JP2020009339A - Data management device and degree of fatigue estimation method - Google Patents

Abstract

To prevent a caregiver of a home patient from becoming exhausted physically and mentally.SOLUTION: A data management device manages patient information about a home patient, caregiver information about a caregiver who cares for the home patient, and home medical care information about medical care, nursing or care for the home patient. The data management device estimates the degree of fatigue of a caregiver caring for a target home patient on the basis of patient information about the target home patient, caregiver information, and home medical care information (steps S34 to S36), and when the estimated degree of fatigue is beyond a predetermined threshold (step S37; YES), transmits an e-mail to a welfare institution in a region including a residence of the home patient, notifying that support is needed for the caregiver whose degree of fatigue is beyond the predetermined threshold (step S38).SELECTED DRAWING: Figure 11

Description

  The present invention relates to a data management device and a fatigue estimation method.

  In recent years, the importance of home medical care and nursing care has been increasing, and patient information has been shared among facilities such as hospitals, clinics, visiting nursing stations, and nursing care establishments. Generally, in the care of home patients, the family of the patient often becomes a caregiver. As the patient's condition changes daily, caregivers may feel anxious about what to do. Therefore, a home care support system has been developed which accepts consultations of home patients and families caring for the patients and provides appropriate advice (see Patent Document 1). In this system, it is possible to connect to a medical customer center from a web terminal via the Internet and to ask a consultant for an opinion.

JP-A-2002-92173

  However, home care has a problem in that the burden on the patient's family (caregiver) is large, and the patient's family is exhausted mentally and physically. When the burden on the caregiver increases, the caregiver may become sick or lead to abuse of the cared person, and thus a function to check the fatigue state of the caregiver is required.

  The present invention has been made in view of the above-described problems in the related art, and has an object to prevent a caregiver of a home patient from being physically and mentally exhausted.

  In order to solve the above-mentioned problem, the invention according to claim 1 includes patient information of a home patient, caregiver information on a caregiver who cares for the home patient, home medical information on medical care, nursing or nursing of the home patient. An estimating means for estimating a degree of fatigue of a caregiver who cares for the home patient of the processing target, based on the patient information on the home patient to be processed, the caregiver information or the home medical information. Warning means for notifying a warning when the estimated degree of fatigue exceeds a predetermined value.

  According to a second aspect of the present invention, in the data management device according to the first aspect, the patient information includes a degree of care or a degree of independence in daily life of the elderly with dementia, and the estimating unit performs processing on the processing target. The degree of fatigue of the caregiver is estimated based on the degree of care of the home patient or the degree of independence of the elderly with dementia in daily life.

  According to a third aspect of the present invention, in the data management device according to the first or second aspect, the caregiver information includes a care period, the number of caregivers, or the age of the caregiver, and the estimating means includes: The degree of fatigue of the caregiver is estimated based on the care period, the number of caregivers, or the age of the caregiver for the home patient to be processed.

  According to a fourth aspect of the present invention, in the data management apparatus according to any one of the first to third aspects, the home medical information includes a use state of a home patient's external facility, and the estimating means includes: And estimating the degree of fatigue of the caregiver based on the use status of the external facility related to the home patient to be processed.

  According to a fifth aspect of the present invention, in the data management device according to any one of the first to fourth aspects, the home medical information includes a vital sign of a home patient, and the estimating unit performs the processing. The caregiver's degree of fatigue is estimated based on vital signs of the target home patient.

  According to a sixth aspect of the present invention, in the data management apparatus according to any one of the first to fifth aspects, the warning means includes a home patient whose caregiver's degree of fatigue exceeds the predetermined value. The information indicating that the caregiver needs support is transmitted to the local welfare institution including the home.

  The invention according to claim 7 is the degree of fatigue in a data management device that manages patient information of a home patient, caregiver information on a caregiver who cares for the home patient, and medical care, nursing or home care information on the home patient. An estimation method, based on patient information, caregiver information, or home medical information relating to a home patient to be processed, an estimation step of estimating a degree of fatigue of a caregiver who cares for the home patient to be processed, and the estimation. And a warning step of notifying a warning when the determined degree of fatigue exceeds a predetermined value.

  ADVANTAGE OF THE INVENTION According to this invention, a caregiver of a home patient can be prevented from exhausting physically and mentally.

It is a system block diagram of a home care support system. FIG. 2 is a block diagram illustrating a functional configuration of a data management device. 5 is a data configuration example of a user information table. It is a data structure example of a patient related information table. It is a figure which shows the classification | category of a care degree, and its standard. It is a figure which shows the rank of the independence degree of daily life of the elderly with dementia, and the determination criteria. It is an example of a data structure of a file attribute table. It is a block diagram which shows the functional structure of a facility terminal. It is a ladder chart which shows the patient registration process performed by a data management device and a facility terminal. It is a ladder chart which shows a home medical information registration process performed by a data management device and a facility terminal. It is a flowchart which shows the caregiver fatigue degree estimation process performed by a data management apparatus. (A) is a correspondence table for converting the degree of care into points. (B) is a correspondence table for converting the degree of independence of daily life of the elderly with dementia into points. (A) is a correspondence table for converting a care period into points. (B) is a correspondence table for converting the number of caregivers into points. (C) is a correspondence table for converting caregiver age into points. It is a company size specification table for specifying the size of a company from the type of business and the number of employees. (A) is a correspondence table for converting a company size during employment into points. (B) is a correspondence table for converting a post in office into a point. (A) is a correspondence table for converting day service use status into points. (B) is a correspondence table for converting the short stay use status into points. (A) is a correspondence table for converting the range of SpO ₂ and the rate of change from one week ago into points. (B) is a correspondence table for converting the range of blood pressure and the rate of change from one week ago into points.

