support program for causing a computer to execute processing for specifying a subject is provided.

  In one aspect, the expansion of the occurrence of infectious diseases can be effectively suppressed.

It is a figure for demonstrating the process by a medical examination assistance apparatus. It is a figure which shows an example of a medical examination support system. It is a figure which shows an example of the hardware constitutions of an electronic medical record server. It is a figure which shows an example of the function which an infection management system has. It is a figure which shows an example of patient position information DB and staff position information DB. It is a figure which shows an example of patient information DB and staff information DB. It is a figure which shows an example of test result DB and observation item DB. It is a figure which shows an example of a contact reference | standard and an evaluation reference | standard. It is FIG. (1) which shows the example of an evaluation criteria table. It is FIG. (2) which shows the example of an evaluation criteria table. It is FIG. (3) which shows the example of an evaluation criteria table. It is FIG. (4) which shows the example of an evaluation criteria table. It is a figure for demonstrating contact evaluation. It is a figure which shows an example of contact person information DB. It is a figure which shows an example of medical examination list DB. It is a flowchart which shows the example of a positional information acquisition process. It is a flowchart which shows the example of a monitoring object information acquisition process. It is a flowchart which shows the example of a medical examination support process. It is a flowchart which shows the example of a contact evaluation process. It is a flowchart which shows the example of a medical examination priority evaluation process. It is a flowchart which shows the example of a contact density evaluation process. It is a flowchart which shows the example of an age evaluation process. It is a flowchart which shows the example of a sex evaluation process. It is a flowchart which shows the example of a pregnancy evaluation process. It is a flowchart which shows the example of a heat_generation | fever evaluation process. It is a flowchart which shows the example of a diarrhea evaluation process. It is a flowchart which shows the example of the past disease evaluation process. It is a flowchart which shows the example of a vaccination history evaluation process. It is a flowchart which shows the example of an immunosuppressant administration history evaluation process. It is a flowchart which shows the example of an organ transplant history evaluation process. It is a flowchart which shows the example of a dialysis treatment evaluation process. It is a flowchart which shows the example of the medical practice evaluation process to an infected person. It is a figure (the 1) which shows the example of the output of a medical examination support system. It is a figure (the 2) which shows the example of the output of a medical examination support system. It is a figure (the 3) which shows the example of the output of a medical examination support system.

Hereinafter, embodiments will be described with reference to the drawings.
[First Embodiment]
FIG. 1 is a diagram for explaining processing by the medical examination support apparatus.

  The medical examination support apparatus 1 illustrated in FIG. 1 identifies a monitoring target that has a predetermined contact with a monitoring target that is an infection source detected from among a plurality of monitoring targets, and the infection risk of the identified monitoring target (response priority) Degree), and identify the monitoring target that should be dealt with preferentially. Here, the monitoring target that is the source of infection is a monitoring target to which a pathogen (protozoan, bacterium, microorganism such as a virus) that causes infection is attached or invaded (held) and infects other monitoring targets. This refers to a monitoring target that may cause illness. In addition, the pathogen which causes an infectious disease is also called a microbe below.

  The plurality of monitoring targets of the medical examination support apparatus 1 are, for example, a patient at a hospital and a staff member who works at the hospital. Monitored patients may include inpatients as well as outpatients. The staff to be monitored includes various staff such as doctors, nurses, pharmacists, laboratory technicians, radiographers, physiotherapists, office workers, and cleaning staff. In addition, the monitoring targets may include visitors and traders who enter and exit the hospital. Furthermore, the monitoring target may include hospital facilities and equipment.

  The medical examination support apparatus 1 includes a storage unit 10 and a processing unit 20. The storage unit 10 may be a volatile semiconductor memory such as a RAM (Random Access Memory) or a non-volatile storage such as an HDD (Hard Disk Drive) or a flash memory. The processing unit 20 is, for example, a processor such as a CPU (Central Processing Unit) or a DSP (Digital Signal Processor). The processing unit 20 may include a specific purpose electronic circuit such as an application specific integrated circuit (ASIC) or a field programmable gate array (FPGA). The processor executes a program stored in a memory such as a RAM (or the storage unit 10).

  FIG. 1 shows monitoring targets P, Q, and R as a plurality of monitoring targets. In FIG. 1, among the monitoring targets P, Q, and R, the monitoring target P is set as a monitoring target serving as an infection source that holds a pathogen of the infectious disease N. Note that the monitoring target P that is an infection source includes hospital patients and staff, as well as visitors and traders entering and exiting the hospital, facilities and equipment in the hospital, and the like. The monitoring targets Q and R are hospital patients and staff, as well as visitors and traders who enter and exit the hospital. The storage unit 10 includes position history information 11 that indicates the history of the positions of the monitoring targets P, Q, and R, attribute information 12 that indicates information on the attributes of the monitoring targets P, Q, and R, and contact criteria set for the infectious disease N. A reference table 13 in which a and evaluation criteria b are recorded is stored.

  Based on the position history information 11 of the monitoring targets P, Q, and R, the processing unit 20 specifies the position history information 11 of the monitoring target P that is an infection source detected from the monitoring targets P, Q, and R. Based on the position history information 11 of the monitoring target P that is the identified infection source, the processing unit 20 performs monitoring with the monitoring target P that has been in contact with the monitoring target P for the distance and time set by the contact reference a in the reference table 13. The target, in this example, the monitoring targets Q and R are specified. And the process part 20 evaluates the infection risk of the monitoring object Q and R using the evaluation criteria b of the reference | standard table 13, based on attribute information, such as age, sex, and a past disease of the specified monitoring object Q and R, A monitoring target to be dealt with preferentially among the monitoring targets Q and R is specified.

  For example, the processing unit 20 performs scoring of the monitoring targets Q and R using a score set for each attribute item of the monitoring target Q and R attribute information. The score is set to be higher for attribute items that tend to be infected by infectious disease N and those that are likely to develop after infection. The processing unit 20 generates the medical examination list 21 including the score total after scoring and information on the handling priority based on the score total. The processing unit 20 identifies a monitoring target whose score total satisfies a predetermined criterion, in this example, the monitoring target Q, as a monitoring target that has a high infection risk and should be preferentially dealt with.

  Because there are individual differences in the infection and subsequent symptoms of infectious pathogens, it is necessary to deal with people who are relatively likely to develop and develop infections, such as medical examination, examination, and isolation, The risk of onset, severity and spread of infection increases.

  As described above, the medical examination support apparatus 1 identifies a monitoring target that has a predetermined contact with a monitoring target that is an infection source, evaluates an infection risk, and specifies a monitoring target that should be dealt with preferentially. Considering the age, sex, and history of the subject in the assessment of the risk of infection, priority is given to subjects that are likely to become infected, likely to develop after infection, and likely to become serious. Is identified as a monitoring target to be addressed. The monitoring target specified in this way is preferentially examined by a doctor. In the medical examination support apparatus 1, in addition to inpatients as outpatients, outpatients, hospital staff, and the like, the infection risk of a wide range of people related to hospitals can be evaluated. According to the medical examination support apparatus 1, it is possible to effectively suppress the expansion of the occurrence of infectious diseases.

[Second Embodiment]
FIG. 2 is a diagram illustrating an example of a medical examination support system.
A medical examination support system 1000 shown in FIG. 2 includes a location information server 200, a staff server 300, and an electronic medical record server 400 connected to the network 100. The electronic medical record server 400 includes, for example, an infection management system 500 incorporated therein.

The network 100 is, for example, a local area network (LAN), a wide area network (WAN), or the Internet.
The position information server 200 is a server computer that performs processing for acquiring position information of monitoring targets, in this example, hospital patients and staff. The position information server 200 includes a patient position information database (DB) 210 and a staff position information DB 220. The position information server 200 records patient and staff position information (position history information) collected using the beacon 230 attached to the patient and staff in the patient position information database 210 and staff position information DB 220, respectively. The processing of the location information server 200 is realized by software executed by the location information server 200.

  In the location information server 200, not only the patient and the staff, but also the location information of other monitoring targets such as a visitor and a trader is acquired, and the location information is recorded in the corresponding location information DB. Also good.

  The staff server 300 is a server computer that manages staff information including attribute information of hospital staff among monitoring targets. The staff server 300 manages basic information such as age and gender of hospital staff such as doctors and nurses, presence / absence of medical treatment on patients, information on vaccination history, and the like as attribute information of staff. The information on the presence or absence of medical practice for the patient includes, for example, information on the presence or absence of medical practice such as sputum suction, bathing assistance, rehabilitation, bronchoscopy, and respiratory function test. The information on the history of vaccination includes, for example, information on the presence or absence of vaccination such as influenza.

