JP2020135401A - Software and diagnosis support device - Google Patents

Abstract

To provide software and a diagnosis support device capable of making medical information of an object person to be mutually and efficiently grasped among care workers, nursing assistants, nurses and doctors and performing highly accurate diagnosis support.SOLUTION: In a diagnosis support device 1, an operation part 2 includes information input means 23 of a tablet terminal 3, information recording means 24, reference calculation means 5, determination processing means 6, or the like. The operation part 2 generates life support factor information, extracts diagnosis contribution candidate information, notifies abnormality based on the life support factor information, creates a vital thermal type table, performs scoring based on contents of vital information, sets a scoring condition, determines abnormality in score value information, sets determination reference of abnormality about a score value, notifies a determination result about the score value, determines abnormality in a value of a vital sign, sets determination reference of abnormality about the value of the vital sign, notifies a determination result about the value of the vital sign, and creates and displays display information.SELECTED DRAWING: Figure 1

Description

The present invention relates to software and a diagnostic support device. For details, software that enables caregivers, nursing assistants, nurses, and doctors to efficiently grasp the medical information of the target person and provides highly accurate diagnostic support for doctors' diagnosis. And related to diagnostic support equipment.

For inpatients in hospitals, nursing care facilities, or elderly people who receive home medical care at home, multiple occupations such as caregivers, nursing assistants, nurses, and doctors work together to provide medical care. The offer is being made.

Among these occupations, caregivers and nursing assistants who provide various life support in the lives of the target people have increasing needs for their occupations due to the increase in the number of target people due to the aging and longevity of the population. ing.

Nursing assistants are occupations that assist the work of doctors and nurses, mainly in the work of supporting the lives of the target people, although they do not perform medical treatment in hospitals, etc., and are also called nursing assistants. ..

In addition, the contents of life support include, for example, assistance such as meals, bathing, excretion, movement, and management of medicines to be taken regularly, and the work of supporting the life of the target person is the center.

In addition, the information on the content of life support provided by the caregiver and nursing assistant verifies the purpose of sharing information on the condition of the target person among the staff such as the caregiver and whether the content of the life support provided was appropriate. It is recorded as a life support record (nursing record) on a paper medium or an electronic medium using nursing care recording software or the like for the purpose of doing so.

For example, in the life support record, for each subject, the amount of food for the day is described as "completed or leftover", and the amount of urination or defecation is described as "large, normal, small, none" or "yes," None "is described.

In addition, strict rules have not been established for the description format of life support records, and the current situation is that the description contents are different depending on the caregiver and nursing assistant who creates the record, the hospital, or the care facility. is there.

Further, in order to reduce the burden of creating a life support record, for example, there is an input support program described in Patent Document 1.

Here, the input support program described in Patent Document 1 accepts the selection of the long-term care action performed for a specific long-term care person from a plurality of types of long-term care actions, and stores the symptoms of the long-term care person. With reference to, the symptom of the specific long-term care person is identified, and one or a plurality of information input candidates relating to one or a plurality of long-term care according to the combination of the selected long-term care action and the specified long-term care. Is displayed, and the computer is made to execute a process of registering the selected care action and the selected information input candidate among the one or a plurality of information input candidates in association with the care recipient.

Japanese Unexamined Patent Publication No. 2016-81236

However, the conventional life support records, including the input support program described in Patent Document 1, are difficult for nurses and doctors to use as medical information about the subject.

That is, since the life support record is created with the above-mentioned contents, the information as recorded (or input) by the caregiver or the nursing assistant can be used by the nurse to grasp the health condition of the patient, etc., and by the doctor. It is difficult to use as reference information for diagnosis.

In the first place, life support records are not created for the purpose of contributing to doctors'diagnosis, so if nurses or doctors need information on life support records when grasping or diagnosing symptoms, the contents Had to be used after analyzing and organizing.

Furthermore, regarding the information recorded numerically such as the amount of drinking water, it was necessary for the nurse to extract the value for the required number of days, perform the calculation, and convert it into the information required by the doctor.

On the other hand, among the occupations involved in providing medical care, the occupations that are closest to the target person and have familiar information on a daily basis are not nurses and doctors but caregivers and nursing assistants.

Therefore, the information in the life support record may include important reference information in diagnosis and the like, and has the property of being extracted as an appropriate range and content as necessary. Nevertheless, in the medical field, the information in the life support record cannot be used efficiently.

In addition, as records that nurses and doctors handle on a daily basis, there are nursing records created by nurses and doctor records created when doctors perform medical examinations. For example, nursing records and doctor records are stored separately or recorded as separate documents in one electronic medical record.

In addition to nursing records and doctor records, the vital sign values of the subjects are measured and the values for each measurement day are recorded in paper-based records and electronic medical records, and recorded for a predetermined number of days. Is graphed, and a thermal chart is created to confirm the fluctuation tendency of vital sign values.

This fever type table is information that is used on a daily basis when diagnosing a doctor and grasping a nurse's medical condition.

Here, when diagnosing a doctor, there are few cases in which the doctor himself looks at the contents of the nursing record, fever type table, etc. and searches for the information necessary for the diagnosis.

In this case, the doctor asks the nurse about the information he / she wants to know, or the nurse extracts the information necessary for diagnosis from the recorded contents such as the nursing record and reports it to the doctor. Gets the information needed for diagnosis.

For example, among the information described in nursing records, doctors need the presence or absence of symptoms such as fever, items for which abnormalities have been confirmed by observation or interviews, changes in vital sign values, and abnormalities. This is information when the value of the vital sign is given. On the other hand, information on regular medicines that the subject is taking on a regular basis is often not required for diagnosis.

In other words, with regard to nursing records, doctors rarely use the recorded contents as they are, and items that are particularly noteworthy, such as the latest symptoms and sudden changes in vital signs (pathology peculiar to each disease). Information on how much the factor is confirmed) is needed.

In addition, there are few cases in which nurses check the contents of doctor records and use them to grasp the medical condition of the subject, and the current situation is that the medical condition of the subject is grasped based on the content verbally supported by the doctor. Is.

Therefore, it is difficult to efficiently utilize the recorded information not only for life support records but also for nursing records and doctor records among a plurality of occupations involved in providing medical care.

The present invention was devised in view of the above points, and the caregiver, the nursing assistant, the nurse, and the doctor can efficiently grasp the medical information of the subject and can efficiently grasp the medical information of the subject. It is an object of the present invention to provide software and a diagnostic support device capable of providing highly accurate diagnostic support for a doctor's diagnosis.

In order to achieve the above object, the software of the present invention provides vital heat type table information obtained by graphing the vital information in chronological order based on the measured vital sign values, and living support. The life support record information, which is the content information, and the diagnosis contribution information, which contributes to the diagnosis of the doctor screened based on the nursing record information including at least one information of the individual's medical condition or observation result, are aggregated. It is software for generating the list screen information to be displayed and supporting the diagnosis of the doctor for the individual, and the information processing device is used to measure the vital information from the same individual, the information on the measurement date and time of the vital information, and the like. The information input means that accepts at least a part of the life support record information, the nursing record information, and the diagnosis contribution information, and all or a part of the input plurality of the life support record information are subjected to the diagnosis contribution. The structured processing means for converting into life support factor information that can be used as information, and the diagnosis contribution information for inputting the life support factor information satisfying a predetermined condition when accepting the input of the diagnosis contribution information. The risk life support factor generation means to be generated as the diagnostic contribution candidate information, the input vital information, the measurement date and time information of the vital information, the life support record information, the nursing record information, and the life support. An information recording means for recording factor information in association with an individual identification information that can identify an individual, and a vital heat type that generates the vital heat type table information of all or a part of the plurality of recorded vital information. The table processing means and at least the display information processing means for generating the list screen information including the individual identification information, the vital heat type table information corresponding to the individual identification information, and the diagnosis contribution information in the display information are included. It is configured as software to function as a means. In this specification, the software is a program related to the operation of a computer. A program is a program consisting of an ordered sequence of instructions suitable for processing by a computer.

Here, the information input means accepts the input of vital information, life support record information, and nursing record information measured from the same individual, and the vital information, life support record information, and life support record information input to the information recording means are received. By recording the nursing record information, the vital information, the life support record information, and the nursing record information of the same individual can be accumulated. The same individual as used herein refers to a subject to be diagnosed by a doctor. In addition, the same individual also refers to a determination target for determining whether or not the measured vital sign value is an abnormal value.

Further, the "vital information measured from the same individual" referred to here means that the individual can be distinguished at the stage of input by the information input means. For example, input such as a mode in which one target person inputs his / her own vital information, or a mode in which a specific personal input screen is displayed and vital information is input when handling information of a plurality of target persons. It is conceivable to distinguish individuals by different forms for doing so.

In addition, since the diagnosis contribution information is screened based on the life support record information, which is the information on the contents of the life support, it becomes possible to obtain the information that can be used as a reference for the diagnosis of the target person based on the contents of the life support. .. That is, for example, information that can be used as a reference for diagnosis can be obtained from information such as the amount of food, the amount of drinking water, and the amount of urination confirmed from the subject through the life support work performed by the caregiver or the nursing assistant.

In addition, the diagnosis contribution information was screened based on the nursing record information including at least one of the information of the individual's medical condition or the observation result, and the subject was based on the contents of the nursing performed by the nurse to the subject. It becomes possible to obtain information that can be used as a reference for a person's diagnosis. The medical condition of the individual referred to here is, for example, information on the presence or absence or degree of fever, the presence or absence or degree of headache, abnormalities recognized as a result of interviews with the subject, subjective symptoms, objective symptoms, and the like. Further, the observation result referred to here is information such as, for example, the complexion of the subject, the presence or absence or degree of swelling of the body, a decrease in muscular strength and tendon reflex, and a reaction to conversation.

In addition, the structured processing means converts all or part of the input plurality of life support record information into life support factor information that can be used as diagnostic contribution information, so that the information of the life support record can be obtained. The contents will be easy for nurses to grasp the health condition of the target person and for the diagnosis of doctors, and it will be easy for nurses and doctors to grasp the contents of the information in the life support record.

In addition, when the risk life support factor generation means accepts the input of the diagnosis contribution information, the life support factor information satisfying a predetermined condition is generated as the diagnosis contribution candidate information of the diagnosis contribution information to be input, thereby supporting the life. From the contents of the factor information, it becomes easy to grasp the information satisfying the predetermined conditions as information useful for the diagnosis of the subject.

In addition, the structured processing means converts all or part of the input plurality of life support record information into life support factor information that can be used as diagnostic contribution information, and the risk life support factor generation means When accepting the input of the diagnosis contribution information, the life support factor information satisfying a predetermined condition is generated as the diagnosis contribution candidate information of the diagnosis contribution information to be input, and the information input means is at least a part of the diagnosis contribution information. By accepting the input, it becomes easy to present the information satisfying the predetermined conditions to the doctor as the information necessary for the diagnosis of the subject from the contents of the life support factor information. That is, for example, when examining information that a nurse should report to a doctor from the contents of a life support record, as information on items that should be particularly noted (how much a pathological factor peculiar to each disease is confirmed). , It becomes easy to select information that meets the predetermined conditions.

In addition, the information recording means links the input vital information, the measurement date and time information of the vital information, the life support record information, the nursing record information, and the life support factor information with the individual identification information capable of identifying the individual. By attaching and recording, various information can be recorded and accumulated in association with the individual. The term "individual" as used herein means a single organism (human or animal). The present invention includes a mode of recording information of a single same individual and a mode of recording information of a plurality of the same individual for each same individual with a single software. The same individual means, for example, the same person in the case of a human being.

In addition, the vital heat type table processing means generates vital heat type table information of all or a part of the recorded vital information, so that the vital heat type table of the subject can be easily confirmed. In addition, it is possible to save the trouble of a nurse or the like creating a vital heat type table.

In addition, the information input means receives at least a part of the diagnosis contribution information, and the display information processing means includes the individual identification information, the vital heat type table information corresponding to the individual identification information, and the diagnosis contribution information in the display information. By generating the screen information, it is possible to easily obtain information that can be used as a reference when diagnosing the target person simply by checking the list screen information. That is, for example, a nurse screens information that is considered necessary for diagnosis from life support record information, life support factor information, and nursing record information, and selects and inputs it via an information input means to contribute to diagnosis. And. Then, the doctor confirms the diagnosis contribution information of the subject on the list screen information, omitting the work of hearing the nurse and analyzing the contents by looking at the nursing record and the life support record, and makes a diagnosis. It becomes possible to obtain the necessary information. In addition, from the information in the vital heat type table, the vital fluctuation of the subject and the abnormal value in the vital sign value can be easily confirmed, and can be used as reference information for diagnosis.

Further, the list screen information is information that aggregates and displays the vital heat type table information and the diagnosis contribution information, and the display information processing means is the vital heat type table information corresponding to the individual identification information and the individual identification information. By generating list screen information that includes diagnosis contribution information in the display information, nurses, doctors, caregivers, and nursing assistants can display the vital fever type table of individual subjects and diagnosis contribution information on the list screen information. You can easily grasp the contents just by checking. That is, the vital heat type table and the diagnosis contribution information can be easily shared among a plurality of occupations in an organized state.

Further, the information input means receives the vital information measured from the same individual, and the information recording means records the input vital information, whereby the vital information of the same individual can be accumulated.

In addition, the information input means accepts the input of the vital information measured from the same individual and the information of the measurement date and time, and the information recording means records the input vital information and the information of the measurement date and time, thereby causing the vitals of the same individual. The information will be accumulated together with the information on the date and time of measurement. That is, it is possible to handle a plurality of vital information of the same individual in association with the information of the measurement date and time. Further, when comparing different vital information, it is possible to confirm the displacement status and the displacement amount between the vital information to be compared. The measurement date and time information referred to here is automatically used in the information input means when the input person inputs the measurement date and time information when the vital information is input to the information input means and the time when the vital information is input. Aspects to be input are included.

In addition, when the information recording means records disease information including information on the type of disease including the name of the disease and information on pathological factors specified for each type of disease, the type of disease and its link. Information on pathological factors will be available when screening diagnostic contribution information.

In addition, when accepting the input of diagnostic contribution information, the deficient pathological factor generating means is the nursing record information or the life support record information which is the basis of the screened diagnosis contribution information, and the life support satisfying the predetermined conditions. When extracting disease information having a pathological factor related to factor information, and generating information on a pathological factor different from the related pathological factor from the extracted disease information as diagnostic contribution candidate information or diagnostic contribution information. Makes it easier to present to the doctor information that can be used as a reference for more accurate diagnosis. That is, for example, the deficient pathological factor generation means is related from the contents of the diagnosis contribution information screened by the nurse based on the nursing record information, the life support record information, and the life support factor information satisfying a predetermined condition. Extract candidates for the type of disease, including pathological factors. Then, the deficient pathological factor generating means further extracts the pathological factors that are not the basis of the diagnostic contribution information screened by the nurse, and the diagnostic contribution candidate information is generated. This generated diagnostic contribution candidate information is information on pathological factors of the disease that the subject may have, and the nurse could not grasp it from the contents of the nursing record or the like, or further confirmed it. Information on items to be used. That is, the diagnosis contribution candidate information can be used as additional reference information for identifying the type of illness from the information on the screening result of the nurse and the illness information. As a result, it becomes possible to present more accurate reference information in the diagnosis. Furthermore, if the information generated by the deficient pathological factor generating means does not serve as diagnostic contribution candidate information but directly serves as diagnostic contribution information, the information directly confirmed by the doctor without screening by a nurse. It can also be.

In addition, the life support record information includes at least the information on the amount of meals, and as the life support factor information, the amount of meals is compared with the ratio of eating meals in a predetermined number of days or the threshold value for the calories of meals by the structured processing means. When converted into a result, it becomes possible to easily confirm whether or not the food amount of the subject satisfies a predetermined condition, and it becomes information that is easy to use for grasping and diagnosing the health condition. The comparison result with the threshold value here is, for example, quantifying the ratio of meals for several days, and if the ratio of the amount of meals eaten exceeds the set standard value, it is regarded as ○ and is equal to or less than the standard value. If so, the result information is x. In addition, for example, the calorie of the amount of food consumed by the subject in several days is calculated, and if the amount of calorie ingested exceeds the set standard value, it is evaluated as ○, and if it is less than the standard value, it is evaluated as ×. The result information.

In addition, the life support record information includes at least information on the amount of water consumed, and as the information on the amount of water consumed, the amount of water consumed is converted into a comparison result with the threshold value for the amount of water consumed in a predetermined number of days by the structured processing means. In this case, it becomes possible to easily confirm whether or not the amount of drinking water of the subject satisfies the predetermined condition, and the information becomes easy to use when grasping the health condition and diagnosing. The comparison result with the threshold value referred to here is, for example, if the amount of drinking water (ml) for several days is acquired and the amount of drinking water exceeds the set reference value, it is regarded as ○, and it is equal to or less than the reference value. It is the information of the result such as x.

Further, when the life support record information includes at least the information on the amount of urination, and the amount of urination is converted into the comparison result with the threshold value for the amount of urination in a predetermined number of days by the structured processing means as the life support factor information. Can easily confirm whether or not the urination volume of the subject satisfies a predetermined condition, and is information that is easy to use for grasping and diagnosing the health condition. The comparison result with the threshold value referred to here is, for example, obtained the amount of urination (ml) for several days, and if the amount of urination is within the set reference value range, the upper limit reference value is set as ○. It is the information of the result such as × when it exceeds or falls below the lower limit reference value.

Further, when the life support record information includes at least the information on the defecation amount and is converted into the comparison result of the defecation amount with the threshold value for the defecation amount in a predetermined number of days by the structured processing means as the life support factor information. Can easily confirm whether or not the defecation volume of the subject satisfies a predetermined condition, and is information that is easy to use for grasping and diagnosing the health condition. The comparison result with the threshold value referred to here may be, for example, once or more as x if the information on the presence or absence of defecation for several days is acquired and the defecation amount is 0 times in the set number of days. It is the information of the result such as ○.