  Hereinafter, an embodiment of a data management device and a fatigue estimation method according to the present invention will be described with reference to the drawings. However, the scope of the invention is not limited to the illustrated example.

[Configuration of home care support system]
FIG. 1 shows a system configuration of a home care support system 100.
As shown in FIG. 1, the home care support system 100 includes a data management device 10, a facility terminal 20 used by a medical worker belonging to each facility such as a medical facility, a nursing facility, and a care facility, and a facility terminal belonging to a welfare institution. And a welfare institution terminal 30 that is used by a staff member. The data management device 10, the facility terminal 20, and the welfare institution terminal 30 are connected via a communication network N so that data communication is possible.

  The data management device 10 accumulates and manages patient information of a home patient registered from the facility terminal 20, caregiver information on a caregiver who cares for the home patient, and home medical information on medical care, nursing, or nursing of the home patient. . Home medical information about medical treatment is called medical information, home medical information about nursing is called nursing information, and home medical information about nursing is called nursing information. The data management device 10 may be a cloud server provided in a cloud environment.

The facility terminal 20 is a computer device such as a PC (Personal Computer), a tablet terminal, and a smartphone that are used by medical personnel belonging to each facility. Medical facilities include hospitals and clinics to which doctors belong. Examples of the nursing facility include a home-visit nursing station to which a nurse performing home-visit nursing of a patient belongs. Examples of the nursing care facility include a care manager who creates a care plan for a patient, a nursing care facility to which a helper (visiting care worker) who performs on-site nursing care of the patient, and the like.
The facility terminal 20 is registered in the data management device 10 when a medical worker engaged in patient examination, treatment, home medical treatment / care, etc. registers patient information, caregiver information, and home medical information in the data management device 10. It is used when referring to information that is stored.

  The welfare institution terminal 30 is a computer device such as a PC, a tablet terminal, and a smartphone used by staff members belonging to the welfare institution. Examples of the welfare institution include a regional comprehensive support center, a home care support establishment, and a health center.

[Configuration of data management device]
FIG. 2 shows a functional configuration of the data management device 10.
As shown in FIG. 2, the data management device 10 includes a control unit 11, a communication unit 12, a RAM 13, a clock unit 14, a storage unit 15, and the like, and each unit is connected by a bus 16.

  The control unit 11 is configured by a CPU (Central Processing Unit) and the like, and controls the processing operation of each unit of the data management device 10 as a whole. Specifically, the CPU reads various processing programs stored in the storage unit 15 and expands them in the RAM 13, and performs various processing in cooperation with the programs.

  The communication unit 12 is configured by a network interface or the like, and transmits and receives data to and from external devices connected via a communication network N such as a LAN (Local Area Network), a WAN (Wide Area Network), and the Internet.

  The RAM 13 forms a work area for temporarily storing various programs, input or output data, parameters, and the like read from the storage unit 15 in various processes executed and controlled by the control unit 11.

  The clock unit 14 has a clock circuit (RTC: Real Time Clock), and the current clock is clocked by the clock circuit and output to the control unit 11.

  The storage unit 15 is configured by an HDD (Hard Disk Drive), a nonvolatile semiconductor memory, or the like, and stores various processing programs, parameters and files necessary for executing the programs, and the like. For example, the storage unit 15 stores a Web server program for realizing a function as a Web server that provides various Web screens to the Web browser by performing communication with a Web browser mounted on an external device using the HTTP protocol, or a Web server. An application program that operates on the above and provides a home care support service to a user of an external device via a Web browser is stored.

  The storage unit 15 stores a user information table T1 and a patient-related information table T2. The storage unit 15 has a file storage unit 151. The file storage unit 151 stores a file of home medical information.

FIG. 3 shows a data configuration example of the user information table T1. The user information table T1 is a table for managing user information on the user for each user (medical worker) who uses the home care support system 100. In the user information table T1, a user ID, a registration date and time, a user type, an email address, a password, a user name, a user qualification, a facility code, a facility name, a facility type, a facility address, a facility telephone number, and the like are associated with each user. Stored.
The user ID is identification information of the user.
The registration date and time is the date and time when the user was registered in the data management device 10.
The user type is information indicating whether the user is an administrator user or a general user. The administrator user is a user defined as an administrator for each facility. The user type is indicated by 0: administrator user, 1: general user.
The e-mail address is the user's e-mail address and is also used as a login account.
The password is used for user authentication when the user logs in to the system.
The user name is the name of the user.
The user qualification is information indicating the qualification of the user. The user qualifications are indicated as 0: doctor, 1: dentist, 2: pharmacist, 3: nurse, 4: other.
The facility code is identification information of the facility to which the user belongs.
The facility name is the name of the facility to which the user belongs.
The facility type is the type of the facility to which the user belongs. The facility type is indicated by 0: medical care, 1: nursing, 2: care.
The facility address is the address of the facility to which the user belongs.
The facility telephone number is the telephone number of the facility to which the user belongs.

