JP2020123106A - Medical system - Google Patents

Abstract

To provide techniques for easily introducing a regional medical cooperation system commonly available to regional medical institutions and reducing the running costs after the introduction.SOLUTION: A medical information sharing server 10 comprises a people DB 120 and a business operator DB 130. A medical institution terminal 20 of a medical institution 92 causes an electronic medical record system to function in a thin client environment by regarding itself as a thin client terminal and regarding a business operator system support server 13 as a thin client management server. The electronic medical record system operating in the medical institution terminal 20 records inspection data (electronic medical record and prescription data) in an electronic medical record DB 125 and a prescription DB 126, and refers to them for records from other medical institutions 92.SELECTED DRAWING: Figure 3

Description

The present invention relates to a medical system, and for example, relates to a medical system accessed by a business operator who provides a product/service related to medical care/welfare and a user who uses the product/service provided by the business operator.

BACKGROUND ART In recent years, in the field of medical care, digitization of documents created by doctors has been progressing, and electronic medical charts that store and manage information such as patient's medical condition, examination contents, drug prescription, etc. by digitizing have become popular. In addition, we propose a technology that allows electronic medical records to be stored on the network, and electronic medical record devices installed at multiple medical institutions can be connected to each other via an electronic medical record server on the network, making it possible for medical institutions to use electronic medical records for the same patient. (For example, refer to Patent Document 1).

Japanese Unexamined Patent Application Publication No. 2018-81528

As described above, although a technique has been proposed in which an electronic medical record is stored on a network and used by a plurality of medical institutions, it is difficult to introduce the medical record, and there is a problem that the regional medical care cannot be shared. In general, each medical institution independently procures and operates electronic medical chart devices provided by various manufacturers. In other words, individual sales and contracts tend to keep the introduction cost high, and there is a tendency that the systems cannot be unified among medical institutions. As a matter of course, running costs are high, and updating of the OS of the PC may require updating and replacement of the installed system, which is a heavy burden. From the viewpoint of visualization of regional medical care, not only medical institutions but also other related businesses, such as pharmacies, will be important, so technology that is easy for such businesses to use is necessary. Has become.

The present invention has been made in view of the above circumstances, and an object thereof is to easily introduce a regional medical cooperation system that can be commonly used by regional medical institutions, and a technique for suppressing the running cost after the introduction. Is to provide. Another object of the present invention is to provide a technique for effectively using the patient information on the network with appropriate security.

(1) The medical system of the present invention is a business entity database that records business entity information of a plurality of businesses that provide products and services related to medical care and welfare, and users who use the businesses and products of the business entities. A user database that records user information of the user in association with identification information, and an information processing terminal of the business operator, the business operator including a medical institution, and the medical information The shared server includes a management server that manages the operation of the information processing terminal of the business operator, and the management server and the medical institution terminal that is the information processing terminal of the medical institution include the medical institution terminal as a thin client terminal. In the thin client environment, the electronic medical record system is made to function, and the electronic medical record system records the electronic medical record recording the medical examination information and the prescription content when the user is medically examined in the user database as the user information. At the same time, the user information of the same user recorded in the user database can be referred to and displayed.
There are, for example, hospitals, pharmacies, nursing homes, pharmaceutical companies, etc. as providers of products and services related to medical care and welfare, and medical services centered on medical institutions, including at least medical institutions (hospitals, clinics, etc.) The system is built. This medical system is suitable for a regional medical cooperation system that has been promoted in recent years. The user is mainly a patient, an elderly person, and a person with a disability, but is a concept that includes an ordinary person. This is because even a healthy person may use a medical institution for health checkups, medical checkups, etc., and may also use it as a patient in the future or in the past. When a business operator is used, the user information is recorded in the user database and shared with other businesses, so that the user information used by a certain business operator (for example, electronic medical record or computerized prescription data) Etc.) can be used by another business operator, so that it is possible to suppress omission of confirmation of items (duplication or avoidance items) that should be noted when providing products/services, and improve the quality of those items. Also, at least in medical institutions, it is possible to build an electronic medical record system (which may include other in-hospital systems such as an accounting system and an inspection system) in a thin client environment, and the hardware and OS of the information processing terminal (PC, etc.) of the business operator can be constructed. The system can be updated without being largely dependent, and the substantial life of the system can be significantly extended at a low cost. The provision of products and services refers to the provision of services (services) such as medical services to businesses such as medical institutions and the provision of products such as pharmaceutical products, and includes the case where only one or both are provided. Note that the electronic prescription data is, for example, an electronic prescription based on an electronic prescription standard format (electronic prescription CDA description specification) that is standardized use issued by the country, but is not limited to this. It may be described in a format having the same function. Also, the transmission/reception form of prescription data (that is, electronic prescription) is not particularly limited, and can be directly recorded in the electronic medical record system in the prescription database, or can be sent as an attached file in an e-mail and the prescription database can be attached. A form of acquiring and recording a file may be used. In the following, when the "electronic prescription" is used, the specific form is not particularly limited, and is described as "electronic prescription (or data thereof)" in a broad sense.

(2) When selecting a prescription drug for the user, the electronic medical record system refers to the user information recorded in the user database and selects a drug having the same or similar efficacy. If there is an overlapping prescription period, that effect may be displayed and confirmation of the prescriber may be obtained.
By referring to the user information in the user database (electronic charts and electronic prescriptions of other hospitals) in the electronic medical chart system, the system can be used when prescribing the same or similar medicines when selecting medicines to prescribe to the patient. Since a warning is issued from the user and confirmation of the prescriber is required, it is possible to avoid duplicate prescriptions, prescribe only the necessary amount, and reduce waste of medical expenses. In addition, by notifying that effect when outputting a prescription, it is possible to suppress work such as inquiry from a pharmacy (pharmacist) to a doctor for inquiries, which leads to more efficient work at both hospitals and pharmacies.

(3) When selecting a prescription drug for the user, the electronic medical record system refers to the user information recorded in the user database to prescribe a drug to be prescribed and a drug to be avoided. It may be determined whether or not there is a drug to be avoided, and a message to that effect may be displayed to obtain confirmation from the prescribing doctor.
If a repellent is prescribed, the alerted doctor may choose another, or if there is no choice, discontinue the prescription. Or you can change to another medicine. When discontinuing/changing, the previous medical institution can be known, so contact can be made smoothly, and it is reflected in the user information of the patient as a process in the medical system and the drug was canceled/changed at another hospital. , You can understand the reason. By noting changes or cancellations when outputting a prescription, it is possible to suppress work such as inquiry from a pharmacy (pharmacist) to a doctor, which leads to more efficient work at both hospitals and pharmacies.