  The staff server 300 includes a staff information DB 310. The staff server 300 stores information such as basic staff information, presence / absence of medical treatment for patients, and vaccination history in the staff information DB 310. The processing of the staff server 300 is realized by software executed on the staff server 300.

  The electronic medical record server 400 is a server computer that manages patient information including attribute information of hospital patients among monitoring targets. The electronic medical record server 400 manages basic information such as the age and sex of hospitalized patients and outpatients, information such as the condition, past medical history, medication history, vaccination history, and test results as patient attribute information. The information on the condition includes information on observation items of symptoms such as fever, cough, sneeze, vomiting, chills, and headache. The information on the past illness includes, for example, information on the presence or absence of diseases such as HIV (Human Immunodeficiency Virus) and diabetes in which immunity is reduced. The information on the medication history includes, for example, information on the presence / absence of administration of an immunosuppressant and the presence / absence of dialysis treatment. The information on the history of vaccination includes, for example, information on the presence or absence of vaccination such as influenza. The information on the test results includes, for example, information on blood tests and virus tests.

  The electronic medical record server 400 includes a patient information DB 410, an examination result DB 420, and an observation item DB 430. The electronic medical record server 400 stores information such as basic patient information, past medical history, medication history, and vaccination history in the patient information DB 410. The electronic medical record server 400 stores information on patient test results in the test result DB 420. The electronic medical record server 400 stores information on patient observation items in the observation item DB 430. The processing of the electronic medical record server 400 is realized by software executed on the electronic medical record server 400.

  The electronic medical record server 400 incorporates an infection management system 500. The infection management system 500 manages information related to an infected person (monitoring target as an infection source) of an infectious disease. The infection management system 500 is a server computer that manages information on a contact person who has a predetermined contact with an infected person among the monitoring targets, and information on a health check priority of the contact person.

  Infection management system 500 includes contact information DB 510 and medical examination list DB 520. The infection management system 500 generates information about the contact person and stores it in the contact person information DB 510. The infection management system 500 generates information on the medical examination priority of the contact person and stores the information in the medical examination list DB 520. The processing of the infection management system 500 is realized by software executed by the infection management system 500 incorporated in the electronic medical record server 400, for example.

Next, the hardware configuration of the electronic medical record server 400 will be described.
FIG. 3 is a diagram illustrating an example of a hardware configuration of the electronic medical record server.
The electronic medical record server 400 includes a processor 401, a RAM 402, an HDD 403, an image signal processing unit 404, an input signal processing unit 405, a reading device 406, and a communication interface 407. Here, the processor 401 is an example that realizes the function of the processing unit 20 of the first embodiment. The RAM 402 or the HDD 403 is an example that realizes the function of the storage unit 10 according to the first embodiment.

  The processor 401 may be a multiprocessor. The processor 401 is, for example, a CPU, DSP, ASIC, or FPGA. The processor 401 may be a combination of two or more of CPU, DSP, ASIC, FPGA, and the like.

  The RAM 402 is a main storage device of the electronic medical record server 400. The RAM 402 temporarily stores at least part of an OS (Operating System) program and application programs to be executed by the processor 401. The RAM 402 stores various data used for processing by the processor 401.

  The HDD 403 is an auxiliary storage device of the electronic medical record server 400. The HDD 403 magnetically writes data to and reads data from a built-in magnetic disk. The HDD 403 stores an OS program, application programs, and various data. The electronic medical record server 400 may include other types of auxiliary storage devices such as an SSD (Solid State Drive), or may include a plurality of auxiliary storage devices.

  The image signal processing unit 404 displays an image on the display 404 a connected to the electronic medical record server 400 in accordance with a command from the processor 401. As the display 404a, a CRT (Cathode Ray Tube) display, a liquid crystal display, or the like can be used.

  The input signal processing unit 405 acquires an input signal from the input device 405 a connected to the electronic medical record server 400 and outputs the input signal to the processor 401. As the input device 405a, for example, a pointing device such as a mouse or a touch panel, a keyboard, or the like can be used.

  The reading device 406 is a device that reads a program and data recorded on the recording medium 406a. Examples of the recording medium 406a include a magnetic disk such as a flexible disk (FD) and an HDD, an optical disk such as a CD (Compact Disc) and a DVD (Digital Versatile Disc), and a magneto-optical disk (MO). Can be used. Further, as the recording medium 406a, for example, a nonvolatile semiconductor memory such as a flash memory card can be used. The reading device 406 stores, for example, a program or data read from the recording medium 406 a in the RAM 402 or the HDD 403 in accordance with an instruction from the processor 401.

The communication interface 407 is an interface for communicating with the location information server 200 and the staff server 300 via the network 100.
The location information server 200 and the staff server 300 can also be realized using the same hardware as the electronic medical record server 400 as shown in FIG.

  Here, an example in which the infection management system 500 is incorporated in the electronic medical record server 400 is shown, but the infection management system 500 may be realized by a server computer different from the electronic medical record server 400. In this case, the server computer that functions as the infection management system 500 can be realized by using the same hardware as in FIG.

Next, functions of the infection management system 500 will be described.
FIG. 4 is a diagram illustrating an example of the functions of the infection management system.
The infection management system 500 illustrated in FIG. 4 includes a storage unit 530 and a control unit 540. The storage unit 530 is mounted using a storage area secured in the RAM 402 or the HDD 403, for example. The control unit 540 is mounted using a program executed by the processor 401, for example.

  The storage unit 530 stores various information used for processing of the infection management system 500. The storage unit 530 has a reference table in which contact criteria for specifying a contact person who has a predetermined contact with an infected person among the monitoring targets, and an evaluation reference for evaluating the medical examination priority of the contact person are set. 550 is stored. The reference table 550 includes a contact reference table 551 that records contact criteria for each type of infectious disease and an evaluation criteria table 552 that records evaluation criteria for each type of infectious disease.

The control unit 540 includes an information acquisition unit 541, a contact evaluation unit 542, and a medical examination priority evaluation unit 543.
The information acquisition unit 541 acquires patient and staff position information from the patient position information DB 210 and staff position information DB 220, respectively. The information acquisition unit 541 acquires patient information from the patient information DB 410 and acquires staff information from the staff information DB 310. The information acquisition unit 541 acquires inspection result information from the inspection result DB 420 and acquires observation item information from the observation item DB 430.

  The contact evaluation unit 542 performs predetermined contact with the infected person based on the position information of the patient and the staff acquired by the information acquisition unit 541, the information on the examination result of the infected person, and the contact reference table 551 stored in the storage unit 530. Identify the contact person who was.

  For example, the contact evaluation unit 542 identifies, as a contact, a monitoring target that has coexisted with the infected person for a certain period of time at a certain distance set in the contact reference table 551 during the infectivity period determined by the type of infectious disease of the infected person. To do.

  The medical examination priority evaluation unit 543 includes the patient and staff position information, patient information, staff information, examination results, and observation item information acquired by the information acquisition section 541, and an evaluation criterion table stored in the storage section 530. Based on 552, the health check priority and infection risk of the contact are evaluated.

  For example, the medical examination priority evaluation unit 543 sets, for the contact person specified by the contact evaluation unit 542, a score set for each evaluation item (patient and staff attribute item) for each type of infection in the evaluation criterion table 552. Scoring according to And the medical examination priority evaluation part 543 produces | generates the medical examination list | wrist including the score total of each contact person, and the medical examination priority based on it. Each contact's score total and medical examination priority are each an index representing the infection risk of each contact person's infection. For example, the medical examination priority evaluation unit 543 generates and outputs a medical examination list in which the contacts are arranged in the order of the highest score total and the higher medical examination priority.

Next, the patient position information DB 210 and the staff position information DB 220 will be described.
FIG. 5 is a diagram illustrating an example of the patient position information DB and the staff position information DB.
As shown in FIG. 5A, the patient position information DB 210 records a patient ID for identifying a patient and the name of the patient. In the patient position information DB 210, from the position information of each patient collected using the beacon 230 attached to the patient to be monitored, the area code and area name of the area where the patient was, the date of entry to the area, The entry time and the withdrawal date and withdrawal time from the area are recorded. That is, the position history information indicating the history of the position of each patient is recorded in the patient position information DB 210.

  In addition, in the patient position information DB 210 in FIG. 5A, areas such as a ward or a room where the patient is located are recorded as position information, and more detailed position information such as the position (coordinates) in the room is recorded. Also good.

  In addition, in the staff position information DB 220 shown in FIG. 5B, a staff ID for identifying the staff and the name of the staff are recorded. In the staff position information DB 220, from the position information of each staff member collected using the beacon 230 attached to the staff member to be monitored, the area code and area name of the area where the staff person was, the entry date to the area, The entry time and the withdrawal date and withdrawal time from the area are recorded. In other words, the position history information indicating the position history of each staff member is recorded in the staff member position information DB 220.