In addition, the life support record information includes at least information on the state of urine, and as life support factor information, comment information on the state of urine, hematuria, urine turbidity, urine odor, and other urine is input by the structured processing means. Then, when it is converted into an abnormal urine condition, it becomes possible to easily confirm whether or not the urine condition of the subject is abnormal, and it becomes information that is easy to use for grasping and diagnosing the health condition.

In addition, the life support record information includes at least information on the stool status and the bathing status, and as the life support factor information, the stool status, loose stool, bloody stool, and other stool comment information are input by the structured processing means. Then, when it is converted into an abnormal stool condition, it becomes possible to easily confirm whether or not the stool condition of the subject is abnormal, and the information is easy to use for grasping and diagnosing the health condition.

In addition, when the life support record information includes at least the information on the bathing state and the information on the reason why the bathing state is stopped by the structured processing means is input as the life support factor information, the bathing is stopped. When converted, it becomes possible to easily confirm that the subject has stopped bathing, and the information is easy to use for grasping and diagnosing the health condition. The reasons for discontinuing bathing here are, for example, discontinuation due to fever, discontinuation due to an increase in blood pressure, discontinuation due to eczema / internal bleeding, and the like.

In addition, when the nursing record information includes the temporary drug information which is the information of the temporary drug administered to the individual, the information of the temporary drug administered to the individual can also be used when screening the diagnostic contribution information. Become. In addition, the temporary medicine mentioned here includes a medicine that is mainly composed of an antipyretic and the like, and a prescription medicine that is prescribed based on a doctor's diagnosis.

In addition, the information recording means records the drug information which is the drug information and the temporary drug information which is the information of the temporary drug administered to the individual, and the display information processing means displays the vital sign in the vital heat type table information. The above-mentioned information including the display of the vital signs to be changed on the day when the temporary drug having the effect of changing the value was administered to the individual, different from the display of the vital signs on other days. When generating list screen information, it becomes easier to perform subsequent changes in vital signs, observation / diagnosis, etc., in consideration of the effect of the temporary drug being administered to the subject. That is, for example, when it is recorded that a prescription drug having an antipyretic effect is prescribed as a temporary drug, the body temperature of the administration date in the vital fever type table information is displayed (for example, it is indicated by a white circle in the vital fever type table). Can be displayed in a manner different from the display of body temperature on other days (usually displayed by black circles). As a result, even if the subject's body temperature drops and is displayed on the vital fever type table on the day after the administration date of the drug, it is a temporary decrease in body temperature due to the effect of the drug, and the subject's own body temperature. It becomes easier to understand that it is not the result of guaranteeing that the symptoms have improved or that the person is in good physical condition.

In addition, when the reference calculation means calculates the average μ of all or part of the recorded vital information, it is possible to use the information of the average value of the vital information reflecting the intra-individual variation of the same individual. Become. The average μ here means a value obtained by dividing the “total number of vital value data” by the “total number of vital value data”. Further, the "average μ of a plurality of recorded vital information" referred to here includes not only the one calculated from all the recorded vital information data but also the one calculated from a part of all the data. There is. Further, the vital information on which the average μ is calculated may be calculated not only from continuous data, for example, data measured continuously every day, but also from data extracted at intervals of days.

Further, when the standard calculation means calculates the standard deviation σ of all or part of the recorded vital information, the standard deviation information of the vital information reflecting the intra-individual variation of the same individual can be used. It becomes. The standard deviation σ referred to here is the “root mean square of deviation” of vital information for a predetermined period. Furthermore, the "deviation" is a value obtained by subtracting the "average value of the vital values of the predetermined period" from the "each vital value" of the vital information of the predetermined period. Further, the "standard deviation σ of a plurality of recorded vital information" referred to here includes not only the one calculated from all the recorded vital information data but also the one calculated from a part of all the data. I'm out. Further, the vital information on which the standard deviation σ is calculated may be calculated not only from continuous data, for example, data measured continuously every day, but also from data extracted at intervals of days. ..

Further, when the reference calculation means calculates at least one of all or a part of the recorded vital information selected from the average μ and the standard deviation σ, any one of the average μ and the standard deviation σ. One can be calculated. It is also possible to calculate both the mean μ and the standard deviation σ.

Further, the vital determination means determines whether or not the input predetermined vital information is an abnormal value based on a predetermined numerical range set based on at least one selected from the average μ and the standard deviation σ. In the case of determination, it is possible to determine whether or not the vital information of the same individual is an abnormal value based on the criteria reflecting the intra-individual variation of the same individual. That is, since the predetermined numerical range serving as the judgment standard is set by using the average value and standard deviation calculated from the vital information accumulated for the same individual, it is unique to the same individual and the average of the vital information. Whether or not it is abnormal can be determined based on the criteria that reflect the dispersion from the values and average values. The "input predetermined vital information" referred to here means the vital information to be determined. Further, the "predetermined numerical range" referred to here is a numerical range set including the input predetermined vital information, that is, the predetermined vital information to be determined, and the predetermined vital to be determined. It does not include information, but includes both of the numerical ranges set from the previous vital information. In addition, the "predetermined numerical range" is a mode in which a reference value, for example, an upper limit value is set and the numerical value to be determined becomes "abnormal" when the numerical value to be determined exceeds the upper limit value, and the upper limit value is set. It includes both aspects that are considered "abnormal" when exceeded. The input predetermined vital information can be the most recently input vital information. In addition, the input predetermined vital information can be one or more vital information of the previously input vital information.

In addition, the vital signs include vital signs that follow a normal distribution, the vital information includes values determined by the vital determination means as abnormal values, and the vital information of at least 30 measurement data includes individual-specific individuals. Reflecting internal fluctuations, the normal distribution is created from vital information of at least 30 measurement data, so that vital information can be used as a biomarker to realize personalized medicine, especially in the chronic phase. Deterioration of the subject's condition can be detected at an early stage. That is, vital information can be used as a "biomarker" that differs for each individual.

Further, in the present invention, the "vital information of 30 measurement data" is broadly the data of vital information measured every second, for example, every minute, every few minutes, every hour, 1 It includes data with different lengths of time, such as vital information data measured daily and monthly. Further, the "vital information of 30 measurement data" includes not only the data regularly acquired at regular intervals such as the above-mentioned every second or every minute, but also irregularly acquired data. Data is also included. For example, at least 30 pieces of data (for example, 1 second, 3 seconds, 6 seconds, 7 seconds, 9 seconds, etc.) acquired irregularly instead of being acquired at regular intervals in 1 minute (60 seconds). Acquisition) can be adopted. Also, for example, at least 30 data irregularly acquired in 30 minutes, at least 30 data irregularly acquired in 1 hour, and at least 30 irregularly acquired in several hours. Data, at least 30 data acquired irregularly in a day, at least 30 data acquired irregularly in a few days, at least 30 data acquired irregularly in a week, At least 30 data irregularly acquired in a few weeks, at least 30 data irregularly acquired in a month, etc. shall be adopted as "vital information of 30 measurement data". Can be done. Furthermore, at least 30 pieces of data are randomly extracted from the accumulated vital information regardless of regular intervals or irregular intervals, and adopted as "vital information of 30 pieces of measurement data". be able to. As will be described later, a normal distribution that reflects the intra-individual variation of the subject can be obtained by acquiring at least 30 measurement data regardless of the length of time or the regularity of the measurement interval.

In addition, the vital signs include vital signs that follow a normal distribution, and the vital information of at least 30 measurement data reflects the intra-individual variation peculiar to the individual, and the normal distribution is the measurement data of at least 30 pieces. By creating from the vital information, it becomes possible to sufficiently capture the abnormal value of the vital sign in the target individual by the vital determination means.

Here, the technical significance of adopting "measurement data for 30 pieces" in the present invention will be described. More specifically, regardless of the length of time or the regularity of measurement intervals, if at least 30 measurement data of vital signs are acquired, a normal distribution reflecting the intra-individual variation of the subject can be obtained. Explain the points that can be done.

According to the studies so far, if at least 30 measurement data can be obtained for vital data obtained from the same individual, the measurement data will be normally distributed reflecting the intra-individual variation for each subject. It was confirmed.

For example, as shown in FIGS. 19 to 26, when the pulse is measured under each condition, if 30 measurement data are prepared, a normal distribution curve different for each subject can be obtained based on the measured data. It became. 19, FIG. 21, FIG. 23 and FIG. 25 are the results of the pulse obtained from the same subject (referred to as Mr. A here), and FIGS. 20, 22, 24 and 26 are different identical subjects. It is the result of the pulse obtained from the person (referred to as Mr. B here). In FIGS. 19 to 26, 30 measurement data are shown, and the circles on the curve correspond to one measurement data, but since there are a plurality of overlapping data centered on the average value, they are shown on the drawing. Then, the circles for 30 pieces do not appear.

More specifically, in FIGS. 19 and 20, it is a graph based on the result of measuring the pulse every minute and acquiring the measurement data of 30 pulses. In each case, the results showing the shape of the normal distribution with the average value as the apex were obtained. In addition, Mr. A and Mr. B have different average values at the vertices, and the values (minimum value and maximum value) located at both ends of the curve are also different. Therefore, it is clear that an individual normal distribution can be obtained. Regarding this point, the same tendency was confirmed in FIGS. 21 to 26.

Further, FIGS. 21 and 22 are graphs based on the result of measuring the pulse every 7 minutes and acquiring the measurement data of 30 pulses. In this way, even when the measurement time interval was changed, the shape of the normal distribution with the average value of each subject as the apex was obtained.

In addition, FIGS. 23 and 24 are graphs based on the results of acquiring measurement data of 30 pulses at irregular times in a day. Further, FIG. 25 is a graph based on the result of acquiring measurement data of 30 pulses at irregular times in 30 hours, and FIG. 26 is an irregular time in 30 days. It is a graph based on the result of acquiring the measurement data of 30 pulses. As shown here, even if the data is not regularly acquired at regular intervals, if 30 measurement data are acquired, the data will have a normal distribution shape with the average value of each subject as the apex. It was confirmed to take.

Further, for example, as shown in FIGS. 27 and 28, if 30 measurement data are prepared for body temperature, a normal distribution curve different for each subject can be obtained based on the measured data. .. 27 and 28 are graphs based on the results of measuring body temperature every 2 minutes and acquiring measurement data of 30 body temperatures. Further, in FIGS. 27 and 28, the subjects whose body temperature was measured are different. In this way, it was confirmed that even with body temperature, if 30 measurement data were acquired, the data would take the form of a normal distribution with the average value of each subject as the apex.

From the measurement data for 30 pieces, it was confirmed that not only the pulse and body temperature but also the blood pressure (systolic blood pressure and diastolic blood pressure), pulse pressure, and respiratory rate can be obtained as a normal distribution for each individual.

Therefore, the present inventor can obtain a normal distribution that reflects the intra-individual variation of the subject by acquiring at least 30 measurement data for vital signs regardless of the length of time or the regularity of the measurement interval. We have found the possibility that it can be obtained and can be used as a biomarker, and have reached the present invention.

That is, regardless of the length of time and the presence or absence of regularity of measurement intervals, by acquiring at least 30 vital information and obtaining a normal distribution, the physiological parameters (vital signs) of the target individual can be observed. The values of vital signs that make up that one cycle can be confirmed. In other words, if 30 vital information is used, it is possible to sufficiently capture the abnormal value of vital signs in the target individual, and the present invention pays attention to this point.

Further, the vital determination means uses the average μ, the standard deviation σ, and n and m, which are numbers larger than 0, to express the value of the following equation (1) as the lower limit value and the value of the equation (2) as the upper limit value. When determining whether or not the input predetermined vital information is an abnormal value based on at least one of the lower limit value and the upper limit value, a numerical value separated by a value of nσ in the negative direction from the average μ. It is possible to determine whether or not there is an abnormality in the value of vital information, using the lower limit value and the upper limit value separated from the average μ by the value of mσ.
μ-nσ ・ ・ ・ Equation (1)
μ + mσ ・ ・ ・ Equation (2)
That is, whether or not the value obtained by subtracting nσ from the average μ is the lower limit value and the value obtained by adding mσ to the average μ is the upper limit value with respect to the vital information measured from the same individual based on at least one of these values. Can be determined. As described above, the values of n and m may be numbers larger than 0, and the values of n and m can be used for various conditions such as the strictness of the standard, the type of vital signs, and the history of the subject. It can be set as appropriate in consideration. Further, since it is "at least one of the lower limit value and the upper limit value", it includes not only a mode in which only the lower limit value or only the upper limit value is set as a reference, but also a mode in which both the lower limit value and the upper limit value are adopted as a reference. Further, the values of the equations (1) and (2) here are numerical ranges set based on the normal distribution with the average μ as the peak value.

Further, when the display information processing means generates the list screen information including the information of the average μ and the predetermined numerical range on each input date in the vital heat type table information, the vital information can be obtained from the vital heat type table. The average μ on each input day and the range for determining whether or not the vital information on that day is abnormal (reference range for abnormality determination) can be easily confirmed. At the same time, it becomes possible to easily confirm whether or not the measured vital sign value is within the reference range (whether or not it is an abnormal value). As a result, it becomes easier to visually grasp the presence or absence of abnormalities in the vital information of the target person and fluctuations in the vital information.

In addition, the information recording means further, among the information on the subjective symptom and the objective symptom acquired from the individual when the individual is diagnosed as having a specific disease, and the vital information of the individual, the vital determination means. When the pattern information of the change of vital information determined to be an abnormal value is linked to the identification information of the individual and recorded as the history information of the individual, the symptom peculiar to the subject or the abnormality of the vital information is recorded. It will be easier to check the appearance of. As a result, it is possible to provide information that can be used as a reference for more accurate diagnosis based on the medical history information. The change pattern information of the vital information determined by the vital determination means as an abnormal value is, for example, the vital abnormality observed before and after the individual is diagnosed as having a specific disease. This information indicates changes in vital information before and after the value of vital abnormalities appears. That is, for example, there is a tendency for the body temperature to rise for several days before the diagnosis.

In addition, the scoring processing means scores the input predetermined vital information based on the predetermined scoring conditions, and calculates the score result information which is the value of the score, so that the input vital information can be obtained. , Can be converted into score result information (points) according to the content.

In addition, when the predetermined scoring conditions are set based on a normal distribution with at least the average μ as the peak value, when the measured values of vital signs obtained from the same individual are input as vital information, the average. According to the standard set based on the normal distribution with μ as the peak value, it is possible to obtain the score result information according to the content. In addition, the standard set based on the normal distribution with the average μ as the peak value at this time is a standard that reflects the intra-individual variation of the same individual, and the vital information of the same individual is reflected in the state that reflects the intra-individual variation. It becomes possible to score. The "input predetermined vital information" referred to here means vital information to be scored. Further, the "predetermined scoring condition set based on the normal distribution with at least the average μ as the peak value" here refers to the input predetermined vital information, that is, the predetermined vital information to be scored. It includes both those set by including and those set from the past vital information before that without including the predetermined vital information to be scored. Further, the input predetermined vital information can be the most recently input vital information. In addition, the input predetermined vital information can be one or more vital information of the previously input vital information.

In addition, when the score determination means determines the degree of risk of abnormality by dividing all total points or some points of the score result information into at least two stages or more based on a predetermined score determination condition. , The degree of risk of abnormality can be determined for the value of the score result information obtained from the contents of vital information acquired from the same individual. It should be noted that the determination based on the predetermined score determination condition here is a mode for determining whether or not the score result information obtained from one vital sign is an abnormal value, or the sum of a plurality of score result information. It is possible to make a judgment based on a point, and further, a mode of judging a combination of two or more score result information.

In addition, for at least one measured value selected from body temperature, blood pressure, pulse and pulse pressure as a predetermined scoring condition, mean μ, standard deviation σ, and n and m which are numbers larger than 0 are used. When the value of the following equation (1) is used as the lower limit value and the value of equation (2) is used as the upper limit value, and at least one of the lower limit value and the upper limit value is used as a reference, nσ in the negative direction from the average μ. It is possible to score using the value separated by the lower limit value and the value separated by the average μ to mσ as the upper limit value.
μ-nσ ・ ・ ・ Equation (1)
μ + mσ ・ ・ ・ Equation (2)
That is, the lower limit is the value obtained by subtracting nσ from the average μ, and the upper limit is the value obtained by adding mσ to the average μ, and the measured values of body temperature, blood pressure, pulse, and pulse pressure measured from the same individual based on at least one of these. However, score result information can be obtained. In addition, when the measured values of body temperature, blood pressure, pulse and pulse pressure obtained from the same individual were input as vital information, the contents were adjusted according to the criteria set based on the normal distribution with the average μ as the peak value. It is possible to obtain score result information. In addition, the standard set based on the normal distribution with the average μ as the peak value at this time is a standard that reflects the intra-individual variation of the same individual, and the vital information of the same individual is reflected in the form that reflects the intra-individual variation. It becomes possible to score. In addition, "scoring" here means that when a reference value, for example, a constant value is set, the numerical value to be scored becomes 2 points when the numerical value is equal to or more than the constant value, and 1 point when the numerical value is less than the constant value. It includes both the aspect and the aspect in which 2 points are given when the numerical value to be scored exceeds a certain value and 1 point is given when the numerical value is below a certain value. Further, the values of n and m may be numbers larger than 0 as described above, and the values of n and m can be used for various conditions such as the strictness of the standard, the type of vital signs, and the history of the subject. It can be set as appropriate in consideration. Further, since it is "at least one of the lower limit value and the upper limit value", it includes not only a mode in which only the lower limit value or only the upper limit value is set as a reference, but also a mode in which both the lower limit value and the upper limit value are adopted as a reference. Further, the values of the equations (1) and (2) here are numerical ranges set based on the normal distribution with the average μ as the peak value.