  FIG. 4 shows a data configuration example of the patient-related information table T2. The patient-related information table T2 is a table for managing patient-related information related to a patient for each patient. In the patient-related information table T2, patient information, caregiver fatigue degree estimation date, caregiver information, and in-service information are stored in association with each other for each patient.

The patient information includes a local patient ID, registration date and time, patient name, patient gender, patient date of birth, patient address, patient phone number, insurance card information, degree of nursing care, and the degree of independence of the elderly living with disabilities (hereinafter referred to as “daily The degree of independence in life (disability) "), the degree of independence in daily life of the elderly with dementia (hereinafter referred to as" independence in daily life (dementia) "), in-house patient information, and the like are included.
The regional patient ID is identification information of a patient common in the system.
The registration date and time is the date and time when the patient was registered in the data management device 10.
The patient name is the name of the patient.
Patient gender is the gender of the patient.
The patient's date of birth is the patient's date of birth.
The patient address is the address of the patient.
The patient telephone number is the telephone number of the patient.
The insurance card information is a symbol / number written on the patient's health insurance card.
The degree of nursing represents the degree of need for support and nursing care. The degree of nursing care is indicated by 1-2 required support / 1-5 required nursing care. FIG. 5 shows the categories of nursing care levels and their guidelines.
The degree of independence in daily life (disability) indicates the degree of independence of a disabled elderly person in daily life. The degree of independence in daily life (disability) is indicated by rank J / A / B / C.
The degree of independence in daily life (dementia) indicates the degree of independence of the elderly with dementia in daily life. The degree of independence in daily life (dementia) is indicated by rank 1/2 / 2a / 2b / 3 / 3a / 3b / 4 / M. FIG. 6 shows the rank of the degree of independence in daily life (dementia) and the criteria for determining the rank.

The in-facility patient information is information on patients in each facility, and includes the number of facilities, a facility code for each facility, and an in-facility patient ID.
The number of facilities is the number of registered combinations of the facility code of the target patient and the patient ID in the facility.
The facility code is a facility code of a facility engaged in medical care, nursing, nursing, etc. of the target patient.
The in-facility patient ID is a patient ID in the facility corresponding to the facility code combined with the in-facility patient ID.

  The caregiver fatigue estimation date is the date on which the latest caregiver fatigue estimation processing was performed.

The caregiver information includes the home care start date and the number of caregivers, and for each caregiver, the caregiver name, caregiver relationship, caregiver birth date, caregiver residence category, and caregiver contact information. It is. The main caregiver who provides care for the home patient is called “main caregiver”, and the main caregiver name, main caregiver relationship, primary caregiver birth date, main caregiver residence category, Distinguish as a caregiver contact.
The home medical treatment start date is the date when the patient started home medical treatment.
The number of caregivers is the number of caregivers of home patients.
The caregiver name is the name of the caregiver.
The caregiver relationship is the relationship between the home patient and the caregiver. The caregiver relationship is indicated as 0: husband, 1: wife, 2: parent, 3: child, 4: sibling, 5: other.
The caregiver's date of birth is the date of birth of the caregiver.
The caregiver residence category is information indicating the residence status of the home patient and the caregiver, and is indicated by 0: living together and 1: living separately.
The caregiver contact information is a contact information (a mobile phone number or the like) of the caregiver.

The information at the time of employment includes the type of company at the time of employment, the number of employees of the company at employment, the position at employment, and the like.
The company type at the time of employment is the type of company in which the home patient was employed. The company type at the time of employment is shown as 0: retail business, 1: service business, 2: wholesale business, 3: manufacturing, construction, transportation, and others.
The number of company employees at the time of employment is the number of employees of the company in which the home patient was employed. The number of corporate employees during employment is 0: 5 or less, 1: 6 or more and 20 or less, 2:21 or more and 50 or less, 3:51 or more and 100 or less, 4: 101 or more and 300 or less. : Shown by more than 301 people.
The in-service post is the post of the at-home patient at the time of employment. The positions in office are indicated by 0: general, 1: section manager, 2: manager, and 3: director.

As shown in FIG. 2, in the file storage unit 151, a regional patient ID folder 152 having a folder name of the regional patient ID of the patient is created for each patient.
Each regional patient ID folder 152 manages a file of home medical information (medical information, nursing information, and nursing information) of a patient corresponding to the regional patient ID folder 152 and a file of home medical information of the patient. And a file attribute table T3.

FIG. 7 shows a data configuration example of the file attribute table T3. In the file attribute table T3, for each home medical information file stored under the regional patient ID folder 152 in which the file attribute table T3 is stored, a file name, an upload date and time, and a facility code are stored in association with each other. You.
The file name is the file name of the home medical information file.
The upload date and time is the date and time when the home medical information file was uploaded. The upload date and time is the current date and time acquired from the clock unit 14 when the home medical information file is uploaded.
The facility code is a facility code corresponding to the facility at which the home medical information file upload operation was performed.

Further, the storage unit 15 stores caregiver fatigue degree estimation intervals. The caregiver fatigue degree estimation interval is the number of days to be the time interval of the processing for estimating the caregiver fatigue degree of the home patient.
The storage unit 15 stores thresholds used in the caregiver fatigue degree estimation process (see FIG. 11). This threshold is a threshold for determining whether or not the caregiver's fatigue level is at the warning level in the caregiver fatigue level estimation process.
In addition, the storage unit 15 stores, for each welfare institution, a range of an area under the jurisdiction of the welfare institution and a mail address of the welfare institution in association with each other.