  In addition, in the staff position information DB 220 in FIG. 5B, the area such as the ward or the room where the staff is located is recorded as the position information, and more detailed position information such as the position (coordinates) in the hospital room is recorded. Also good.

Next, the patient information DB 410 and the staff information DB 310 will be described.
FIG. 6 is a diagram illustrating an example of the patient information DB and the staff information DB.
As shown in FIG. 6 (A), the patient information DB 410 includes, for example, a patient ID for identifying a patient, the patient's name, age, sex, presence / absence of pregnancy, past illness, vaccination history, drugs in use, and organ transplant history. Information about the presence or absence of dialysis treatment is recorded.

  As shown in FIG. 6B, the staff information DB 310 includes, for example, a staff ID for identifying the staff, the name of the staff, age, sex, presence / absence of pregnancy, past illness, vaccination history, drugs in use, and organ transplant history. Information about the presence or absence of dialysis treatment is recorded. The staff information DB 310 further records information on medical practices performed by the staff. For example, information on the date and content (type) of medical practice is recorded in the staff information DB 310 in association with information (for example, patient ID) identifying the patient on whom the medical practice was performed.

Next, the inspection result DB 420 and the observation item DB 430 will be described.
FIG. 7 is a diagram illustrating an example of the inspection result DB and the observation item DB.
As shown in FIG. 7A, in the test result DB 420, for example, the patient ID for identifying the patient, the patient's name, the name of the bacterium detected by the test (type of infectious disease), the test result report date, the bacterium The start date and end date of the infectivity period determined by the infection route and the bacterial species are recorded.

  As shown in FIG. 7B, the observation item DB 430 includes, for example, a patient ID for identifying the patient, the patient's name, the highest body temperature in the past 24 hours, the presence or absence of cough or sneezing, the presence or absence of vomiting, the presence or absence of diarrhea Information about the presence of chills and headaches is recorded.

  The medical examination support system 1000 is determined by the staff ID for identifying the staff, the name of the staff, the name of the bacterium detected by the test (type of infectious disease), the test result report date, the bacterial infection route, and the bacterial species. A test result DB in which information on the start date and end date of the infectious period is recorded may be included. Such an inspection result DB for the staff may be implemented in the staff server 300.

  The medical examination support system 1000 includes a patient ID for identifying the staff, the name of the staff, the maximum body temperature for the past 24 hours, the presence of cough and sneezing, the presence of vomiting, the presence of diarrhea, the presence of chills, and the presence of headaches. An observation item DB in which information on the information is recorded may be included. Such an observation item DB for the staff may be implemented in the staff server 300.

Next, contact criteria and evaluation criteria will be described.
FIG. 8 is a diagram illustrating an example of contact criteria and evaluation criteria.
In the infection management system 500, as a contact standard and an evaluation standard, as shown in FIG. 8A, a contact standard N and an evaluation standard N for each infectious disease bacteria N = A, B, C,. The reference table 550 in which is set is used. In the reference table 550, the contact standard A and the evaluation standard A are set for the infectious disease of the bacterium A. Similarly, in the standard table 550, the contact standard B and the evaluation standard B are set for the infection of the fungus B, and the contact standard C and the evaluation standard C are set for the infection of the fungus C. The contents of the contact reference N and the evaluation reference N in the reference table 550 may be recorded as a contact reference table 551 as shown in FIG. 8B and an evaluation reference table 552 as shown in FIG. 8C, respectively.

In the contact reference table 551, as shown in FIG. 8B, for each contact reference N (N = A, B, C,...) Set for each type of infectious disease, a distance d _N (N = A, B, C,...) And contact time T _N (N = A, B, C,...) Are set. The contact evaluation unit 542 of the infection management system 500 contacts the monitoring target coexisting with the infected person for a distance d _N or less and a contact time T _N or more for each type of infectious disease based on such a contact reference table 551. Identify as a person.

In the evaluation criteria table 552, as shown in FIG. 8C, for each evaluation criteria N (N = A, B, C,...) A score S _N (N = A, B, C,...) For each evaluation item (attribute item of patients and staff members) is set. The medical examination priority evaluation unit 543 of the infection management system 500 determines, based on such an evaluation criterion table 552, for each type of infectious disease, a contact person having a predetermined contact with the infected person is score S _{N for} each evaluation item. Scoring according to the above, and obtain medical examination priority.

Here, the contents of the evaluation criterion table 552 will be further described.
9 to 12 are diagrams showing examples of the evaluation criterion table.
FIG. 9A shows an evaluation criterion table 552a in which the evaluation item of the medical examination priority is the contact density. For example, in the evaluation standard A for bacteria A, scores are set for each contact density, such as 5 points when the contact density is high and medium, and 3 points when the contact density is low. Similarly, scores are set for each contact density in the evaluation criteria B of the bacteria B and the evaluation criteria C of the bacteria C.

  FIG. 9B shows an evaluation criterion table 552b in which the evaluation item of the medical examination priority is age. For example, in the evaluation standard A of bacteria A, when the age is less than 1 year, it is 5 points, when it is 1 to 6 years old, 3 points, when it is 7 to 19 years old, 3 points, when it is 20 to 64 years old A score is set for each age range, such as 1 point and 3 points for those 65 and older. Similarly, in the evaluation criteria B for the bacteria B and the evaluation criteria C for the bacteria C, a score is set for each age range.

  FIG. 9C shows an evaluation criterion table 552c in which the evaluation items of the medical examination priority are sex. For example, in the evaluation standard A for bacteria A, a score is set for each gender, such as 1 point when the gender is male, 3 points when the gender is unknown, and 1 point when the gender is unknown. Similarly, scores are set for each sex in the evaluation criteria B for the bacteria B and the evaluation criteria C for the bacteria C.

  FIG. 10A shows an evaluation criterion table 552d in which the evaluation item of the medical examination priority is the presence or absence of pregnancy. For example, in the evaluation standard A for bacteria A, a score is set for each pregnancy, such as 5 points when pregnant and 1 point when not pregnant. Similarly, in the evaluation criteria B of the bacteria B and the evaluation criteria C of the bacteria C, a score is set for each pregnancy.

  FIG. 10B shows an evaluation criterion table 552e in which the evaluation item of the medical examination priority is the presence or absence of fever. For example, in the evaluation standard A for bacteria A, a score is set for each presence or absence of fever, such as 5 points if there has been fever in the past 24 hours and 1 point if there has been no fever. Similarly, in the evaluation standard B of the bacteria B and the evaluation standard C of the bacteria C, a score is set for each presence or absence of fever in the past 24 hours.

  FIG. 10C shows an evaluation criterion table 552f in which the evaluation item of the medical examination priority is the presence or absence of diarrhea. For example, in the evaluation standard A for bacteria A, a score is set for each presence or absence of diarrhea, such as 5 points when there is diarrhea and 1 point when there is no diarrhea. Similarly, in the evaluation standard B of the bacterium B and the evaluation standard C of the bacterium C, a score is set for each presence or absence of diarrhea.

FIG. 11A shows an evaluation criterion table 552g in which the evaluation item of the medical examination priority is a past disease Y _M (M = 1, 2, 3,...). For example, the evaluation criteria A bacteria A, 1 point if there are pre-existing conditions Y _1, 3 points if there is a previous illness Y _2, if there is a previous illness Y ₃ as such a point, the score for each pre-existing condition Y _M Is set. Similarly, in evaluation criteria C criteria B and fungi C fungus B, score each anamnesis Y _M are set.

  FIG. 11B shows an evaluation criterion table 552h in which the evaluation item of the medical examination priority is the vaccination history. For example, in the evaluation standard A for bacteria A, a score is set for each vaccination history, such as 1 point if there is a vaccination history, 5 points if there is no vaccination history, 5 points if unknown. Yes. Similarly, in the evaluation criteria B of the bacteria B and the evaluation criteria C of the bacteria C, a score is set for each vaccination history.

  FIG. 11C shows an evaluation criterion table 552i in which the evaluation item of the medical examination priority is an immunosuppressant administration history. For example, in the evaluation standard A for bacteria A, a score is set for each vaccination history, such as 5 points if there has been an immunosuppressant history in the past month and 1 point if there has not been an immunosuppressant history. ing. Similarly, in the evaluation standard B of the bacteria B and the evaluation standard C of the bacteria C, a score is set for each vaccination history for the past month.

  FIG. 12A shows an evaluation criterion table 552j in which the evaluation item of the medical examination priority is an organ transplant history. For example, in the evaluation standard A for bacteria A, a score is set for each organ transplant history, such as 5 points when there is an organ transplant history and 1 point when there is no organ transplant history. Similarly, in the evaluation criteria B for the bacteria B and the evaluation criteria C for the bacteria C, a score is set for each organ transplant history.

