JP2020113239A - Medical system - Google Patents

Abstract

To provide techniques for: facilitating introducing a medical system that can be used by regional medical institutions in cooperation and in common; reducing running cost; and optimizing inventory management of medicaments.SOLUTION: A regional medical cooperation system 1 has a medical information sharing server 10 and information processing terminals (a medical facility terminal 20, a pharmacy terminal 60, and a nursing facility terminal 80) functioning as thin client terminals. An enterprise system support server 13 of the medical information sharing server 10 functions as a thin client management server, and a medical system such as an electronic medical record system operates in a thin client environment. The medical information sharing server has an inventory management device 19 to perform inventory management of medicaments used during a medical service provided by the medical system, and a medicament inventory database (a common inventory DB 138) to record inventory states of the medicaments. A prescription information management unit 193 of the inventory management device 19 acquires prescription information from multiple medical institutions, and stores it in the common inventory DB 138 as prescription information storage information.SELECTED DRAWING: Figure 3

Description

The present invention relates to a medical system, for example, a medical system used when a plurality of medical institutions involved in medical care/welfare cooperate to provide medical care.

In recent years, in the field of medical care, it is required to promote necessary information collaboration among medical institutions in the area. In such regional medical cooperation, ICT (Information and Communication Technology) plays an important role, and various technologies have been proposed. For example, a technology has been proposed in which a medical system (electronic medical record system, prescription system, inspection system, medical accounting system, etc.) of a medical institution participating in regional medical cooperation is constructed in a virtual desktop environment (thin client environment) (for example, See Patent Document 1).

In such regional medical cooperation, in addition to sharing medical information, it has been proposed to introduce a technology used for joint purchase of medicines to reduce the purchase cost of medicines (for example, refer to Patent Document 2). Specifically, it supports the distribution, ordering, and delivery of medicines in the region via the network. At this time, the distribution amount is predicted based on the dispensing fee statement (receipt) issuance management information and inventory management information of the dispensing pharmacy, and a delivery plan is made based on this prediction. It also issues a receipt based on prescription data sent from the hospital, manages inventory information, and orders medicines based on the inventory information. Furthermore, based on the drug ordering information sent from the hospitals/dispensing pharmacies in the region, joint orders are placed with drug wholesalers and the delivered drugs are delivered.

Patent No. 6384847 JP, 2003-6344, A

The technology disclosed in Patent Document 1 improves the convenience of the system, high security, and drastically reduces the installation/operation cost by constructing a medical system operating in a medical institution in a thin client environment, particularly a virtual desktop environment. Was realized. However, there is room for improvement in cost reduction of medicines used in medical institutions, and new technology has been required. In the technique disclosed in Patent Document 2, individual pharmacies perform order processing of pharmaceuticals, and order processing of a plurality of pharmacies is put together to perform joint order processing. In other words, drug inventory management is performed only by individual medical institutions (here, pharmacies), and there is a limit to the cost reduction that can be realized in the system introduced by regional medical cooperation, and another technology is required. It was being done.

The present invention has been made in view of the above situation, and an object thereof is to easily introduce a medical system that can be commonly used in cooperation with local medical institutions, and to provide a technique for suppressing the running cost after the introduction. To provide. It is another object of the present invention to provide a technology capable of optimizing inventory management of medicines used in linked medical institutions and reducing procurement costs.

(1) The present invention is a medical system in which a plurality of medical institutions cooperate to provide medical care in a predetermined area,
An electronic medical record system used by the medical institution,
When providing medical care using the electronic medical record system, an inventory management device for managing inventory of prescription medicines,
A drug inventory database that records the inventory status of the drug,
Have
The inventory management device has an overall management function that collectively manages the inventory of a plurality of the medical institutions,
The electronic medical record system notifies the inventory management device of the prescription information when outputting the prescription to the patient, and also notifies the inventory management device of the drug provision information regarding the medicine actually provided to the patient. Then
The inventory management device,
An inventory information management function that manages inventory information by reflecting the drug provision information in the drug inventory database,
A prescription information management function of storing the prescription information in the drug inventory database as prescription storage information and disclosing the prescription storage information to the supplier of the drug;
In the electronic medical chart system, when the medicines prescribed by the doctor are selectably displayed, the medicine inventory database is referred to, the medicines having the same or similar efficacy as the medicine are grouped, and the stock status in the group unit Is displayed so that it can be grasped.
This medical system is suitable for a regional medical cooperation system that has been promoted in recent years. Medical institutions are assumed to be defined as medical institutions by the Medical Law, such as medical facilities (hospitals, clinics, dental clinics, ophthalmology, etc.), pharmacies, nursing homes for the elderly, but not defined by the Medical Law. Even an institution includes institutions that cooperate with these medical institutions and contribute to regional medical care. In this way, in the entire regional medical cooperation system, prescription information can be accumulated and the usage status of the drug at the prescribed institution can be grasped, so that the inventory management and order processing of the drug can be efficiently performed, and the man-hour of the order processing can be reduced. As a result, costs can be reduced and procurement costs can be reduced by enabling bulk ordering.
The drug supplier is assumed to be a pharmaceutical company or a drug wholesaler, and not only a supply contractor who has an actual supply contract, but also a supply applicant who desires supply. The supply contract is updated, for example, in terms of price, quantity, etc. on a yearly basis. The same medicinal product may be contracted with multiple suppliers. The actual supply contractor can not only know the stock status of the medicines that he/she supplies, but also at the medical institutions participating in the system, including the medicines of others, drugs with the same or similar effects (new drug, generic, same drug). Drugs, etc.) can be understood. That is, the trend of the entire market can be grasped, the supply system can be prepared, and the supply can be optimized. In addition, by displaying the stock status of medicines to be prescribed together with the electronic medical chart displayed when the doctor decides the prescription, it is assumed that the patient will be headed by displaying the stock status of medicines with the same or similar efficacy. It is possible to avoid prescribing a drug that may be out of stock at a pharmacy.
The groups may be hierarchized. For example, medicines having similar efficacy and purpose such as analgesics are included in the same group. Further, drugs having different brand names but the same generic name belong to the same group. More specifically, for example, analgesics are (A) NSAIDs (nonsteroidal anti-inflammatory drugs), (B) descending inhibitory system activators, and (C) voltage-dependent Ca2, depending on specific ingredients and efficacy. +Channel blockers, (D) opioid-related drugs, etc. can be classified, and among them, some can be classified (that is, hierarchical). Furthermore, it can be classified by specific products such as original drugs and generic drugs. By accumulating in units of groups in this way, it is possible to grasp what kind of medicines and how much they tend to be used in that area.

(2) The prescription information management function, when disclosing the prescription accumulation information to the supplier, prescribes the prescription status of the drug provided by the supplier itself and the drug having the same or similar efficacy as the drug. The prescription status may be disclosed in units.
By displaying not only the stock but also the prescription status, you can quickly check the status before the stock is reflected.

(3) The electronic medical chart system may display the medicines prescribed by the doctor in a selectable manner so that the medicines can be compared with the alternative medicines.
For example, in a hospital or the like, when a doctor selects a medicine to be prescribed by an electronic medical chart system, the stock status is displayed so that the stock status can be understood in group units. If there is a drug that has the same efficacy and can be replaced, such as an analgesic, when displaying and selecting a list of analgesics prescribed by the doctor in the electronic medical record system, the analgesics to be displayed can be sorted in the order of stock or inventory. Drugs with small quantities are displayed in red. When no particular designation is required, the doctor can select the one with a large inventory, and can optimize the inventory of the system.

(4) The prescription information management function of the inventory management device predicts the consumption of the medicine in the region based on the prescription accumulation information, and predicts the epidemic of an infectious disease from the consumption prediction, The electronic medical record system may display the prediction result.
The doctor can grasp the occurrence of infectious diseases at an early stage. For example, it is possible to promptly respond to a rapid onset of an infectious disease. In the case of infectious diseases such as influenza and infectious gastroenteritis, the occurrence situation may show regional characteristics. Therefore, if the trend can be grasped quickly in the area where the system is operating, doctors and hospitals can take measures to prevent the spread of infectious diseases. At the pharmacy, it is possible to prevent the relevant drug from running out, and even if the inventory temporarily runs out, the supplier can predict the inventory from the prescription information before the actual inventory reflection (fluctuation). Arrangements can be made in advance before contacting, and the time to wait for the patient at the pharmacy can be suppressed.