  The control unit 11 refers to the user information table T1 of the storage unit 15 in advance when the facility terminal 20 accesses the data management device 10 from the login account (mail address / password) corresponding to each user. Determine whether the user is a registered user. When the combination of the e-mail address and the password input at the facility terminal 20 is registered in the user information table T1, the control unit 11 determines that this user is a valid user.

  The control unit 11 estimates the degree of fatigue of a caregiver who cares for the home patient to be processed, based on the patient information, caregiver information, or home medical information related to the home patient to be processed. That is, the control unit 11 functions as an estimation unit.

  For example, the control unit 11 acquires and uses the degree of care or the degree of independence in daily life (dementia) included in the patient information of the processing target patient from the patient-related information table T2 of the storage unit 15. The control unit 11 estimates the degree of fatigue of the caregiver based on the degree of care of the home patient to be processed or the degree of independence in daily living (dementia). That is, the control unit 11 estimates the physical and mental burden of the caregiver from the degree of care or the degree of independence in daily life (dementia).

  In addition, the control unit 11 acquires and uses the care period, the number of caregivers, or the age of the caregivers included in the caregiver information of the processing target patient from the patient-related information table T2 of the storage unit 15. If the nursing care period itself is not stored, the nursing care time is calculated from the home medical treatment start date and the current date and time. If the age of the caregiver is not stored, the age of the caregiver is calculated from the date of birth of the caregiver and the current date and time. The control unit 11 estimates the degree of fatigue of the caregiver based on the care period, the number of caregivers, or the age of the caregiver for the home patient to be processed. That is, the control unit 11 estimates the physical and mental burden of the caregiver from the care period, the number of caregivers, or the age of the caregiver.

  In addition, the control unit 11 acquires and uses the use status of the home patient's external facility included in the home medical information (care information) stored in the local patient ID folder 152 corresponding to the patient to be processed. Specifically, the control unit 11 uses the usage status of the day service (day care), the usage status of the short stay (short-term nursing care), and the like. The control unit 11 estimates the caregiver's degree of fatigue based on the use status of the external facility related to the home patient to be processed. That is, the control unit 11 estimates that the caregiver is periodically released from the care by using the day service and the short stay, and the physical and mental burdens on the care are reduced.

In addition, the control unit 11 acquires and uses the home patient's vital sign included in the home medical information (medical information and nursing information) stored in the regional patient ID folder 152 corresponding to the processing target patient. The control unit 11 estimates the degree of caregiver fatigue based on the vital signs of the home patient to be processed. Specifically, the control unit 11 estimates a care burden due to a change in the patient's condition using SpO ₂ , blood pressure, and the like as vital signs.

  In addition, the control unit 11 acquires and uses the in-employment company type, the number of in-employment company employees, and the in-service post included in the in-service information of the processing target patient from the patient-related information table T2 in the storage unit 15. The control unit 11 estimates the degree of fatigue of the caregiver based on the occupational business type, the number of occupational company employees, and the occupational position of the at-employment company related to the home patient to be processed. That is, the control unit 11 estimates the mental burden of the caregiver, such as the possibility that the home patient treats the caregiver as a subordinate, from the business type at the time of employment, the number of company employees at the time of employment, and the position at the time of employment.

The control unit 11 issues a warning when the estimated degree of caregiver fatigue exceeds a predetermined value (threshold). That is, the control unit 11 functions as a warning unit.
Specifically, the control unit 11 sends information indicating that the caregiver needs support to a local welfare institution including the home of a home patient whose fatigue degree of the caregiver exceeds a predetermined value. Send.

[Configuration of facility terminals]
FIG. 8 shows a functional configuration of the facility terminal 20.
As shown in FIG. 8, the facility terminal 20 includes a control unit 21, an operation unit 22, a display unit 23, a communication unit 24, a RAM 25, a storage unit 26, and the like. I have.

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

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

  The display unit 23 includes a monitor such as an LCD (Liquid Crystal Display), and displays various screens in accordance with a display signal input from the control unit 21. For example, the display unit 23 displays various web screens based on display data of various web screens received from the data management device 10.

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

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

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

[Operation in home care support system]
Next, an operation in the home care support system 100 will be described.

<Patient registration process>
FIG. 9 is a ladder chart showing a patient registration process executed by the data management device 10 and the facility terminal 20. This process is a process of registering a patient in the data management device 10 from the facility terminal 20 of any facility.

First, in the facility terminal 20, when a medical worker inputs a URL for accessing the data management device 10 from a Web browser by using the operation unit 22, the control unit 21 sets the communication unit 24 based on the input URL. An access is made to the data management device 10 via the server.
In the data management device 10, the control unit 11 transmits display data for displaying a login screen to the facility terminal 20 via the communication unit 12. The display data of various Web screens including the login screen transmitted to the facility terminal 20 by the Web server function of the data management apparatus 10 includes HTML, style sheets, image data, and predetermined processing by the facility terminal 20. Scripts to be executed are included.