  FIG. 12B shows an evaluation criterion table 552k in which the evaluation item of the medical examination priority is the presence or absence of dialysis treatment. For example, in the evaluation standard A for bacteria A, a score is set for each presence or absence of dialysis treatment, such as 5 points when dialysis treatment is performed and 1 point when dialysis treatment is not performed. Similarly, in the evaluation standard B of the bacterium B and the evaluation standard C of the bacterium C, a score is set for each presence / absence of dialysis treatment.

  FIG. 12C shows an evaluation criterion table 552l in which the evaluation item of the medical examination priority is the presence / absence of medical practice for the infected person of the staff. For example, according to the evaluation standard A of bacteria A, 5 points are given when there is a medical practice for staff infected persons, and 1 point when there is no medical practice for staff infected persons. A score is set for each act. Similarly, in the evaluation standard B of the bacteria B and the evaluation standard C of the bacteria C, a score is set for each presence or absence of medical practice for the infected person of the staff.

Next, contact evaluation by the contact evaluation unit 542 of the infection management system 500 and medical examination priority evaluation by the medical examination priority evaluation unit 543 will be described.
Based on the contact reference table 551, the contact evaluation unit 542 identifies, as a contact, a monitoring target that has coexisted with an infected person with a fungus N infection at a distance d _N or less and a contact time _TN or more. Perform contact evaluation.

FIG. 13 is a diagram for explaining the contact evaluation.
FIG. 13 schematically shows the occupancy status of patients P, Q, and R in a certain hospital room (north wing 6F2 room) as an example. The positions of the patients P, Q, and R are collected by the beacon 230 and the coordinate specifying device 231 attached to each, and recorded in the patient position information DB 210 (FIG. 5A).

  Now, it is assumed that an infectious disease (influenza) has been detected for the patient P as in the record of the test result DB 420 (FIG. 7A). The contact evaluation unit 542 identifies the monitoring target, for example, the patients Q and R in this example, in the same room as the patient P during the infectious period (2017/12/10 to 2017/12/16) of the patient P. The contact evaluation unit 542 obtains the distance and contact time between the patient P and the patients Q and R from the history of the positional information between the patient P and the patients Q and R collected by the beacon 230 and the coordinate specifying device 231.

FIG. 14 is a diagram illustrating an example of the contactor information DB.
In the contact information DB 510, for example, the patient ID and coordinates X and Y of the contact evaluation subject or the contact person (patients Q and R), the patient ID and coordinates X and Y of the infected person (patient P), the contact person and the infection Information on the distance to the person, the contact start date and the contact start time, the contact end date and the contact end time, and the contact time is recorded. Information on the distance and contact time between each contact person and the infected person recorded in the contact person information DB 510 can be identified by an identification number such as a document number as shown in FIG. 14, for example.

For example, as shown in FIG. 13, the coordinates (X, Y) = (2, 9) of the patient P, the coordinates (X, Y) = (3, 3) of the patient Q, and the coordinates (X, Y) of the patient R In the case of = (13, 3), assuming that one coordinate point is 30 cm, the distance between the patient P and the patients Q and R is as follows. That is, the distance between the patient P and the patient Q is √ {(3-2) ² + (9-3) ² } × 30 cm = 180 cm, and the distance between the patient P and the patient R is √ {(13-2) ² + (9-3) ² } × 30 cm = 390 cm. In addition, the time during which patient P and patients Q and R were in the same room during the infectious period of patient P (the time from contact start time to contact end time) is the contact time between patient P and patients Q and R. Desired.

Based on the contact reference table 551, the contact evaluation unit 542 determines the contact reference N that is set for the infectious disease N of the patient P among the patients Q and R, and the distance and contact time obtained with the patient P. those satisfying (distance d _N or less and the contact time T _N or higher), to identify as a contact person. For example, if the distance and contact time of the patients Q and R with the patient P satisfy the contact criteria N set for the infectious disease bacteria N of the patient P, the patients Q and R are both identified as contacts. FIG. 14 shows an example of the contact information DB 510 when the patients Q and R are both identified as contacts as described above.

FIG. 15 is a diagram illustrating an example of a medical examination list DB.
The medical examination priority evaluation unit 543 is set for each evaluation item (patient attribute item) based on the evaluation criterion table 552 for the patients Q and R identified as contacts of the infectious patient P by the contact evaluation unit 542. Scoring is performed according to the score S _{N obtained} . The medical examination priority evaluation unit 543 records the total score of the patients Q and R obtained by scoring and information on the medical examination priority based on the total score in the medical examination list DB 520 as illustrated in FIG. In the medical examination list DB 520, for example, the patient IDs and names of the patients Q and R, the obtained total score and the medical examination priority, and information on the inspection target items and scheduled examination dates to be performed on the patients Q and R Are listed and recorded. The medical examination priority evaluation unit 543 outputs the contents of the medical examination list DB 520 as a medical examination list.

In the score S _N of the evaluation criterion table 552, an item having a higher medical examination priority has a higher score. Therefore, the medical examination priority becomes higher as the patient's total score obtained by scoring by the medical examination priority evaluation unit 543 increases. In this example, the total score of the patient Q who is relatively close to the patient P with the infection is 85, and the total score of the patient R who is relatively far from the patient P is 60. The medical examination priority of the patient Q with a large total score is high, and the medical examination priority of the patient R with a small total score is medium.

  In the infection management system 500, for example, the range of the score total from 0 to 30 has a low medical examination priority, the range of the score total from 31 to 70 has a medium medical examination priority, and the score total is from 71 to 100. As the range has a high medical examination priority, the relationship between the total score and the medical examination priority is set in advance. Based on such a relationship, the medical examination priority evaluation unit 543 obtains a corresponding medical examination priority from the obtained total score and records it in the medical examination list DB 520.

  Information on the examination target item and the scheduled examination date in the medical examination list DB 520 is recorded by, for example, a doctor. That is, the doctor who has seen the contents of the medical examination list DB 520 in which the patient IDs, names, score totals, and medical examination priority information of the patients Q and R are recorded as the medical examination list is given priority to the medical examination. It sets based on degree and records it in medical examination list DB520.

  Alternatively, when the doctor records the items to be examined and the scheduled date of examination in the electronic medical records of the patients Q and R, the information about the items to be examined and the scheduled date of examination may be recorded in the medical examination list DB 520. Good. In addition, the medical examination priority evaluation unit 543 performs the examination of the patients Q and R based on the bacteria name of the infectious patient P and the examination result report date recorded in the examination result DB 420 (FIG. 7A). The target item and the scheduled examination date may be automatically set, and the set information may be recorded in the medical examination list DB 520.

  When the examination is performed on the patients Q and R based on the medical examination list DB 520 as shown in FIG. 15A, the medical examination list DB 520 is displayed on the medical examination list DB 520 by a doctor or the like as shown in FIG. The inspection date of Q and R and the information of the inspection result are recorded. Alternatively, when a doctor or the like records information on the date of examination and the result of the examination in the electronic medical records of the patients Q and R, the information on the date of examination and the result of the examination may be recorded in the medical examination list DB 520. .

  In the medical examination list DB, in addition to the information shown in FIGS. 15 (A) and 15 (B), the contact location of the patients Q and R with the infectious patient P, the contact time, the latest contact distance, the condition Other information, such as (presence or absence of fever or diarrhea) may be included.

  Here, patients Q and R who were in the same room as an infectious patient P were taken as an example. In addition, contact evaluation by the contact evaluation unit 542 (generation of contactor information DB 510) according to the above example using the staff position information DB 220 (FIG. 5 (B)), including the staff entering and leaving the hospital room, and The medical examination priority evaluation (generation of the medical examination list DB 520) by the medical examination priority evaluation unit 543 may be performed.

  According to the medical examination support system 1000, the infection management system 500 specifies a patient or a staff member who has a predetermined contact with an infected person from the patients and staff members to be monitored, and obtains a score total and a medical examination priority. Assess the risk of infection and identify what should be monitored preferentially. Considering the attribute information such as age and sex of the patient and staff in the assessment of infection risk, the possibility of infection, the possibility of onset after infection, patients or staff who are highly likely to become serious, Identified as a monitoring target to be examined with priority. The patient or staff thus identified is preferentially examined by a doctor. In the medical examination support apparatus 1, since the monitoring target is the staff in addition to the patient, the infection risk of people in the hospital is evaluated, and it is possible to effectively suppress the spread of the occurrence of infectious diseases.