(4) The business operator includes a pharmacy, and the pharmacy terminal, which is the information processing terminal of the pharmacy, and a management server operate a prescription system in a thin client environment in which the pharmacy terminal is a thin client terminal. The prescription system acquires information on a prescription for a user and records it in the user database as the user information, and refers to the user information recorded in the user database to prescribe a prescription according to the prescription. Judgment is made as to whether or not duplicate or repellant drugs are prescribed for the specified drug, and if duplicate or repellant drugs are prescribed, a warning is output and the pharmacist's confirmation of the warning is obtained. May be.
The system introduced at the pharmacy is also constructed in a thin client environment, similar to medical institutions, and the contents of prescriptions are recorded in the user database. The pharmacy system determines duplicate/aversion prescriptions and prompts confirmation by the pharmacist. If there is a note on the prescription, the pharmacist can inform the patient of the content, and if there is no note, the doctor can confirm. Also, the pharmacy system cooperates with the system of the medical institution and refers to the same user database (user information), so the doctor's prescription decisions can be grasped within a certain range and unnecessary work such as inquiry of doubts is eliminated. Therefore, the medicine can be smoothly provided to the patient. In some cases, patients may not receive medication, allowing for regional inventory control.

(5) The medical information sharing server includes a doctor database that records information about doctors who belong to the medical institution, and the electronic medical record system has an introduction function of introducing a patient who is the user to another medical institution. A doctor search medical institution search function for searching a doctor suitable for treatment of a patient from the doctor database, wherein the referral function is a data obtained by digitizing the patient information during the referral process. Information providing function to be provided to the medical institution, and a reservation function of reserving the medical examination date and time (medical examination day, time or time zone) to the doctor of the medical institution selected by the doctor search medical institution search function may be provided. ..
In the medical system, a medical institution (doctor) makes a reservation for another medical institution using the terminal of the medical institution, so that the medical institution, the clinical department, and the doctor in charge can be appropriately selected. In addition, in the reservation process, computerized patient information (electronic medical record, prescription data, test data, etc.) is provided directly or indirectly via a database, so that the medical institution to which the patient is referred can quickly respond.

(6) The medical institution terminal of the medical personnel includes a mobile terminal connectable to the thin client terminal, and the thin client terminal and the mobile terminal are in a connected state, and authentication means provided in the mobile terminal is used. When the user authentication is established, the electronic medical record system may limit the use in the electronic medical record system according to the authentication means used for the user authentication.
The thin client terminal of the medical institution terminal can connect to the doctor's mobile terminal (smartphone or tablet terminal) and perform authentication using the authentication means of the mobile terminal. Then, usage restrictions are added according to the type and number of authentication means, "all functions can be used", "only referenceable", "reference range limited" (only in own clinic, other clinics, etc.), etc. Can decide.

(7) The business operator includes a care facility, and the care facility terminal, which is the information processing terminal of the care facility, and the management server are in a thin client environment in which the care facility terminal is a thin client terminal, and a care support system is provided. The care support system records the usage status of the user in the care facility in the user database as user information, and can refer to the user information recorded in the user database. May be
The involvement of nursing care facilities as a business operator facilitates coordination between medical institutions and nursing care institutions. Even when a medical institution manages a nursing facility, the base of the system to be introduced may be different and cooperation may be difficult. This is especially true when the operator is different. However, since medical institutions, pharmacies, and nursing facilities can use the same medical system and refer to the same user database, cooperation will be smooth. In particular, in elderly care facilities, the resident is often a patient of a medical institution. In such a case, close cooperation with medical institutions is desired, and since the same medical system can be realized in a thin client environment, introduction/operation can be efficiently realized. In addition, the usage status of nursing care facilities means the status of what kind of services the users living in the nursing care facilities use regarding the nursing care services provided at the nursing care facilities, and the usage status associated with such services. Assume the usage of medical supplies, medical supplies, hygiene products (nursing care products) such as diapers and tarpaulins.

(8) The management server acquires the provision status of the company's products and services, and when the provisionable status falls below a certain level, order processing of the product or notification processing to the effect that the level falls below a certain level. May be executed.
By commonly managing the usage status of products etc. provided by businesses participating in the medical system, when the common inventory level falls below a certain level, order processing and inventory managers are warned of inventory confirmation. By issuing it, it is possible to reduce the cost and the man-hours of inventory management by batch ordering. In addition, since inventory control is achieved by accumulating and using information on the entire medical system, cost reductions can be realized, so the return of the above cost reductions is not appropriate to a specific operator but to the system operation cost. It can be returned to contributions, which is an incentive for many companies to enter the medical system.

(9) The thin client environment may be constructed by a virtualization technique of generating a virtual desktop environment on the management server and operating the virtual desktop environment from an information processing terminal of the business operator.
By implementing the thin client environment as a virtual desktop environment in particular, the burden on the user (business operator) is reduced in managing and updating the system.

According to the present invention, an information processing terminal of a medical/welfare-related business operator is configured in a thin client environment, and a management server shares and manages and operates a medical information system. Not only the security cost but also the cost can be reduced from the technical point of view, and the introduction becomes easy. In addition, a system common to community medical personnel or a system assuming collaboration will be introduced, which also reduces the burden of introduction and operation.

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 concerning this 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 a block diagram of a medical institution terminal concerning this embodiment. It is the figure which showed the example of the service which a patient can access and use a medical institution 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 chart figure explaining processing when a patient brings a prescription to a pharmacy according to this embodiment. It is a figure which shows the example of a screen of the reservation function between medical institutions which concerns 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.

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 businesses in a certain range of areas, here, businesses operating a medical institution 92, a pharmacy 96, a pharmaceutical company 97, and a nursing care facility 98, use the medical information sharing server 10, Providing medical and welfare products and services to users such as 94. As a person who provides medical/welfare products/services, it is not intended to be limited to these, and although not particularly explained here, it is also applicable to those who provide medical supplies, dental materials, hygiene products, etc. In that case, the position can be the same as that of the pharmaceutical company 97.

The “user” is assumed to be a patient 94 who uses the medical institution 92 or the pharmacy 96, or an elderly person who uses the nursing care facility 98, but is not intended to be limited to these, and all the products and services of the business operator are used. It includes those of. Hereinafter, for convenience, the description will be given as “patient 94”. The medical institution 92 is a broad concept including dentistry and ophthalmology, and is assumed to be various businesses providing medical services. It should be noted that, of course, those specified by laws and guidelines will be processed according to them. For example, in electronic medical records 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, a regional sharing DB 12, a medical information sharing site 100, and a communication IF 19. 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 an entrance of the medical information sharing site 100, and the patient 94 or the business operator who accesses from the outside accesses the target site via the portal site 101 at each information processing terminal.