  In the facility terminal 20, when the display data of the login screen is received by the communication unit 24, the control unit 21 causes the display unit 23 to display the login screen. The login screen includes input fields for an email address and a password. When the medical worker inputs an e-mail address and a password by operating the operation unit 22 on the login screen (step S1), the control unit 21 transmits the input e-mail address and password to the data management device via the communication unit 24. Send to 10.

  In the data management device 10, when the communication unit 12 receives the mail address and the password, the control unit 11 performs user authentication (step S2). Specifically, the control unit 11 searches the user information table T1 of the storage unit 15 for a record that matches the e-mail address input at the facility terminal 20, and searches the facility terminal 20 for a password included in the searched record. If the entered passwords match, it is determined that the user authentication has succeeded.

  Next, in the facility terminal 20, when the control unit 21 transmits a patient registration request to the data management device 10 via the communication unit 24 in response to an operation from the operation unit 22 (step S3), the data management device 10 The control unit 11 transmits display data for displaying the patient registration screen to the facility terminal 20 via the communication unit 12.

In the facility terminal 20, when the display data of the patient registration screen is received by the communication unit 24, the control unit 21 causes the display unit 23 to display the patient registration screen (step S4).
On the patient registration screen, the medical staff operates the operation unit 22 to operate the patient information (patient ID, patient name, patient gender, patient date of birth, patient address, patient phone number, insurance card information, etc.) of the target patient. Sign / number), degree of nursing care, degree of independence in daily life (disability), degree of independence in daily life (dementia), etc., caregiver information (home care start date, number of caregivers, name of primary caregiver, relationship of primary caregiver, Primary caregiver birth date, primary caregiver residence category, primary caregiver contact information, caregiver name, caregiver relationship, caregiver birth date, caregiver residence category, caregiver contact information, etc. When the company type, the number of company employees at the time of employment, the position at the time of employment, etc.) are entered (step S5), and the registration button is pressed, the control unit 21 transmits the patient information, the caregiver information, and the information at the time of the employment to the communication unit. 24 to the data management device 10.

  In the data management device 10, when the communication unit 12 receives the patient information, caregiver information, and occupational information of the target patient, the control unit 11 determines whether the target patient has been registered from another facility. (Step S6). Specifically, the control unit 11 refers to the patient-related information table T2 of the storage unit 15 and refers to the patient name, the patient's gender, the patient's date of birth, the patient's address, the patient's phone number, the insurance card information (symbol / Number) is determined. Further, the control unit 11 acquires the facility code corresponding to the login user (the user who operates the facility terminal 20) from the user information table T1 of the storage unit 15, and combines the facility code with the in-facility patient ID of the target patient. It is determined whether or not the record including the information is in the patient-related information table T2.

  If the target patient has not been registered from another facility (step S6; NO), that is, if the target patient is to be newly registered, the control unit 11 newly assigns a regional patient ID (step S7). Then, the control unit 11 sets the registration date and time to the current date and time acquired from the timer unit 14 as a record of the newly numbered regional patient ID in the patient-related information table T2.

  Further, the control unit 11 sets 1 as the number of facilities as the in-facility patient information of the target patient in the patient-related information table T2, and sets a combination of a facility code (facility code corresponding to the login user) and a in-facility patient ID. Register (step S8).

  In addition, the control unit 11 stores the patient information, caregiver information, and in-service information registered from the facility terminal 20 in the patient-related information table T2 of the storage unit 15 in association with the regional patient ID (step S9).

  Next, the control unit 11 creates a regional patient ID folder 152 with the newly numbered regional patient ID as a folder name in the file storage unit 151 of the storage unit 15 (step S10).

  In step S6, if the target patient has been registered from another facility (step S6; YES), the control unit 11 stores the patient-related information table T2 in the storage unit 15 as in-facility patient information of the target patient. In addition to adding 1 to the number of facilities, a combination of the facility code (facility code corresponding to the login user) and the in-facility patient ID is added (step S11).

In addition, if there is newly added patient information, caregiver information, and occupational information, the control unit 11 stores it in the patient-related information table T2 as a record of the target patient (step S12).
After step S10 or step S12, the patient registration process ends.

<Home medical information registration process>
FIG. 10 is a ladder chart showing a home medical information registration process executed by the data management device 10 and the facility terminal 20. This process is a process of registering a file of home medical information (medical information, nursing information, and nursing information) from the facility terminal 20 of any facility in the data management device 10.

  The processing in steps S21 and S22 is the same as the processing in steps S1 and S2 of the patient registration processing (see FIG. 9), and thus the description is omitted.

  Next, in the facility terminal 20, when the in-facility patient ID of the patient related to the home medical information to be uploaded is designated by the operation from the operation unit 22 (step S23), the control unit 21 determines the designated in-facility patient. The ID is transmitted to the data management device 10 via the communication unit 24.

In the data management apparatus 10, when the in-facility patient ID is received from the facility terminal 20 by the communication unit 12, the control unit 11 uses the in-facility code of the login user and the received in-facility patient ID to specify the in-facility in the designated facility. The local patient ID corresponding to the patient ID is specified (Step S24). Specifically, the control unit 11 acquires the facility code corresponding to the login user from the user information table T1 of the storage unit 15, and stores the regional patient ID corresponding to the combination of the facility code and the in-facility patient ID in the storage unit. It is obtained from 15 patient-related information tables T2.
The control unit 11 transmits the specified regional patient ID to the facility terminal 20 via the communication unit 12.