(5) The inventory management device has the overall management function and an individual management function for managing inventory of individual medical institutions,
The drug is divided into a common inventory that is commonly managed by the plurality of medical institutions in each medical institution, and an individual inventory that is individually managed by each medical institution,
For the medicine determined to be insufficient in inventory by the individual management function, the common inventory of the medicine may be applied to the insufficient inventory of the medical institution.

According to the present invention, it is possible to implement a technology that facilitates the introduction of a regional medical sharing system that can be commonly used in cooperation with regional medical institutions, and that can reduce running costs after the introduction. In addition, by acquiring and storing prescription information from linked medical institutions, it is possible to realize technology that can optimize inventory management of medicines used throughout and reduce procurement costs.

It is a figure which shows schematic structure of the regional medical cooperation system based on this embodiment. It is a block diagram of the regional medical cooperation system according to the present embodiment. It is a block diagram of a medical information sharing server concerning this embodiment. It is a figure which shows the example of patient DB based on this embodiment. It is a figure which shows the example of medical personnel DB based on this embodiment. It is a figure which shows the example of pharmacist DB based on this embodiment. It is a figure which shows the example of caregiver DB based on this embodiment. It is a figure which shows the example of company DB based on this embodiment. It is the figure which showed an example of the inventory table hold|maintained at common inventory DB based on this embodiment. It is the figure which showed the example of the service which a patient can access and use for a patient site based on this embodiment. It is an example of a screen of an electronic medical record displayed on a thin client terminal of a medical institution terminal according to the present embodiment. It is a flow chart which shows an example of processing at the time of entering a medicine to prescribe in an ORDER description field of an electronic chart according to this embodiment. It is a figure which shows the example of a screen displayed including a stock state at the time of the list display of the medicines which are prescribed in the electronic medical record system concerning this embodiment. It is a chart figure explaining processing when a patient brings a prescription to a pharmacy according to this embodiment. It is the figure which showed the example of the service which a pharmaceutical company etc. can access and utilize a site for pharmaceutical institutions based on this embodiment.

Next, a mode for carrying out the present invention (hereinafter, simply referred to as “embodiment”) will be specifically described with reference to the drawings. The outline of this embodiment is as follows (1) to (3).

(1) Building a system in a thin client environment In a regional medical cooperation system, a terminal of a medical institution is built in a thin client environment (virtual desktop environment), and medical systems that are various subsystems operate in that environment. The technology of the virtual desktop environment is premised on the one disclosed in Japanese Patent No. 6384847 of the present applicant (Patent Document 1 mentioned above). With this technology, the regional medical cooperation system, as a medical system that is a subsystem, electronic medical record system, medical accounting system, drug management system, sample test system, physiological test system, medical image management system (PACS: Picture Archiving and Communication Systems), nursing management systems, rehabilitation systems, blood transfusion management systems, Radiology Information Systems (RIS), nutrition management systems, medical appointment systems, labor and salary systems, etc.

(2) Accumulation of prescription information and overall prediction When a medical facility (hospital, clinic, etc.) gives a prescription to a patient about a drug used by a medical institution of the regional medical cooperation system, the prescription information is used as prescription accumulation information. accumulate. Prescribing information will be disclosed to medical institutions in the regional medical cooperation system as well as to pharmaceutical suppliers (pharmaceutical companies, drug wholesalers, etc.). In general, a pharmaceutical company or the like only manages the inventory of individual products of its own company and cannot grasp how the same or similar medicines including other companies' products are prescribed. However, not only the inventory but also the prescription status (that is, consumption tendency) of the entire regional medical cooperation system can be grasped, so that pharmaceutical companies can also grasp the overall image of the regional medical cooperation system, and the contract conditions (quantity, price, etc.) in the supply of medicines ), the supply system at the time of supply (demand forecasting, manufacturing, securing logistics, etc.) can be made appropriate. In the disclosure, from the viewpoint of personal information protection, only the appropriate information range or information obtained by omitting the information is used.

(3) Common inventory management of medicines It has an overall inventory management function that commonly manages inventory management of medicines used by medical institutions of the regional medical cooperation system, and an individual inventory management function that manages inventory of individual medical institutions. .. In this way, we will try to optimize drug inventory in the entire regional medical cooperation system and achieve a large cost reduction by bulk ordering of drugs. Furthermore, we will try to keep inventory levels low by clarifying the uneven distribution of inventory and selecting and recommending alternative products according to inventory conditions. In addition, in the following embodiments, from the viewpoint of making the description easy to understand, a drug to be prescribed to a patient at a pharmacy based on a doctor's prescription (that is, a prescription drug) is exemplified as an object product of inventory management. Naturally, the application range can be extended to other medical institutions.
The details will be described below.

FIG. 1 shows a schematic configuration of a regional medical cooperation system 1 realized in this embodiment, and FIG. 2 is a functional block diagram thereof. FIG. 3 is a functional block diagram showing a schematic configuration of the medical information sharing server 10.

In the regional medical cooperation system 1, a plurality of medical institutions (here, the medical facility 92, the pharmacy 96, the nursing care facility 98 and the pharmaceutical company 97) use a medical information sharing server 10 in a certain area. Provide medical/welfare products/services to users such as patients 94. As a person who provides medical and welfare products/services, it is not intended to be limited to these, and although not particularly explained here, for example, those who provide medical equipment such as medical supplies, dental materials, hygiene products, etc. Can be applied, and in that case, it can be positioned similarly to the pharmaceutical company 97.

The "user" is assumed to be a patient 94 who uses the medical facility 92 or the pharmacy 96, or an elderly person who uses the nursing care facility 98, but is not limited to them and all who use the products and services of the business operator. However, the following description will be given as “patient 94” for convenience. The medical facility 92 is a broad concept including a hospital, a clinic, a dental clinic, an ophthalmology clinic, and the like. In addition, of course, those specified by laws and guidelines are processed according to them. For example, in electronic medical charts and electronic prescriptions (prescription data), electronic signatures and time stamps of doctors, etc. For essential data, an electronic signature or the like is added and referred to at the required timing.

As shown in FIG. 1 and FIG. 3, the medical information sharing server 10 includes an overall device 11, an area sharing DB 12, an inventory management device 19, a medical information sharing site 100, and a communication IF 17. The overall device 11 comprehensively controls the components of the medical information sharing server 10.

The medical information sharing site 100 includes a portal site 101, a medical institution site 110, a patient site 140, a pharmacy site 160, a pharmaceutical institution site 170, and a nursing facility site, which are the access destinations of the patient 94 and the business. 180 is provided.

The portal site 101 functions as a gateway of the medical information sharing site 100, and the patient 94 or the business operator who accesses from outside accesses the target site via the portal site 101 with each information processing terminal.

The patient 94 accesses the medical information sharing server 10 using his/her own PC (personal computer), tablet terminal, patient terminal 40 such as a smartphone. When the patient terminal 40 is a tablet terminal or a smartphone, a dedicated application may be introduced and used. The patient terminal 40 accesses the patient site 140 and uses the product/service provided by the business operator. For example, when the doctor visits the medical facility 92, he/she can access the WEB page of the medical facility 92 to reserve the medical examination. Further, for example, a “medicine notebook” application is installed in the patient terminal 40, and it is possible to refer to the prescription history in synchronization with the medical information sharing server 10.

The medical facility 92 includes the medical institution terminal 20 and connects to the medical information sharing server 10 via the network 2. Here, as shown in FIG. 2, the medical institution terminal (1) 20_1 to the medical institution terminal (n) 20_n are installed in each of the plurality of medical facilities 92. When the medical institution terminal (1) 20_1 to the medical institution terminal (n) 20_n are not distinguished from each other, they are simply referred to as “medical institution terminal 20”.