The patient 94 accesses the medical information sharing server 10 using his/her own PC (personal computer), tablet terminal, or patient terminal 40 such as a smartphone. Here, as shown in FIG. 2, the patient 94 uses the respective patient terminals (1) 40_1 to patient terminals (n) 40_n. When the patient terminals (1) 40_1 to patient terminals (n) 40_n are not distinguished, they will be simply referred to as "patient terminal 40".

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 medical institution 92 receives a medical examination, it is possible to access the WEB page of the medical institution 92 and 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 institution 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 institutions 92. When the medical institution terminal (1) 20_1 to the medical institution terminal (n) 20_n are not distinguished, they will be simply referred to as the “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 institution 92. The functions prepared for the medical institution 92 include, for example, an electronic medical chart system, a clinical examination system, a medical accounting system, and a receipt support system. In the following, description will be given mainly focusing on the electronic medical record 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 institution 92 records the electronic medical chart 30 created in its own medical treatment in the regional shared DB 12, and each medical institution 92 can refer to the electronic medical chart 30 recorded in the regional shared DB 12 for use. .. Further, the electronic medical record system is linked with the 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 the electronic prescription. Furthermore, other companies 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, the pharmacy terminals (1) 60_1 to pharmacy terminals (n) 60_n are installed in each of the plurality of pharmacy 96. 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 institution 92 registers the electronic prescription, and the pharmacy 96 acquires the electronic prescription.

The pharmaceutical company 97 includes the 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 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. Here, as shown in FIG. 2, a care facility terminal (1) 80_1 to a care facility terminal (n) 80_n are installed in each of the plurality of care facilities 98. When the care facility terminal (1) 80_1 to the care facility terminal (n) 80_n are not distinguished, the care facility terminal (1) 80_1 will be simply referred to as the "care facility terminal 80". The functions prepared for the care facility 98 include, for example, a care management system (input of assessment/plan/monthly plan; function of capturing care support progress record), visiting care/nursing support system, outpatient care/nursing support. System, nursing home for the elderly, 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, the care facility terminal 80 is a thin client terminal, 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 technology to be applied, a known technology (for example, the technology disclosed in Japanese Patent No. 6384847 by the present applicant) can be used. 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 care due to the nature of its business format, the pharmaceutical institution terminal 70 is configured by a general PC, Certain functions may be performed on the web. Further, even if all or part of the configuration of the regional medical cooperation system 1 is constructed in the cloud environment, a certain effect can be realized.

Next, with reference to FIG. 3, a specific configuration of the medical information sharing server 10, particularly the area sharing DB 12, will be described. 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 a single high-performance server, and virtual machines for virtual desktops are run on that server by 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 in 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 medical institutions 92 and pharmacies 96, 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 institution 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 registration information/registration process of the business operator and the person who belongs to the business operator, and a specific example of the registration processing 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 institution 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 business operator. 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 so that 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 institution 92 or the like, the medical institution 92 or the like may register.

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. Further, 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", etc. .. By registering the "life extension treatment intention" and the "organ donation intention", when the patient 94 dies, the medical institution 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. In addition, by registering an anamnestic disease, a surgical history, or the like as the “precautions”, it is possible to grasp the treatment to be avoided at the medical institution 92 in a situation where it is difficult to confirm with the patient 94, and the treatment can be smoothly performed. In the “precautions/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/her own drug, it is registered with the reason. By having a “family pharmacies”, when a doctor gives a prescription, it is possible to know the stock status of the drug in advance. Further, a doctor or a 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, information of the registrant (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. Various authentication functions such as “fingerprint authentication”, “face authentication”, and “voiceprint authentication” can be used in the mobile terminal 22 such as a smartphone or a tablet terminal. Further, two-factor authentication that combines “memory (password or the like)”, “possession (IC card or the like)” and “biometric information (fingerprint or the like)” may be used instead of a plurality of authentication means.

The social security number may be, for example, a health insurance number or a government-managed personal number (so-called my number), and a driver's license number may be used as another official number. Considering actual operation, it is desirable that the health insurance number is officially registered only after the medical institution 92 is used, after confirmation by the insurance card. 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 institution 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, 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 “111122223-123”, 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”. In addition, as voluntary registration information, emergency contact information "03-234-xxxx/child", living situation "living alone, moving into a facility", dementia "〇", 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, for example, whether or not the patient is MRI compatible during MRI treatment. Further, since there is cautionary drug information “Allelock/headache”, it can be seen 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 (medical institution 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 institution 92, and only the essential disclosure items may be disclosed to the pharmacy 96. Further, it is possible to disclose all the items to the doctor in the medical institution 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 institution 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.

With reference to the example of the medical staff DB 122 shown in FIG. 5, the registration information (business information) of the medical staff will be specifically described. As a registration item of a person who belongs to the medical institution 92 (that is, a medical person), "name", "attribute (doctor, nurse, other, etc.)" "affiliation (affiliation 1, affiliation 2, ...)", "specialization" , “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. It is also 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 affiliation 1 “A clinic”, the affiliation 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”. In addition, the mobile terminal 22 with the MAC address “21:43:65:87:09:BA” (details will be described later with reference to FIG. 9) is connected to the thin client terminal 21 or the network 2 such as the Internet is connected. It is directly accessible via.

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 information other than the pharmacist, in that case, there may be restrictions on the user information of the patient 94 who can access.

Next, with reference to the caregiver DB 124 in FIG. 7, the registration information (company 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.

In the electronic medical chart DB 125, the data of the electronic medical chart created by the medical institution 92 is recorded in association with the patient 94. In the prescription DB 126, the prescription data created by the medical institution 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 a drug to the patient 94, and specific information (date and time, drug name, maker, amount, etc.) when actually delivering the drug is added. Since the electronic medical chart 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 being prescribed. Therefore, it is possible to eliminate unnecessary tests and take immediate measures.

Subsequently, the business operator 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 institution 92, "medical institution ID" "name" "type" "medical department" "reservation cooperation" "address" "phone number" "representative" There are (ID), "affiliation (ID)" and "registered terminal (MAC)". The "type" is the type of the medical institution 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" means an emergency cooperation function in which medical institutions 92 communicate with each other by 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 institutions 92. In addition, the homepage address of the medical institution 92 may be registered.

For example, regarding 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),...,” and the MAC address of the registered terminal is “12:34:56:78:90:12,. Therefore, for example, from the information of the registered terminal, in the hospital with the medical institution ID “20001”, the terminal with the MAC address “12:34:56:78:90:12” (medical institution terminal 20) is used as a thin client terminal to perform medical treatment. The information sharing server 10 will be accessed. Further, it can be seen that the medical institution terminal 20 with the medical institution ID “20001” participates in the emergency cooperation function provided by the regional medical cooperation system 1 and the reservation function between the medical institutions 92. The emergency cooperation function and the reservation function between the medical institutions 92 will be described later.

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, care facility terminal 80) of the registration terminal (MAC).