Further, when the display information processing means includes all the total points or some points of the score result information in a predetermined number of days in the display information and generates the list screen information, the score result information of the target person is passed over time. It becomes easy to grasp the signs that the subject's physical condition is abnormal, and it becomes reference information for raising the observation level of the subject. That is, for example, by displaying the total score of all the score result information of the target person for that day together with the number of days for displaying the vital heat type table, the total score of the score result information is a constant value (for example, 3 points or more). ) Can be easily confirmed. For example, in elderly people with chronic diseases, the onset of illness or deterioration of physical condition does not occur on the day when the total score of the score result information exceeds a certain value, and the onset of illness occurs several days later. It often occurs. Therefore, when the total score of the score result information exceeds a certain value, it is regarded as a sign that the onset of illness or deterioration of physical condition may occur, and the total score of the score result information after the day is constant. Even if it is less than the value, it will be easier to observe carefully.

In addition, when the display information processing means further includes all or part of the life support record information and all or part of the nursing record information in the display information and generates the list screen information, the life support record The detailed contents of the information and the nursing record information can be easily grasped by checking the list screen information.

Further, the information input means accepts the input of the doctor record information which is the information of the diagnosis for the individual doctor, and the information recording means records the input doctor record information in association with the individual identification information, and displays the information processing means. Furthermore, when the display information includes the doctor record information and the list screen information is generated, the content of the doctor's diagnosis result information can be easily grasped by checking the list screen information. Become.

Further, in order to achieve the above object, the diagnostic support device according to the present invention is a vital heat type table in which the vital information for a predetermined period is graphed based on the vital information which is the value of the measured vital signs. Diagnostic contribution that contributes to the diagnosis of doctors screened based on information, life support record information that is information on the content of life support, and nursing record information that includes at least one information of an individual's medical condition or observation result. It is a diagnostic support device for supporting a doctor's diagnosis of an individual by generating list screen information that aggregates and displays the information, and is the vital information measured from the same individual and the measurement date and time of the vital information. Information, the life support record information, the nursing record information, and an information input means that accepts at least a part of the diagnosis contribution information, and all or a part of the plurality of input life support record information. The structured processing means for converting into life support factor information that can be used as the diagnosis contribution information, and the life support factor information satisfying a predetermined condition when accepting the input of the diagnosis contribution information. Risk life support factor generation means generated as diagnosis contribution candidate information of diagnosis contribution information, input vital information, information on measurement date and time of the vital information, life support record information, nursing record information, and An information recording means for recording the life support factor information in association with the individual identification information that can identify an individual, and the vital heat type table information of all or a part of the plurality of recorded vital information are generated. Vital heat type table processing means, and at least display information processing means for generating the list screen information including the individual identification information, the vital heat type table information corresponding to the individual identification information, and the diagnosis contribution information in the display information. , A display means capable of displaying the list screen information generated by the display information processing means.

The software and the diagnostic support device according to the present invention can efficiently grasp the medical information of the subject between the caregiver, the nursing assistant, the nurse and the doctor, and can accurately diagnose the doctor. It is possible to provide high diagnostic support.

It is a figure which shows the schematic structure of the tablet terminal which introduced the software to which this invention is applied (the first system structure). It is the schematic which shows the 2nd system configuration which has the software to which this invention is applied. It is the schematic which shows the 3rd system configuration which has the software to which this invention is applied. It is a block diagram which shows the structure of the calculation unit, the information transmission / reception unit, and the information recording unit. It is a schematic diagram which shows an example of setting of the calculation period of a vital average value and a vital standard deviation. It is the schematic which showed the example of the extraction of vital information. (A) is a schematic diagram showing an example of an apparatus used when operating software to which the present invention is applied, and (b) is a schematic diagram showing another example of the apparatus. It is the schematic which shows an example of the input screen of the value of vital signs. It is the schematic which shows the other example of the input screen of the value of vital signs. It is a schematic diagram which shows an example of a life support record screen. It is a schematic diagram which shows an example of a nursing record screen. It is a schematic diagram which shows an example (congestive heart failure) of the elderly dictionary screen. It is a schematic diagram which shows an example (chronic heart failure) of the elderly dictionary screen. It is a schematic diagram which shows an example (pneumonia) of the elderly dictionary screen. It is the schematic which shows an example of the medication list screen. It is the schematic which shows an example of the list display screen. (A) is a graph of a normal distribution curve created based on the vital information of a plurality of subjects, and (b) is a graph of a normal distribution curve created based on the vital information of the same subject. is there. It is a flow chart which shows the flow of information processing from input of vital information to judgment of abnormality in score value information, and display of result information. It is a normal distribution curve based on the result of measuring the pulse every minute and acquiring the measurement data of 30 pulse. It is a normal distribution curve based on the result of measuring the pulse every minute and acquiring the measurement data of 30 pulse. It is a normal distribution curve based on the result of measuring the pulse every 7 minutes and acquiring the measurement data of 30 pulses. It is a normal distribution curve based on the result of measuring the pulse every 7 minutes and acquiring the measurement data of 30 pulses. It is a normal distribution curve based on the result of acquiring the measurement data of 30 pulses at an irregular time in a day. It is a normal distribution curve based on the result of acquiring the measurement data of 30 pulses at an irregular time in a day. It is a normal distribution curve based on the result of acquiring the measurement data of 30 pulses at an irregular time in 30 hours. It is a normal distribution curve based on the result of acquiring the measurement data of 30 pulses at an irregular time in 30 days. It is a normal distribution curve based on the result of measuring the body temperature every 2 minutes and acquiring the measurement data of the body temperature of 30 pieces. It is a normal distribution curve based on the result of measuring the body temperature every 2 minutes and acquiring the measurement data of the body temperature of 30 pieces.

In the present invention, in addition to the above-mentioned problems, the present invention has been created in consideration of the following contents.

In recent years, the importance of "personalized medicine" has increased in the medical field. Personalized medicine generally refers to tailor-made medicine, which means "providing medical care that suits each individual's individuality."

Until now, medical treatment has been carried out based on a disease-centered way of thinking, and its main purpose is to search for the cause of the disease and to develop a treatment method for the disease. On the other hand, it has long been known that the state of the disease varies from person to person, and it is not always correct to apply the same treatment method even for the same disease.

However, in conventional medical treatment, individual differences in therapeutic effects cannot be understood without observing the treatment and its effects, and it is difficult to make an optimal treatment plan for each individual.

Here, in order to realize personalized medicine, it is important to grasp different "biomarkers" for each individual. In general, biomarkers are indicators of the condition of a particular medical condition or organism, and a research group at the National Institutes of Health in 1998 described biomarkers as "ordinary biology." It is defined as "a characteristic that is objectively measured and evaluated as an indicator of a pharmacological response to a physical process, pathological process, or therapeutic intervention." Also, in the past, biomarkers have primarily meant physiological indicators such as blood pressure and heart rate.

Under these circumstances, in the conventional device that supports diagnosis, an absolute value as a reference is set, and the health condition is ranked and an abnormality is detected based on the magnitude of the measured value with respect to the absolute value.

However, the conventional mechanism for detecting an abnormality based on the measurement of the vital information of the subject does not take into consideration the intra-individual variation of the subject. For example, in a conventional device that supports diagnosis, the average value of measurement information for three days is simply calculated and used as a reference for a normal value, and it is hard to say that the detection takes into account the intra-individual variation of the subject.

Further, in the prior art, for example, when determining an abnormality from body temperature information, it is often the case that the normal temperature obtained from the subject is used as a reference value and the abnormality exceeds the range of 1.0 ° C above and below. Be done. It is assumed that there are individual differences in the fluctuation range of the body temperature change from this normal temperature, and it cannot be an appropriate reference value.

That is, a person who should be judged to be normal even if the displacement of the body temperature is large, or a person who should detect an abnormality even if the displacement of the body temperature is small cannot be appropriately determined. With such a configuration, it is difficult to accurately evaluate the health condition.

In personalized medicine, which is expected to expand in the future, biomarkers suitable for purposes such as diagnosis, prognosis, pharmacodynamics, and monitoring will be indispensable. The present inventor has been conducting research focusing on biomarkers for the purpose of "onset of illness in the elderly" and "diagnosis". Among them, the present inventor biomarks "vital signs" such as body temperature, pulse, and blood pressure, which are the most basic information on human life, instead of biomarkers that are analyzed at the gene level, which have been carried out in recent years. We found the possibility of using it as a marker.

The reason why this vital sign can be used as a biomarker is that each person has different "individual fluctuations" in vital signs such as body temperature, blood pressure, pulse rate, and respiratory rate. In other words, the way the vital signs change differs depending on the subject, and we thought that we could develop a technology that contributes to the health management and diagnosis of the subject by appropriately grasping and analyzing this change. It is.

In addition, the present inventor has confirmed from previous studies that, basically, human vital signs are normally distributed when the distribution is observed over a certain period of time. In addition, the normal distribution of vital signs is distributed including intra-individual variation peculiar to the person.

However, in medical statistics, although there are papers and reports on "individual variation" that look at the standard deviation of many people regarding vital signs, none of them deal with "individual variation" of the same subject. is there.

In addition, in conventional medicine, analysis focusing on "inter-individual variation" that collects vital sign data of multiple different patients and compares the collected data of many patients with the vital sign data of a specific patient is performed. Although there are many, there was no analysis focusing on the fluctuation of the vital sign of the same subject, that is, the "intra-individual fluctuation".

Furthermore, in conventional medicine, many analyzes have been performed focusing on the normal distribution of "individual variation", but analysis focusing on the normal distribution of "individual variation" and utilization for diagnosis have not been performed at all. It was.

Under such circumstances, in vital signs and their analysis, which are useful biomarkers in personalized medicine, it is important to have criteria that sufficiently reflect the individual variation of the individual subject, and a judgment technique using this is strongly desired. ing.

In addition, the health condition determination technology using intra-individual variation can be used not only for early detection of the condition in which the subject has an abnormality in physical condition, but also for self-management and prevention of the physical condition before the abnormality occurs in the physical condition. There is a sufficient possibility that it can be used for so-called self-management.

The present invention was devised in consideration of the above points, and reflects the vital signs and daily physical conditions in consideration of individual differences of the subject, and accurately captures the intra-individual variation different for each subject. Is possible.

Hereinafter, embodiments of the present invention will be described with reference to the drawings for the purpose of understanding the present invention.
FIG. 1 is a diagram showing a schematic configuration of a tablet terminal into which software to which the present invention is applied has been introduced. The structure shown below is an example of the present invention, and the content of the present invention is not limited thereto.

[1. About the overall device configuration]
The software to which the present invention is applied can be introduced into a general-purpose information processing device, and imparts each information processing function necessary for carrying out the present invention to the embedded information processing device.

As a result, on the tablet terminal 3 (or user terminal, etc.), life support record information, nursing record information, doctor record information, etc. related to the target person are input and recorded, and the medical information entered by each occupation is organized for the target person. -It is analyzed and made available as listable information. As a result, medical information about the target person can be efficiently shared among caregivers, nursing assistants, nurses and doctors. Furthermore, it is possible to efficiently provide information that supports the diagnosis of a doctor.

Further, in the tablet terminal 3, the caregiver or the nursing assistant inputs the life support record information of the target person, converts the content into the structured life support factor information, and records the content. As a result, the life support record information can be confirmed as information that is easy for nurses and doctors to use.

In addition, in the tablet terminal 3, the vital information of the target person is input, scoring is performed according to the contents, and the obtained score result information (hereinafter referred to as "score value information") is of an abnormal degree. Judgment can be made.

The information processing device includes a calculation unit such as a CPU, a storage unit such as a RAM or ROM, a display screen such as a liquid crystal screen, an input unit such as a keyboard, and a communication unit that controls communication with the Internet or the like. It is prepared. For example, a general-purpose personal computer, a tablet terminal, a smartphone, or the like. Further, as the information processing device, for example, various healthcare devices, medical systems and long-term care systems installed in hospitals, facilities, etc. are also targeted, and software to which the present invention is applied is incorporated and used in these. It may be.

The software to which the present invention is applied is downloaded and incorporated in the tablet terminal 3, and has an input / display function for life support record information, nursing record information, doctor record information, etc., an input / display function for vital information, diagnostic contribution information, and the like. The diagnosis support device 1 is a tablet terminal having a function of inputting / displaying candidate information for diagnosis contribution, a function of creating / displaying a vital heat type table, a function of scoring vital information, a function of determining a score value, and the like.
In the following, a person to be diagnosed using the diagnosis support device 1 will be referred to as a “target person”.

Further, in the diagnostic support device 1 of the present invention, it is possible to input, record, display and process information about a plurality of target persons, and various information of each target person includes the name or identification number of the target person and the like. The information is organized so that it can be identified.

As shown in FIG. 1, the diagnosis support device 1 (tablet terminal 3) includes a calculation unit 2. The calculation unit 2 is a processing unit that executes each information processing function of the diagnosis support device 1. That is, in the software to which the present invention is applied, the calculation unit 2 of the tablet terminal 3 functions as an information input means 23, an information recording means 24, a reference calculation means 5, an information processing means 100, a determination processing means 6, and the like.

By the function of each means possessed by the calculation unit 2, information transmission / reception, information recording, information display, life support factor information generation, diagnosis contribution candidate information extraction, abnormality notification based on life support factor information, vital fever Creation of type table, scoring based on the contents of vital information, setting of scoring conditions (scoring standard information), judgment of abnormality in score value information, setting of judgment standard of abnormality related to score value, judgment result related to score value Notification, judgment of abnormality in vital sign value, setting of judgment standard of abnormality regarding vital sign value, notification of judgment result regarding vital sign value, creation and display of display information, etc. are performed.

The tablet terminal 3 can access an external server, terminal, etc. via the Internet, and can also send and receive information to and from the external server, terminal, and the like. The information recording means 24, the reference calculation means 5, the information processing means 100, and the determination processing means 6 are the "information recording means", the "reference calculation means", the "structured processing means, and the vital heat type table processing means" of the claims of the present application, respectively. , Display information processing means, deficient pathological factor generation means and scoring processing means ”,“ score determination means and vital determination means ”.

The tablet terminal 3 has an information recording unit 4, an information transmission / reception unit 3c, an input unit 3a, and a display unit 3b.

The information transmission / reception unit 3c is a part responsible for transmitting / receiving information between the calculation unit 2, the information recording unit 4, the input unit 3a, the display unit 3b, and the like. Also. It may be configured so that information can be transmitted and received between the tablet terminal 3 and the external terminal.

Here, hereinafter, each information handled by the software to which the present invention is applied does not necessarily have to be recorded in the information recording unit 4 of the tablet terminal 3. For example, even in a mode in which various information is transmitted to an external server or an external terminal via the information transmission / reception unit 3c of the tablet terminal 3 to be recorded, and necessary information is received from the external server or the like at the time of determination or the like. Good.

Furthermore, it is not necessary to download all the main configurations of the diagnostic support device 1 to the tablet terminal 3. For example, in the tablet terminal 3, various types such as life support record information, nursing record information, doctor record information, vital information, diagnosis contribution information, diagnosis contribution candidate information, vital fever type table, vital information, score value determination result information, etc. Only the information may be displayed, and various information may be recorded and the determination process may be performed by an external server or the like.

The software to which the present invention is applied may have a plurality of variations in the configuration on the system. Examples of some variations will be described below.

(First system configuration)
The schematic configuration of the tablet terminal 3 shown in FIG. 1 is such that the software to which the present invention is applied is introduced into the terminal, and the terminal itself inputs / records life support record information, nursing record information, doctor record information, and vital information. Display, input / record / display of diagnostic contribution information and diagnostic contribution candidate information, creation / display of vital heat type table, display of score value, judgment of score value, display of judgment result of score value, setting of scoring conditions, It is possible to set the judgment calculation standard of the score value, judge the vital sign value, display the judgment result of the vital sign value, set the judgment calculation standard of the vital sign value, set / generate / display the life support factor information, etc. It has become. That is, the function of the present invention can be executed by the device alone.

The schematic configuration shown in FIG. 1 shows the use of software to which the present invention is applied in a "stand-alone format" device that is not connected to an Internet environment. The software of the present invention can be introduced into an information processing device that is not connected to the Internet environment, for example, various healthcare devices, a medical system / nursing system such as a hospital, and used as a dedicated device. Since the tablet terminal 3 is taken as an example of the information processing device here, it is possible to connect to the Internet environment. However, in the configuration shown in FIG. 1, the target person can be diagnosed only by the internal function of the tablet terminal 3. Can provide support.

In the present invention, even if the caregiver, the nursing assistant, the nurse, and the doctor are physically separated from each other, information can be efficiently shared between a plurality of terminals in which the software of the present invention is installed. Is possible. Therefore, it is preferable to adopt a configuration in which information can be transmitted and received between a plurality of terminals in which the software of the present invention is installed. Hereinafter, a second system configuration or a third system configuration having such a configuration will be described.

(Second system configuration)
In FIG. 2, as the second system configuration, a configuration in which the function of the software 1a to which the present invention is applied is provided to an external server can also be adopted. Here, a plurality of terminals such as the user terminal 50a and the external terminal 50b can access the information management server 32a via the Internet 30a. The information management server 32a is, for example, an external server provided in a cloud format, and the function of software 1a to which the present invention is applied can be used on the information management server 32a.

The information management server 2a has an information recording unit 4a, an information transmission / reception unit 3c, and a calculation unit 2a. Further, the calculation unit 2a includes a reference calculation means 5a, an information recording means 24a, an information processing means 100a, and a determination processing means 6a. Various information is input via the user terminal 50a or the external terminal 50b, and the information input from each terminal is transmitted to the information management server 32a, and the information management server 32a records the information and generates display information. The score value is judged. The displayed information, the determination result of the score value, and the recorded information are transmitted to the user terminal 50a and the external terminal 50b, and can be confirmed on each terminal. In this way, a system configuration that imparts the functions of software 1a on the external server can also be adopted.

(Third system configuration)
FIG. 3 shows the configuration of the management terminal 70b including the module A having a plurality of software 32c, 32d, etc., in addition to the functions of the software 32b to which the present invention is applied, as the third system configuration. The software 32b to which the present invention is applied constitutes one module A together with other software that causes the management terminal 70b to execute various functions different from the software 32b. That is, it is possible to incorporate the software 32b into the module A of the management terminal 70b into which a plurality of software 32c, 32d, etc. have been introduced in advance to function. For example, software to which the present invention is applied can be incorporated into a module provided in a management terminal of a system for calculating long-term care costs and the like.