At this time, the medical institution terminal 20 accesses the medical institution site 110 from the portal site 101 and uses the function prepared for the medical facility 92. The functions prepared for the medical facility 92 include, for example, a medical system such as an electronic medical chart system, a clinical examination system, a medical accounting system, and a receipt support system. Below, it demonstrates focusing mainly on an electronic medical chart system. Although details will be described later, the electronic medical chart system and other functions are realized in cooperation with the medical information sharing server 10 as a thin client environment (particularly VDI (virtual desktop environment) system), for example. The medical facility 92 records the electronic medical chart 30 created in its own medical care in the regional shared DB 12, and each medical facility 92 can be used by mutually referencing the electronic medical record 30 recorded in the regional shared DB 12. .. Further, the electronic medical record system is linked with an electronic prescription system provided by the medical information sharing server 10 as an ASP (application service provider), and when outputting the prescription, it can be output as an electronic prescription. Furthermore, other businesses can refer to the data recorded in the area sharing DB 12 of the medical information sharing server 10 under certain conditions.

The pharmacy 96 includes a pharmacy terminal 60 and connects to the medical information sharing server 10 via the network 2. Here, as shown in FIG. 2, each of the plurality of pharmacies 96 is provided with a pharmacy terminal (1) 60_1 to a pharmacy terminal (n) 60_n. When the pharmacy terminal (1) 60_1 to the pharmacy terminal (n) 60_n are not distinguished, they will be simply described as "pharmacy terminal 60".

At this time, the pharmacy terminal 60 uses the function prepared for the pharmacy 96 by accessing the pharmacy site 160 from the portal site 101. The function prepared for the pharmacy 96 is, for example, an electronic prescription system. In the electronic prescription system, the medical information sharing server 10 functions as an ASP server, the medical facility 92 registers the electronic prescription, and the pharmacy 96 acquires the electronic prescription.

The pharmaceutical company 97 includes a pharmaceutical institution terminal 70, accesses the pharmaceutical institution site 170 from the portal site 101, and uses the functions prepared for the pharmaceutical company 97. Functions prepared for the pharmaceutical company 97 include a drug inventory management/ordering function, a prescription storage information, a pharmaceutical information registration function, and a notification function to medical personnel. Here, as shown in FIG. 2, the pharmaceutical institution terminal (1) 70_1 to the pharmaceutical institution terminal (n) 70_n are installed in each of the plurality of pharmaceutical companies 97. When the pharmaceutical institution terminal (1) 70_1 to the pharmaceutical institution terminal (n) 70_n are not distinguished, they will be simply referred to as the “pharmaceutical institution terminal 70”.

The care facility 98 includes a care facility terminal 80, accesses the care facility site 180 from the portal site 101, and uses the function prepared for the care facility 98. The functions prepared for the care facility 98 include, for example, a care management system (input of assessment/plan/monthly plan; function of capturing record of care support progress), visiting care/nursing support system, outpatient care/nursing support. System, nursing home for the elderly support system, etc.

The information processing terminal of the above-mentioned business operator, that is, the medical institution terminal 20, the pharmacy terminal 60, the pharmaceutical institution terminal 70, and the care facility terminal 80 are thin client terminals, the medical information sharing server 10 is its management server, and the thin client environment is Composed.

The thin client environment is constructed by, for example, a virtualization technology (hereinafter, “VDI method”) that creates a virtual desktop environment on the medical information sharing server 10 of the management server and operates the virtual desktop environment from the information processing terminal of the business operator. Is more preferable. As a specific virtualization technique to be applied, the technique disclosed in Japanese Patent No. 6384847 by the present applicant is used as described above. Note that it is not necessary to realize everything as a thin client environment. For example, since the pharmaceutical company 97 is not specialized in specific regional medical treatment due to the nature of its business format, the pharmaceutical institution terminal 70 is composed of a general PC, Certain functions may be performed on the web. Even if a part or all of the regional medical cooperation system 1 is constructed in a cloud environment, a certain effect can be realized.

Next, with reference to FIG. 3, the description will be made focusing on the area sharing DB 12 and the inventory management device 19 of the medical information sharing server 10. The area sharing DB 12 is a company system support server 13, client common software 14, a registration management unit 15, an authentication unit 16, a person DB 120, a company DB 130, a technical information DB 135, a common inventory DB 138, A device management DB 139 is provided.

The business entity system support server 13 functions as a thin client server (management server) in a thin client environment. Although various types of thin client environments have been proposed, the VDI method is adopted as described above. In the VDI method, a hypervisor is installed on one high-performance server, and virtual machines for virtual desktops are run on the same number of users as the number of users. The thin client terminal connects to the virtual desktop assigned to each user via the authentication server and the connection broker.

The client common software 14 holds various software (applications) used for the information processing terminal (for example, the medical institution terminal 20) of the thin client of each business operator in the thin client environment. That is, when the business entity system support server 13 operates a virtual desktop as a thin client server, it holds an application to be operated on the virtual desktop.

The registration management unit 15 registers patients 94 who use the regional medical cooperation system 1, businesses such as the medical facility 92 and the pharmacy 96, and doctors and pharmacists who belong to these businesses. More specifically, regarding the patient information (user information) of the patient 94, when the patient 94 himself/herself registers or uses a business operator such as the medical facility 92 or the pharmacy 96, the consent of the patient 94 is obtained. , Those businesses register.

A specific example of the patient information to be registered, the business operator, and the registration information/registration processing of the person who belongs to the business operator will be described together with the description of the person DB 120, the business operator DB 130, and the like described later with reference to FIGS. 4 to 8.

The authentication unit 16 registers the authentication information (authentication information registered by the registration management unit 15 when the business operator (medical facility 92, pharmacy 96, pharmaceutical company 97, nursing facility 98) or patient 94 accesses the regional medical cooperation system 1. Authentication processing is performed based on the type of means and the registration information based on it.

The person DB 120 records and holds various kinds of information of a person who uses the regional medical cooperation system 1, that is, a patient 94 who is a user and a person who belongs to a company. Specifically, the person DB 120 includes a patient DB 121, a medical staff DB 122, a pharmacist DB 123, a caregiver DB 124, an electronic medical record DB 125, and a prescription DB 126.

The specific content of the user information of the patient 94 and the registration processing by the registration management unit 15 will be described with reference to the example of the patient DB 121 shown in FIG.

When the patient 94 himself/herself registers, the patient 94 accesses the registration page of the patient site 140 from the portal site 101 operated by the regional medical cooperation system 1, and the registration process is performed by the registration management unit 15. Predetermined items are registered in the patient DB 121 of the DB 120. Further, when an unregistered patient 94 uses the medical facility 92 or the like, the medical facility 92 or the like may be registered.

As shown in the patient DB 121 of FIG. 4, “name (name)”, “social security number”, “date of birth”, “address/telephone number”, and “authentication information” are required to be registered as patient information items registered by the patient 94. When the essential registration information is registered as the information, the patient common ID is attached. In addition, the voluntary registration information includes, for example, "emergency contact information", "will for life extension treatment", "will for organ donation", "precautions", "careful drug information/side effect information", "helper", "careee", "family pharmacies" .. By registering the “life extension treatment intention” and the “organ donation intention”, if the patient 94 dies, the medical facility 92 can confirm the intentions smoothly. In addition, by registering the “emergency contact”, “helper”, and “nurse care”, it is possible to contact family members, relatives, etc. even when it is difficult for the patient 94 to confirm. Further, by registering an anamnesis, a surgical history, etc. as the “attention matter”, it is possible to grasp the treatment to be avoided in the medical facility 92 in a situation where it is difficult to confirm with the patient 94, and the treatment can be smoothly performed. In the "careful drug information/side effect information", if there is a drug that the patient 94 wants to avoid due to side effects or the like from the history of his or her own drug, it is registered with the reason. Having a “family pharmacies” allows us to know in advance the stock status of medicines when a doctor gives a prescription. Further, a doctor or pharmacist may register in an electronic medical record system that operates on the medical institution terminal 20 or a prescription system that operates on the pharmacy terminal 60, which will be described later. At this time, registrant information (doctor ID or pharmacist ID) is also associated and registered.