Next, the processing procedure of the medical examination support system 1000 will be described.
First, the position information acquisition process will be described.
FIG. 16 is a flowchart illustrating an example of position information acquisition processing.

  (S10) The position information server 200 determines whether or not a trigger for acquiring the position information of the monitoring target is established. The monitoring targets are hospital patients and staff. The trigger is an event trigger or a timer trigger. For example, when the position information server 200 receives a signal transmitted from the beacon 230 attached to the monitoring target, the position information server 200 determines that the trigger is established. In this case, the transmission of the signal from the beacon 230 and the reception of the signal transmitted from the beacon 230 may be performed continuously or intermittently. Further, the position information server 200 determines that the trigger is established when it detects that the monitoring targets to which the transceivers are attached contact each other and a predetermined transmission / reception is performed between the transceivers. May be.

  (S11) When the predetermined trigger is established, the position information server 200 acquires the position information of the corresponding monitoring target. For example, the position information server 200 specifies a position (a ward, a ward, a coordinate, etc.) of a monitoring target to which the beacon 230 that has received the signal is attached by a predetermined position specifying device, and the specified position is position information (position history). Information).

  (S12) When the position information server 200 acquires the position information for the corresponding monitoring target, the position information server 200 records the position information. For example, the position information server 200 records the acquired position information in the patient position information DB 210 if the monitoring target is a patient, and records the acquired position information in the staff position information DB 220 if the monitoring target is a staff member. To do.

Next, the monitoring target information acquisition process will be described.
FIG. 17 is a flowchart illustrating an example of monitoring target information acquisition processing.
(S20) Each of the electronic medical record server 400 and the staff server 300 determines whether or not a trigger for acquiring information related to the monitoring target is established. For example, the electronic medical record server 400 determines that the trigger has been established when a doctor inputs information about the patient (age, gender, condition, medical history, etc.) to the patient's electronic medical record. For example, the staff server 300 determines that a trigger has been established when information regarding staff (age, gender, medical practice for a patient, etc.) is input.

(S21) Each of the electronic medical record server 400 and the staff server 300 acquires information on a corresponding monitoring target when a predetermined trigger is established.
(S22) When the electronic medical record server 400 and the staff server 300 each acquire information on the corresponding monitoring target, the information is recorded. For example, the electronic medical record server 400 records information acquired about the corresponding patient in the patient information DB 410, the examination result DB 420, or the observation item DB 430 according to the content. For example, the staff server 300 records information acquired about the staff in the staff information DB 310.

Next, the medical examination support process of the infection management system 500 will be described.
FIG. 18 is a flowchart illustrating an example of a medical examination support process.
When an infection occurs, a medical examination support process as shown in FIG. 18 is started. For example, when information indicating the occurrence of an infectious disease is recorded in an electronic medical record or a test result managed by the electronic medical record server 400, a medical examination support process as shown in FIG. 18 is executed by the infection management system 500. The

  (S30) The contact evaluation unit 542 acquires information about an infected person. For example, the contact evaluation unit 542 includes the infected person's position information (history) recorded in the patient position information DB 210 and the test result DB 420, and the patient ID, name, bacteria of the infectious disease, test result report date (occurrence of infectious disease) Day), infection route and infectious period are obtained.

  (S31) The contact evaluation unit 542 acquires information on the person to be evaluated. For example, the contact evaluation unit 542 includes the position information (position history information) recorded in the patient position information DB 210 and the staff position information DB 220, such as the position information of the infected person and the infectivity period, the patient information recorded in the patient information DB 410, Based on the observation item information recorded in the observation item DB 430 and the staff information recorded in the staff information DB 310, information on patients and staff who were in the same ward or ward as the infected person during the infectious period is acquired.

(S32) The contact evaluation unit 542 acquires a contact criterion set for the bacteria of the infectious disease that has occurred. For example, the contact evaluation unit 542 specifies the contact reference N of the bacteria N from the reference table 550 and acquires the content (distance d _N or less and contact time t _N or more) from the contact reference table 551.

(S33) The contact evaluation unit 542 identifies an evaluation target person that satisfies the contact criteria among the evaluation target persons as a contact person. For example, the contact evaluation unit 542 identifies a patient and a staff member who are in contact with an infected person for a distance d _N or less indicated by the contact criterion N and for a contact time t _N or more indicated by the contact criterion N as a contact person. In addition, the process (contact evaluation process) which specifies a contact person is further mentioned later.

  (S34) The medical examination priority evaluation unit 543 determines whether there is a contact person specified by the contact evaluation unit 542. If there is a contact person, the process proceeds to step S35. If there is no contact person, the medical examination support process is terminated.

(S35) When there is a contact, the medical examination priority evaluation unit 543 acquires the evaluation criteria set for the bacteria of the infectious disease that has occurred. For example, the medical examination priority evaluation unit 543 identifies the evaluation standard N of the bacterium N from the standard table 550, and the content (score S _{N for} each medical examination priority evaluation item) is the evaluation standard table 552 (evaluation standard table 552a). ~ 552l).

(S36) The medical examination priority evaluation unit 543 evaluates the medical examination priority. For example, the medical examination priority evaluation unit 543 sets, for the contact person specified by the contact evaluation unit 542, the score set for each evaluation item (patient and staff attribute item) of the bacterial N infection in the evaluation standard table 552. Scoring according to S _N. And the medical examination priority evaluation part 543 calculates | requires the medical examination priority applicable to the score total of each contact person from the relationship between the preset score total and medical examination priority, and records it in medical examination list DB520. . In addition, the process (health examination priority evaluation process) which evaluates a medical examination priority is further mentioned later.

  (S37) The medical examination priority evaluation unit 543 determines whether or not the medical examination priority has been evaluated for all the contacts specified by the contact evaluation unit 542. The medical examination priority evaluation part 543 repeats the process of step S36 until the medical examination priority is evaluated about all the contacts.

  (S38) When the medical examination priority is evaluated for all the contacts, the medical examination priority evaluation unit 543 generates a medical examination list including information on the total score and the medical examination priority recorded in the medical examination list DB 520. Generate and output to the display. For example, the medical examination priority evaluation unit 543 generates a medical examination list in which contacts are arranged in the order of the highest score total and the higher medical examination priority, and outputs the medical examination list to the display.

The infection management system 500 executes the medical examination support process as in steps S30 to S38 for each type of infectious disease (bacteria) affected by the infected person.
Next, the contact evaluation process in step S33 will be described.

FIG. 19 is a flowchart illustrating an example of the contact evaluation process.
(S40) The contact evaluation unit 542 determines whether or not the distance between the infected person and the evaluation subject (patient and staff) is equal to or less than the distance d _N of the contact reference N based on the contact reference N for the infection of the fungus N. Determine. Contact evaluation unit 542, the distance is less than or equal to the distance d _N of the contact reference N, the process proceeds to step S41, if not less distance d _N of the contact reference N, the process proceeds to step S43.

(S41) Whether the contact evaluation unit 542 has a contact time between the infected person and the evaluation subject (patient and staff) equal to or longer than the contact time t _N of the contact reference N based on the contact reference N of the infection of the fungus N Determine whether or not. Contact evaluation unit 542, the contact time, if it is the contact time t _N or more contact reference N, the process proceeds to step S42, if the contact time of the contact reference N not t _N or more, the process proceeds to step S43.

(S42) contact evaluation unit 542, the distance between the infected person is less distance d _N of the contact reference N, the evaluation subject contact time with the infected person is the contact time t _N or more contact reference N, contact Judged as a person.

(S43) contact evaluation unit 542, infected persons distance between rather than distance d _N of the contact reference N, the evaluation subject contact time with the infected person is not the contact time t _N or more contact reference N, noncontact Judged as a person.

Next, the medical examination priority evaluation process in step S36 will be described.
FIG. 20 is a flowchart illustrating an example of the medical examination priority evaluation process.
(S50) The medical examination priority evaluation unit 543 evaluates the contact density between the infected person and the contact person. For example, the medical examination priority evaluation unit 543 performs scoring based on the contact density between the infected person and the contact person.

(S51) The medical examination priority evaluation unit 543 evaluates the age of the contact person. For example, the medical examination priority evaluation unit 543 performs scoring based on the contact person's age.
(S52) The medical examination priority evaluation unit 543 evaluates the sex of the contact person. For example, the medical examination priority evaluation unit 543 performs scoring based on the sex of the contact person.

(S53) The medical examination priority evaluation unit 543 evaluates the presence or absence of pregnancy of the contact person. For example, the medical examination priority evaluation unit 543 performs scoring based on the presence / absence of pregnancy of the contact person.
(S54) The medical examination priority evaluation unit 543 evaluates whether or not the contact person generates heat. For example, the medical examination priority evaluation unit 543 performs scoring based on whether or not the contact person generates heat.