Returning to FIG. 3, in the common inventory DB 138, data relating to the inventory of articles commonly used and procured by businesses participating in the regional medical cooperation system 1 is recorded. Target articles include, for example, medicines (prescription medicines and over-the-counter medicines), medical goods such as bandages and masks, and the like. For example, when a prescription drug is given to the patient 94 at the pharmacy 96, the data is reflected in the common inventory DB 138. When the stock level falls below a certain level, a warning is output to a predetermined stock manager, and an order can be automatically placed depending on the setting. Since the participating companies collectively place an order and manage the inventory, it is possible to reduce the procurement man-hours (reducing the office work man-hours) and ordering costs. Further, when the inventory reduction rate is faster than the past data, it may be determined that there is a possibility of an infectious disease epidemic, and a warning may be issued by the medical institution 92 or the like. Since the data is not for the single medical institution 92 but for the entire regional medical cooperation system 1, the medical institution 92 or the like that has received the warning can take an early action.

Subsequently, the configuration of the medical institution terminal 20 will be specifically described with reference to FIG. The medical institution terminal 20 includes a thin client terminal 21 fixedly used in the medical institution 92 and a mobile terminal 22 carried by a doctor or the like. A local storage device 23 is also provided as needed.

The thin client terminal 21 realizes a VDI thin client environment together with the business entity system support server 13 that functions as a thin client server (management server) as described above. As a specific functional configuration, the thin client terminal 21 includes a user IF 211 such as a keyboard and a mouse, a display unit 212 such as a liquid crystal display, a common software execution unit 213, and communication such as LAN, USB, and HDMI (registered trademark). An IF 214 and a mobile terminal connection IF 215 are provided.

The common software execution unit 213 connects to the virtual desktop of the business entity system support server 13 using a predetermined screen transfer protocol. That is, an electronic medical record system (including other hospital systems such as an accounting system and an inspection system) that operates on the virtual desktop of the business entity system support server 13 is operably displayed on the thin client terminal 21.

The mobile terminal connection IF 215 is an IF connected to the mobile terminal 22 (external device connection IF 225) such as a smartphone or a tablet terminal, and may be shared with the communication IF 214. A connection IF with an iOS (registered trademark) terminal or an Android (registered trademark) terminal, which is one of the above, is introduced, and the same display as the mobile terminal 22 is displayed on the display unit 212 of the thin client terminal 21 and operated. You can

As a general configuration, the mobile terminal 22 includes a user IF 221, a display unit 222, a communication IF 223, an external device connection IF 225, and an authentication device 226. The authentication device 226 includes a fingerprint authentication unit 226a, a face authentication unit 226b, and a voiceprint authentication unit 226c. The mobile terminal 22 can be used in the regional medical cooperation system 1 only when its MAC address is already registered.

Further, the mobile terminal 22 has a medical information service application 227 as a characteristic configuration of this embodiment, that is, a configuration for functioning as the medical institution terminal 20. When connected to the thin client terminal 21, the medical information service application 227 causes the mobile terminal 22 to function as an authentication unit, the mobile terminal 22 itself to function as a thin client terminal, and the medical information sharing server 10 alone. When connecting to, function as a dedicated application.

For example, if the doctor has registered “fingerprint information” and “face authentication information” as authentication information, and the thin client terminal 21 is not provided with an authentication device for acquiring those authentication information, the mobile terminal 22 is made to function as an authentication device.

The technical information DB 135 includes a pharmaceutical affairs information DB 136 and a medical information DB 137. Safety information regarding medicines is recorded in the drug information DB 136. 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.

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 and use at 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.

The patient/general portal site has selection buttons for "hospital list", "pharmacy list", and "my page" at the top of the screen. When the "hospital list" is selected, the medical institutions 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 similarly displayed. When the patient 94 is registered and has accessed by performing the authentication process, the patient 94 may be displayed in order from the address of the patient 94 or in the order of the medical institution 92 having a large usage history.

In 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 individual hospital 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)" and "△. (Reservation frame is small), “× (reservation impossible)”, 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 "-". By pressing the desired hospital/date, Transition to the reservation screen.

In this way, it is possible to implement a service that is implemented in the portal and shares the regional outpatient reservation system with the region. The patient 94 can visually find out the busy time zone from the reservation status of other patients on the day when he/she desires the first visit outpatient department, and can select the relatively free time zone from the crowded condition and make a reservation. 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 easy to search for vacant hospitals in real time. The medical institution 92 can analyze and improve the management from various directions based on the reservation data.

Further, in the hospital list screen A11, when the “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-related tab is selected, it is possible to apply for a medical certificate, certificate, letter of introduction, etc., and if the receipt-related tab is selected, the medical 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, drug prescription history, and registered items can be displayed. In the example of the illustrated My Page screen A15, the visit tab is selected, and five visit histories are displayed starting 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 institution 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 according to 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. Furthermore, as another function, for example, a page (tab) in which the data measured by the patient 94 such as blood pressure and blood glucose level on a daily basis can be input may be provided. At this time, the input data is recorded/stored in the patient DB 121, and the transition of the stored data can be displayed in a graph. At this time, the data measured by the medical institution 92 and recorded in the patient DB 121, the guidance content (comment) of the doctor, and the like may be displayed together.

(Addition/subsequent paragraph numbers are carried forward)
In the conventional regional medical cooperation system, the medical cooperation information mainly including the patient medical care information by the doctors and the medical institutions 92 is biased, and the medical information including the patient 94 is not exchanged in the regional cooperation. In other words, the patient 94 has rarely referred to his/her patient information on the network 2 before. However, in the regional medical cooperation system 1 of the present embodiment, the patient 94 can access the patient DB 121 through the network 2 from the patient terminal 40 and refer to his/her own patient information. Since the patient 94 can see his/her own patient information, he/she can confirm the examination result such as the instruction from the doctor. The patient 94 inputs daily measured data such as blood pressure and blood sugar level to the patient DB 121 of the regional medical cooperation system 1 from the patient terminal 40, so that the medical institution 92 side can see the daily data of the patient 94. Moreover, by inputting by the patient 94, the transition of the daily measurement result of the patient 94 can be easily confirmed on the patient terminal 40.

Next, with reference to FIG. 11 and FIG. 12, an example of using a medical chart system by a doctor in the medical institution 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. In the upper area 301 of the screen, the name of the doctor in charge “AABB” and the medical person ID “D0001” are displayed as the login user. 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", and the patient ID is "C0002". The medical examination ticket number “00035” of the medical institution 92, the medical history “high blood pressure”, and the allergy “− (none)” are displayed.