The authentication information can be registered by a plurality of types of authentication means. For example, there are "password" (denoted as "pass" in the figure), "fingerprint authentication", "face authentication", "voiceprint authentication" and the like. Mobile terminals such as smartphones and tablet terminals can use various authentication functions such as "fingerprint authentication", "face authentication" and "voiceprint authentication".

The social security number may be, for example, a health insurance number or a government-managed personal number, and a driver's license number may be used as another public number. Considering the actual operation, it is desirable that the health insurance number is officially registered after confirmation by the insurance card only when the medical facility 92 is used. Until then, it can be assumed that the social security number is not registered and the user information is provisionally registered. As a place (institution) where the official registration can be made, there is the above-mentioned medical facility 92, pharmacy 96 or the like, which requires presentation of official identification. In addition, when a local public body participates in the regional medical cooperation system 1, the official registration may be made at the local public body office (public office).

In the example of FIG. 4, the user information of the patient 94 having the common patient ID “C0002” is required registration information such as the name “EFGI”, the social security number “11112223-123”, and the date of birth “January 23, 1999”. It can be seen that the address/telephone number is “△○ ward×□9-9” and the authentication information is “password, fingerprint”. Furthermore, as optional registration information, emergency contact information "03-234-xxxxxx/child", living situation "living alone, moving into facility", dementia "○", infectious disease "C type, x (none)", life extension treatment intention “X (none)”, organ donation intention “cornea”, and precautionary note “bolt” are registered. When the patient 94 is treated for the first time, since there is a caution "bolt", it is possible to confirm in advance whether or not the MRI is suitable, for example, during MRI treatment. In addition, since there is cautionary drug information “Allelock/headache”, it can be understood that there is a side effect that a headache occurs when this patient 94 takes Allelock.

At the time of registration, the patient 94 may be allowed to set a disclosure range other than a predetermined mandatory disclosure item such as a name, and which item is to be of a business operator of any kind (medical facility 92, pharmacy 96, pharmaceutical company 97, nursing care). The facility 98) and also the attributes of the business operator (doctor, nurse, pharmacist, clerical worker, etc.) can be decided. For example, all items may be disclosed to the medical facility 92, and only essential items may be disclosed to the pharmacy 96. Further, it is possible to disclose all the items to the doctor in the medical facility 92 and not to disclose the items other than the essential disclosure items for the nurse.

Subsequently, the registration information of the business operator will be described with reference to FIGS. When the medical facility 92, the pharmacy 96, the pharmaceutical company 97, and the nursing care facility 98 are registered, a person who is given a predetermined authority in advance by the administrator of the regional medical cooperation system 1 registers the person who belongs to each institution. As an administrator of the regional medical cooperation system 1, for example, there is a medical association in that area (or a person who is delegated from it).

The registration information (business information) of the medical staff will be specifically described with reference to the example of the medical staff DB 122 shown in FIG. "Name", "attribute (doctor, nurse, other, etc.)" "affiliation (affiliation 1, affiliation 2, ...)", "specialization" as registration items for persons who belong to the medical facility 92 (that is, medical personnel) , “Authentication information”, and “mobile terminal ID (MAC address)”, and when registered, a medical person ID is given. When moving to another business, the affiliation change process is performed. Further, it is possible to belong to a plurality of businesses, and a plurality of affiliation destinations such as “affiliation 1” and “affiliation 2” are registered. You can register "specialty fields" for doctors. It should be noted that occupations defined by national qualifications such as doctors, nurses, and pharmacists may be registered by a predetermined organization such as a medical association.

In the example of FIG. 5, for the person indicated by the medical person ID “D0003”, the name “CCDD”, the attribute “doctor”, the department 1 “A clinic”, the department 2 “B clinic”, the specialty “internal medicine”, the authentication information. “Password, face authentication, fingerprint authentication” and mobile terminal ID “21:43:65:87:09:BA”. From this information, it can be seen that the person with the medical staff ID “D0003” is a doctor of internal medicine and belongs to the “A clinic” and the “B clinic”. Further, the mobile terminal having the MAC address “21:43:65:87:09:BA” can be directly connected to the thin client terminal 21 or directly via the network 2 such as the Internet.

Registration information (business information) of an employee of the pharmacy 96 will be specifically described with reference to the example of the pharmacist DB 123 shown in FIG. 6. There are “name”, “affiliation”, and “authentication information” as registration items of a person who belongs to the pharmacy 96, and a pharmacist ID is given after registration. For example, it can be seen that the name “GGHH”, the affiliation “A pharmacy”, and the authentication information “password, fingerprint” are registered for the pharmacist with the pharmacist ID “F0001”. When moving to another business, the affiliation change process is performed. It should be noted that although it is possible to register the information other than the pharmacist, in that case, the user information of the accessible patient 94 may be restricted.

Next, with reference to the caregiver DB 124 in FIG. 7, the registration information (business information) of the employees (caregivers, care managers, etc.) of the care facility 98 will be specifically described. There are “name”, “affiliation”, “attribute”, and “authentication information” as registration information of a person who belongs to the care facility 98, and a caregiver ID is given after registration. For example, it can be seen that the name “QQRR”, the affiliation “B nursing home”, the attribute “care manager, caregiver”, and the authentication information “password, fingerprint” are registered for the employee with the caregiver ID “G0004”. When moving to another business, the affiliation change process is performed.

Returning to FIG. 3, the electronic medical chart DB 125 records the electronic medical chart data created in the medical facility 92 in association with the patient 94. In the prescription DB 126, the prescription data created in the medical facility 92 is recorded in association with the patient 94 and the management number. The prescription DB 126 is referred to by the pharmacy terminal 60 when the pharmacy 96 delivers the drug to the patient 94, and the specific information (date and time, drug name, manufacturer, amount, etc.) when actually delivering the drug is added. Since the electronic medical record and prescription history of the patient 94 are recorded, not only the doctor can easily make a judgment at the time of medical treatment described later, but also when the unconscious patient 94 is transported by an ambulance or the like. As long as the identity can be confirmed, it is possible to know what kind of treatment is being performed and what kind of medicine is prescribed, so that it is possible to omit unnecessary tests and take immediate action.

The technical information DB 135 includes a pharmaceutical affairs information DB 136 and a medical information DB 137. The pharmaceutical information DB 136 records safety information regarding medicines. The safety information is registered/updated by the corresponding pharmaceutical company 97, or registered/updated by the administrator of the regional medical cooperation system 1. The medical information DB 137 records and updates information on infectious diseases by public institutions and medical associations, and information by businesses participating in the regional medical cooperation system 1.

Subsequently, the business entity DB 130 will be described with reference to FIGS. 3 and 8. The business entity DB 130 is for registering/recording information on the business entity itself, and is registered by the administrator of the regional medical cooperation system 1. Specifically, the business entity DB 130 includes a hospital DB 131, a pharmacy DB 132, a pharmaceutical institution DB 133, and a care facility DB 134.

As shown in the hospital DB 131 of FIG. 8A, as the registration information of the medical facility 92, "medical institution ID" "name" "type" "medical department" "reservation cooperation" "address" "phone number" "representative" There are (ID), "affiliation (ID)", "registered terminal (MAC)", "reservation", and "application". The "type" is the type of the medical facility 92, whether it is a hospital or a clinic (type: 04), and if it is a hospital, a specific function hospital (type: 01), a regional medical support hospital (type: : 02) and other general hospitals (type: 03). The "reservation cooperation" is an emergency cooperation function in which medical facilities 92 communicate with each other using the regional medical cooperation system 1 in addition to the conventional communication means such as a telephone when an emergency patient or the like occurs. 11) or whether to participate in the reservation function (cooperation: 12) between the medical facilities 92. In addition, the homepage address of the medical facility 92 may be registered. “Reservation” indicates whether or not the patient 94 has a function of reserving the medical facility 92. Note that “application” indicates whether or not there is a function of providing a function for the patient 94 to make various applications.