  In the facility terminal 20, when a file of home medical information to be uploaded is selected by an operation from the operation unit 22 (step S25), the control unit 21 specifies the selected home medical information file in the data management device 10. The registered local patient ID and the facility code of the facility to which the login user belongs are uploaded to the data management device 10 via the communication unit 24 (step S26).

  In the data management device 10, when the communication unit 12 receives the home medical information file, the regional patient ID, and the facility code, the control unit 11 stores the uploaded home medical information file in the file storage unit 151 in the step It is stored in the regional patient ID folder 152 corresponding to the regional patient ID specified in S24 (step S27).

The control unit 11 stores the file name, the upload date and time, and the facility code in the file attribute table T3 under the regional patient ID folder 152 corresponding to the regional patient ID specified in step S24 (step S28). . The file name is the file name of the home medical information file. The upload date and time is the current date and time acquired from the clock unit 14 when the home medical information file is uploaded. The facility code is a facility code transmitted from the facility terminal 20 to the data management device 10 together with the home medical information file.
With this, the home medical information registration processing ends.

<Carer fatigue estimation process>
FIG. 11 is a flowchart illustrating a caregiver fatigue degree estimation process performed by the data management device 10. This process is executed once a day at a predetermined time, such as at midnight when the use of the system is low.

  First, the control unit 11 sets a patient to be processed from the patient-related information table T2 of the storage unit 15 (Step S31).

  Next, the control unit 11 acquires the “caregiver fatigue degree estimation date” of the processing target patient from the patient-related information table T2, acquires the current date and time from the clock unit 14, and acquires the “caregiver fatigue degree estimation date”. Then, the number of days elapsed from the current date to today is calculated (step S32).

  Next, the control unit 11 acquires the “caregiver fatigue degree estimation interval” stored in the storage unit 15 and calculates the number of days elapsed from the “caregiver fatigue degree estimation date” to the present day as “caregiver fatigue degree estimation interval”. Is determined (step S33).

  When the number of days elapsed from the “caregiver fatigue degree estimation date” to the present day exceeds the “caregiver fatigue degree estimation interval” (step S33; YES), the control unit 11 performs processing on the patient-related information table T2. The information of the patient (patient information, caregiver information, information during employment) is analyzed (step S34).

FIG. 12A is a correspondence table for converting the degree of care included in the patient information into points. This correspondence table is stored in the storage unit 15. The control unit 11 refers to the correspondence table illustrated in FIG. 12A and sets a point corresponding to the category of the care degree of the processing target patient as a “care degree point”.
FIG. 12B is a correspondence table for converting the degree of independence in daily life (dementia) included in the patient information into points. This correspondence table is stored in the storage unit 15. The control unit 11 refers to the correspondence table shown in FIG. 12 (b) and sets the point corresponding to the rank of the degree of independence of daily life (dementia) of the processing target patient to the “independence degree of daily life (dementia) point”. And

The control unit 11 calculates the “fatigue degree based on the patient information” from the “care degree point” and the “daily life independence degree (dementia) point” using the following equation (1).
"Fatigue degree based on patient information" = "Care point" x 2 + "Independence in daily life (dementia) point" x 2 ... (1)

FIG. 13A is a correspondence table for converting the care period (which can be calculated from the home medical treatment start date) included in the caregiver information into points. This correspondence table is stored in the storage unit 15. The control unit 11 calculates a care period from the home treatment start date to today based on the home treatment start date included in the caregiver information of the patient to be processed and the current date and time acquired from the clock unit 14. Then, the control unit 11 refers to the correspondence table shown in FIG. 13A and sets a point corresponding to the number of years of the care period of the processing target patient as a “care period point”.
FIG. 13B is a correspondence table for converting the number of caregivers included in the caregiver information into points. This correspondence table is stored in the storage unit 15. The control unit 11 refers to the correspondence table shown in FIG. 13B and sets a point corresponding to the number of caregivers of the processing target patient as “the number of caregivers”.
FIG. 13C is a correspondence table for converting the caregiver age (which can be calculated from the caregiver's birth date) included in the caregiver information into points. This correspondence table is stored in the storage unit 15. The burden on caregivers depends on the caregiver's age, and many caregivers are particularly chased, especially in their 60s ("Nippon's 240th Nursing Care Study, which understands the" now "of the super-aged society", [online] , March 29, 2017, Everyone's Care, [Searched on July 10, 2018], Internet <URL: https://www.minnanokaigo.com/news/kaigogaku/no240/>). The caregiver age is calculated based on the caregiver's birth date (usually the main caregiver's birth date) included in the caregiver information of the target patient and the current date and time acquired from the clock unit 14. Reference numeral 11 denotes a point corresponding to the caregiver age of the patient to be processed as “caregiver age point” with reference to the correspondence table shown in FIG. When calculating the degree of fatigue of a caregiver other than the main caregiver, the date of birth of a caregiver other than the main caregiver may be used.

The control unit 11 calculates “degree of fatigue based on caregiver information” from “caregiver period point”, “caregiver number point”, and “caregiver age point” using the following equation (2).
"Fatigue degree based on caregiver information" = "caregiver point" x "number of caregivers" x "caregiver age point" ... (2)

  FIG. 14 is a company size specifying table for specifying the size of a company based on the type of business and the number of employees. The company size specification table is stored in the storage unit 15. For example, when the type of business is “retail business”, if the number of employees is “5 or less”, the company size is “small business”, and if the number of employees is “6 or more and 50 or less”, the company size is “ If the number of employees is "51 or more," the company size is "large company."