In such a third system configuration, various information is input to the management terminal 70b, and the information management server 32a records the information, generates the display information, determines the score value, and the like, and obtains the display information and the determination result. Information and the like can be confirmed on the management terminal 70b. Further, the user terminal 60a or the external terminal 60b is connected to the management terminal 70b, various information is input from the user terminal 60a or the external terminal 60b and transmitted to the management terminal 70b, and the management terminal 70b generates display information. , The score value can be determined, and the display information, the determination result information, and the like can be received and confirmed by the user terminal 60a or the external terminal 60b. As described above, the software to which the present invention is applied may also adopt a configuration in which it functions as a part of a module composed of a plurality of software.

As described above, there are a plurality of variations in the system configuration of the software (or diagnostic support device) to which the present invention is applied. Although the above description has focused on three examples, the configuration of software (or diagnostic support device) to which the present invention is applied is not limited to this. For example, the information recording unit may be provided in the user terminal, the information processing means may be provided in the external server, and the location of the necessary function may be divided into the terminal and the server, and various configurations may be adopted.

Using the usage mode of the tablet terminal 3 shown in FIG. 1, a detailed description of the configuration will be continued below.

[2. Information recording department]
As shown in FIG. 4, various information is recorded in the information recording unit 4.
Various types of information recorded in the information recording unit 4 can be input and information can be modified via the input unit 3a, the information transmission / reception unit 3c, and the information input means 24 (not shown) of the tablet terminal 3. Further, the contents of various information recorded in the information recording unit 4 can be confirmed via the display unit 3b and the information transmission / reception unit 3c of the tablet terminal 3.

The information recording unit 4 records the personal information 7 of the target person. The personal information 7 includes the name, age, gender, address or room information of the occupancy facility, current medical history, medical history, etc. of the subject.

In addition, personal information 7 and various information (vital information 8, life support record information 81, nursing record information 82, life support factor information 83, diagnosis contribution candidate information 84, diagnosis contribution information 85, etc.) identify individual subjects. It is configured to be recordable in association with possible identification information. As a result, a plurality of target persons can be identified, and a plurality of target persons can use one diagnostic support device 1.

In addition, the information recording unit 4 records life support record information 81, which is information on the contents of life support provided by the caregiver or the nursing assistant to the target person.

In addition, the information recording unit 4 records information on the content of nursing performed by the nurse on the subject and nursing record information 82, which is information obtained from the content of nursing.

Further, the information recording unit 4 records the life support factor information 83 in which the life support record information 81 is converted and processed by the information processing means 100 (functioning as a structured processing means) described later. The life support factor information 83 is information obtained by converting the contents of the life support record information into contents that can be easily used for grasping the health condition by a nurse and diagnosing a doctor.

Further, in the information recording unit 4, when the content of the life support factor information 83 satisfies a predetermined condition (life support factor risk condition), the life support factor information 83 satisfying the predetermined condition is information processing described later. The diagnostic contribution candidate information 84 converted and processed by the means 100 (functioning as a risk life support factor generating means) is recorded. The diagnosis contribution candidate information 84 is information that may be screened by a nurse and become diagnosis contribution information 85 necessary for a doctor's diagnosis. In addition, the diagnostic contribution candidate information 84 also includes information on pathological factors to be confirmed, which are generated by the information processing means 100 (functioning as a deficient pathological factor generating means) described later.
Converted

Further, the diagnosis contribution information 85 is recorded in the information recording unit 4. The diagnosis contribution information 85 is necessary for the nurse to make a diagnosis from the nursing record information 82, the diagnosis contribution candidate information 84, and the vital information 8 determined by the vital determination processing means 6 to be abnormal. This is the information screened as information.

That is, since the diagnosis contribution information 85 is displayed as the information constituting the list screen information 120, the doctor can confirm this and use it as reference information when diagnosing the subject.

In addition, the information recording unit 4 records disease information 87, medical history information 88, temporary drug information 89 of the subject, and drug information 89a. Further, the doctor record information 90 is recorded in the information recording unit 4.

[Life support record information and life support factor information]
The life support record information 81 is, for example, the amount of food, drinking water, urination, defecation, urine condition, stool condition, and bathing of the subject confirmed while the caregiver or nursing assistant provides life support. State information. This information is acquired at each date or at each timing when the caregiver or the like provides life support.

More specifically, in the case of the amount of meals, for example, the numerical values of the staple food 10 and the side dish 10 are assigned to each meal of breakfast, lunch and dinner, and the total amount of one meal is set to 20. In addition, the total amount of three meals is used as the numerator for 60, which is the denominator of one day. If the total amount of daily meals is 30 (for example, 5: 5 in the morning, 2: 8 in the afternoon, and 5: 5 in the evening), the ratio of daily meals is 50%.

In addition, when the life support factor risk condition regarding the amount of food is set to "50% or less for 3 days", "abnormality (or content of ×)" is recorded for the amount of food, and "50% or less for 3 days" is recorded. If not recorded, "normal (or content of ○)" is recorded with respect to the amount of food.

The numerical information of "5: 5, noon 2: 8, evening 5: 5" referred to here is the life support record information 81, and also "abnormal (or ×)" and "normal (or ○)". Is the life support factor information 83. Further, the condition of "50% or less for 3 days" is the life support factor risk condition, and the information of the result of "abnormality (or ×)" regarding the amount of food is the diagnosis contribution candidate information 84.

It should be noted that the content of the information to be input regarding the amount of food and the content of the risk condition of the life support factor that serves as a criterion can be set as appropriate, and the above-mentioned content is only an example. The same applies to the information on the amount of drinking water, the amount of urination, the amount of defecation, the state of urine, the state of stool, and the state of bathing described below.

In the case of drinking water, for example, a caregiver or the like inputs and records the daily drinking amount (ml). In addition, when the life support factor risk condition regarding the amount of drinking water is set to "X ml or less for 3 days", if the amount of drinking water for 3 days meets the condition, "abnormality (or the content of x)" is recorded and the condition is satisfied. If not, "normal (or content of ○)" is recorded with respect to the amount of drinking water.

The numerical information of "daily drinking water (ml)" referred to here is the life support record information 81, and the information of "abnormal (or ×)" and "normal (or ○)" is the life. Support factor information 83. Further, the condition of "X ml or less for 3 days" is the life support factor risk condition, and the information of the result of "abnormality (or ×)" regarding the amount of drinking water becomes the diagnosis contribution candidate information 84.

Regarding the amount of drinking water, conditions for obtaining three levels of judgment results such as "small, medium, and large" are set according to the amount, and according to the result of conversion processing based on the conditions, " A configuration that records "abnormal (or x)" and "normal (or ○)" can also be adopted.

In the case of urination volume, for example, a caregiver or the like inputs and records the daily urination volume (ml). In addition, when the life support factor risk condition for urination volume is set to "X ml or less in 3 days (lower limit) or Y ml or more in 3 days (upper limit)", the urination volume for 3 days is below the lower limit or If the condition above the upper limit is met, "abnormality (or content of x)" is recorded, and if the condition is not met within the range from the lower limit to less than the upper limit, the amount of urination is "normal (or the content of ○)". Is recorded.

The numerical information of "daily urination volume (ml)" referred to here is the life support record information 81, and the information of "abnormal (or ×)" and "normal (or ○)" is the life. Support factor information 83. Furthermore, the condition of "X ml or less in 3 days (lower limit) or Y ml or more in 3 days (upper limit)" is a life support factor risk condition, and the information on the result of "abnormality (or ×)" regarding the amount of urination is provided. It becomes the diagnosis contribution candidate information 84.

Regarding the amount of urination, conditions for obtaining a three-stage judgment result such as "small / medium / large" are set according to the amount, and according to the result of conversion processing based on the conditions, " A configuration that records "abnormality (or x)" and "normality (or ○)" can also be adopted.

As for the amount of defecation, for example, a caregiver or the like inputs and records the number of defecations per day. In addition, when the life support factor risk condition regarding the amount of defecation is set to "0 defecation is 3 days or more", "constipation (or x content)" will occur if the condition of 0 defecation is satisfied in 3 days. If it is recorded and the conditions are not met, "normal (or content of ○)" is recorded with respect to the amount of defecation.

The information of "the number of defecations per day" here is the life support record information 81, and the information of "constipation (or ×)" and "normal (or ○)" is the life support factor information 83. Is. Further, the condition of "0 defecation for 3 days or more" is the life support factor risk condition, and the information of the result of "constipation (or x)" regarding the amount of defecation is the diagnosis contribution candidate information 84.

Regarding the amount of defecation, conditions for obtaining three-step judgment results such as "small, medium, and large" are set according to the number of times, and according to the result of conversion processing based on the conditions, " A configuration that records "abnormality / constipation (or x)" and "normal (or ○)" can also be adopted.
In addition, regarding the amount of defecation, the information is changed to "the number of defecations per day", and the amount of defecation is divided into "no, small, medium, and large", input and calculated, and the predetermined amount. Information on the result of defecation volume can be obtained depending on whether or not the condition is satisfied. At this time, for example, if "none" or "small" continues, the result can be "constipation (or x)".

In the case of urine condition, for example, a caregiver or the like observes the urine condition of the subject and inputs and records the observation result. In addition, if the life support factor risk condition for urine condition is set to "Comment information on hematuria, urine turbidity, urine odor and other urine has been entered", hematuria, urine turbidity, urine odor and other If comment information about urine (for example, "urine turbidity") is input, the input content is recorded as information indicating abnormal urine condition, and no information indicating abnormal urine condition is input. , "Normal (or content of ○)" is recorded for the condition of urine.

The information here that "there is no comment information or input regarding hematuria, urine turbidity, urine odor and other urine" is the life support record information 81, and "hematuria, urine odor, urine odor and The information of "comment information on other urine" and "normal (or ○)" is the life support factor information 83. Furthermore, the condition that "comment information on hematuria, urine turbidity, urine odor and other urine was entered" is a life support factor risk condition, and the condition "hematuria, urine turbidity, urine odor and other urine" regarding urine condition The information of "comment information regarding" is the diagnostic contribution candidate information 84.

In the case of a stool condition, for example, a caregiver or the like observes the stool condition of the subject and inputs and records the observation result. In addition, if the life support factor risk condition related to the stool condition is set to "comment information on loose stool (diarrhea), bloody stool and other stools has been entered", comment information on loose stools (diarrhea), bloody stools and other stools. If is entered, the entered content is recorded as information indicating an abnormal stool condition, and if no information indicating an abnormal stool condition is input, the stool condition is "normal (or the content of ○)". ) ”Is recorded.

The information here that "comment information on loose stools (diarrhea), bloody stools and other stools, or no input" is the life support record information 81, and "loose stools (diarrhea), bloody stools and other stools". The information of "comment information" and "normal (or ○)" is the life support factor information 83. Furthermore, the condition that "comment information on loose stool (diarrhea), bloody stool and other stool was entered" is a life support factor risk condition, and "comment information on loose stool (diarrhea), bloody stool and other stool" regarding the condition of stool. Is the diagnostic contribution candidate information 84.

In the case of bathing, for example, a caregiver or the like confirms whether or not the subject has stopped bathing and the reason, and when the bathing is stopped, the reason for stopping the bathing is input and recorded. In addition, when the life support factor risk condition related to the bathing state is set to "the reason for stopping bathing has been entered", information on the reason for stopping bathing (for example, fever of the subject) is input. If so, the entered content is recorded as information indicating an abnormal bathing condition, and if no information on the reason for stopping the bathing is input, "normal (or content of ○)" is displayed regarding the bathing status. Recorded.

The information "reason for stopping bathing or no input" is the life support record information 81, and the information for "reason for stopping bathing" and "normal (or ○)" is , Life support factor information 83. Further, the condition of "the reason for stopping bathing is input" is the life support factor risk condition, and the information of "reason for stopping bathing" regarding the stool condition is the diagnosis contribution candidate information 84.

In this way, various life support record information 81 acquired from the contents of the life support by the caregiver or the nursing assistant and the life support factor information 83 obtained by converting the contents are recorded in the information recording unit 4. The type of life support factor information 83 is not limited to the above-mentioned contents, and any information on life support related to the diagnosis of the subject can be appropriately adopted.

For example, other types of life support record information 81 that can be adopted include the "sleep amount" and "activity amount" of the subject.

Here, the amount of sleep is determined by, for example, a sensor placed under the mattress to measure the subject's turning over, respiration, heartbeat, etc. to grasp the amount of sleep, or placed on the bedside to determine the subject's chest. You can use the one that grasps the amount of sleep from the movement and turning over. Then, by providing a predetermined determination condition for the measured sleep amount, the diagnosis contribution candidate information 84 can be generated.

Further, the amount of activity can be measured using, for example, an activity meter that calculates the amount of activity based on the number of steps. The activity meter is worn by the subject to measure daily walking and physical activity. Then, by providing a predetermined determination condition for the measured activity amount, the diagnosis contribution candidate information 84 can be generated.

[Nursing record information]
The nursing record information 82 is information on the contents of nursing performed by a nurse on a subject, or information obtained through the contents of nursing. The nursing record information 82 is, for example, information on the medical condition of the individual subject or the observation result.

More specifically, the medical condition of an individual is, for example, information on the presence or absence or degree of fever, the presence or absence or degree of headache, abnormalities recognized as a result of interviews with the subject, subjective symptoms, objective symptoms, and the like. Further, the observation result referred to here is information such as, for example, the complexion of the subject, the presence or absence or degree of swelling of the body, a decrease in muscular strength and tendon reflex, and a reaction to conversation.

Further, in the nursing record information 82, the value of the vital sign selected by the nurse from the vital information 8 and the value determined by the determination processing unit 6 (vital abnormality determination unit) among the vital information 8 are used. May be included.

In addition, the nursing record information 82 may include information on the fluctuation tendency of the vital sign value, which is particularly noteworthy, from the vital fever type table information 86 described later. Further, the nursing record information 82 may include information selected by the nurse from the disease information 87 and the medical history information 88, which will be described later.

In addition, the nursing record information 82 may include temporary drug information 89 in the subject. The information on the temporary drug information is information on the prescription drug prescribed to the subject and the prescription drug prescribed based on the diagnosis of the doctor, and information on the type of drug, the amount to be taken, the timing of taking the drug, etc. is recorded. .. In addition, if the effect of the drug changes the value of each vital sign, the temporary drug information 89 also includes information to that effect.

The temporary drug information 89 included in the nursing record information 82 is input by the nurse as the nursing record information 82, for example, when the nurse administers the drug to the subject. In addition, when the subject received a doctor's diagnosis and the doctor gave an instruction to prescribe, the nurse input it as nursing record information 82, or the doctor input information on the prescription drug into the doctor record 90. At that time, it is automatically reflected in the nursing record information 82.

Further, in the drug information 89a, information such as the type of drug, the effect, the target symptom, the amount to be taken, the timing of taking, and the period of taking is recorded. In addition, if the effect of the drug affects the value of each vital sign, the drug information 89a also includes information to that effect. Further, the drug information 89a referred to here may include information on the medicines to be taken by the subject on a regular basis as well as the medicines to be taken and prescription medicines.

Further, the drug information 89a may include information on symptoms in which the drug should not be administered and contraindications regarding the combination of a plurality of drugs to be avoided. This makes it difficult for nurses, doctors, caregivers, and nursing assistants to mistake the medicine to be administered to the subject.

Further, the nursing record information 82 may include information indicating that the subject has been diagnosed by a doctor, and may record the information received, for example, "Weekly nursing: Received". ..

The type of nursing record information 82 is not limited to the above-mentioned contents, and any nursing record information related to the diagnosis of the subject can be appropriately adopted.

[Vital information]
The information recording unit 4 is composed of vital sign values measured by various vital measuring instruments and evaluation results of consciousness level obtained by observation by a caregiver or a nursing assistant of the subject. It is a part that records information together with information on measurement date and time or acquisition date and time.

The information recording unit 4 includes personal information 7 of the target person, measured values of vital signs measured by each vital measuring instrument, evaluation results of the consciousness level obtained from observation of the target person, and information on the measurement date and time or acquisition date and time. Vital information 8 including is recorded.

Vital information 8 includes measured values of body temperature, pulse, systolic blood pressure, diastolic blood pressure, pulse pressure, and respiratory rate, which are vital signs. In addition, the vital information 8 includes a measured value of oxygen saturation. Further, the vital information includes the above-mentioned evaluation result of the consciousness level. In addition to the above-mentioned contents, the vital sign may also include values of oxygen saturation and urine volume.

The measurement date and time or acquisition date and time included in the vital information 8 is the date and time when the subject performed the vital measurement and the date and time when the consciousness level was confirmed. For example, the subject performed the vital measurement by himself / herself. The time confirmed at that time and the time when the caregiver, nursing assistant, nurse, etc. observed the subject are input.

Further, the vital information 8 includes the value of vital signs, which is the basis for determining that the score value information 103 is an abnormal value based on the scoring reference information 102. That is, the vital information 8 includes not only the value of the vital sign when the score value information 103 is determined to be normal, but also the value of the vital sign when the score value information 103 is determined to be abnormal.

Further, the vital information 8 includes a value determined that the measured value of vital signs is an abnormal value based on the vital determination reference information 102a. That is, the vital information 8 includes not only the value at which the measured value of vital signs is determined to be normal, but also the value at which the measured value of vital signs is determined to be abnormal.

Here, it is not always necessary that the vital information 8 includes both the value of the vital sign that is the basis when the score value information 103 is determined to be abnormal and the value that the measured value of the vital sign is determined to be abnormal. However, as will be described later, if the vital information of at least 30 measurement data reflects the intra-individual variation peculiar to the individual, one of the vital signs judged to be abnormal. The value of may be adopted. However, by including both abnormal values in the vital information 8, the variation of how to grasp the intra-individual variation increases, and it becomes possible to select appropriately. Therefore, the score value information 103 is abnormal in the vital information 8. It is preferable that both the value of vital signs, which is the basis for the determination, and the value at which the measured value of vital signs is determined to be abnormal are included.