For example, for the medical institution terminal 20 with the medical institution ID “20001”, the name is “A clinic”, the type is “04: clinic”, the clinical department is “internal medicine, allergy department”, and the cooperation is “11: emergency cooperation, 12: reservation cooperation”. , Address "XX city XX8-7", telephone number "XX-123-34XX", representative name (ID) "AABB (D0001)", member (ID) "BBCC (D0002), CCDD ( D0003),..., MAC address of registered terminal “12:34:56:78:90:12,... ”, reservation “◯”, and application “◯”. Therefore, for example, from the information of the registered terminal, in the hospital with the medical institution ID “2001”, the terminal with the MAC address “12:34:56:78:90:12” (medical institution terminal 20) is the The information sharing server 10 will be accessed. Further, it can be seen that the medical institution terminal 20 with the medical institution ID “2001” participates in the emergency cooperation function provided by the regional medical cooperation system 1 and the reservation function between the medical facilities 92. The emergency cooperation function and the reservation function between the medical facilities 92 will be described later. Furthermore, the patient 94 can use medical appointments and various applications of the A clinic. Specific functions of “reservation” and “application” will be described later with reference to FIG.

Similarly, regarding the pharmacy DB 132 of FIG. 8B, the pharmaceutical institution DB 133 of FIG. 8C, and the care facility DB 134 of FIG. 8D, as the registration information of each enterprise, “enterprise (pharmacy ID, pharmaceutical institution) ID, care facility ID)" name" "address" "phone number" "representative (ID)" "member (ID)" "registration terminal (MAC)". These businesses can access the medical information sharing server 10 only from the information processing terminals (pharmacy terminal 60, pharmaceutical institution terminal 70, nursing facility terminal 80) of the registration terminal (MAC). As described above, the regional medical cooperation system 1 commonly manages the inventory of the medicines prescribed by the pharmacy 96. Therefore, in each pharmacy 96, an inventory manager (and its ID) is designated as a person in charge of inventory management, and is registered in the pharmacy DB 132. For example, in the pharmacy 96 with the pharmacy ID "60001," the inventory manager (ID) "GGHH(F0001)" is registered. Only the registered inventory manager has the authority to place an order for medicines, and the ordering process can be performed only when the user logs in with the ID.

With reference to FIG. 3 and FIG. 9, the inventory management/prescription storage information of medicines used in the regional medical cooperation system 1 will be described. FIG. 3 shows a schematic configuration of the inventory management device 19. FIG. 9 shows an example of an inventory table of the common inventory DB 138.

As shown in FIG. 3, the inventory management device 19 includes an inventory management unit 191, a prescription information management unit 193, an ordering unit 194, an inventory warning unit 195, and an inventory adjustment unit 196.

The inventory management unit 191 refers to the common inventory DB 138, and has an overall inventory management function that comprehensively manages each drug used/inventory in the regional medical cooperation system 1 as a whole, and an appropriate drug inventory in each pharmacy 96. And an individual inventory management function for determining whether or not Details of the overall inventory management function and the individual management function will be described later with an example of the inventory table in FIG.

Further, the inventory management unit 191 has an inventory forecasting function that forecasts inventory based on the inventory transition status. For the stock forecast, a known technique such as a statistical method (a time series analysis method, a moving average method, a weighted moving average method) or a deep learning prediction (AI prediction) method can be used. The prediction result can be viewed by a manager who manages the regional medical cooperation system 1 or an inventory manager of the pharmacy 96 on a terminal that can be used by each. Further, when the stock management unit 191 determines that the stock is less than the predetermined standard stock as a result of the prediction, the stock management unit 191 notifies the ordering unit 194 and the stock warning unit 195 to that effect. When notifying to the ordering unit 194, an optimally ordered quantity is calculated from the demand forecast (consumption forecast), and the recommended ordered quantity is also notified.

The prescription information management unit 193 acquires the prescription information output by the doctor at the medical facility terminal 20 and records it in the prescription DB 126, and stores the prescription drug information in the common inventory DB 138 as prescription storage information. The prescription storage information is information obtained by appropriately removing (or editing) personal information from the prescription information so that the usage status of the drug in the regional medical cooperation system 1 can be grasped. In addition, when there is a request for disclosure of prescription storage information from the pharmaceutical company 97 or the like, the prescription storage information is disclosed according to the authority of the request source. Prescription storage information and its disclosure form will be described later. In addition, the prescription information management unit 193 can also perform prescription prediction (consumption prediction) from the prescription information. That is, the epidemic of an infectious disease or the like is predicted from the prescription accumulated information, and the information is disclosed to the related persons on the regional medical cooperation system 1. As the forecasting method, the same method as the above-mentioned stock forecasting is used.

The ordering unit 194 automatically performs the ordering process for the lacking drug when an order is required by an administrator or when the stock management unit 191 predicts. In the case of automatic ordering, the recommended order quantity obtained from the inventory management unit 191 is ordered to a predetermined ordering party.

The inventory warning unit 195 outputs a predetermined warning when the forecast result of the inventory management unit 191 or the actual inventory falls below a predetermined inventory level. For example, when the total inventory amount is insufficient, the person in charge of inventory management of the regional medical cooperation system 1 is notified by e-mail or the like. When the stock of each pharmacy 96 is insufficient, the stock manager of the pharmacy 96 shown in FIG. 8 is notified by e-mail or the like. When the automatic ordering process is set, the inventory warning unit 195 notifies the contents of the ordering process in the ordering unit 194.

The inventory adjusting unit 196 has ample total inventory of the regional medical cooperation system 1 for each drug, but when the individual pharmacies 96 are viewed and the appropriate inventory level has not been reached, other inventory is ample. Adjust from a different pharmacy 96. In this case, the part in the common inventory is to be sent to another.

Next, the common inventory DB 138 will be described with reference to FIG. In the common inventory DB 138, the data regarding the inventory of the articles commonly used and procured by the businesses participating in the regional medical cooperation system 1 is recorded in the inventory table as shown in FIG. 9. Target articles include, for example, medicines (prescription medicines and over-the-counter medicines), medical goods such as bandages and masks, and the like. As for prescription drugs, when they are given to the patient 94 at the pharmacy 96, the data are reflected in the common inventory DB 138. Further, when a doctor outputs a prescription at the medical facility terminal 20, a predetermined item (for example, prescription drug name, prescription date and time, quantity, address, patient age, etc.) is extracted and recorded/updated as prescription accumulated information. To be done.

The illustrated inventory table shows some of the pain medications among the prescription drugs. Here, in order to facilitate understanding, differences are shown in simplified form without taking into consideration differences in dosage forms and packaging units of pharmaceutical products, manufacturing lot numbers, and the like. As shown in the figure, "product information", "stock information", and "prescription storage information" are provided as items in the stock table. Further, as the product information, "generic name", "product name", "management code", "group", and "order destination" are provided. As the inventory information, “standard inventory”, “whole inventory”, and “individual inventory” are provided. The inventory information is generally managed in more detail and includes items such as order quantity, order backlog, and shipping status (physical distribution status). These general order processing are particularly characteristic of this embodiment. Descriptions other than those are omitted as appropriate. As "prescription accumulation information", the cumulative total of prescriptions and the prescription amount of each week are recorded for each drug (product).

Regarding product information, it is a formulation name based on the general name of the active ingredient of the drug and is a simplified one part. For example, as shown in the figure, "Loxoprofen sodium hydrate tablet" and "acetaminophen tablet" etc. Is. If the drug is a new drug, the name of the product is described, and if the drug is generic, the fact (if there is more than one drug, it can be identified by a symbol such as ABC or the name of the pharmaceutical company) is described. The management code can identify the product, and is, for example, a JAN code, a HOT code, a receipt computer code, or the like. These codes can be mutually converted by a predetermined code correspondence conversion table (file) not shown.

A “group” is a group of drugs having the same or similar efficacy, which are shown in multiple layers. Therefore, it is possible to manage and refer to the stock status of medicines having similar effects, using the group as a key. For example, in the group “A-01”, “A” is attached to the analgesic group, and further the branch number “01” is attached to the generic name “loxoprofen sodium hydrate tablet”. The branch number "05" is attached to the generic name "acetaminophen tablets". In the grouping, what kind of standard is used is arbitrary, but the grouping is performed with the group as a key so that the stock status of substitutable drugs can be referred to.