FIG. 15A is a correspondence table for converting the in-employment company size (identifiable from the in-employment company type and the number of in-employment company employees) included in the in-employment information into points. This correspondence table is stored in the storage unit 15. The control unit 11 refers to the company size identification table shown in FIG. 14 and identifies the in-employment company size from the in-employment company industry and the number of in-employment company employees of the processing target patient. Then, the control unit 11 refers to the correspondence table shown in FIG. 15A and sets a point corresponding to the company size at the time of occupation of the processing target patient as “the company size point at employment”.
FIG. 15B is a correspondence table for converting the post at the time of employment included in the information at the time of employment into points. This correspondence table is stored in the storage unit 15. The control unit 11 refers to the correspondence table shown in FIG. 15B and sets a point corresponding to the post at the time of the post of the patient to be processed as “post post at the post”.

The control unit 11 calculates “the degree of fatigue based on the information at the time of employment” from “the company size point at the time of employment” and “the position point at the time of employment” using the following equation (3). "Fatigue degree based on in-employment information" is based on a study that, in a large company, a person who has held a certain position tends to treat a family as a subordinate even at home.
“Fatigue degree based on information during employment” = (“Company size points during employment” + “Position points during employment”) × 4 (3)

  Next, the control unit 11 analyzes files registered after the previous analysis among the home medical information files under the regional patient ID folder 152 corresponding to the processing target patient (step S35). Specifically, the control unit 11 refers to the file attribute table T3 under the local patient ID folder 152 corresponding to the processing target patient, and based on the “upload date and time”, based on the “caregiver fatigue estimation date” of the processing target patient. ”And the files that have been uploaded up to today are identified, and the identified files are analyzed. When the change rate or the change amount of the data is used for the analysis, the home medical information file uploaded at the reference time (eg, one week ago) is also used.

FIG. 16A is a correspondence table for converting the day service usage status included in the nursing care information into points. This correspondence table is stored in the storage unit 15. The control unit 11 refers to the correspondence table illustrated in FIG. 16A and sets a point corresponding to the use frequency of the day service use status of the processing target patient as a “day service point”.
FIG. 16B is a correspondence table for converting the short stay use status included in the nursing care information into points. This correspondence table is stored in the storage unit 15. The control unit 11 refers to the correspondence table shown in FIG. 16B and sets a point corresponding to the frequency of use of the short stay usage status of the processing target patient as a “short stay point”.

The control unit 11 calculates the “fatigue degree based on the care information” from the “day service point” and the “short stay point” by using the following equation (4).
"Fatigue degree based on nursing care information" = "Day service point" x "Short stay point" (4)

FIG. 17 (a), of the vital signs included in the medical information or nursing information, a correspondence table for converting the rate of change from the week before the range of SpO ₂ points. This correspondence table is stored in the storage unit 15. The change rate is a value obtained by dividing the absolute value of the difference between the latest value and the value at the reference time (here, one week ago) by the value at the reference time and multiplying by 100. The control unit 11 refers to the correspondence table illustrated in FIG. 17A and sets a point corresponding to the range of the SpO ₂ of the treatment target patient and the change rate from one week ago as “SpO ₂ point”.
FIG. 17B is a correspondence table for converting a blood pressure range and a change rate from one week ago into points in vital signs included in medical information or nursing information. This correspondence table is stored in the storage unit 15. The control unit 11 refers to the correspondence table illustrated in FIG. 17B and sets a point corresponding to the range of the blood pressure of the processing target patient and the change rate from one week ago as a “blood pressure point”.

The control unit 11 calculates the “degree of fatigue based on vital signs” from the “SpO ₂ point” and the “blood pressure point” using the following equation (5).
“Vital sign-based fatigue” = “SpO ₂ points” + “blood pressure points” (5)

Next, the control unit 11 estimates the degree of fatigue of the caregiver who cares for the patient to be processed based on the analysis results of step S34 and step S35 (step S36). Specifically, the control unit 11 calculates the “degree of caregiver fatigue” using the following equation (6).
"Career fatigue" = "Fatigue based on patient information" + "Fatigue based on caregiver information" + "Fatigue based on occupational information" + "Fatigue based on care information" + "Vital sign" Based on fatigue ”(6)

Next, the control unit 11 determines whether or not the estimated degree of fatigue of the caregiver exceeds a threshold value (for example, 50) stored in the storage unit 15 (Step S37).
When the degree of fatigue of the caregiver exceeds the threshold (step S37; YES), the control unit 11 sends the caregiver the local welfare institution including the home of the home patient whose degree of fatigue of the caregiver exceeds the threshold. An email notifying that support is required is transmitted (step S38). That is, the control unit 11 notifies the caregiver of a warning that support is required. Specifically, the control unit 11 acquires the patient address of the home patient from the patient-related information table T2 of the storage unit 15, and includes the patient address based on the range of the area associated with each welfare institution. Identify local welfare agencies. Then, the control unit 11 sends a warning mail via the communication unit 12 to the mail address associated with the specified welfare institution.