A “coordinated hospital reservation” button 321 is provided on the right side of the patient profile area 302. By pressing the "coordinated hospital reservation" button 321, the cooperative hospital reservation frame 323 shown in FIG. 14 pops up. Although the details will be described later, the doctor creates an electronic medical information providing document (so-called referral letter) in the cooperative hospital reservation frame 323, and the data regarding the patient 94 (or reference destination) is sent to the medical institution 92 referred to through the network 2. ) Is sent.

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 thereof is the ORDER writing area 313. In the ORDER entry area 313, a drug selection field is displayed and a drug 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 consultation area 307 is selected. In the other consultation area 307, another consultation 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 another medical institution 92 is past a predetermined period. (For example, one year) is displayed. In the prescription history area 309, the prescription history by another medical institution 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 and the medicine prescription history of another medical institution 92 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 treatment, especially in the case of this treatment, the doctor who treats it will consider the past illness and provide an appropriate treatment and prescription drug. You can choose. This is a reference for narrowing down the medicine to be newly prescribed to the patient 94 when using an old medicine or when it has already disappeared.

In addition, a patient 94 such as an elderly person having various diseases may be in a multidrug prescription state or in a multidrug combination state (so-called polypharmacy). For example, when a total of 5 types of medicines are prescribed by a plurality of medical institutions 92, a doctor of a medical institution 92 determines 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, the latest medical treatment for the patient 94 is provided by adding a function of notifying and receiving the change to the medical institution 92 that has been prescribed in advance, as a function of the electronic medical record system of the medical institution terminal 20. The medical institution 92 can also grasp the policy and the prescription policy. In addition, when the patient 94 is using the care facility 98, the care facility terminal 80 of the 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 that many medicines having the same or similar medicinal effect are prescribed in duplicate at different medical institutions 92. 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 a duplicate prescription occurs, a warning is issued by the electronic medical record system of the medical institution 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 writing 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).

When the doctor selects the desired drug (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). If the doctor prescribes another drug, the process returns to the selection process of another drug (S100).

If there is no repulsion check in the medical checkup of the doctor's office (N of S104) or if a warning is confirmed (S106), the electronic medical record at another medical institution 92 is checked, and the repulsion check is also performed (S107). ). If the avoidance is applicable (Y of S108), a warning is displayed (S109), and the warning confirmation is requested again by the doctor (S110). If the doctor prescribes another drug, the process returns to the selection process of another drug (S100).

If there is no avoidance in the medical check of another clinic (N of S108) or if a warning is confirmed (S110), the prescription processed by the other medical institution 92 and processed by the pharmacy 96 is checked (S111). ). In the case where there is overlap/repellence (S112), a warning is displayed (S113), and the warning confirmation is requested again by the doctor (S114). If 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 determined (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 one week's worth of medicine was left. Even if it is judged 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 is prescribed at another medical institution 92, it is possible to decide not to prescribe an antibiotic related to this examination, because duplicate antibiotic prescription is prohibited. .. The past history of the medical institution 92 can be checked by referring to the electronic medical chart of the medical institution. As in the present embodiment, the contents of the electronic medical chart and prescription of the same patient 94 by another medical institution 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. Further, when adjustment of the prescription amount due to the duplicate prescription is performed, the fact may be noted on the prescription.

Next, with reference to the flowchart of FIG. 13, 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 institution 92, the medical institution 92 issues the prescription 50 and is recorded in the prescription DB 126 (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 the prescription history, checks the content of the prescription at the medical institution 92, and checks whether the prescription is duplicated with a prescription that has been prescribed during another medical treatment. Confirmation is performed (S24a). Further, the pharmacy terminal 60 accesses the drug information 136 and checks whether or not there are any matters that must be avoided or cautioned against such as the combined use of prescription drugs (S24b). The pharmacist of the pharmacy 96 makes a question inquiry to the prescribed medical institution 92 as necessary.

When the prescription check is completed and the medicine is delivered to the patient 94, information such as the actual prescription date, the medicine name, the prescription amount, and the pharmacist in charge is reflected in the prescription data of the prescription DB 126 (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).

Next, the reservation system (emergency cooperation function and reservation function) between the medical institutions 92 will be described with reference to FIG. As described above, pressing the “cooperative hospital reservation” button 321 of the electronic medical record 30 causes the illustrated cooperative hospital reservation frame 323 to pop up.

<Adjustment of line break position>
In a general medical treatment appointment system, a patient 94 makes an appointment with a desired medical institution 92 by telephone or through an appointment page on the web. Ask a doctor to write a medical information book (letter of introduction) if necessary, and bring it with you. However, the reservation system of the electronic medical chart system searches the medical staff DB 122 (doctor database) for an introduction function of introducing the patient 94 who is the user to another medical institution 92 and a doctor suitable for the treatment of the patient 94. A doctor search medical institution search function is provided. Further, the referral function provides an information providing function of providing the information of the patient 94 as electronic data to another medical institution 92 during the referral process and a doctor of the medical institution selected by the doctor search medical institution search function. A reservation function for reserving the medical examination date and time is provided. In addition, the referral function is an information providing function that provides information to the patient 94 to another medical institution 92 (that is, the referral destination medical institution 92) as electronic data (electronic medical chart or prescription data) during the referral process. And a reservation function of reserving the medical examination date and time for the doctor of the medical institution 92 selected by the doctor search medical institution search function.

Specifically, it is as follows. According to this reservation system, when a doctor determines that it is desirable to receive advanced medical treatment or more specialized treatment at a medical institution 92, a doctor with a specific function (type: 01) or a regional medical support hospital Even if it is a basic hospital such as (type: 02), a general hospital (type: 03) or a clinic (type: 04), a doctor reserves medical treatment at a medical institution 92 that has specialized knowledge. is there.

As shown in the figure, in the cooperative hospital reservation frame 323, information on the reservation source (information on the medical institution 92 and the doctor in charge) is displayed as basic information in the upper area of the frame. Below that, basic information of the medical institution 92 is displayed.

A reservation type selection area 330 is provided below the patient information. Here, select "Regular reservation" or "Emergency reservation". In the figure, "normal reservation" is selected. The "regular reservation" is a reservation for an illness that does not have an emergency, and is expected to be reserved several days to one month ahead. "Ambulance appointment" is a time-consuming situation where a life-threatening stroke or myocardial infarction (acute coronary syndrome) is suspected, or it is necessary to be hospitalized/transferred on the same day due to its high severity and urgency. It is assumed to be used for diseases such as trauma, burns, poisoning, abdominal pain (acute abdomen) and leukemia. It should be noted that, although two types of divisions are used here, naturally, three or more types of divisions may be used.

Below the reservation type selection area 330, a reservation destination medical institution designation area 331 is provided. In the reserved medical institution designation area 331, the doctor consults with the patient 94 and selects an appropriate hospital. Medical departments and doctors in charge can be selected as needed. Note that the selectable medical institution 92 needs to be registered to participate in the “reservation cooperation” as described above in the description of FIG. 8.