(S55) The medical examination priority evaluation unit 543 evaluates the presence or absence of diarrhea of the contact person. For example, the medical examination priority evaluation unit 543 performs scoring based on the presence or absence of contact person diarrhea.
(S56) The medical examination priority evaluation unit 543 evaluates the past symptoms of the contact person. For example, the medical examination priority evaluation unit 543 performs scoring based on the past history of the contact person.

(S57) The medical examination priority evaluation unit 543 evaluates the contact person's vaccination history. For example, the medical examination priority evaluation unit 543 performs scoring based on the vaccination history of the contact person.
(S58) The medical examination priority evaluation unit 543 evaluates the contact person's history of immunosuppressant administration. For example, the medical examination priority evaluation unit 543 performs scoring based on the contact person's immunosuppressant administration history.

(S59) The medical examination priority evaluation unit 543 evaluates the organ transplant history of the contact person. For example, the medical examination priority evaluation unit 543 performs scoring based on the organ transplant history of the contact person.
(S60) The medical examination priority evaluation unit 543 evaluates the presence or absence of dialysis treatment for the contact person. For example, the medical examination priority evaluation unit 543 performs scoring based on the presence or absence of dialysis treatment of the contact person.

  (S61) The medical examination priority evaluation unit 543 determines whether or not the contact person is a staff member. The medical examination priority evaluation part 543 advances a process to step S62, when a contact person is a staff member, and advances a process to step S63 when a contact person is not a staff member.

  (S62) When the contact person is a staff member, the medical examination priority evaluation unit 543 evaluates whether the contact person has a medical action on the infected person. For example, the medical examination priority evaluation unit 543 performs scoring based on the presence / absence of a medical action on the infected person by the contact person.

  (S63) The medical examination priority evaluation part 543 calculates | requires a medical examination priority based on evaluation of step S50-S62. For example, the medical examination priority evaluation part 543 calculates | requires applicable medical examination priority from the score total of the scoring of step S50-S62 based on the relationship between the preset score total and medical examination priority.

The order of steps S50 to S61 is not limited to the order shown in FIG.
Each process of said step S50-S60, S62 is further demonstrated.
FIG. 21 is a flowchart illustrating an example of the contact density evaluation process.

(S70) The medical examination priority evaluation unit 543 acquires information on the distance between the contact person and the infected person (distance d _N or less of the contact reference N) and the contact time (contact time t _N or more of the contact reference N). Information on the distance and contact time between the contact person and the infected person is acquired from the contact person information DB 510.

(S71) The medical examination priority evaluation unit 543 determines that the distance between the contact person and the infected person is equal to or less than the distance d _N of the contact reference N and exceeds a predetermined distance d _N1 (<d _N ). and a contact time of contact reference N contact time t _N or more and determines whether less than a predetermined contact time t _{N1 (>} t _N). The medical examination priority evaluation unit 543 advances the process to step S72 when this condition is satisfied, and advances the process to step S73 when this condition is not satisfied.

(S72) When it is determined that the condition of step S71 is satisfied, the medical examination priority evaluation unit 543 determines that the contact density of the contact person with the infected person is low.
(S73) When it is determined that the condition of step S71 is not satisfied, the medical examination priority evaluation unit 543 performs the following process. The medical examination priority evaluation unit 543 is configured such that the distance between the contact person and the infected person is equal to or less than the distance d _N1 of the contact reference N and exceeds a predetermined distance d _N2 (<d _N1 <d _N ). It is determined whether or not the contact time is a contact time t _N1 or more of the contact reference N and less than a predetermined contact time t _N2 (> t _N1 > t _N ). The medical examination priority evaluation unit 543 advances the process to step S74 when this condition is satisfied, and advances the process to step S75 when this condition is not satisfied.

(S74) When it is determined that the condition of step S73 is satisfied, the medical examination priority evaluation unit 543 determines that the contact density of the contact person with the infected person is medium.
(S75) When it is determined that the condition of step S73 is not satisfied, the medical examination priority evaluation unit 543 determines that the contact density of the contact person with the infected person is high.

  (S76) The medical examination priority evaluation unit 543 performs scoring on the contact person based on the evaluation criterion N of the evaluation criterion table 552a (FIG. 9A). For example, if the infectious disease affected by the infected person is caused by bacteria A, 5 points if the contact density of the contact person with the infected person is high, 5 points if the medium is low, and 3 points if the contact density is low. Is granted.

FIG. 22 is a flowchart showing an example of age evaluation processing.
(S80) The medical examination priority evaluation unit 543 acquires information on the age of the contact person. Information on the contact person's age is acquired from the patient information in the patient information DB 410 and the staff information in the staff information DB 310.

  (S81) The medical examination priority evaluation unit 543 determines whether or not the contact person is less than one year old. The medical examination priority evaluation part 543 advances a process to step S86, when a contact person is under 1 year old, and advances a process to step S82 when a contact person is not under 1 year old.

  (S82) The medical examination priority evaluation unit 543 determines whether the contact person is 1 year old or older and 6 years old or younger. The medical examination priority evaluation part 543 advances a process to step S86, when a contact person is 1 to 6 years old, and advances a process to step S83 when a contact person is not 1 to 6 years old.

  (S83) The medical examination priority evaluation part 543 determines whether a contact person is 7 years old or older and 19 years old or less. The medical examination priority evaluation part 543 advances a process to step S86, when a contact person is 7 years old or older and 19 years old or less, and advances a process to step S84 when a contact person is not 7 years old or older and 19 years old or less.

  (S84) The medical examination priority evaluation part 543 determines whether a contact person is 20 years old or more and 64 years old or less. The medical examination priority evaluation part 543 advances a process to step S86, when a contact person is 20 years old or more and 64 years old or less, and advances a process to step S85 when a contact person is not 20 years old or more and 64 years old or less.

(S85) The medical examination priority evaluation unit 543 determines that the contact person is 65 years or older.
(S86) The medical examination priority evaluation unit 543 performs scoring on the contact person based on the evaluation criterion N in the evaluation criterion table 552b (FIG. 9B). For example, if the infectious disease affected by the infected person is due to bacteria A, 5 points if the contact person's age is less than 1 year, 3 points if the age is between 6 and 6 years, 3 points if the age is between 7 and 19 years, One point is given to the contact if it is 20 years old or older, and 3 points if it is 65 years old or older.

FIG. 23 is a flowchart showing an example of the gender evaluation process.
(S90) The medical examination priority evaluation unit 543 acquires the sex information of the contact person. The information on the gender of the contact person is acquired from the patient information in the patient information DB 410 and the staff information in the staff information DB 310.

  (S91) The medical examination priority evaluation unit 543 determines whether or not the contact person is a male. If the contact person is a male, the medical examination priority evaluation unit 543 advances the process to step S94. If the contact person is not a male, the medical examination priority evaluation unit 543 advances the process to step S92.

  (S92) The medical examination priority evaluation part 543 determines whether a contact person is a woman. The medical examination priority evaluation part 543 advances a process to step S94, when a contact person is a woman, and advances a process to step S93 when a contact person is not a woman.

(S93) The medical examination priority evaluation unit 543 determines that the gender of the contact is unknown.
(S94) The medical examination priority evaluation unit 543 performs scoring on the contact person based on the evaluation criterion N of the evaluation criterion table 552c (FIG. 9C). For example, when the infectious disease affected by the infected person is due to the bacterium A, 1 point is given to the contact person if the contact person is male, 3 points if the contact person is female, and 1 point if the contact person is unknown.

FIG. 24 is a flowchart showing an example of pregnancy evaluation processing.
(S100) The medical examination priority evaluation unit 543 acquires information on presence / absence of pregnancy of the contact person. Information on the presence or absence of the contact person's pregnancy is acquired from the patient information in the patient information DB 410 and the staff information in the staff information DB 310.

  (S101) The medical examination priority evaluation unit 543 determines whether or not the contact person is currently pregnant. If the contact person is currently pregnant, the medical examination priority evaluation unit 543 advances the process to step S102. If the contact person is not currently pregnant, the medical examination priority evaluation unit 543 advances the process to step S103.

(S102) The medical examination priority evaluation unit 543 determines that the contact is pregnant.
(S103) The medical examination priority evaluation unit 543 determines that the contact person is not pregnant.
(S104) The medical examination priority evaluation unit 543 performs scoring on the contact person based on the evaluation criterion N of the evaluation criterion table 552d (FIG. 10A). For example, when the infectious disease affected by the infected person is caused by the bacteria A, 5 points are given to the contact person if the contact person is pregnant and 1 point if the contact person is not pregnant.