In addition, the types of vital information 8 are not necessarily limited to body temperature, pulse, systolic blood pressure, diastolic blood pressure, pulse pressure, respiratory rate, oxygen saturation measurement values, and consciousness level evaluation results, and other information. The score value may be determined by performing scoring including vital signs. For example, urine volume, body weight, pain (presence or absence or degree of pain), and other medical abnormalities can be included in vital information. However, the above-mentioned vital signs are the most typical vital signs, and it is preferable to adopt them because it is easy to acquire vital information. Furthermore, among the above, the measured values of body temperature, pulse, systolic blood pressure, diastolic blood pressure, pulse pressure and respiratory rate of classical vital signs follow a normal distribution when obtained by the same subject, and are normal. Since the scoring condition based on the distribution can be set, it is particularly preferable to be adopted.

In addition, among the vital information, the vital measuring device for measuring the value of vital signs is not particularly limited, and can measure body temperature, pulse, systolic blood pressure, diastolic blood pressure, respiratory rate and oxygen saturation. Is enough. For example, vitals may be measured using a household vital measuring device. Furthermore, if the value of vital signs is measurable, it is not essential to use a vital measuring instrument. For example, it is possible to measure the pulse rate and the respiratory rate per minute while measuring the time with a clock, and use this as vital information. However, from the viewpoint of accurately capturing the intra-individual fluctuations of the measured values of body temperature, pulse, systolic blood pressure, and diastolic blood pressure, which are classical vital signs and follow a normal distribution, the vital sign values should be obtained by the same method. Is preferable. In daily measurement, the type of vital measuring instrument is changed frequently, and the measurement with the vital measuring device and the measurement without the vital measuring device are mixed, so that the vital sign measurement method is biased. .. Therefore, it is preferable to measure the vital sign value by the same method or the same vital measuring device as much as possible.

The vital information 8 is broadly configured to be capable of recording the vital information 8 every second. Further, the vital information 8 can be set to be recorded at different time intervals, for example, every minute or every hour.

Further, the vital information 8 may adopt a configuration in which the measured values measured at irregular times are recorded instead of the measurements at regular intervals. Further, in the case of this irregular measurement, for example, at least 30 vital information 8s are acquired in 1 minute, and at least 30 vital information 8s are acquired in 30 minutes, and at least 30 vital information 8s are acquired in 1 hour. Acquire vital information 8; acquire at least 30 vital information 8 in a few hours. Acquire at least 30 vital information 8 in a day. Acquire at least 30 vital information 8 in a few days. Acquire at least 30 vital information 8 in a week, acquire at least 30 vital information 8 in a few weeks, acquire at least 30 vital information 8 in a month Etc., at least 30 vital information 8 may be recorded in a certain period of time.

Further, the vital information 8 randomly extracts at least 30 pieces of data from the accumulated vital information regardless of the fixed interval or the irregular interval, and "vitals of 30 pieces of measurement data". It can also be recorded as "information 8".

As described above, the vital information 8 is configured to be able to record at least 30 measurement data regardless of the length of time and the presence or absence of regularity of measurement intervals.

Further, the information recording unit 4 can record the guideline time information 9 which is the guideline time information for the target person to measure and acquire the vital information. The guideline time information 9 records the guideline time for measuring and acquiring the vital information of the target person, for example, 8:30 in the morning and 18:00 in the evening. The guideline time information 9 can be freely set and modified.

The information recording unit 4 records posture information 10 which is information on the correct posture when measuring the value of each vital sign. The posture information 10 is, for example, as follows.
(1) Body temperature For example, when measuring body temperature with a thermometer that measures body temperature under the armpit, "Is the measuring part of the thermometer located in the center of the armpit?", "Is the armpit and the thermometer in close contact?", "Every time It is posture information such as "Is it the same posture?"
(2) Pulse For example, when measuring the pulse rate with an electronic pulse rate monitor or a finger on the wrist, "is it in a resting state", "is it in a relaxed and comfortable posture", and "is the same posture every time?" It is information on posture such as "is it?"
(3) Systolic blood pressure, diastolic blood pressure For example, when measuring by the oscillometric method that measures the vibration of blood vessels, "is it in a resting state?", "Is the arm or wrist wrapped with an arm band located at the height of the heart?" Information on postures such as "whether you are doing it" and "whether you are in the same posture every time".

As will be described later, a certain number of data (at least 30) used in the calculation of the scoring conditions by the reference calculation means and the scoring processing means, the vital average value used for the calculation of the scoring conditions, and the calculation of the vital standard deviation. The number of times vital information is recorded is not limited as long as the number of vital information is recorded. Further, it is not necessary that the vital information 8 is always recorded at regular intervals such as every second, every minute, every hour, and every day, and there may be a time when the vital information 8 is not recorded. Here, from the viewpoint of appropriately grasping the intra-individual variation of the same individual, it is preferable to record the vital information every second in a wide range, and the vital information is recorded once to 24 times a day. May be good.

Further, it is not always necessary to record the reference time information 9 in the information recording unit 4. However, by recording the reference time information 9, it becomes easy to measure and acquire vital information in a time zone that seems appropriate. In addition, when the estimated time comes, the target person, the caregiver, or the like may be notified to that effect.

Further, it is not always necessary to record the posture information 10 in the information recording unit 4. However, by recording the posture information 10, it is possible to prompt the subject to measure in an appropriate posture while displaying the posture information 10 when measuring each vital sign.

Further, the measurement method of each vital sign and the content of the posture information 10 are not limited to those described above, and the vital measurement method and the content of the posture information 10 suitable for the measurement method can be appropriately changed.

The information recording unit 4 can record the temperature information 11 of the place where the vital information is measured and acquired. The air temperature information 11 is recorded in association with the records at the time of measurement and acquisition of the vital information 8. As the air temperature information 11, for example, information that the subject confirms and inputs the air temperature at the measurement location is adopted.

Here, it is not always necessary for the information recording unit 4 to be able to record the air temperature information 11 at the place where the vital information is measured and acquired. However, by recording the temperature information 11, it is possible to confirm whether or not the environment in which the vital information was measured and acquired was an appropriate place.

[Vital heat type table]
As shown in FIG. 4, the vital information recording unit 4 records the vital heat type table information 86 graphed with the information of a predetermined number of days for the vital information 8. The vital heat type table information 86 is information indicating changes in vital sign values over time, which are created by the information processing means (functioning as the vital heat type table processing means) based on the vital information 8.

Vital heat type table information 86 can be created for body temperature, pulse rate, oxygen saturation (SpO2), systolic blood pressure, diastolic blood pressure, and the like.

The predetermined number of days in the vital heat type table information 86 displays, for example, daily measurement results for 2 to 3 weeks, but is not limited thereto. For example, it is possible to display in a shorter period or in a longer period of one month or more. Further, the vital information 8 is not limited to the one created from the result of daily measurement, and may be created from the result including every other day or the day when the vital information 8 is not acquired.

For the values of individual vital signs in the vital heat type table information 86, the result of one measurement on the measurement day may be adopted, or if multiple measurements are performed on the same measurement day, the average value during the same day. May be adopted. The predetermined number of days in the vital heat type table information 86 and the setting of the vital sign value adopted for creating the vital heat type table can be appropriately changed.

As shown in FIG. 4, the information recording unit 4 records scoring reference information 102, which is a reference when scoring each input vital information by the information processing means 100. Further, the information recording unit 4 records the score value information 103, which is numerical information of the result of scoring based on the scoring reference information 102.

Further, in the information recording unit 4, the score value information obtained from the contents of the input vital information is used as the determination processing means 6, and the score determination standard is used as a reference for determining whether or not the value is an abnormal value. Information 18 is recorded.

Information of the scoring reference information 102 and the score determination reference information 18 described later can be added or modified via the input unit 3a of the tablet terminal 3, the information transmission / reception unit 3c, and the information input means 24 of the calculation unit 2. .. Further, the contents of each scoring reference information 102 can be confirmed via the display unit 3b of the tablet terminal 3. The detailed contents of each standard in the scoring standard setting means 101 will be described later.

In the information recording unit 4, the score determination result information 12 which is the information of the determination result which the determination processing means 6 has determined whether or not the score value information 103 is an abnormal value is recorded. The contents can be confirmed via the display unit 3b of the tablet terminal 3. Further, the score determination result information 12 can show the determination result not only by display due to abnormality or normality but also by color coding according to the score. For example, 3 points or more are red, 2 points are yellow, 1 point or less is no color, and so on, and it is possible to indicate whether or not there is an abnormality by color coding.

Further, the score determination result information 12 is determined not only for the result of determination for each score value information 103 but also for the total score obtained by adding a plurality of (for example, all or part) score value information 103. It may be the result. In this case, the total score obtained by adding the plurality of score value information 103 can be determined to be abnormal or normal, or the determination result can be indicated by color coding according to the score.

Further, the information recording unit 4 records vital determination reference information 102a, which is a reference for determining whether or not the input vital sign value is an abnormal value by the determination processing means 6. ..

Information can be added or modified from the vital determination reference information 102a via the input unit 3a of the tablet terminal 3, the information transmission / reception unit 3c, and the information input means 24 of the calculation unit 2.

The information recording unit 4 records vital determination result information 12a, which is information on the determination result that the determination processing means 6 has determined whether or not the value of the vital sign is an abnormal value. The contents can be confirmed via the display unit 3b of the tablet terminal 3.

Further, in the information recording unit 4, as the vital information 8, it is possible to record the vital information when the measurement and acquisition of the vital information are performed again and the remeasurement vital information 13 which is the information of the date at the time of measurement. It has become. The remeasurement vital information 13 is, for example, the remeasurement performed in order to confirm the accuracy of the vital information when the determination processing means 6 determines that the score value obtained for the vital information is an abnormal value. It can be vital information.

Further, when displaying each vital information on the display unit 3b of the tablet terminal 3, the normal vital information recorded without remeasurement, the vital information to be remeasured, and the vital information to be remeasured are measured again. The vital information of the above is configured to be displayable with different colors of characters indicating the vital information of three patterns.

Here, it is not always necessary for the information recording unit 4 to be able to record the remeasurement vital information 13. However, it is preferable that the remeasurement vital information 13 can be recorded in the information recording unit 4 from the viewpoint that it is possible to verify whether or not the vital measurement is accurate by using the remeasurement vital information 13.

[Disease information]
The disease information 87 is information including information on the type of disease including the name of the disease and information on pathological factors defined for each type of disease. For example, regarding the type of illness "congestive heart failure", it is information on pathological factors of "systolic hypotension, shortness of breath, asthma, sputum, malaise, lower limbs (levitation)". In this way, with respect to various types of diseases, information on pathological factors that are characteristic of diagnosing the diseases is recorded in combination.

[History information]
The medical history information 88 is, apart from the medical history included in the personal information 7, information on the type of illness that the subject has suffered in the past and has been diagnosed by a doctor, and the subject when the subject is diagnosed with the illness. It includes information on subjective symptoms and objective symptoms acquired from a person, and pattern information on changes in vital information determined by the determination processing means 6 to be an abnormal value among the vital information 8. The medical history information 88 is set separately from the medical history included in the personal information 7.

The information included in the nursing record information 82 can be adopted as the information on the subjective symptom and the objective symptom acquired from the subject here. Further, the pattern information of the change of the vital information includes a predetermined period before the abnormal value of the vital information 8 appears, a predetermined period after the abnormal value appears, a predetermined period before and after the abnormal value appears, and the like at the time of onset. It is possible to appropriately adopt the one that can confirm the change of the vital information of.

[Temporary drug information / drug information]
As described above, the temporary drug information 89 is information on the prescription drug prescribed to the subject and the prescription drug prescribed based on the diagnosis of the doctor, and includes information on the type of drug, the amount to be taken, the timing of taking the drug, and the like. Recorded. In addition, if the effect of the drug changes the value of each vital sign, the temporary drug information 89 also includes information to that effect.

The drug information 89a records information such as the type of drug, the effect, the target symptom, the amount to be taken, the timing of taking the drug, and the period of taking the drug. In addition, if the effect of the drug affects the value of each vital sign, the drug information 89a also includes information to that effect.

[Diagnosis Contribution Candidate Information and Diagnosis Contribution Information]
As described above, the diagnosis contribution candidate information 84 is information that may be screened by the nurse and become the diagnosis contribution information 85 necessary for the diagnosis of the doctor.

The diagnostic contribution candidate information 84 includes life support factor information 83 that satisfies a predetermined condition (life support factor risk condition). As described above, the life support factor information 83 that satisfies the predetermined conditions is, for example, information on the result of “abnormality (or ×)” regarding the amount of food and information on inputting a comment of “hematuria” regarding the state of urine. is there.

The diagnosis contribution candidate information 84 is displayed on a “nursing record screen” described later, and is a target of screening by a nurse in order to generate diagnosis contribution information.

In addition, the diagnostic contribution candidate information 84 also includes information on pathological factors to be confirmed, which are generated by the information processing means 100 (functioning as a deficient pathological factor generating means). This information on pathological factors to be further confirmed is temporary based on the content of the disease information 87 when the nurse screens from the nurse record information 82 and the like to temporarily generate the diagnosis contribution information 85. From the contents of the diagnosis contribution information 85, the information processing means 100 collates the type of the candidate disease with the pathological factor thereof, and the pathological factor of the type of the candidate disease is the content of the temporary diagnosis contribution information 85. This is information that is not included in, that is, is extracted as a pathological factor of an item that the nurse should confirm.

By including this "pathological factor of the item that the nurse should confirm" in the diagnosis contribution candidate information 84, the pathology that is related to the diagnosis of a specific disease and that the nurse does not notice (or should confirm further). It will be easier to check the factors without omission and consider them as information that may be reported to the doctor.

The information of "pathological factors of items to be confirmed by the nurse" can be displayed as information to be screened by the nurse, for example, on the nursing record screen. It is also possible for a nurse to separately open the disease dictionary DB screen from the list screen information 120 and check from the items in the candidate list on the screen of the candidate disease type that pops up on the DB screen. is there. At this time, in the items of the candidate list, it is conceivable to clearly indicate "pathological factors of items that the nurse should confirm" among a plurality of contents by displaying them in different colors or showing them in a separate display area. Get it.

Further, the diagnosis contribution candidate information 84 may be in a mode in which the nurse includes information necessary for the diagnosis of the doctor from the vital information 8 determined by the vital determination processing means 6 to be abnormal among the vital information 8. Further, among the vital information, the information that the vital determination processing means 6 does not determine as abnormal can also be selected by the nurse and included in the diagnosis contribution information 85.

As described above, the diagnosis contribution information 85 includes the nursing record information 82, the diagnosis contribution candidate information 84, and the vital information 8 among the vital information 8 determined by the vital determination processing means 6 to be abnormal. This is the information screened as the information necessary for the diagnosis of.

Further, the diagnosis contribution information 85 may include information selected by the nurse from the contents of the life support factor information 83. That is, not only the life support factor information 83 satisfying the life support factor risk condition is the diagnosis contribution information 85, but the life support factor information 83 selectively screened by the nurse can be used for the diagnosis of the doctor. ..

Further, the diagnosis contribution information 85 may be in a mode in which the nurse includes information necessary for the diagnosis of the doctor from the vital information 8 determined by the vital determination processing means 6 to be abnormal among the vital information 8. Further, among the vital information, the information that the vital determination processing means 6 does not determine as abnormal can also be selected by the nurse and included in the diagnosis contribution information 85.

Here, the diagnosis contribution candidate information 84 does not necessarily have to be the diagnosis contribution information 85 as a result of being screened by the nurse. For example, a configuration may be adopted in which the diagnosis contribution candidate information 84 is used as the diagnosis contribution information 85 as it is without being screened by a nurse, and is displayed on the list screen information 120. As a result, it becomes possible to use the life support factor information 83 that satisfies the life support factor risk condition without interposing the judgment of the nurse for the diagnosis of the doctor. However, since the amount of information is selected by screening by a nurse and there is a possibility that less accurate information can be provided to a doctor, the diagnosis contribution candidate information 84 is screened by a nurse. , It is preferable that the diagnostic contribution information is 85.

[Doctor record information]
The doctor record information 90 records information related to a doctor's examination, such as information on prescription instructions for drugs instructed at the time of diagnosis of a subject, information on progress during follow-up, and the like.

[3. Criteria calculation method]
The reference calculation means 5 will be described. The reference calculation means 5 is one of the functions executed by the software to which the present invention is applied to the calculation unit 2, and calculates the score value information 103 for the vital information (input vital information) recorded in the information recording unit 4. The calculation of the numerical range that becomes the scoring reference information 102, and the calculation of the vital average value and the vital standard deviation used for the calculation of the numerical range that becomes the scoring reference information 102 are performed. In the diagnostic support device 1, the reference calculation means 5 calculates a numerical range of scoring reference information 102 for the measured values of body temperature, pulse, systolic blood pressure, diastolic blood pressure, pulse pressure, and respiratory rate, and this is the score. It serves as a reference for the ring.

Further, the reference calculation means 5 includes vital determination reference information 102a for determining whether or not the vital sign value of the vital information (input vital information) recorded in the information recording unit 4 is an abnormal value. The vital average value and the vital standard deviation used for calculating the vital determination numerical range, which is the vital determination reference information 102a, and the vital standard deviation are calculated. In the diagnostic support device 1, for the measured values of body temperature, pulse, systolic blood pressure, diastolic blood pressure, pulse pressure, and respiratory rate, a numerical range for vital determination, which is vital determination reference information 102a, is calculated by the reference calculation means 5. , This is the standard for determining whether the vital sign value is an abnormal value.

Various information calculated or recorded by using the calculation unit 2 as the reference calculation means 5 can be added or added via the input unit 3a of the tablet terminal 3, the information transmission / reception unit 3c, and the information input means 24 of the calculation unit 2. It can be modified. Further, various information calculated or recorded by using the calculation unit 2 as the reference calculation means 5 can be confirmed via the display unit 3b of the tablet terminal 3.