Below the reserved medical institution designation area 331, a reserved date/time designation area 332 for designating “reservation date/time” is provided. If the reservation date has not been decided, "Undecided" can be entered. When "emergency reservation" is selected in the reservation type selection area 330, "emergency" is automatically input.

Below the reservation date and time designation area 332, a referral letter type designation area 333 for selecting the type of medical information provision book (introduction letter) is provided. Here, it is selected whether the medical information provision document (introduction letter) is electronic data or a paper medium as in the conventional case. When electronic data is selected, electronic data such as inspection data and insurance policy number, or access information to the data is attached and transmitted. In the case of a paper medium, access information to patient information (especially electronic medical chart) is added by encrypted information such as a barcode.

Below the referral letter type designation area 333, a patient DB access right designation area 334 is provided. Here, with respect to the patient information of the corresponding patient 94, it is possible to specify whether to disclose all the electronic medical record information of the medical institution 92 of the introduction source or the electronic medical record information of only the medical examination.

Below the patient DB access right designation area 334, a secondary referral destination prior contact designation area 335 is provided. Here, if the referral medical institution 92 determines that there is an appropriate other medical institution 92 depending on the symptom and timing, whether the referral source medical institution 92 or the patient 94 needs to be confirmed is determined. select. For example, when I found a gastric cancer in a medical examination and introduced it to a university hospital, the university hospital that saw the result of the medical examination recommended laparoscopic surgery. It is assumed that there is capacity and surgery can be performed early, and it will be introduced again. Secondary referral request When "necessary" is selected in the advance contact designation area 335, the medical institution 92 (university hospital) of the reservation destination is a secondary referral destination to the medical institution 92 of the reservation source. Notify medical institution 92 (oncology hospital) to make a reservation directly. In the case of "not required", it is an indication that there is no plan to make a reservation directly to the secondary referral destination.

Below the secondary referral request advance contact designation area 335, an introduction purpose designation area 336 for designating an introduction purpose is provided. Here, “inspection”, “hospitalization”, “surgery”, and “others” are selected. If "Other", enter the specific details.

Below the introduction purpose designation area 336, a disease name/treatment history summary designation area 337 is provided. Select “As described in electronic medical record” or “Additional information”. In the case of “as described in the electronic medical record”, request the reference of the electronic medical record for the disease name/treatment history. In the case of “with additional information”, the doctor fills in the blanks with the items that need to be reported.

A confirmation button 338 is provided in the lowermost area, and by pressing the confirmation button 338, the medical institution 92 of the reservation destination is notified of a request (regular reservation introduction or emergency reservation) regarding reservation cooperation. The contents specified in the cooperative hospital reservation frame 323 are attached to the request notification.

With such a function of the reservation system between the medical institutions 92, it is possible to reduce the inquiry processing between the medical institutions 92 at the time of introduction. Moreover, the information of the patient 94 can be smoothly transmitted and received via the network 2. Further, when this reservation system is used, a fee (introduction fee) is generated for both medical institutions 92, so that it is possible to prevent the referral work from causing unnecessary work. In addition, an insurance score may be set for the referral work.

In addition, even in a situation where it is not directly connected to life but the severity and urgency are high and immediate treatment is necessary, it is possible to smoothly and effectively communicate between the medical institutions 92, more specifically, the doctors belonging to the medical institution 92. Information can be accurately transmitted to the medical institution 92 at the transfer destination. In addition, explanations to the crew of the ambulance at the time of emergency transportation can be performed without waste. That is, for example, it is judged that it is desirable to transfer to a hospital in which a patient 94 who has been diagnosed as having a fever at an outpatient clinic continues to have leukemia at a certain medical institution 92 and also considers transplantation. At this time, the capacity of the hematology department at each hospital is assumed to be small. Conventionally, doctors have been exchanging telephone calls with each other, and it takes a very long time to find a hospital, and it is necessary to make an immediate improvement in distributing doctors' resources especially in a crowded state. In particular, in the case of a situation where the patient must be hospitalized urgently on the same day, the doctor needs to take time for the work, and other medical treatment may be delayed. When sending an emergency patient from a clinic (clinic, etc.) to a core hospital, the doctor at the clinic will make a commitment to call the doctor in charge of the emergency department of the core hospital by telephone, and if OK is given, a referral letter will be created. Then, the procedure was to contact the ambulance and give an explanation to the ambulance team that arrived, which was a very time-consuming task. However, such work can be suppressed, the patient 94 can be transported quickly, and the examination of other patients 94 can be prevented from being delayed.

The following is a summary of the features of the present embodiment.
In at least the medical institution 92 of the enterprises, the medical institution terminal 20 is a thin client terminal 21 of the VDI system together with the enterprise system support server 13 of the medical information sharing server 10 in the thin client environment (particularly the VDI system). The electronic medical chart system is operated, and the electronic medical chart and the prescription data are recorded and held in the medical information sharing server 10. As a result, the introduction/operation cost of the medical institution terminal 20 (information processing terminal) in the medical institution 92 can be reduced. In particular, by adopting the VDI thin client environment, even if a large number of medical institution terminals 20 are operating in different medical institutes 92, the cost does not increase significantly depending on the number of medical institution terminals 20. Further, since the medical institution terminals 20 of the same environment are used in the area, the medical institutions 92 (doctors, nurses, etc. operating the medical institution terminals 20) can easily exchange information on the operation and operation, and the learning can be facilitated. In addition, the security of the medical institution terminal 20 can be easily ensured.

(2) The electronic medical record system operating on the medical institution terminal 20 refers to the information recorded in the user DB (electronic medical record DB 125 or prescription DB 126) when selecting a drug to be prescribed for the patient 94, and the same or In the case of selecting medicines having similar effects and overlapping prescription periods, that effect (warning) is displayed, and the doctor who is the prescriber confirms. You can avoid duplicate prescriptions, prescribe as much as you need, and reduce waste of medical expenses. When the prescription is output, by notifying that fact, it is possible to suppress work such as inquiry from the pharmacy 96 (pharmacist) to the doctor, which leads to the efficiency of the work of both the hospital and the pharmacy.

(3) The electronic medical record system operating on the medical institution terminal 20 refers to the data recorded in the user DB (electronic medical record DB 125 or prescription DB 126) when selecting a drug to be prescribed for the patient 94, and the combination is performed. If a drug to be avoided is prescribed, the fact is displayed and confirmation of the prescribing doctor is obtained. When the discontinuation/change is made, the previous medical institution 92 can be known, so that the contact can be made smoothly, or it is reflected as the user information of the patient 94 as the processing in the regional medical cooperation system 1, and the previous medical institution 92 is different from the medical institution 92. It is possible to understand that the drug was discontinued/changed and the reason for it. By making a note of changes/discontinuations when outputting a prescription, it is possible to suppress work such as inquiry from the pharmacy 96 (pharmacist) to the doctor, which leads to more efficient work at both the medical institution 92 and the pharmacy 96. ..