  At the welfare institution that has received the notification, the staff of the welfare institution checks the e-mail transmitted from the data management device 10 at the welfare institution terminal 30. The staff of the welfare institution urges a care manager or the like in charge of a home patient corresponding to the caregiver to be warned to get advice on the caregiver and provide care support information.

  After step S38 or when the degree of fatigue of the caregiver is equal to or smaller than the threshold in step S37 (step S37; NO), the control unit 11 determines in the patient-related information table T2 that the "caregiver fatigue" The current date and time are stored in “degree estimation date” (step S39).

  After step S39 or in step S33, if the number of days elapsed from the “caregiver fatigue degree estimation date” to today is equal to or less than the “caregiver fatigue degree estimation interval” (step S33; NO), the control unit 11 It is determined whether or not the processing has been completed for all patients in the patient-related information table T2 (step S40).

If an unprocessed patient remains in the patient-related information table T2 (step S40; NO), the process returns to step S31, and the process is repeated with another patient as a processing target.
In step S40, when the processing is completed for all the patients in the patient-related information table T2 (step S40; YES), the caregiver fatigue degree estimation processing ends.

  As described above, according to the present embodiment, the degree of fatigue of a caregiver who cares for a home patient to be processed is determined based on patient information, caregiver information, and home medical information related to the home patient to be processed. When the estimated degree of fatigue exceeds a predetermined value, a warning is notified, so that the caregiver of the home patient can be prevented from being physically and mentally exhausted. it can.

Specifically, by estimating the degree of fatigue of the caregiver based on the degree of care of the home patient to be processed and the degree of independence in daily life (dementia), the physical and mental burden of the caregiver is estimated. be able to.
It is also possible to estimate the physical and mental burden of the caregiver by estimating the caregiver's degree of fatigue based on the care period, the number of caregivers, and the age of the caregiver pertaining to the home patient to be processed. it can.

In addition, by estimating the degree of fatigue of the caregiver based on the use of external facilities related to the home patient to be processed, depending on whether the caregiver has a chance to be periodically released from care, It is possible to estimate the reduction in the physical and mental burden of care.
Further, by estimating the degree of fatigue of the caregiver based on the vital signs related to the home patient to be processed, it is possible to estimate the burden of nursing care due to a change in the patient's condition.

  In addition, by transmitting information indicating that the caregiver needs support to a local welfare institution including the home of a home patient whose caregiver's fatigue exceeds a predetermined value, the welfare institution Can provide support to caregivers.

  The description in the above embodiment is an example of the data management device and the fatigue estimation method according to the present invention, and the present invention is not limited to this. The detailed configuration and detailed operation of each unit constituting each device can be appropriately changed without departing from the spirit of the present invention.

  For example, in the caregiver fatigue estimation process (see FIG. 11), the fatigue calculated based on each of the patient information, caregiver information, occupational information, and home medical information (care information, vital signs) of the patient to be processed. Are added to calculate the overall fatigue level, but in calculating the overall fatigue level, what items are used can be changed as appropriate.

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

Reference Signs List 10 data management device 11 control unit 12 communication unit 14 clock unit 15 storage unit 20 facility terminal 21 control unit 22 operation unit 23 display unit 24 communication unit 26 storage unit 30 welfare institution terminal 100 home care support system 151 file storage unit 152 local patient ID folder N Communication network T1 User information table T2 Patient related information table T3 File attribute table

Claims (7)

A data management device that manages patient information of a home patient, caregiver information about a caregiver who cares for the home patient, medical care of the home patient, home medical information about nursing or care,
Estimating means for estimating the degree of fatigue of a caregiver who cares for the home patient of the processing target, based on the patient information pertaining to the home patient to be processed, the caregiver information or the home medical information,
When the estimated degree of fatigue exceeds a predetermined value, a warning unit that notifies a warning,
A data management device comprising: The patient information includes the degree of nursing care or the degree of independence in daily living of the elderly with dementia,
2. The data management device according to claim 1, wherein the estimating unit estimates the degree of fatigue of the caregiver based on a degree of care of the at-home patient to be processed or a degree of independence in daily life of the elderly with dementia. The caregiver information includes a care period, the number of caregivers or the age of the caregiver,
3. The data management device according to claim 1, wherein the estimation unit estimates the degree of fatigue of the caregiver based on a care period, the number of caregivers, or the age of the caregiver for the home patient to be processed. 4. The home medical information includes usage status of external facilities of home patients,
4. The data management device according to claim 1, wherein the estimating unit estimates the degree of fatigue of the caregiver based on a use state of an external facility related to the home patient to be processed. 5. The home medical information includes vital signs of home patients,
5. The data management device according to claim 1, wherein the estimating unit estimates a degree of fatigue of the caregiver based on a vital sign of the home patient to be processed. 6.   The warning means may transmit information indicating that the caregiver needs support to a local welfare institution including the home of a home patient whose fatigue degree of the caregiver exceeds the predetermined value. Item 6. The data management device according to any one of Items 1 to 5. Patient information of a home patient, caregiver information about a caregiver who cares for the home patient, medical care of the home patient, a fatigue degree estimation method in a data management device that manages home medical information related to nursing or care,
An estimation step of estimating the degree of fatigue of a caregiver who cares for the home patient of the processing target, based on the patient information of the home patient to be processed, the caregiver information or the home medical information,
When the estimated degree of fatigue exceeds a predetermined value, a warning step of notifying a warning,
Fatigue estimation method including

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