By performing the group classification in this way, for example, when the inventory management unit 191 makes an inventory forecast, it is possible to make a forecast for each group. In other words, even if a shortage of the stock of a certain drug is predicted, it may be possible to sufficiently secure it on a group basis. In such a case, since it is not necessary to place an order in a hurry, the inventory can be optimized more effectively.

Regarding the inventory information, the “standard inventory” is a target inventory amount of the entire regional medical cooperation system 1 and is a standard value for inventory management. For example, automatic order processing may be performed when the target inventory amount reaches 50%. Although the standard stock is set for each drug here, it may be set for each group.

The “total inventory amount” is the total inventory amount in all pharmacies 96 of the regional medical cooperation system 1. In addition, the inventory amount is “common” (common use inventory) indicating the inventory amount that can be used in the pharmacies 96 of the entire regional medical cooperation system 1 and is assumed to be interchangeable among the pharmacies 96, and is used only in each pharmacy 96. It is managed by dividing it into “individual” (individually used inventory) and “total” which is a combination of “common” and “individual”. In the pharmacy 96, each stock manager sets an individual standard stock. When the ordering unit 194 places a collective order, for example, the ordered medicines are distributed so as to be an individual standard inventory. The “individual inventory” manages the inventory quantity of each pharmacy 96 for “common”, “individual”, and “total”.

For example, looking at the stock information on "Loxoprofen sodium hydrate tablets", the total stock amount of all three products under the product names "Loxonin", "Generic A" and "Generic B" is compared to the standard stock. You can see that there is a shortage. On the contrary, it can be seen that the three products of acetaminophen are in excess of the standard stock. Looking at the accumulated prescription information, the product name "Loxonin" has a cumulative total of "5000", the first week "300", the second week "200", and so on. The pharmaceutical company 97 can acquire the inventory information for its own product and the prescription accumulation information for its own product in group units. Although the prescription accumulated information is collected on a weekly basis, it may be collected on a daily basis and can be set as appropriate.

Specific examples of services and the like provided by the regional medical cooperation system 1 having the above configuration will be described. FIG. 10 is a diagram showing an example of services that the patient 94 can access by using the medical institution site 110. The patient 94 activates the Internet browsing application on the patient terminal 40 and accesses the portal site 101 of the medical institution site 110. When the patient 94 presses the “patient/general” button provided at the top of the site, the display transitions to the patient/general portal site.

On the patient/general portal site, selection buttons for "hospital list", "pharmacy list", and "my page" are provided at the top of the screen. When the “hospital list” is selected, the medical facilities 92 participating in the regional medical cooperation system 1 are displayed in a list for each clinical department. When the “pharmacy list” is pressed, a list of pharmacies 96 participating in the regional medical cooperation system 1 is displayed in the same manner. When the patient 94 is registered and is accessing by performing the authentication process, the patient 94 can be displayed in the order of closer to the address of the patient 94 or in the order of the medical facility 92 with a larger usage history.

In the example of the illustrated hospital list screen A11, a list of internal medicine hospitals is shown. In the list, a hospital name and an address are described, and a reservation button and an application button are provided next to some hospital names. For example, when the reservation button of the A clinic is pressed, the screen shifts to the hospital individual reservation screen A12 regarding the A clinic. In the illustrated hospital individual reservation screen A12, the reservation registration tab is selected, and the reservation status (congestion status) for several days (here, 1/23 to 1/26) is "○ (reservation frame available)" or "△. (Reservation limit is small), “× (reservation not possible)”, and “− (closed)”. “O” and “Δ” can be pressed, and when pressed, the screen changes to a predetermined reservation screen (not shown). When the reservation confirmation tab is selected, if the reservation has been made, the reserved contents are displayed.

A reservable hospital list button is provided below the hospital list screen A11. By pressing this button, the reservable hospital list screen A13 is displayed. Reservable by each department The reservable/congested status of hospitals is displayed in a selectable list with "○", "△", "×", and "-". Transition to the reservation screen.

In this way, it is possible to realize a service that is implemented in the portal and shares the regional outpatient reservation system with the region. The patient 94 can visually confirm a busy time slot from the reservation status of other patients on the day when he/she desires to visit the first visit outpatient department, and can make a reservation by selecting a relatively free time slot based on the congestion. Since the ordering is based on regional cooperation, it is possible to visually check the current congestion of hospitals and the waiting time of the patient 94 from the list of hospitals in the same department, and it is possible to easily find a vacant hospital in real time. The medical facility 92 can diversify and analyze management from the reservation data.

Further, in the hospital list screen A11, when an “application button” is provided next to the hospital name, pressing the button causes a transition to the application screen A14. On the application screen A14, if the application form related tab is selected, it is possible to apply for a medical certificate, certificate, referral letter, etc., and if the receipt related tab is selected, the medical treatment statement or It is possible to apply for a receipt certificate.

When “My Page” is selected, the user information of the patient 94 is displayed. That is, the visit history, the prescription history of the medicine, and the registered items can be displayed. In the illustrated My Page screen A15, the visit tab is selected, and four visit history records are displayed, beginning with the use of "January 23, 2018 A clinic". By pressing each list, it is possible to browse the electronic medical record (items that the medical facility 92 can view) and the prescription at the time of use. That is, the patient 94 can browse all or a certain range of his/her own data recorded in the electronic medical record DB 125 and the prescription DB 126. In addition, in the example of the My Page screen A16, the medicine tab showing the prescription history of the medicine is selected, and the medicine is displayed by the prescription issued at the “A clinic” at the “XY dispensing pharmacy” on “January 23, 2018”. Is received. By pressing the "list display" button in the lower area of the My Page screen A16, a list of prescription histories for the latest predetermined period is displayed.

Next, referring to FIGS. 11 to 13, an example of using a medical chart system by a doctor in the medical facility 92 will be described. FIG. 11 is a screen example of the electronic medical chart 30 displayed on the thin client terminal 21 of the medical institution terminal 20. The name “AABB” of the medical doctor in charge and the medical doctor ID “D0001” are displayed as the login user in the upper area 301 of the screen. Below that, a patient profile area 302 is provided. The name of the patient 94 is “EFGI”, the date of birth/age/sex is “2000.01.01/18 years old/male”, the patient ID is “C0002”, The medical examination ticket number “00035”, medical history “high blood pressure”, and allergy “− (none)” of the medical facility 92 are displayed.

Below the patient profile area 302, three buttons 303 of “reception”, “examination”, and “accounting” are provided, and “examination” is selected here. Further, a medical record area 304 is provided below the buttons. The left 1/3 of the medical record area 304 is the previous medical care area 311, the right 2/3 is the current medical care area, the left half thereof is the SOAP writing area 312, and the right half is the ORDER writing area 313. In the ORDER description area 313, a medicine selection field is displayed and a medicine to be prescribed is selected and entered from the list. Although details will be described later, when selecting a drug, the electronic medical record DB 125 and the prescription DB 126 are referred to so that the patient 94 cannot immediately select a duplicate prescription or a repellent prescription.

A usage history area 305 is provided on the right side of the medical record area 304. In the usage history area 305, the own hospital history area 306 and the other consultation area 307 can be designated and displayed by tab selection. Here, the other medical examination etc. area 307 is selected, and in the other medical examination etc. area 307, another medical examination history area 308 and a prescription history area 309 are provided.

In the other medical examination history area 308, the electronic medical chart data is referred to and extracted from the electronic medical chart DB 125 by using the patient ID of the same patient 94 (here, “C0002”) as a key, and the medical examination history of the other medical facility 92 is past a predetermined period. (For example, one year) is displayed. In the prescription history area 309, a prescription history by another medical facility 92 whose prescription data is referred to and extracted from the prescription DB 126 by using the patient ID of the same patient 94 as a key is displayed for a predetermined period in the past (for example, one year).