(4) The system introduced into the pharmacy 96 is also constructed in a thin client environment like the medical institution 92, and the content of the prescription is recorded in the user DB (prescription DB 126). The system of the pharmacy 96 determines the duplicate/avoidance prescription and prompts confirmation by the pharmacist. If there is a note on the prescription, the pharmacist can inform the patient 94 of the content, and if there is no note, can confirm it with the doctor. Moreover, since the system of the pharmacy 96 cooperates with the system of the medical institution 92 and refers to the same user DB (prescription DB 126), it is possible to grasp the judgment of the doctor at the time of prescription within a certain range. Therefore, the medicine can be smoothly provided to the patient 94.

(5) The appointment system of the electronic medical record system is suitable for the introduction function of introducing the patient 94 who is the user to another medical institution 92 and the treatment of the patient 94, as shown in the cooperative hospital reservation frame 323 of FIG. And a doctor search medical institution search function for searching for a doctor from the medical staff DB 122 (doctor database). Further, the referral function provides an information providing function of providing the information of the patient 94 as electronic data to another medical institution 92 during the referral process and a doctor of the medical institution selected by the doctor search medical institution search function. A reservation function for reserving the medical examination date and time is provided. In addition, the referral function is an information providing function that provides information to the patient 94 to another medical institution 92 (that is, the referral destination medical institution 92) as electronic data (electronic medical chart or prescription data) during the referral process. And a reservation function of reserving the medical examination date and time for the doctor of the medical institution 92 selected by the doctor search medical institution search function. In the regional medical cooperation system 1, the medical institution 92 (doctor) makes a reservation for another medical institution 92 using the medical institution terminal 20 in this way. As a result, it is possible to appropriately select the medical institution 92, its medical department, and the doctor in charge. Further, in the reservation process, the computerized patient information (electronic medical chart or prescription data) is directly or indirectly provided via the electronic medical chart DB 125 or the prescription DB 126, so that the medical institution 92 referred to can also promptly respond. ..

(6) The thin client terminal 21 of the medical institution terminal 20 can connect to the doctor's mobile terminal 22 (smartphone or tablet terminal) and perform authentication using the authentication means of the mobile terminal 22. Then, usage restrictions are added according to the type and number of authentication means, "all functions can be used", "only referenceable", "reference range limited" (only in own clinic, other clinics, etc.), etc. Can decide.

(7) With respect to the nursing care facility terminal 80, which is the information processing terminal of the nursing care facility 98, the nursing care support system is operated in the thin client environment. With the care facility 98 participating as a business operator, the cooperation between the medical institution 92 and the care facility 98 becomes smooth. Even when the medical institution 92 operates the nursing care facility 98, the base of the system to be introduced may be different, which may make cooperation difficult. This is even more the case when the operator is different. However, since the medical institution 92 and the care facility 98 can use the same regional medical cooperation system 1 and refer to the same user DB, the cooperation becomes smooth. In particular, in elderly care facilities, the resident is often a patient 94 of a medical institution 92 in the same area. In such a case, close cooperation with the medical institution 92 is desired, and since it can be realized in the thin client environment of the same regional medical cooperation system 1, introduction/operation can be realized efficiently.

(8) The common stock DB 138 of the medical information sharing server 10 acquires the provision status of the company's products/services, and when the provisionable status falls below a certain level, the ordering process for the product falls below the certain level. The notification processing to that effect is executed. Cost reduction and inventory management man-hours can be realized by batch ordering. By applying the expenses floating due to the standardization of inventory to the operating expenses of the regional medical cooperation system 1, the burden on the business operator can be suppressed. Further, since the epidemic state of the disease in the entire region can be grasped from the stock situation, the medical institutions 92 and the like participating in the regional medical cooperation system 1 can grasp the epidemic state at an early timing.

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. For example, although the above embodiment has been described on the assumption of insurance medical treatment, it is also applicable to free medical treatment. In that case, a new "information system for free medical care" may be introduced, or the system may be installed based on the content that it is stipulated that insurance medical care and free medical care should be handled separately under the current laws and guidelines. You may adjust. For example, in medical insurance, medical fees are managed and calculated by so-called receipts, and details are managed and output. On the other hand, in the free medical treatment, there is no restriction on the receipt, so a function corresponding to the restriction is added to manage the details and output the receipt or the like.

1 Regional Medical Cooperation System 2 Network 10 Medical Information Sharing Server 11 Control Unit 12 Regional Sharing DB
13 Business system support server 14 Common software for clients 15 Registration management unit 16 Authentication unit 20 Medical institution terminal 21 Thin client terminal 22 Mobile terminal 23 Local storage device 30 Electronic medical chart 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 Business 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
139 Device management DB
140 Patient site 160 Pharmacy site 170 Pharmaceutical institution site 180 Nursing care facility site 226 Authentication device 226a Fingerprint authentication unit 226b Face authentication unit 226c Voice print authentication unit 227 Medical information service application 307 Other consultation area 308 Other consultation history area 309 Prescription History area