FIG. 4 shows a function to be executed by the software to which the present invention is applied to the calculation unit 2. The calculation unit 2 includes an average value calculation means 14, a standard deviation calculation means 15, a normal distribution calculation means 16, a mode calculation means 110, a scoring standard setting means 101, and a vital determination standard setting means 101a, which constitute the reference calculation means 5. Functions as.

The mean value calculation means 14 and the standard deviation calculation means 15 include vital information 8 (measured values of body temperature, pulse, systolic blood pressure, diastolic blood pressure, and pulse pressure) recorded in the information recording unit 4, and remeasured vital information 13 thereof. Based on the above, the "average value of vital information" under the same conditions and the "standard deviation of vital information" in the statistical distribution of vital information under the same conditions are calculated from the recorded information under the predetermined conditions. In the following, the average value of vital information is referred to as "vital information average value", and the standard deviation of vital information is referred to as "Vital information average value", except when referring to the name of the type of average value or standard deviation for which special calculation is performed. It shall be called "vital information standard deviation". The predetermined conditions will be described later.

Further, in the average value calculating means 14 and the standard deviation calculating means 15, regarding the vital information 8 recorded in the information recording unit 4, the score value information 103 is based on the score determination reference information 18, and the score value information 103 is an abnormal value. The average value of vital information and the standard deviation of vital information are calculated including the value of vital signs when it is determined to be. Further, in the average value calculating means 14 and the standard deviation calculating means 15, the vital sign values at the time of input determination of the vital information 8 recorded in the information recording unit 4 are abnormal based on the vital determination reference information 102a. The vital information average value and the vital information standard deviation are calculated including the value of the vital sign when it is determined to be a value.

In this way, by calculating the vital mean value and vital standard deviation including not only the value of vital signs that is the basis for determining normality but also the value of vital signs that is the basis for determining abnormality, the subject It can be an average value or standard deviation that reflects the intra-individual variation of. In addition, by using these average values and standard deviations, it is possible to create a standard that reflects the intra-individual variation of the subject when setting the scoring standard information 102 and the vital determination standard information 102a.

The mode calculating means 110 calculates the mode from the measured value of the respiratory rate in the vital information under a predetermined condition. The calculated mode is used to set a numerical value that serves as a reference for the respiratory rate scoring conditions. Further, the calculated respiratory rate mode is recorded in the information recording unit 4 together with the calculation conditions (adopted conditions, period, date).

The "predetermined conditions" adopted when calculating the average value calculating means 14, the standard deviation calculating means 15, and the most frequent value calculating means 110 are usually 30 vital information (body temperature, pulse) starting from the time of determination. , Systolic blood pressure, diastolic blood pressure, pulse pressure and respiratory rate measurements) have been adopted. The vital information during this period is the vital information 8 and the remeasurement vital information 13 for the past 30 pieces including the measurement data at the time of determination.

Here, as described above, the settings for the past 30 pieces are broadly the data of vital information measured every second, and in addition to this, every minute, every few minutes, every hour, every day. Data with different lengths of time, such as vital information data measured every month, can be adopted. In addition, the data acquired irregularly may be extracted for the past 30 pieces. At this time, a method of simply extracting 30 pieces so as to go back in the order of acquisition may be used. Alternatively, a method may be used in which 30 pieces of data are extracted by setting some extraction conditions for the irregularly acquired data. The extraction conditions include, for example, the condition that 30 pieces are extracted from within a predetermined 1-hour range, and the interval between the acquisition times of vital information satisfies certain conditions (the interval is at least 5 minutes or more, or the interval). Is within 1 hour, etc.) Conditions are also conceivable. Further, a method may be used in which 30 vital information 8s are randomly selected and extracted with respect to the vital information 8 measured regularly at regular intervals. The extraction conditions for the past 30 pieces can be appropriately set as needed. Regardless of how it is taken, if at least 30 vital information 8 can be extracted, a normal distribution reflecting intra-individual variation can be obtained and used for scoring standard information 102 or vital judgment standard information 102a. it can.

Further, as described above, the vital information 8 is broadly configured to be capable of recording the vital information 8 every second. Further, the vital information 8 can be set to be recorded at different time intervals, for example, every minute or every hour. Further, the vital information measured a plurality of times a day is irregularly configured to be recordable. When the calculation unit 2 functions as the mean value calculation means 14, the standard deviation calculation means 15, and the mode calculation means 110 to calculate the vital mean value, the vital standard deviation, and the mode, the conditions set appropriately are set. The vital mean value, vital standard deviation and mode can be calculated with. For example, if conditions for extracting 30 vital information are set, the vital mean value, vital standard deviation, and mode can be calculated from the extracted 30 vital information.

Further, the mean value calculation means 14, the standard deviation calculation means 15, and the mode calculation means 110 each time determine the score value information 103 or the vital sign value based on the input vital information of the target person. With reference to the vital information 8 and the remeasured vital information 13 recorded before the time point, the vital information mean value, the vital information standard deviation, and the mode value at the time of the determination are calculated. As a result, the criteria used by the determination processing means 6 (or the score processing means 100) are revised at each determination time point, and it is determined whether or not the score value information 103 based on the vital information is an abnormal value. , It becomes easy to reflect the intra-individual variation of the vital information of the subject in the determination of whether or not the value of the vital signs is an abnormal value.

Further, the number of vital information used may be 30 or more, and a larger number such as 90 or more may be used. By increasing the number of vital information 8, the accuracy of the contents of the normal distribution reflecting the intra-individual variation can be improved. In addition, the minimum number of data for capturing intra-individual variation is preferably 30 or more.

When, for example, "90 days" is adopted as the "predetermined condition" adopted when calculating the average value calculating means 14, the standard deviation calculating means 15, and the mode calculating means 110, the calculation period is set. For example, the 90-day range can be set to move one day at a time as shown in FIG. That is, the 90-day period used for the calculation on a certain measurement date (determination date) is indicated by the range (reference numeral A) from 90 days before the measurement date to the measurement date including the measurement date. Further, the "predetermined condition" used for the calculation one day before the measurement date is indicated by the range (reference numeral B) from 91 days before the measurement date to the day one day before the measurement date. Further, the "predetermined condition" used for the calculation two days before the measurement date is indicated by the range (reference numeral C) from 92 days before the measurement date to the day two days before the measurement date. In this way, the 90-day range of the "predetermined condition" can be set to move one day at a time with the passage of time (direction of the arrow of the symbol T). This point is the same when it is used as the number of data for 30 pieces with different lengths of time (for example, several minutes, several hours, in one day).

Further, as the "predetermined condition" adopted when calculating the mean value calculation means 14, the standard deviation calculation means 15, and the mode calculation means 110, 30 vital information including the time of determination is used. However, it is not always necessary for the judgment time point to be the starting point. For example, a setting in which 30 vital information is used starting from "data before the judgment time" can be adopted except for the judgment time point. However, by including the judgment time point, the latest state of the same individual can be reflected, and the intra-individual variation of the individual can be easily grasped. Therefore, the mean value calculation means 14, the standard deviation calculation means 15, and the mode calculation means As the "predetermined condition" adopted in the calculation of 110, it is preferable that 30 vital information including the time of determination is used.

Further, the "predetermined condition" adopted when calculating the mean value calculating means 14, the standard deviation calculating means 15, and the mode calculating means 110 is not necessarily vital information measured on consecutive dates (number of pieces). There is no need. For example, in the case where there is a day (timing) in which the subject does not perform vital measurement and there is a day (timing) in which vital information is not recorded, the number of days (number) of a predetermined condition is "30 days in total (30 days). (Individual) ”may be used.

For example, as shown by reference numeral A (black circle figure) in FIG. 6, vital information is recorded twice a day, in the morning and in the afternoon, and all the information is recorded by the mean value calculation means 14, the standard deviation. It is used for the calculation of the calculation means 15 and the mode calculation means 110.

Here, in the present invention, as long as the set number of vital information data is available, the vital information does not necessarily have to be continuously acquired such as every second, every minute, every hour, and every day. Like the vital information indicated by the reference numeral B (cross shape) and the reference numeral C (white triangle) in FIG. 6, the days (timing) at which the vital information is acquired are discontinuous, and can be set to several days (several times). It may be a mode acquired once. Further, it may be a mode in which partial extraction is performed based on the set conditions in the presence of continuous recording of vital information. The set conditions are, for example, the contents such as extracting only the vital information of every Monday, extracting only the vital information acquired in the morning, and extracting only the specified date.

The normal distribution calculation means 16 is a portion for calculating a normal distribution from the mean value and standard deviation of vital information under a predetermined condition. The normal distribution at each judgment time of the subject can be calculated, and the calculated normal distribution is created as a normal distribution curve that graphs the probability density function, and this normal distribution curve is displayed on the display unit 3b of the tablet terminal 3. It is configured to be. Further, as described above, the average value and standard deviation of the vital information under a predetermined condition are calculated including the value of the vital sign that is the basis for determining the abnormality. Therefore, the normal distribution calculated by the normal distribution calculation means 16 is also created by including the value of vital signs that is the basis for determining the abnormality.

The scoring standard setting means 101 interlocks with the mean value calculation means 14, the standard deviation calculation means 15, and the mode calculation means 110 to obtain the vital mean value, the vital standard deviation, and the mode calculated from each calculation unit. Based on this, the scoring reference information 102 used by the information processing means 100 for scoring is created. The created scoring reference information 102 is recorded in the information recording unit 4.

More specifically, the scoring standard setting means 101 interlocks with the mean value calculation means 14, the standard deviation calculation means 15, and the normal distribution calculation means 16, and the body temperature, pulse, systolic blood pressure, and diastole measured from the subject. With respect to the measured values of systolic blood pressure and pulse pressure, scoring reference information 102 used for scoring is created based on the vital mean value and vital standard deviation calculated from each calculation means.

Further, here, as described above, in the creation of the scoring reference information 102, the value of the vital sign (or the input determination) when the score value information 103 is determined to be an abnormal value in the vital information 8. The value of vital signs when the value of vital signs at the time is determined to be an abnormal value) is included.

Further, the scoring standard setting means 101 interlocks with the mode calculation means 110 to set the mode to the mode calculated from the mode calculation means 110 with respect to the measured value of the respiratory rate measured by the subject. Based on this, the scoring reference information 102 used by the information processing means 100 for scoring is created. In addition, the mode in which the average value is used instead of the mode value may be used.

Further, the scoring reference information 102 includes not only the calculation result of each calculation means, but also information in a certain preset numerical range used when scoring the measured value of oxygen saturation, and consciousness. It also contains information on the content of a given observational state that can distinguish the degree of level.

More specifically, for the measured value of oxygen saturation measured by the subject, a predetermined numerical range can be input from the input unit 3a of the tablet terminal 3 and set as the scoring reference information 102. it can. The set scoring reference information 102 is recorded in the information recording unit 4.

Further, for the evaluation result of the consciousness level acquired from the subject, the content of a predetermined observation state capable of distinguishing the degree of the consciousness level can be input and set as the scoring reference information 102. The set scoring reference information 102 is recorded in the information recording unit 4. The details of the calculation of the vital mean value, the vital standard deviation, the mode, and the scoring reference information 102, and the setting of the scoring reference information 102 composed of a plurality of items will be described later.

The vital determination standard setting means 101a is linked with the average value calculation means 14 and the standard deviation calculation means 15, and the determination processing means 6 sets the vital sign value based on the vital average value and the vital standard deviation calculated from each calculation unit. Vital judgment standard information 102a used for the judgment of is created. The created vital determination reference information 102a is recorded in the information recording unit 4.

More specifically, the vital determination standard setting means 101a interlocks with the mean value calculation means 14, the standard deviation calculation means 15, and the normal distribution calculation means 16, and the body temperature, pulse, systolic blood pressure, and dilatation measured from the subject. Vital determination reference information 102a used for determining the value of vital signs is created based on the vital average value and vital standard deviation calculated from each calculation means with respect to the measured values of blood pressure and pulse pressure.

Further, here, as described above, in the creation of the vital determination reference information 102a, the value of the vital sign when the value of the vital sign at the time of the input determination is determined to be an abnormal value is determined in the vital information 8. (Or the value of vital signs when the score value information 103 is determined to be an abnormal value) is included.

[4. Information processing means 100 (scoring processing means)]
The information processing means 100 will be described. The information processing means 100 is one of the functions to be executed by the software to which the present invention is applied to the arithmetic unit 2, and the input life support record information 81 can be easily confirmed by a nurse or a doctor as described above. Performs a process of converting to factor information 83 (functioning as a structured processing means).

Further, the information processing means 100 extracts the life support factor information 83 satisfying the conditions as the diagnosis contribution candidate information 84 based on the set predetermined condition (risk life support factor risk condition) (risk life support factor generation means). Function as).

Further, the information processing means 100 uses the processing information of the mean value calculation means 14, the standard deviation calculation means 15, and the mode calculation means 110 for the vital information at the time of determination input via the input unit 3a of the tablet terminal 3. , The process of calculating the score value information 103 (point score information) according to the content of the vital information is performed based on the scoring standard information 102 including the preset standard.

The score value information 103 calculated by the information processing means 100 is recorded in the information recording unit 4 as described above. At that time, the score value information 103 is recorded in association with the identification information that can identify the individual and the information that is the calculation standard of the score value. The information processing means 100 is configured to output score value information 103 in conjunction with the information recording unit 4 and the reference calculation means 5.

Further, the content of the score value information 103 can be confirmed via the display unit 3b of the tablet terminal 3. Further, the score value information 103 transmits score determination result information 12 not only to the display unit 3b of the tablet terminal 3 but also to an external server or an external terminal via the information transmission / reception unit 3c of the tablet terminal 3, and these You can also check it on the screen of. The content of the score value information 103 can be displayed as an individual numerical value or a total score of a plurality of score values at the time of determination of the same individual.

Further, the information processing means 100 performs a process of creating the vital heat type table information 86 (functioning as the vital heat type table processing means) based on the input vital information 8. The vital heat type table information 86 is created each time the vital information 8 is input, but the conditions for creating the vital information 86 can be appropriately set.

Further, the information processing means 100 performs a process (functions as a display information processing means) for creating list screen information 120 (see FIG. 16) based on various information.

[5. Judgment processing means]
The determination processing means 6 will be described. The determination processing means 6 is one of the functions executed by the software to which the present invention is applied to the calculation unit 2, and the vital information at the time of determination input via the input unit 3a of the tablet terminal 3 is transmitted by the information processing means 100. With respect to the scored score value information 103, based on the score determination reference information 18, a determination process is performed as to whether or not the score value information 103 is an abnormal value. Further, the determination processing means 6 performs determination processing as to whether or not the value of the vital signs at the input determination time is an abnormal value based on the vital determination reference information 102a.

The score determination result information 12 and the vital determination result information 12a, which are the determination results determined by the determination processing means 6, are recorded in the information recording unit 4 as described above. Further, the contents of the score determination result information 12 and the vital determination result information 12a can be confirmed via the display unit 3b of the tablet terminal 3. Further, the score determination result information 12 and the vital determination result information 12a are sent to an external server or an external terminal via the information transmission / reception unit 3c of the tablet terminal 3 as well as the display unit 3b of the tablet terminal 3. 12 and vital determination result information 12a can be transmitted and confirmed on these screens and the like.

Further, the score determination result information 12 and the vital determination result information 12a not only display on the display unit 3b of the tablet terminal 3, but also notify that the score determination result information 12 and the vital determination result information 12a have been issued. It is also possible to notify a remote nurse, doctor, etc. by a notification sound or an e-mail message. When notifying the score determination result information 12 and the vital determination result information 12a with the notification sound, for example, the type of the notification sound may be changed depending on whether the content is an abnormal value or not. it can.

Further, when the life support factor information 83 satisfies the predetermined life support factor risk condition, it is not only displayed on the display unit 3b of the tablet terminal 3, but also by a notification sound or an e-mail message notifying the fact. It can also be configured to notify remote nurses, doctors, etc.

Further, the method of notifying an abnormal state by the above-mentioned notification sound or e-mail message notification is not limited to these, for example, pop-up on the display screen 2c, notification to SIM or income, outside the room where the target person is. Various methods such as lighting of the installed lamp can be adopted.

Further, the content of the score determination result information 12 can be displayed by color-coding (coloring) according to the degree of urgency. For example, if the score is "3 points", it is red, if it is "2 points", it is yellow, and if it is "1 point or less", there is no color. As a result, subjects who show a red or yellow colored score will be treated as subjects that caregivers, nursing assistants, nurses or doctors should pay attention to for several days from the timing of coloring. It will be easier.

Next, a device used for operating the software to which the present invention is applied and specific contents of the input screen will be described.

For example, as shown in FIG. 7A, the vital information is acquired by a wearable vital measuring device 21a, a thermometer 21b, or the like, and the measured values measured by these are combined with the measured time information and the tablet terminal. Input is performed via the screen displayed on the display unit 3b of 3. A touch panel type input unit 3a is displayed on the display unit 3b, and vital information is input here. If the tablet terminal 3 (first system configuration) into which the software to which the present invention is applied is installed, it is possible to record information, determine the health condition, and display the determination result by the terminal alone.

In addition, each time vital information is acquired, its average value, standard deviation, vital judgment reference information (reference range at each timing), and vital heat type table are created / updated and recorded in the information recording unit 4. To. Further, based on the recorded vital information 8, the vital heat type table information 86 is created by the processing of the information processing means (functioning as the vital heat type table processing means).

Further, in FIG. 7B, the vital information is transmitted from the smartphone terminal 22a and the personal computer terminal 22b (hereinafter, referred to as “PC terminal 22b)” to the information management server which is the external server described in the second system configuration described above. It is also possible to access 32a and input vital information from the smartphone terminal 22a or the PC terminal 22b. Based on the vital information transmitted from each terminal, the information management server 32a determines the health condition, and the result is The information is transmitted to each terminal, and the result information is displayed on the screen of each terminal.