When examining a patient 94 or prescribing a medicine, the doctor can refer to the examination history of another medical facility 92 or the medicine prescription history on the same screen. By knowing what kind of treatment the patient 94 has received, an appropriate treatment method can be selected. In particular, when the cause is unknown and a referral letter exists, the past treatment history can be confirmed from the contents or from the patient 94. However, even if there is no referral or if the patient 94 is not conscious of this illness especially in this treatment, the doctor who treats it will consider the illness in the past and provide an appropriate treatment and prescription drug. You can choose. This is a reference for narrowing down the medicines to be newly prescribed to the patient 94 when using old medicines or when the medicines have already disappeared.

In addition, a patient 94 such as an elderly person who has various diseases may be in a state of multiple drugs being prescribed and taking multiple drugs or using multiple drugs together (so-called polypharmacy). For example, when a total of 5 types of medicines are prescribed from a plurality of medical facilities 92, a doctor of a certain medical facility 92 judges that 3 types are sufficient when considering comprehensively, and changes the prescription. In addition, the prescription amount can be suppressed, and finally the drug cost can be reduced. In such a case, as a function of the electronic medical chart system of the medical institution terminal 20, by giving a function of notifying and receiving the change to the medical facility 92 that has been prescribed in advance, the latest treatment for the patient 94 is given. The medical facility 92 can also grasp the policy and the prescription policy. Further, when the patient 94 is using the nursing care facility 98, the nursing care facility terminal 80 of the nursing care facility 98 also has a function of receiving such a notification, so that the medicine can be shared among the persons related to the patient 94. You can share your changes.

The patient 94 may not be able to convey accurate information (disease name or drug name) regarding the past treatment history due to ambiguous memory, and in some cases, may transmit erroneous and inappropriate information. However, such a situation can be prevented. Furthermore, it is easy to find out that many medicines having the same or similar medicinal effect are prescribed in different medical facilities 92 in an overlapping manner. This type of situation is often aimed at resale of illegal drugs, allowing physicians to prevent illegal prescriptions early. It should be noted that the prescription DB 126 may be provided with a monitoring function for determining the presence or absence of an inappropriate prescription. Since the medicine to be resold is known to a certain extent, if the medicine to be monitored is registered and an overlapping prescription occurs, a warning is issued by the electronic medical record system of the medical facility 92 or the prescription system of the pharmacy 96, and the doctor Etc. may be checked.

Next, with reference to the flowchart of FIG. 12, an example of processing when filling a medicine to be prescribed in the ORDER description area 313 in the electronic medical chart 30 will be described. When the doctor displays the medicine selection field in the ORDER entry area 313 and starts inputting the medicine name (S100), candidate medicine names corresponding to the input characters are displayed in a selectable list (S101). It should be noted that an example of a screen displayed including the stock status when the list is displayed will be described later with reference to FIG.

When the doctor selects the desired medicine (S102), the avoidance check of the patient 94 is performed (S103). For example, it is checked whether or not the drug is repelled from allergies, ages, and past medical conditions. If there is an objection to the avoidance (Y of S104), a warning is displayed (S105), and the warning confirmation by the doctor is requested (S106). When the doctor prescribes another drug, the process returns to the selection process of another drug (S100).

If there is no evasion in the medical check of the own clinic (N in S104) or if a warning is confirmed (S106), the electronic medical record in another medical facility 92 is checked, and the evasion check is also performed (S107). ). If there is an objection to the avoidance (Y of S108), a warning is displayed (S109), and the warning confirmation by the doctor is requested again (S110). When the doctor prescribes another drug, the process returns to the selection process of another drug (S100).

When there is no avoidance in the medical check of another clinic (N of S108) or when a warning is confirmed (S110), the prescription processed in the other medical facility 92 and processed by the pharmacy 96 is checked (S111). ). In the case of overlapping/repelling (S112), a warning is displayed (S113), and the warning confirmation is requested again by the doctor (S114). When the doctor prescribes another drug, the process returns to the selection process of another drug (S100). After confirmation by the doctor, if necessary, the quantity is adjusted (S115), and if there is no overlap or avoidance (N in S112), the prescription period (that is, the amount of the drug) is fixed (S116).

For example, when the prescription periods overlap, if the same drug or drugs having the same or similar drug efficacy are prescribed, the prescription becomes unnecessary or the prescription period (that is, the quantity) is reduced. More specifically, it is assumed that the patient 94 who had a tooth extracted at the dental clinic was prescribed loxoprofen as a pain reliever, and that one week's worth of medicine remained, so the physician could take a week's pain relief for this week's examination. Even if it is determined that the prescription is appropriate, since it has the same medicinal effect (pain relieving) that has already been prescribed, it is possible to perform a treatment such as not prescribing the pain relieving. In addition, when an antibiotic drug in another medical facility 92 is prescribed, it is possible to decide not to prescribe an antibiotic related to this medical examination because duplicate antibiotic prescription is prohibited. .. The past history of the medical facility 92 can be checked by referring to its electronic medical chart. As in the present embodiment, the contents of the electronic medical chart and prescription of the same patient 94 by another medical facility 92 can be referred from the electronic medical chart DB 125 and the prescription DB 126, so that the patient 94 does not recognize or notify the doctor. Even in such cases, it is possible to provide appropriate medical services and reduce medical costs. In addition, when adjustment of the prescription amount accompanying the duplicate prescription is performed, the fact may be noted on the prescription.

FIG. 13 shows an example of a screen that displays the inventory status when displaying a list of drugs to be prescribed in the electronic medical record system. When the medicine selection frame 341 shown in the balloon in the figure is displayed in the ORDER description area 313 of the electronic medical record 30, and the desired medicine name is input in the medicine name input field 342, the medicine candidate list 343 is displayed on the right side. To be done. At this time, in addition to the generic name and product name of the drug, the stock status thereof is indicated by “◯ (appropriate)”, “Δ (cautionary)”, and “x (insufficient)”. For the stock status, the data of the corresponding drug (that is, the stock table shown in FIG. 9) is referenced from the common stock DB 138.

Here, a type of analgesic, loxoprofen sodium hydrate tablets, is listed. It can be seen that the stock status of the upper two products (medicines) is “Δ (dangerous)” and the lower product (medicine) is “x (insufficient)”. Here, when the doctor operating the electronic medical chart system determines that another pain medication can be substituted, the group search button 345 in the lower frame area is pressed. As a result of the operation, the same efficacy drug list frame 351 is displayed, and as described in the inventory table of FIG. 9, drugs that are grouped in advance as having the same efficacy are replaced with the above-mentioned designated drug list 353 and replaceable drugs. List 354 is displayed along with its inventory status. Here, it can be seen that the stock status of the three products of “acetaminophen tablets” is “◯ (appropriate)” as an example of the substitute drug list 354. If the doctor determines that the "acetaminophen tablet" is suitable for prescribing, he or she selects one of the three products.

Although the total inventory amount is reflected as the inventory state, for example, even if the inventory state of the nearby pharmacy 96 registered beforehand or the pharmacy 96 that can be judged as the “family pharmacy” from the prescription history of the patient 94 is displayed. Good. Further, the doctor may select the pharmacy 96 desired by the patient 94. It is possible to eliminate waste such that a patient 94 who goes to the pharmacy 96 to pick up medicine goes to another pharmacy 96 because the pharmacy 96 is out of stock or waits for the drug to be ordered at the pharmacy 96.

Next, with reference to the flowchart of FIG. 14, a process when the patient 94 brings the prescription to the pharmacy 96 will be described. When the patient 94 receives a medical examination at the medical facility 92, the medical facility 92 issues the prescription 50 and records the content of the prescription of the patient 94 in the prescription DB 126 and the information of the prescribed drug in the common stock DB 138 as the prescription accumulated information. (S21). The prescription 50 has a two-dimensional code 51 in which the prescription information is encrypted. As the prescription information, there are identification information (for example, name, patient ID) of the patient 94 and a management number attached when recorded in the prescription DB 126. The two-dimensional code 51 itself may include specific prescription contents (medicine name, prescription amount, etc.).