(9) The thin client environment may be constructed by a virtualization technique of generating a virtual desktop environment on the management server and operating the virtual desktop environment from an information processing terminal of the business operator.
By implementing the thin client environment as a virtual desktop environment in particular, the burden on the user (business operator) is reduced in managing and updating the system.
The outline of the medical system of the present invention is as follows.
The medical system of the present invention includes a business entity database that records business entity information of a plurality of business entities that provide products and services related to medical care and welfare, and users of users who use the businesses and products of the business entities. A medical information sharing server including a user database that records information in association with identification information,
An information processing terminal of the business operator;
Equipped with
The business operator includes a medical institution,
The medical information sharing server includes a management server that manages the operation of the information processing terminal of the business operator,
The management server and the medical institution terminal, which is the information processing terminal of the medical institution, function the electronic medical chart system in a thin client environment in which the medical institution terminal is a thin client terminal,
The electronic medical record system records an electronic medical record, which records medical examination information and prescription content when the user is examined, in the user database as the user information, and the same use recorded in the user database. It is possible to refer to and display the user information of a user, and when selecting a prescription drug for the user, refer to the user information recorded in the user database, and a drug with the same or similar efficacy. When selecting, and if the prescription periods overlap, that fact is displayed, confirmation of the prescriber is obtained, and if the prescription of the medical institution already treated is changed, the user information is Reflect the changes and note the change in the prescription to the issued prescription and the reason therefor, and note the change in the prescription in the user database and the reason therefor, and make the change to the medical institution already treated. Notice.
The medical system of the present invention includes a business entity database that records business entity information of a plurality of business entities that provide products and services related to medical care and welfare, and users of users who use the businesses and products of the business entities. A medical information sharing server including a user database that records information in association with identification information,
An information processing terminal of the business operator;
Equipped with
The business operator includes a medical institution,
The medical information sharing server includes a management server that manages the operation of the information processing terminal of the business operator,
The management server and the medical institution terminal, which is the information processing terminal of the medical institution, function the electronic medical chart system in a thin client environment in which the medical institution terminal is a thin client terminal,
The electronic medical record system records an electronic medical record, which records medical examination information and prescription content when the user is examined, in the user database as the user information, and the same use recorded in the user database. It is possible to refer to and display the user information of a person who is a patient, and further record a drug to be monitored for illegal prescription, and if a duplicate prescription occurs for the drug, the electronic medical record indicating that there is a risk of illegal prescription. It has a monitoring function to notify in the system.
The medical system of the present invention includes a business entity database that records business entity information of a plurality of business entities that provide products and services related to medical care and welfare, and users of users who use the businesses and products of the business entities. A medical information sharing server including a user database that records information in association with identification information,
An information processing terminal of the business operator;
Equipped with
The business operator includes a medical institution,
The medical information sharing server includes a management server that manages the operation of the information processing terminal of the business operator,
The management server and the medical institution terminal, which is the information processing terminal of the medical institution, function the electronic medical chart system in a thin client environment in which the medical institution terminal is a thin client terminal,
The electronic medical record system records an electronic medical record, which records medical examination information and prescription content when the user is examined, in the user database as the user information, and the same use recorded in the user database. Can be displayed by referring to the user information of the person
The medical information sharing server includes a doctor database that records information about doctors who belong to the medical institution,
The electronic medical record system comprises an introduction function of introducing the patient, who is the user, to another medical institution, and a doctor search medical institution search function of searching the doctor database for a doctor who can treat the case of the patient. ,
The referral function is an information providing function to provide to the other medical institution as electronic data of the patient information during the referral process, and a doctor of the medical institution selected by the doctor search medical institution search function. A reservation function for reserving the medical examination date and time is provided.
The medical system of the present invention includes a business entity database that records business entity information of a plurality of business entities that provide products and services related to medical care and welfare, and users of users who use the businesses and products of the business entities. A medical information sharing server including a user database that records information in association with identification information,
An information processing terminal of the business operator;
Equipped with
The business operator includes a medical institution,
The medical information sharing server includes a management server that manages the operation of the information processing terminal of the business operator,
The management server and the medical institution terminal, which is the information processing terminal of the medical institution, make the electronic medical record system function in a thin client environment in which the medical institution terminal is a thin client terminal,
The electronic medical record system records an electronic medical record recording medical examination information and prescription content when the user is examined as the user information in the user database, and the same use recorded in the user database. Can be displayed by referring to the user information of the person
A common inventory database for commonly recording the inventory status of pharmaceuticals used at the plurality of medical institutions is provided,
The common inventory database has a function of predicting the occurrence of infectious diseases based on changes in the inventory status of pharmaceuticals applied to infectious diseases,
The electronic medical record system displays an infectious disease warning on the electronic medical record when the common inventory database determines that an infectious disease has occurred.

Claims (9)

A business entity database that records business entity information of a plurality of businesses that provide medical and welfare-related products and services, and user information of users who use the businesses and products of the business operators in association with identification information. A medical information sharing server equipped with a user database for recording,
An information processing terminal of the business operator;
Equipped with
The business operator includes a medical institution,
The medical information sharing server includes a management server that manages the operation of the information processing terminal of the business operator,
The management server and the medical institution terminal, which is the information processing terminal of the medical institution, function the electronic medical chart system in a thin client environment in which the medical institution terminal is a thin client terminal,
The electronic medical record system records an electronic medical record, which records medical examination information and prescription content when the user is examined, in the user database as the user information, and the same use recorded in the user database. A medical system capable of referring to and displaying the user information of a person. When selecting a prescription drug for the user, the electronic medical record system refers to the user information recorded in the user database and selects a drug having the same or similar drug effect. The medical system according to claim 1, wherein when the periods overlap, the fact is displayed and confirmation of the prescriber is obtained. When selecting a prescription drug for the user, the electronic medical record system refers to the user information recorded in the user database to determine whether the drug to be prescribed and the drug to be avoided are prescribed. The medical system according to claim 1 or 2, wherein when a drug to be avoided is prescribed, the fact is displayed and confirmation of a prescribing doctor is obtained. The business operator includes a pharmacy, and a pharmacy terminal that is the information processing terminal of the pharmacy and a management server operate a prescription system in a thin client environment in which the pharmacy terminal is a thin client terminal,
The prescription system acquires prescription information for a user, records the prescription information as the user information in the user database, and refers to the user information recorded in the user database to prescribe the prescription by the prescription. Judgment whether or not a drug that is duplicate or repellent is prescribed for the specified drug, and if a drug that is duplicate or repellent is prescribed, outputs a warning and obtains confirmation from the pharmacist for that warning The medical system according to any one of claims 1 to 3, wherein The medical information sharing server includes a doctor database that records information about doctors who belong to the medical institution,
The electronic medical chart system includes an introduction function of introducing the patient who is the user to another medical institution, and a doctor search medical institution search function of searching the doctor database for a doctor suitable for treatment of the patient,
The referral function is an information providing function to provide to the other medical institution as electronic data of the patient information during the referral process, and a doctor of the medical institution selected by the doctor search medical institution search function. 5. The medical system according to claim 1, further comprising a reservation function for reserving the medical examination date and time. The medical institution terminal of the medical personnel includes a mobile terminal connectable to the thin client terminal,
When the thin client terminal and the mobile terminal are in a connected state and the user authentication is established by the authentication means provided in the mobile terminal, the electronic medical chart system is operated according to the authentication means used for the user authentication. The medical system according to any one of claims 1 to 5, wherein the medical system is restricted in use in an electronic medical record system. The business operator includes a care facility, and the care facility terminal, which is the information processing terminal of the care facility, and the management server operate the care support system in a thin client environment in which the care facility terminal is a thin client terminal. ,
The care support system records the use status of the user in the care facility as user information in the user database, and can refer to the user information recorded in the user database. The medical system according to any one of claims 1 to 6, which is characterized. The management server acquires the provision status of the company's products/services, and when the provisionable status falls below a certain level, executes an ordering process for the product or a notification process indicating that the product level falls below a certain level The medical system according to any one of claims 1 to 7, which is characterized in that. 9. The thin client environment is constructed by a virtualization technique for generating a virtual desktop environment on the management server and operating the virtual desktop environment from an information processing terminal of the business operator. The medical system described in any of the above.

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