Further, as input screens of the tablet terminal 3, the smartphone terminal 22a and the PC terminal 22b, the screens shown in FIGS. 8 to 15 are shown. 8 and 9 are examples of input screens used when a hospital patient or a resident of a long-term care facility or the like is used as a health condition determination target. In FIG. 8, the input items of the target person for one person and the numeric keypad area displaying the numbers are displayed. There is a field for displaying the names of the subject and the staff in charge, and a field for inputting measurement data for body temperature, blood pressure (up and down), pulse, oxygen concentration, body weight, and respiratory rate. The value of each vital sign can be input by operating the cursor on the touch panel or on the screen in the numeric keypad area.

Further, the present invention has a "principal value mode changing function" when inputting / recording vital information 8. In the measurement of vital sign values, multiple measurements may be performed, and in that case, it is said that the first value must be left. Here, among the measured values, the valid value to be adopted may not be the numerical value of the first measurement result. Here, as a function for changing the principal value mode, the principal value is adopted, for example, "the value of the first measurement result of the day is the principal value" or "the latest value of the day is the principal value". Conditions can be set. As a result, a valid numerical value can be selected as the content of the vital information 8.

Further, in the screen display of FIG. 8, items for observation / interview are provided. The input information is recorded in the information recording unit 4 inside the apparatus or transmitted to the external information management server 32a (information recording unit of the server) by touching or clicking the transmission button. It should be noted that it is not shown in FIG.

The input screen shown in FIG. 9 is provided with input fields for measurement data of a plurality of vital signs and selection items for normal or abnormal physical condition judged by the subject himself / herself on the right side of the screen. In addition, the subjective symptom, objective symptom, and fever type table can be selected to input further physical condition information and confirm the change in vital signs of the subject over time.

Further, on the screen of FIG. 9, the names of a plurality of target persons are displayed, and by selecting the name field, the screens of the selected target persons can be displayed. In addition, information on the time when the vital sign value is input is input at the same time. Furthermore, in addition to the vital sign value input screen, it is possible to record and display information on items related to information registration and items of life support provided such as excretion and meals.

FIG. 10 is a screen (life support record screen) for inputting the life support record information 81. The caregiver or the nursing assistant inputs information on the amount of food, drinking water, urination amount, defecation amount, urine condition, stool condition, and bathing condition of each subject through this screen.

Further, the life support record screen shown in FIG. 10 is a confirmation screen on which the life support record information 81 can be confirmed, and caregivers, nurses, and doctors provide life support as needed. It is also the screen used when viewing the record.

As shown in FIG. 10, for a plurality of target persons, for example, an icon for inputting a meal amount or the like is displayed every hour from 7 o'clock. The caregiver or nursing assistant inputs various information based on the content of life support provided to the target person.

The input information is appropriately recorded in the information recording unit 4. Further, the recorded information is converted into life support factor information 83 by the information processing means, and is appropriately recorded in the information recording unit 4.

FIG. 11 is a screen (nursing record screen) for inputting nursing record information 82. Through this screen, the nurse inputs information on the contents of nursing performed by the nurse to the target person or information obtained through the contents of nursing.

The nursing record screen shown in FIG. 11 is a confirmation screen on which the nursing record information 82 can be confirmed, and when a nurse, a doctor, a caregiver, or the like browses the nursing record as needed. It is also the screen used for.

As shown in FIG. 11, for a plurality of subjects, for example, information selected by a nurse as information to be recorded from daily individual medical conditions, observation results, life support record information 81 and vital information 8. Etc. are input. The input information is appropriately recorded in the information recording unit 4.

Further, in the nursing record screen shown in FIG. 11, the nurse can perform the work of screening the diagnosis contribution information 85 from the diagnosis contribution candidate information 84. For example, the diagnosis contribution information 84 extracted by the information processing means is displayed as light-colored characters on the nursing record screen. When the nurse selects the diagnosis contribution information 85, the color of the characters changes by clicking the diagnosis contribution information 85 of the light-colored characters, and the "nursing record" (see FIG. 16) of the list screen information 120 (see FIG. 16) It is displayed as diagnostic contribution information 85 in the lower right corner of the screen).

Further, the recorded information is converted into life support factor information 83 by the information processing means, and is appropriately recorded in the information recording unit 4.

12 to 14 show the elderly dictionary screen. The elderly dictionary screen is an example of a screen that displays information on individual illnesses from a database of illness information composed of illness information 87. Here, as an example of the disease, information on congestive heart failure (FIG. 12), chronic heart failure (FIG. 13) and pneumonia (FIG. 14) is posted.

The screen of the elderly dictionary screen can be moved from the list screen information 120 to the page, and search words, related words, database search results, and special information about elderly people in each disease type are posted. Here, by inputting the information to be searched in the search word item, the type of disease related to the search word can be displayed as a database search result.

In addition, the database search results may include a plurality of results (types of illness) depending on the content of the search word. In addition, the related word is information on the item of the pathological factor according to the type of the disease described above.

As described above, when the nurse performs the work of screening the diagnosis contribution information 85 from the diagnosis contribution candidate information 84 on the nursing record screen, the types of diseases that are candidates and the types of diseases are displayed on the elderly dictionary screen. Information on the pathological factor can be obtained as a search result.

Further, when the diagnosis contribution information 85 is temporarily generated for the pathological factor of the candidate disease, the information processing means 100 is a candidate from the contents of the temporary diagnosis contribution information 85 based on the contents of the disease information 87. By collating the type of the disease and the pathological factor thereof, information that is the pathological factor of the type of the candidate disease and is not included in the content of the temporary diagnosis contribution information 85 is extracted. The extracted result is clearly shown on the elderly dictionary screen, for example, by displaying the corresponding pathological factors in different colors. Further, for example, it can be displayed as information to be screened by a nurse on a nursing record screen.

Here, the elderly dictionary screen is merely an example of a screen for displaying individual disease information from a database of disease information composed of disease information 87, and is not necessarily configured as information in a dictionary for the elderly. There is no need to. However, by making it easy to display information peculiar to the elderly, it becomes easier to confirm the characteristics of the disease that are not seen in subjects who do not correspond to the elderly, and it is possible to support the diagnosis of doctors more efficiently. Can be done.

FIG. 15 shows a medication list screen for the temporary medication record 89. The screen of this medication list screen can be moved from the nursing record screen to the relevant page. The medication list screen is a screen for registering medication information and displaying a list of registered information in the subject.

To register a new medicine to be taken or check the registered contents, open the new registration / viewing / editing page (right side of Fig. 15) from the main page (left side of Fig. 15) of the medication list screen and register. And browse and edit. The drug information registered on the medication list screen is reflected and displayed on the nursing record screen. In addition, on the medication list screen, the content can be narrowed down by inputting the medication period.

The "list display screen 120" shown in FIG. 16 is created based on the information input on the various input screens described above. The list display screen 120 is a display screen in which various information commonly confirmed by caregivers, nursing assistants, nurses, and doctors are aggregated.

On the list display screen 120, vital heat type table information 86 and diagnosis contribution information 85 (displayed as “nursing records” on the screen) are posted for individual subjects.

In the vital heat type table information 86 shown in FIG. 16, the information of the vital sign value in a predetermined number of days and the range (upper limit and lower limit range) of the vital judgment reference information 102a for each day, which will be described later, are for each type of vital sign. Shown in different hatches. This hatch is color-coded on the actual screen. By displaying in this way, it is possible to visually grasp not only the vital sign value on each measurement day but also the vital determination standard information 102a that is different for each subject as a standard for scoring and vital abnormality determination.

Further, as shown in FIG. 16, in the vital fever type table information 86, when a temporary drug that changes the value of vital signs is administered to the subject (nursing record information and doctor record information of the temporary drug). The day when the information was entered), the value of the vital signs for that day is displayed as a white circle. Here, as an example, the body temperature on February 7 (Wednesday) is indicated by a white circle. On this day, the body temperature may drop due to the prescription of antipyretic for the subject, so the body temperature is indicated by a white circle, and on the day when no other drug is prescribed, the body temperature is indicated by a black circle. it's shown.

As a result, on the day following the day of administration of the antipyretic (February 8), even if the subject's body temperature dropped and was displayed on the vital fever type table, it was a temporary drop in body temperature due to the effect of the drug. It becomes easier for nurses and others to understand that it is not the result of guaranteeing that the subject's own symptoms have improved or that he / she is in good physical condition.

In addition, the item "Medication" is provided at the bottom of FIG. 16, and by clicking the icon of the drug mark provided in the item, information on the prescribed drug and details of the prescription content can be confirmed. You can move to the screen of individual drug information.

Further, on the list display screen 120, score result information (color-coded according to the score value), a part of life support record information and nursing record information, a doctor record information 90, and a part of medical history information (on the screen) are displayed. (Displayed as "observation content") is posted.

Further, the score result information (numbers 0 to 4 in FIG. 16) posted on the list display screen 120 is information on the total points of the individual score value information 103 described later. In addition, the score result information is displayed in different colors according to the value. For example, 0 points are white, 1 point is pink, 2 points are yellow, 3 points are orange, and 4 points are red.

By displaying the score result information in different colors according to the value in this way, it becomes easier to visually recognize the information of the scoring result of the target person. In addition, by displaying the values of 3 points or more in dark colors and displaying the score result information for a predetermined number of days, the score result information can be confirmed over time, which is a sign that the subject's physical condition is abnormal. It becomes easy to understand, and it becomes reference information to raise the observation level of the subject. For example, in elderly people with chronic diseases, if the total score of the score result information is 3 points or more, it should be noted that the onset of illness or deterioration of physical condition may occur in the next few days. It will be easier to observe.

Further, in the upper right of FIG. 16, the measurement / observation results of the body temperature, blood pressure (top), blood pressure (bottom), pulse rate, respiratory rate, SpO2, and consciousness level of the subject on a certain day correspond to each other. The score value information 103 is displayed. The score value information 103 corresponds to "-2" and "-1" on the left side of 0 and "+1" and "+2" on the right side of 0 with 0 in the center. Further, each score value information 103 is color-coded and displayed according to the value (not shown).

In this way, the body temperature, blood pressure (upper), blood pressure (lower), pulse rate, respiratory rate, SpO2, consciousness level used for scoring, and the score value information 103 that is the result of the scoring are displayed on the basis of 0. By doing so, the information on the scoring result can be easily used as reference information when diagnosing by a doctor.

Further, from the list display screen 120, icons that can be moved to various information input pages and pages on which information can be browsed are displayed.

Further, in the vital heat type table information 86 on the list display screen 120, for each type of vital signs, the average value on each measurement day and the range (upper and lower limits) that became the reference for determining the vital abnormality on each measurement day. It is a range and is indicated by hatching) is displayed.

By confirming such a list display screen 120, the caregiver, the nursing assistant, the nurse, and the doctor can easily obtain the information that they need from the information on the screen.

In addition, when diagnosing a doctor, simply checking the items of diagnosis contribution information 85 makes it easy to obtain useful information for diagnosis without having to interview nurses or check and analyze separate life support record information. You can get it.

Here, the display content on the list display screen 120 is an example of the display screen. The display content of the screen can be changed by clicking the screen switching icon that displays more detailed information according to the type of job, for example. For example, it is possible to switch to a screen according to the type of job by clicking an icon on a screen dedicated to nurses and switching to a screen containing items that the nurse wants to see.

Furthermore, if the information displayed on the list display screen 120 is different for each viewer or for each occupation of the viewer, the viewer is identified by reading a card to which the identification information is given, inputting an ID number, or the like. At the same time, it is possible to add a function of restricting viewing of information.

Next, a specific method for determining the score value information obtained from the vital information will be described.

[6. About calculation of vital average value, scoring and judgment of abnormality]
[6-1. Measurements of body temperature, pulse, systolic blood pressure, diastolic blood pressure, and pulse pressure]
The vital average value and the vital standard deviation are based on the vital information 8 and the remeasured vital information 13 recorded in the information recording unit 4, and the calculation unit 2 functions as the average value calculation means 14 and the standard deviation calculation means 15 of the reference calculation means 5. Is calculated. Further, scoring reference information 102 and vital determination reference information 102a for measured values of body temperature, pulse, systolic blood pressure, diastolic blood pressure, and pulse pressure are set based on the vital mean value and the vital standard deviation.

As a method of setting the vital average value, the vital standard deviation, and the scoring standard information 102 and the vital judgment standard information 102a based on these, the vital information 8 and the remeasured vital information 13 recorded in the information recording unit 4 are used as the vital average value and the like. The method used for the calculation can be mentioned. In this method, the standard deviation based on the vital average value and the distribution of vital information is calculated by the average value calculating means 14 and the standard deviation calculating means 15 using the following equations (3) and (4).

μ = (1 / N) × ΣSi ・ ・ ・ Equation (3)
σ ＝ √ ((1 / N) × Σ (Si−μ) ² ) ・ ・ ・ Equation (4)
Here, μ is the average value of vital information, Si is the measured value of each vital information, N is the number of data of all vital information, and σ is the standard deviation. ΣSi indicates the total of the measured values of all vital information. Further, the measured value of each vital information is a value of vital information acquired under a set predetermined condition as described above. As described above, the content of all vital information referred to here may be a part of the information recorded in the information recording unit 4. The vital information here is a measured value of body temperature, pulse, systolic blood pressure, diastolic blood pressure, and pulse pressure.

When determining the vital information of the target person at a certain determination time point, the above equations (3) and (4) are used from the data of the same target person recorded in the information recording unit 4 starting from the determination time point. Is used to calculate the vital mean value μ and the vital standard deviation σ. That is, the scoring reference information 102 and the vital determination reference information 102a are calculated including the value of the vital sign to be determined measured at the time of determination. Subsequently, the scoring standard setting means 101 and the vital judgment standard setting means 101a use the values represented by the following formula (1) or formula (2) as the scoring standard information 102 and the vital judgment standard information 102a. To do.

μ-nσ ・ ・ ・ Equation (1)
μ + mσ ・ ・ ・ Equation (2)
Here, n and m are numbers larger than 0.

In the scoring reference information 102, the values represented by the above equations (1) and (2) and a predetermined score value, that is, information on a score of 0 to 3 points are combined. This combination is as shown in Table 1 below.

なお、表１において、「−３σ」は、式（１）に基づく「μ−３σ」の値であり、「−２．５σ」は、式（１）に基づく「μ−２．５σ」の値であり、「−２σ」は、式（１）に基づく「μ−２σ」の値であり、「＋３σ」は、式（２）に基づく「μ＋３σ」の値であり、「＋２．５σ」は、式（２）に基づく「μ＋２．５σ」の値であり、「＋２σ」は、式（２）に基づく「μ＋２σ」の値を意味している。また、μ及びσは、所定の条件（例えば３０個分のバイタル情報）で測定された各バイタルサインの測定値から算出される値である。

In Table 1, "-3σ" is the value of "μ-3σ" based on the equation (1), and "-2.5σ" is the value of "μ-2.5σ" based on the equation (1). It is a value, "-2σ" is a value of "μ-2σ" based on the equation (1), and "+ 3σ" is a value of "μ + 3σ" based on the equation (2), and is "+ 2.5σ". Is the value of "μ + 2.5σ" based on the equation (2), and "+ 2σ" means the value of "μ + 2σ" based on the equation (2). Further, μ and σ are values calculated from the measured values of each vital sign measured under predetermined conditions (for example, vital information for 30 pieces).

As shown in Table 1, when scoring the measured values of body temperature, pulse, systolic blood pressure, diastolic blood pressure, and pulse pressure to each score value of 0 to 3 points based on the contents, the above-mentioned The values of "μ ± 2σ, μ ± 2.5σ, and μ ± 3σ" calculated based on the equations (1) and (2) are used.

More specifically, if the input measured value of vital signs is within the range of "μ ± 2σ" in the vital mean value and vital standard deviation calculated at the time of the judgment, a score of 0 points, If the value falls within the range of "μ-2.5σ (or more) to μ-2σ (less than)" or "μ + 2σ (or more) to μ + 2.5σ (less than)", the score is 1 point, "μ". If the value falls within the range of "-3σ (or more) to μ-2.5σ (less than)" or "μ + 2.5σ (super) to μ + 3σ (within)", a score of 2 points, "μ-3σ" If the value falls within the range of "(less than)" or "μ + 3σ (super)", the score is 3 points.

For scoring of the input vital sign measurement value, the standard for each judgment time is set based on the vital average value and vital standard deviation calculated at the time of judgment. In addition, the measured values of body temperature, pulse, systolic blood pressure, diastolic blood pressure, and pulse pressure are classical vital signs according to a normal distribution, and the scoring reference information calculated based on the above formula (1) or formula (2). Reference numeral 102 is a standard that reflects the intra-individual variation of the target person and is a standard set based on the normal distribution of the target person. Therefore, it is an index that can accurately grasp the fluctuation of the physical condition of the subject.

Further, the determination processing means 6 determines the score value information 103 as "caution" when one point is calculated, and determines "warning" when two or more points are calculated. When the score value information 103 is 0 points, the determination result of "caution" or "warning" is not output, and it can be regarded as a "normal" state. That is, when it is determined that one or more points are obtained for each measured value of vital signs, it can be determined as an abnormality divided into two stages of "caution" and "warning". .. This content is the score determination standard information 18.

Further, the determination processing means 6 determines that the value of the vital signs (measured value of each vital sign) is “μ ± 2σ or more” as “abnormality (of the value of vital signs)”.

Further, the score value information 103 calculated from the values of each vital sign, the score determination result information 12 such as attention to this value, and the vital determination result information 12a are recorded in the information recording unit 4 in association with the target person. ..

Further, when the determination processing means 6 determines the "warning" for the score value information 103 or the "warning" for the vital sign value, the health condition management device via the information transmission / reception unit 3c. A warning sound can be emitted in step 1, or an e-mail indicating that a "warning" determination has been made can be sent to an external terminal or the like. This makes it possible to notify a caregiver, a nursing assistant, a nurse, or the like that an abnormality has occurred in the physical condition of the subject. Further, here, mainly for the determination of the score value information 103, only for the determination of the "warning" for the score value information 103, when the "warning determination" is performed, a warning sound is emitted or an e-mail is sent to an external terminal or the like. May be configured to send.