When the patient 94 receives the prescription 50 and brings it to the pharmacy 96 (S22), the two-dimensional code 51 of the prescription 50 is read and decoded by the code scanner 55 provided in the pharmacy terminal 60 in the pharmacy 96 (S23). The pharmacy terminal 60 performs a prescription check based on the decrypted data (S24). More specifically, the pharmacy terminal 60 accesses the prescription DB 126, performs a prescription history, checks the content of the prescription at the medical facility 92, and checks whether the prescription is a duplicate prescription during another medical treatment. Confirmation is performed (S24a). Furthermore, the pharmacy terminal 60 accesses the drug information 136 and checks whether or not there are any matters that should be avoided or cautioned against such as the combined use of prescription drugs (S24b). The pharmacist of the pharmacy 96 makes a doubt reference to the prescribed medical facility 92 as necessary.

When the prescription check is completed and the medicine is delivered to the patient 94, the information such as the date of actually prescribing, the medicine name, the prescription amount, and the pharmacist in charge is reflected in the prescription data of the prescription DB 126 and also in the common inventory DB 138. (S25). The patient 94 can browse his/her own prescription history using the “medicine notebook” application on the patient terminal 40 or via the portal site 101 (S26). In addition, even if a prescription is issued, there are some patients 94 who do not receive the drug at the pharmacy 96 in another area or do not receive it during the expiry date of the prescription. Therefore, actually process the data at the pharmacy 96 of the regional medical cooperation system 1. This enables accurate inventory management.

Next, a technique for the pharmaceutical company 97 to confirm the stock status and prescription accumulation information of its own product in the regional medical cooperation system 1 will be described with reference to FIG. The pharmaceutical company 97 uses the pharmaceutical institution terminal 70 to access the portal site 101. By pressing the "pharmaceutical company personnel" button provided on the site, the display transitions to the pharmaceutical personnel portal sites A16 and A17. In the figure, an example of F pharmaceutical company will be described.

On the pharmaceutical-related portal site A16 in the state where the inventory tab is selected, the inventory status of the in-house product is displayed with reference to the common inventory DB 138 shown in FIG. Here, with respect to "loxoprofen sodium hydrate tablet (generic B)", the standard inventory, the total inventory amount, and the inventory amount by pharmacy are displayed.

Further, in the portal site A16 for pharmaceutical personnel in a state where the prescription information tab is selected, referring to the common stock DB 138, the same group (same or same as the “loxoprofen sodium hydrate tablet (generic B)” which is the company's own product is referred to. Prescription accumulated information of drugs with similar efficacy) is displayed. Note that the prescription storage information can be disclosed by contracting with the operator of the regional medical cooperation system 1 even for the pharmaceutical company 97 that does not supply products.

The supply contract is updated, for example, in terms of price, quantity, etc. on a yearly basis. The same medicinal product may be contracted with multiple suppliers. The actual supply contractor can not only know the stock status of the medicines that he/she supplies, but also at the medical institutions participating in the system, including the medicines of others, drugs with the same or similar effects (new drug, generic, same drug). Drugs, etc.) can be understood how they are prescribed. That is, the trend of the entire market can be grasped, the supply system can be prepared, and the supply can be optimized.

Further, when the prescription is output at a medical facility such as a hospital, the data is updated and the supplier can grasp the prescription information. Therefore, for example, it is possible to promptly respond to a rapid onset of an infectious disease. In the case of infectious diseases such as influenza and infectious gastroenteritis, the occurrence situation may show regional characteristics. Therefore, if the trend can be grasped quickly in the area where the system is operating, it is possible to prevent the drug from running out at the pharmacy, and even if the inventory temporarily runs out, before the actual inventory reflection (fluctuation) In addition, since the stock can be predicted from the prescription information, the supplier can make an arrangement in advance before contacting the pharmacy and can suppress the time to wait the patient at the pharmacy.

On the other hand, the supply applicant can help the decision at the next contract by knowing the prescription status in the target area. In other words, since it is possible to grasp the estimated supply amount that is close to reality in advance, it is possible to strategically set the price at the time of contract bidding. In addition, since it is not a stock of medicines, it is possible to judge how medicines having the same or similar efficacy are prescribed. In other words, pharmaceutical suppliers can understand not only the pharmaceuticals that they supply, but also the pharmaceuticals with the same or similar efficacy that other companies supply, establishing the latest supply system and presenting the next contract conditions (quantity/price). Can be used as a reference. As a method of disclosure, there is a method in which a website (portal site) accessible by a pharmaceutical supplier is prepared and desired information can be referred to by using a predetermined authentication means on the website. Alternatively, a method of notifying by e-mail or the like may be used.

The present invention has been described above based on the embodiment. It should be understood by those skilled in the art that this embodiment is an exemplification, that various modifications can be made to the combination of the respective constituent elements, and that such modifications are within the scope of the present invention.

1 Regional Medical Cooperation System 2 Network 10 Medical Information Sharing Server 11 Centralized Device 12 Regional Sharing DB
13 Business system support server 14 Common software for clients 15 Registration management unit 16 Authentication unit 19 Inventory management device 20 Medical facility terminal 21 Thin client terminal 30 Electronic medical record 40 Patient terminal 50 Prescription 51 Two-dimensional code 55 Code scanner 60 Pharmacy terminal 70 Pharmaceutical Institution terminal 80 Nursing facility terminal 92 Medical institution 94 Patient 96 Pharmacy 97 Pharmaceutical company 98 Nursing facility 100 Medical information sharing site 101 Portal site 110 Medical institution site 120 DB
121 Patient DB
122 Medical personnel DB
123 Pharmacist DB
124 Caregiver DB
125 electronic chart DB
126 Prescription DB
130 organization DB
131 Hospital DB
132 Pharmacy DB
133 Pharmaceutical Institution DB
134 Care facility DB
135 Technical information DB
136 Pharmaceutical Affairs Information DB
137 Medical Information DB
138 Common Inventory DB
140 Patient site 160 Pharmacy site 170 Pharmaceutical institution site 180 Nursing facility site 191 Inventory management unit 193 Prescription information management unit 194 Ordering unit 195 Inventory warning unit 196 Inventory adjustment unit 307 Other examination area 308 Other examination history area 309 Prescription History area

Claims (5)

A medical system in which a plurality of medical institutions cooperate to provide medical care in a predetermined area,
An electronic medical record system used by the medical institution,
When providing medical care using the electronic medical record system, an inventory management device for managing inventory of prescription medicines,
A drug inventory database that records the inventory status of the drug,
Have
The inventory management device has an overall management function that collectively manages the inventory of a plurality of the medical institutions,
The electronic medical record system notifies the inventory management device of the prescription information when outputting the prescription to the patient, and also notifies the inventory management device of the drug provision information regarding the medicine actually provided to the patient. Then
The inventory management device,
An inventory information management function that manages inventory information by reflecting the drug provision information in the drug inventory database,
A prescription information management function of storing the prescription information in the drug inventory database as prescription storage information and disclosing the prescription storage information to the supplier of the drug;
In the electronic medical record system, when the medicines prescribed by the doctor are selectably displayed, the medicine inventory database is referred to, the medicines having the same or similar efficacy as the medicine are grouped, and the stock status in group units A medical system characterized by displaying information in a recognizable manner. The prescription information management function, when disclosing the prescription accumulation information to the supplier, prescribes a drug having the same or similar efficacy as the drug together with the prescription status of the drug provided by the supplier itself. The medical system according to claim 1, wherein the medical condition is disclosed. 3. The electronic medical record system, when displaying a drug prescribed by a doctor in a selectable manner, displays the inventory status of the drug and the inventory status of the alternative drug in a mode that allows comparison with the inventory status of the alternative drug. Medical system described in. The prescription information management function of the inventory management device, based on the prescription accumulation information, while predicting the consumption of the drug in the region, from the consumption prediction to predict the epidemic of infectious diseases,
The medical system according to claim 1, wherein the electronic medical chart system displays a prediction result. The inventory management device has the overall management function and an individual management function for managing the inventory of each medical institution,
The drug is divided into a common inventory that is commonly managed by the plurality of medical institutions in each medical institution, and an individual inventory that is individually managed by each medical institution,
5. The medicine which is judged to be insufficient in inventory by the individual management function is allocated from the common inventory of the medicine to the insufficient inventory of the medical institution, any one of claims 1 to 4. The medical system described in Crab.

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