FIG. 25 is a flowchart illustrating an example of the heat generation evaluation process.
(S110) The medical examination priority evaluation unit 543 acquires information on the presence or absence of heat generation by the contact person. Information on whether or not the contact person generates heat is acquired from information on observation items such as the observation item DB 430.

  (S111) The medical examination priority evaluation unit 543 determines whether or not the contact person has generated heat within the past 24 hours, for example, whether or not the heat is generated at 37 ° C. or higher. If the contact person has generated heat within the past 24 hours, the medical examination priority evaluation unit 543 proceeds to step S112. If the contact person has not generated heat within the past 24 hours, the process proceeds to step S113. .

(S112) The medical examination priority evaluation unit 543 determines that the contact person has fever.
(S113) The medical examination priority evaluation unit 543 determines that the contact person has no fever.
(S114) The medical examination priority evaluation unit 543 performs scoring on the contact person based on the evaluation criterion N in the evaluation criterion table 552e (FIG. 10B). For example, when the infectious disease affected by the infected person is caused by the bacterium A, 5 points are given to the contact person if the contact person has fever and 1 point if the contact person has no fever.

FIG. 26 is a flowchart illustrating an example of diarrhea evaluation processing.
(S120) The medical examination priority evaluation unit 543 acquires information on the presence or absence of diarrhea of the contact person. Information on the presence or absence of diarrhea of the contact is acquired from information on observation items such as the observation item DB 430.

  (S121) The medical examination priority evaluation unit 543 determines whether or not the contact person has diarrhea. If the contact person has diarrhea, the medical examination priority evaluation unit 543 advances the process to step S122. If the contact person does not have diarrhea, the medical examination priority evaluation unit 543 advances the process to step S123.

(S122) The medical examination priority evaluation unit 543 determines that the contact person has diarrhea.
(S123) The medical examination priority evaluation unit 543 determines that the contact person has no diarrhea.
(S124) The medical examination priority evaluation unit 543 performs scoring on the contact person based on the evaluation criterion N of the evaluation criterion table 552f (FIG. 10C). For example, when the infectious disease affected by the infected person is caused by the bacterium A, 5 points are given to the contact person if the contact person has diarrhea, and 1 point if the contact person has no diarrhea.

FIG. 27 is a flowchart illustrating an example of a past disease evaluation process.
(S130) The medical examination priority evaluation unit 543 acquires information on the previous symptoms of the contact person. The information on the contact history is acquired from the patient information in the patient information DB 410 and the staff information in the staff information DB 310.

  (S131) The medical examination priority evaluation unit 543 determines whether or not the contact person has a past illness. The medical examination priority evaluation part 543 advances a process to step S137, when a contact person does not have a past medical condition, and when a contact person has a past medical condition, it advances a process to step S132.

(S132) The medical examination priority evaluation unit 543 sets the number M of a pre-set type of past disease Y _M (M = 1, 2, 3,...) To 1 which is an initial value.
(S133) medical examination priority evaluation unit 543 determines whether there is anamnesis _{Y M} to contacts, if there is no pre-existing conditions _{Y M} to contacts, the process proceeds to step S134, anamnesis _{Y M} to contacts If there is, the process proceeds to step S135.

(S134) medical examination priority evaluation unit 543, if there is no pre-existing conditions _{Y M} to contacts, 1 is added to the number of previous disease _{Y M,} the process of step S133.
(S135) medical examination priority evaluation unit 543, if there is a previous illness _{Y M} to contacts, it is determined that there anamnesis _{Y M} the contacts.

(S136) medical examination priority evaluation unit 543 determines whether to evaluate all of the previous disease Y _M, when evaluated, the process proceeds to step S138, if not evaluated, the process proceeds to step S134 .

Examinations priority evaluation unit 543, the processing of step S133～S136, for all the medical history _{Y M,} determines whether each contactor has.
(S137) If it is determined in step S131 that the contact person has no previous medical condition, the medical examination priority evaluation unit 543 determines that the contact person has no previous medical condition, and advances the process to step S138.

(S138) The medical examination priority evaluation unit 543 performs scoring on the contact person based on the evaluation criterion N of the evaluation criterion table 552g (FIG. 11A). For example, when the infectious disease affected by the infected person is caused by bacteria A, the score is 0 if the contact person has no past disease, 1 point if the contact person has a past disease Y ₁ , 3 points if the contact person has a past disease Y ₂ , the past disease Y If there is ₃ , a score is given to the contact person such as 1 point.

FIG. 28 is a flowchart showing an example of the vaccination history evaluation process.
(S140) The medical examination priority evaluation part 543 acquires information on the vaccination history of the contact person. Information on the contact person's vaccination history is acquired from the patient information in the patient information DB 410 and the staff information in the staff information DB 310.

  (S141) The medical examination priority evaluation unit 543 determines whether or not there is a record that the contact person has been vaccinated. If there is a record, the process proceeds to step S142. If there is no record, the process proceeds to step S142. Proceed to S145.

  (S142) The medical examination priority evaluation unit 543 determines whether or not the contact person has been vaccinated within the past year. If yes, the process proceeds to step S143. If not, the process proceeds to step S143. Advances to step S144.

(S143) If the contact person has been vaccinated within the past year, the medical examination priority evaluation unit 543 determines that the contact person has a vaccination history, and the process proceeds to step S146.
(S144) If the contact person has not been vaccinated within the past year, the medical examination priority evaluation unit 543 determines that the contact person has no vaccination history, and the process proceeds to step S146.

  (S145) When it is determined in step S141 that there is no record that the contact person has been vaccinated in step S141, the medical examination priority evaluation unit 543 determines that the contact person has an unknown vaccination history, and proceeds to step S146.

  (S146) The medical examination priority evaluation unit 543 performs scoring on the contact person based on the evaluation criterion N of the evaluation criterion table 552h (FIG. 11B). For example, if the infectious disease affected by the infected person is due to bacteria A, 1 point will be given to the contact if the contact has a history of vaccination, 5 if there is no history of vaccination, and 5 if the history of vaccination is unknown. Is granted.

FIG. 29 is a flowchart showing an example of immunosuppressant administration history evaluation processing.
(S150) The medical examination priority evaluation unit 543 acquires information on the immunosuppressant administration history of the contact person. The information of the contact person's immunosuppressant administration history is acquired from the patient information (medicine in use) of the patient information DB 410 and the staff information (medicine in use) of the staff information DB 310.

  (S151) The medical examination priority evaluation unit 543 determines whether or not the contact has been administered with the immunosuppressant within the past month, and if so, the process proceeds to step S152 for administration. If not, the process proceeds to step S153.

(S152) The medical examination priority evaluation unit 543 determines that the contact person has a history of administration of the immunosuppressant when the contact person has been administered the immunosuppressant within the past month.
(S153) When the contact person has not received the immunosuppressant within the past month, the health examination priority evaluation unit 543 determines that the contact person has no history of immunosuppressant administration.

  (S154) The medical examination priority evaluation unit 543 performs scoring on the contact person based on the evaluation criterion N of the evaluation criterion table 552i (FIG. 11C). For example, when the infected disease of the infected person is caused by bacteria A, 5 points are given to the contact if the contact person has a history of administration of an immunosuppressant, and 1 point if there is no history of administration of an immunosuppressant. .

FIG. 30 is a flowchart showing an example of organ transplant history evaluation processing.
(S160) The medical examination priority evaluation unit 543 acquires information on the organ transplantation history of the contact person. Information on the organ transplantation history of the contact person is acquired from the patient information in the patient information DB 410 and the staff information in the staff information DB 310.

  (S161) The medical examination priority evaluation unit 543 determines whether the contact has undergone organ transplantation. If the contact has undergone organ transplantation, the process proceeds to step S162. If the organ has not undergone organ transplantation, The process proceeds to step S163.

(S162) When the contact person has undergone organ transplantation, the medical examination priority evaluation unit 543 determines that the contact person has an organ transplant history.
(S163) When the contact person has not undergone organ transplantation, the medical examination priority evaluation unit 543 determines that the contact person has no history of organ transplantation.

  (S164) The medical examination priority evaluation unit 543 performs scoring on the contact person based on the evaluation criterion N of the evaluation criterion table 552j (FIG. 12A). For example, when the infectious disease affected by the infected person is caused by the bacterium A, 5 points are given to the contact person if the contact person has an organ transplant history, and 1 point is given to the contact person.

FIG. 31 is a flowchart showing an example of dialysis treatment evaluation processing.
(S170) The medical examination priority evaluation unit 543 acquires information on dialysis treatment of the contact person. Information on the dialysis treatment of the contact person is acquired from the patient information in the patient information DB 410 and the staff information in the staff information DB 310.

  (S171) The medical examination priority evaluation unit 543 determines whether or not the contact person is receiving dialysis treatment. If the contact person is receiving dialysis treatment, the process proceeds to step S172, and if the dialysis treatment is not received, The process proceeds to step S173.

(S172) When the contact person is undergoing dialysis treatment, the medical examination priority evaluation unit 543 determines that the contact person has dialysis treatment.
(S173) When the contact person has not received dialysis treatment, the medical examination priority evaluation unit 543 determines that the contact person has no dialysis treatment.

  (S174) The medical examination priority evaluation unit 543 performs scoring on the contact person based on the evaluation criterion N of the evaluation criterion table 552k (FIG. 12B). For example, when the infectious disease affected by the infected person is caused by bacteria A, 5 points are given to the contact person if the contact person has dialysis treatment, and 1 point if the contact person has no dialysis treatment.

FIG. 32 is a flowchart showing an example of a medical practice evaluation process for an infected person. The medical practice evaluation process for the infected person shown in FIG. 32 is performed for the staff.
(S180) The medical examination priority evaluation unit 543 acquires information on medical practices for infected persons by staff members. Information on medical practice for the infected person is acquired from the staff information in the staff information DB 310.

  (S181) The medical examination priority evaluation unit 543 determines whether or not the staff is performing a medical action on the infected person. If yes, the process proceeds to step S182. If not, the process is performed. The process proceeds to step S183.

(S182) The medical examination priority evaluation unit 543 determines that the staff member has a medical practice when the staff member is performing a medical practice on the infected person.
(S183) When the staff member does not perform medical practice on the infected person, the medical examination priority evaluation unit 543 determines that the staff member has no medical practice on the infected person.

  (S184) The medical examination priority evaluation unit 543 performs scoring on the contact person based on the evaluation criterion N of the evaluation criterion table 552l (FIG. 12C). For example, when the infectious disease affected by the infected person is caused by the bacterium A, 5 points are given to the staff if there is a medical practice for the infected person and 1 point if there is no medical practice for the infected person.

Next, the output of the medical examination support system 1000 will be described.
33 to 35 are diagrams showing examples of outputs from the medical examination support system.
In the medical examination support system 1000, a ward map screen 600 as shown in FIG. 33 is displayed on a display connected to the infection management system 500 or the electronic medical record server 400 in which the infection management system 500 is incorporated. The ward map screen 600 is a screen in which each floor (the fourth floor in this example) of the ward (in this example, the east ward) is represented by a plan view, and the ward rooms 610 (rooms 401 to 437 in this example) on the floor. ) And the accommodation status of the patient 620 in each hospital room 610.

  When an infectious disease occurs in the hospital, on the ward map screen 600, as shown in FIG. 33, a mark (infectious disease occurrence mark) 630 is displayed at a location where the infectious disease has occurred (patient room 610 and patient 620). When the cursor is placed on and clicked on the patient (infected person) 620a in Room 414 on which the infectious disease occurrence mark 630 is displayed, a menu 640 for browsing information on the infected person 620a is displayed.

  For example, when confirming the movement history of the infected person 620a, the “patient movement history” of the menu 640 is selected. Thereby, a patient movement history screen 650 as shown in FIG. 34 is displayed for the infected person 620a. In this example, for an infected person 620a (208 patient) receiving medical treatment, an influenza infection occurred on 1/29/2018, and room 403 on the 4th floor East Ward (4 East) on 2018/1/30. A patient movement history screen 650 is displayed indicating that the patient has moved from the (second bed) to the 414th room (second bed) of the 4th floor East Ward (4 East).

  When the contact list button 660 is clicked on the patient movement history screen 650, a contact list screen 670 as shown in FIG. 35 is displayed. The contact list screen 670 displays a medical examination list 671 that lists and lists the patients Q, R and staff U who have a predetermined contact with the infected person 620a displayed on the patient movement history screen 650. The

  In the medical examination support system 1000 including the infection management system 500, the medical examination list 671 as shown in FIG. 35 is generated and displayed by performing the above processing. In the medical examination list 671 shown in FIG. 35, the ID, name, contact location, contact time, recent contact distance, presence or absence of fever and diarrhea, total score, items to be examined, contact with the infected person 620a, Information on the scheduled inspection date, inspection date, and inspection result is included. In the medical examination list 671, the patients Q and R and the staff U are sorted and displayed in descending order of the score total (health examination priority), the scheduled examination date is set in that order, and the examination is performed. Among patients Q, R and staff U, infection is observed in patient Q who is in the same hospital room as infected person 620a and has the longest contact time and close to the contact distance, while patient Q and staff U have no infection. .

  In the medical examination support system 1000 including the infection management system 500, when an infectious disease occurs in the hospital, a health in which patients Q, R or staff U to be treated with priority as shown in FIG. 35 is listed. A diagnosis list 671 is generated and displayed. In the hospital, such a medical examination list 671 is used, so that it is possible to deal with a person who is relatively likely to be infected and develop early. As a result, it is possible to reduce the onset and severity of patients or staff who have been in contact with patients with infectious diseases, and the risk of spreading infection, and to effectively suppress the spread of infectious diseases.

  In the second embodiment, an example in which the monitoring target is a patient and a staff member has been shown. However, the monitoring target further includes other monitoring targets such as a visitor or a trader who can acquire position information and attribute information. You can also. In the second embodiment, an example has been shown in which an infected person with an infectious disease is a monitoring target as an infection source. However, the monitoring target as an infection source may be a facility or equipment in a hospital. . Thereby, it becomes possible to suppress the expansion of the occurrence of infectious diseases more effectively.

  Moreover, in the medical examination support system 1000, after obtaining the medical examination list as described above, a monitoring target having a high score sum and a high medical examination priority, or a monitoring target having a positive test result are newly added. The same processing as described above may be executed for a monitoring target (infected person) as an infection source. Thereby, it becomes possible to suppress the expansion of the occurrence of infectious diseases more effectively.

DESCRIPTION OF SYMBOLS 1 Medical examination support apparatus 10 Memory | storage part 11 Location history information 12 Attribute information 13 Reference | standard table 20 Processing part 21 Medical examination list N Infectious disease P, Q, R Monitoring object

Claims (7)

Obtaining first position history information indicating history of positions of a plurality of monitoring targets;
Based on the first position history information, identifying second position history information indicating a history of the position of the monitoring target that is an infection source detected from among the plurality of monitoring targets,
Based on the first location history information and the second location history information, identify other monitoring targets that have a predetermined contact with the monitoring target that is the infection source among the plurality of monitoring targets,
An infection risk is evaluated based on attribute information indicating an attribute of the other monitoring target, and a process for specifying a monitoring target to be dealt with preferentially among the other monitoring targets is executed by a computer. Health checkup support program.   The medical examination support program according to claim 1, wherein the plurality of monitoring targets include hospital patients and staff. Based on the type and period of infection, identify the second location history information in the period of the monitoring target that is the source of infection,
Based on the first position history information and the second position history information, and the contact criteria set by the type, the monitoring target to be the infection source and the other monitoring target having the predetermined contact Identify,
The infection risk is evaluated based on the attribute information of the other monitoring target and an evaluation criterion set by the type, and the monitoring target to be preferentially dealt with is specified. The medical examination support program according to 1 or 2.   The score set according to the content of the attribute information is used, the infection risk is evaluated by scoring the other monitoring target, and the monitoring target to be preferentially dealt with is specified. The medical examination support program according to any one of claims 1 to 3.   The medical examination support program according to any one of claims 1 to 4, wherein a list in which the monitoring targets to be dealt with preferentially are listed based on the infection risk is output. A storage unit that stores attribute information indicating attributes of a plurality of monitoring targets;
Obtaining first position history information indicating a history of positions of the plurality of monitoring targets;
Based on the first position history information, identifying second position history information indicating a history of the position of the monitoring target that is an infection source detected from among the plurality of monitoring targets,
Based on the first location history information and the second location history information, identify other monitoring targets that have a predetermined contact with the monitoring target that is the infection source among the plurality of monitoring targets,
A processing unit that evaluates an infection risk based on the attribute information of the other monitoring target and identifies a monitoring target to be preferentially dealt with among the other monitoring targets;
A medical examination support device characterized by comprising: Computer
Obtaining first position history information indicating history of positions of a plurality of monitoring targets;
Based on the first position history information, identifying second position history information indicating a history of the position of the monitoring target that is an infection source detected from among the plurality of monitoring targets,
Based on the first location history information and the second location history information, identify other monitoring targets that have a predetermined contact with the monitoring target that is the infection source among the plurality of monitoring targets,
An examination risk is evaluated based on attribute information indicating an attribute of the other monitoring target, and a monitoring target to be dealt with preferentially among the other monitoring targets is specified.

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