Here, although it was stated that n in the above-mentioned equation (1) or (2) is a number larger than 0, the numerical values such as n and m are "2, 2.5 and" as described above. It is not limited to "3", and the numerical value can be changed as appropriate to obtain the scoring reference information 102.

Further, in the measured values of body temperature, pulse, systolic blood pressure, diastolic blood pressure, and pulse pressure, the numerical values n and m in the formula (1) or the formula (2) do not necessarily have to be the same. Depending on the type of vital signs, the numerical values to be set n and m may be different.

Further, in the scoring standard information 102 shown in Table 1, for example, as a range for distinguishing the score value information of 1 point and the score value information of 2 points, “within μ ± 2σ” and “μ + 2σ (or more) to μ + 2. The range of "5σ (less than)" is set. That is, before and after the numerical value of μ + 2σ, 0 points are given within μ + 2σ, and 1 point is given when μ + 2σ is exceeded, but the setting of the range is not necessarily limited to this content. For example, it is possible to set 0 points for less than μ + 2σ and 1 point for μ + 2σ or more. The same applies to other numerical values.

Further, in the scoring reference information 102 shown in Table 1, the score value information 103 is set in the range of 0 to 3 points, but it is not necessarily limited to this range. For example, it is possible to change the score value information to a setting of scoring in the range of 0 points, 1 point, and 2 points. Furthermore, it is possible to adopt a numerical value larger than 3 points. Needless to say, when the score value information 103 is changed, the scoring reference information 102 can be appropriately set accordingly. This point is also the same in the scoring of oxygen saturation, respiratory rate and consciousness level, which will be described later.

Further, the numerical value determined by the determination processing means 6 to be abnormal with respect to the score value information 103 is not limited to one or more points. For example, a determination of two or more points as abnormal may be adopted. Further, it is not always necessary to judge the abnormality in two stages of "caution" and "warning". For example, the determination may be divided into three or more stages, or the determination may be made in only one stage of "abnormality". However, by judging the abnormality in two stages of "caution" and "warning", it is possible to distinguish the degree of abnormality in the score value information 103, depending on the degree of "caution" and "warning". It is preferable to divide the determination of abnormality into two stages because it becomes easy to set the subsequent countermeasures. This point is also the same in the scoring of oxygen saturation, respiratory rate and consciousness level, which will be described later.

Further, the determination processing means 6 is set to determine whether or not the score value information 103 is an abnormal value based on the measured values of each vital sign, but it is not necessarily set in this way. There is no need to. For example, it is also possible to determine whether or not the "total score" of the score value information 103 based on a plurality of types of vital signs is an abnormal value. In addition, a mode in which a specific type of vital signs (for example, body temperature and pulse) is combined, and whether or not the "total score" of the score value information 103 based on the combined vital signs is an abnormal value is determined. It can also be. However, by determining whether or not the score value information 103 is an abnormal value based on the measured values of each vital sign, the vital sign that is the basis of the abnormality can be easily understood, and measures to be taken after the determination. Since it may easily serve as reference information in the above, it is preferable that the score value information 103 based on the measured values of each vital sign is set so as to determine whether or not it is an abnormal value. This point is also the same in the scoring of oxygen saturation, respiratory rate and consciousness level, which will be described later.

Further, for example, for the "total score" of the score value information 103 based on a plurality of types of vital signs, "caution" and "warning" are set according to the score, and the "caution" and "warning" are set. Can be displayed on the display unit 3b, or an alert can be sounded.

Further, in the scoring standard information 102 shown in Table 1, systolic blood pressure, diastolic blood pressure, pulse pressure, pulse, body temperature, oxygen saturation, respiratory rate, and consciousness level are listed as objects (markers) to be scored. However, this is just one example. Further, the threshold value for distinguishing the points in the scoring reference information 102 is only an example.

That is, the threshold value for distinguishing the type of marker and the score can be set differently depending on the type of disease possessed by the subject and the nature of the subject. For example, a subject having heart failure and a subject having a urinary tract infection are set with different threshold values for distinguishing the type and score of markers. In addition, as a marker, there are cases where only systolic blood pressure is adopted, or both systolic blood pressure and diastolic blood pressure are adopted. Further, for example, a subject who is a healthy person and a subject who is an elderly person having a chronic disease are also set with different threshold values for distinguishing the type and score of the marker.

In addition, the scoring standard information 102 also includes a mode of scoring as a marker, including a history of the subject, a family history of a morbid state in the subject's family and close relatives, a lifestyle, and the like. is there.

In this case, for example, when scoring a subject who has a history of heart disease or a subject who has a family member who has heart disease to determine the degree of heart failure, the history or A score is given to the family history marker, and points are added to the total score of the score value information 103. Further, for example, a subject who has a lifestyle of smoking is given a score as a marker of the lifestyle and is added to the total score of the score value information 103.

Here, the case where the vital information distribution of a plurality of target persons is used to create a distribution of vital information based on the information of different individuals, and the case where the vital information of the same target person is used to create a distribution of vital information of the same individual. The difference from the case of creating is explained.

17 (a) and 17 (b) are both graphs of a normal distribution curve created based on body temperature information. In FIGS. 17 (a) and 17 (b), the horizontal axis is a random variable of body temperature, and the vertical axis is a probability density. (A) is created by a large number of subjects, and (b) is created only by the same subject. FIG. 17 (a) includes people with various normal temperatures and fluctuations in body temperature, and the average value μ is 37.0 ° C., which is the average value of a large number of subjects, and the value of μ + 2σ is 37.7. The values of ° C and μ-2σ are 36.0 ° C.

However, in FIG. 17 (b), the vital information of the same individual is recorded, and since the normal temperature and the fluctuation of the body temperature peculiar to the person are obtained, the average value μ is 35.6 ° C. and the value of μ + 2σ is 37. The value of 0 ° C. and μ-2σ is 35.2 ° C.

That is, if each distribution is used and the reference value that is stabilized by a certain score value when scoring is set to μ + 2σ, in FIG. 17 (a), the body temperature at 37.0 ° C. is the position of μ. (Black circle in FIG. 17 (a)). On the other hand, in FIG. 17 (b), 37. The body temperature at ° C. is at the upper limit of μ + 2σ (black circle in FIG. 17 (b)). That is, in the distribution shown in FIG. 17 (a) and the distribution shown in FIG. 17 (b), the same numerical value of μ + 2σ on the distribution is a completely different value. Therefore, the scoring reference information 102 and the score value information 103 also change, and the determination result also differs. In other words, in determining the target person in FIG. 17B, the scoring reference information 102 and the score value information 103 based on the vital information of a large number of target persons are used to capture "abnormal values". It can be said that it cannot be done. Using the vital information of a large number of people as a reference is nothing but the conventional judgment based on "inter-individual variation", and in order to see the variation of vital information peculiar to the subject, "intra-individual variation" Indicates that is valid.

It should be noted that the subject who performs the average value or fluctuation of the body temperature shown in FIG. 17B does not correspond to a special case. In addition, not only the phenomenon that occurs only in body temperature, but also other vital signs such as systolic blood pressure, diastolic blood pressure, pulse rate, and respiratory rate cause fluctuations peculiar to the subject, and these follow a normal distribution. In the above example of body temperature, there are many elderly people whose body temperature changes in the temperature range shown in FIG. 17 (b), and when determining the health condition of such elderly people by vital signs, "individual" "Fluctuation" is effective.

[6-2. About measured oxygen saturation]
As a method of setting the scoring reference information 102 for the measured value of oxygen saturation measured from the subject, information in a certain numerical range is set as a reference. In the contents shown in Table 1, when scoring each score value of 0 to 3 points for the measured value of oxygen saturation, "93 to 100 (%)" is a score of 0 points, and "90 to 92 (" %) ”Is set to a score of 1 point,“ 85-89 (%) ”is a score of 2 points, and“ 84 (%) or less ”is a score of 3 points.

With respect to the input measured value of oxygen saturation, score value information 103 of 0 to 3 points is calculated based on the scoring reference information 102 shown in Table 1. Further, the determination of whether or not the score value information 103 is an abnormal value by the determination processing means 6 is as described above.

Further, the score value information 103 calculated from the measured value of oxygen saturation and the score determination result information 12 such as attention to this value are recorded in the information recording unit 4 in association with the target person.

Here, the content of the scoring reference information 102 for the oxygen saturation shown in Table 1 is not limited to this. The numerical range for dividing the score value information of 0 to 3 points can be set as the scoring reference information 102 by appropriately changing the setting.

[6-3. Respiratory rate measurements]
As a method of setting the scoring reference information 102 for the measured value of the respiratory rate measured by the subject, a method of using the vital information 8 and the remeasured vital information 13 recorded in the information recording unit 4 for calculating the mode is used. Can be mentioned. In this method, the mode calculating means 110 calculates the mode with respect to the measured value of the respiratory rate under a predetermined condition (for example, 30 breaths). Further, as the measured value of the respiratory rate, the value of the respiratory rate measured under the set conditions can be adopted. As described above, the content of all vital information referred to here may be a part of the information recorded in the information recording unit 4.

When determining the respiratory rate of a subject at a certain determination time, the mode is calculated from the data of the same subject recorded in the information recording unit 4 starting from the determination time. That is, the scoring reference information 102 is calculated including the value of the respiratory rate to be determined, which is measured at the time of determination. The scoring standard setting means 101 sets the scoring standard information 102 from the mode so as to have the contents shown in Table 1.

The contents shown in Table 1 show the criteria set based on the mode of respiratory rate under predetermined conditions. When scoring each score value of 0 to 3 points for respiratory rate, "mode ± 4 (respiratory rate / minute)" is a score of 0 points, and "mode-5 (respiratory rate / minute)" ) ”Or“ mode +5 (respiratory rate / minute) ”is a score of 1 point,“ mode -6 to mode-9 (respiratory rate / minute) ”or“ mode +6 to mode. "+9 (respiratory rate / minute)" is a score of 2 points, and "mode -10 (respiratory rate / minute) or less" or "mode +10 (respiratory rate / minute) or more" is a score of 3 points. Is set to.

The mode value is calculated with respect to the input measured value of the respiratory rate, and based on this mode value, the scoring reference information 102 shown in Table 1 is obtained, and the score value information 103 of 0 to 3 points is calculated. Further, the determination of whether or not the score value information 103 is an abnormal value by the determination processing means 6 is as described above.

Further, the score value information 103 calculated from the measured value of the respiratory rate and the score determination result information 12 such as attention to this value are recorded in the information recording unit 4 in association with the subject.

Here, the content of the scoring reference information 102 for the respiratory rate shown in Table 1 is not limited to this. The numerical range for dividing the score value information of 0 to 3 points can be set as the scoring reference information 102 by appropriately changing the setting.

Further, as the scoring reference information 102 for the measured value of the respiratory rate, the average μ value of the predetermined condition can be used instead of the mode value of the predetermined condition. The value of the average μ can be calculated by the average value calculating means 14. In this case, a predetermined numerical value can be combined with the average μ when setting the scoring reference information 102 and adopted as a reference for scoring.

[6-4. Consciousness level]
A caregiver or the like confirms the consciousness level of the target person, and applies the acquired result to the predetermined observation information set as the scoring reference information 102. A known AVPU assessment can be used to confirm the level of consciousness.

In the AVPU evaluation, normal (awakening and disorientation, A: alert), abnormal (verbal response, but no disorientation, V: verbal), pain response (pain only response, P: Pain), unconscious (U: Unresponsive, which does not respond to words or pain) is set as the predetermined observation state. A caregiver or the like observes the subject, determines which item of the AVPU evaluation the consciousness level corresponds to, and inputs the result via the input unit 3a or the like.

The scoring reference information 102 for the consciousness level is set as shown in Table 1. In Table 1, normal is scored at 0 points, abnormal is scored at 1 point, unresponsiveness is scored at 2 points, and unconsciousness is scored at 3 points. The information processing means 100 calculates the score value information 103 based on the information input by the caregiver or the like. Further, the determination of whether or not the score value information 103 is an abnormal value by the determination processing means 6 is as described above.

Further, the score value information 103 calculated from the evaluation result of the consciousness level of the target person and the score determination result information 12 such as attention to this value are recorded in the information recording unit 4 in association with the target person.

Here, the content of the scoring standard information 102 with respect to the evaluation result of the consciousness level of the subject shown in Table 1 is not limited to this. A consciousness level evaluation method other than the AVPU evaluation may be adopted. Further, the observation state for dividing the score value information of 0 to 3 points can be set as the scoring reference information 102 by appropriately changing the setting.

In the above contents, among the vital signs of the subject, scoring is performed using the measured values of body temperature, pulse, systolic blood pressure, diastolic blood pressure, pulse pressure, oxygen saturation, respiratory rate, and the evaluation result of the consciousness level. This is performed, and it is determined whether or not the calculated score value information 103 is an abnormal value. Here, the vital signs of the subject do not necessarily have to be limited to these contents. For example, it is conceivable to use the urine volume, body weight, pain (presence or absence or degree of pain), and other abnormal medical conditions obtained from the subject as vital sign information as the target for scoring.

[7. Judgment of measurement accuracy and judgment of abnormal values based on the presence or absence of a normal distribution]
In the diagnostic support device 1 to which the present invention is applied, a Q-Q plot can be used as a method for confirming whether the measured vital information fits into the normal distribution. For example, the horizontal axis represents the value of the vital standard deviation, and the vertical axis represents the value of the percentage point of the standard normal distribution corresponding to the cumulative probability of the standard deviation, and the vital standard deviation of the subject is plotted. If each plot is located on a straight line, it is possible to visually confirm that the acquired vital information is normally distributed.

Subsequently, a series of flow of information processing up to the determination of scoring in the software to which the present invention is applied will be described with reference to FIG.
FIG. 18 shows the flow of information processing from the input of vital information to the determination of abnormality in the score value information and the display of the result information.
First, the subjects' vital sign values (measured values of body temperature, pulse, systolic blood pressure, diastolic blood pressure, pulse pressure, oxygen saturation, and respiratory rate) are measured by each measuring device, and the measured values and measurements are taken. The date and time information is input (S1). At this time, the corresponding information of the observation information of the vital reference information 102 is selected or input from the evaluation result of the consciousness level of the subject. The input information is recorded in the information recording unit 4 (DB) as vital information of the target person (S2).

The calculation unit 2 functions as the reference calculation means 5 to calculate the scoring reference information 102 (and the calculation of the vital determination reference information 102a), including the vital information recorded in the information recording unit 4 to be determined. (S3). Here, the vital average value and the vital standard deviation are calculated, and based on these values, scoring standard information (predetermined numerical range, etc.) (and predetermined vital judgment numerical range) under the set conditions is created. Will be done. Here, the criteria for body temperature, pulse, systolic blood pressure, diastolic blood pressure, pulse pressure, and respiratory rate are calculated each time for each scoring (and for determining the value of vital signs).

Next, with respect to the input vital information to be determined, the score value information 103 is calculated for each vital information by the information processing means 100 based on the scoring reference information 102 (S4).

When the score value information 103 is calculated, the determination processing means 6 determines whether or not the score value information is an abnormal value based on the determination criteria (S5). If the result of the determination is not determined to be "abnormal value (caution or warning)", the determination result information is recorded in the information recording unit 4 (DB) (S9), and the determination result information is displayed in the display unit 3b. It is displayed (S11). In addition, based on the vital information of the subject, a thermal type table that graphs changes in vital sign values over time and a normal distribution probability density function (normal distribution curve graph) are created as display information (S10). ), These information can also be confirmed on the display unit 3b.

In addition, regarding the entered vital information to be judged, if the score value information is judged to be "abnormal value (caution or warning)" as a result of the judgment based on the judgment criteria, for example, the display unit. In 3b, a display such as "Do you want to remeasure?" Or a warning of posture when acquiring vitals is displayed, and the subject is confirmed whether or not there is remeasurement vital information (S7).

Here, when the target person, the caregiver, or the like selects "no remeasurement vital information", the judgment result information of the abnormal judgment is recorded in the information recording unit 4 (DB) (S9), and the judgment result information is recorded. It is displayed on the display unit 3b (S11). Further, a vital heat type table 86 (see FIG. 16) and a probability density function of a normal distribution (graph of a normal distribution curve) are created (S10), and these information can also be confirmed on the display unit 3b.

Further, the information recording unit 4 records the value of the vital sign, which is the determination result of the abnormal determination, so as to be included in the vital information 8. As a result, both the vital information in which the score value information is determined to be a normal value and the vital information in which the score value information is determined to be an abnormal value are accumulated in the vital information 8. By collecting at least 30 of these, the intra-individual variation peculiar to the individual is reflected, and it becomes possible to create a normal distribution and capture the abnormal value of vital signs in the target individual.

In addition, when the target person, caregiver, etc. selects "with remeasurement vital information", the input of the remeasured vital sign value and the measurement date and time is prompted, and the information in which the input remeasurement vital information is input is the target. It is recorded in the information recording unit 4 (DB) as the remeasurement vital information of the person (S2). After that, the scoring reference information is calculated again (S3), and the abnormality determination of the score value information (S4) is performed again. In the determination, if it is not determined that the value is abnormal, the determination result information is recorded in the information recording unit 4 (DB) (S9). If it is determined that the value is abnormal, the process may proceed to the step of confirming the presence / absence of remeasurement vital information (S6), or since it is the second determination result, the determination result information is recorded as it is ( You may proceed to S9).

Further, although details are not shown in FIG. 14, the determination processing means 6 determines whether or not the input vital sign value is an abnormal value based on the vital determination reference information 102a. If the result of the determination is not determined to be "an abnormal value (warning)", the determination result information is recorded in the information recording unit 4 (DB), and the determination result information is displayed on the display unit 3b.

Further, regarding the input vital information to be judged, if the value of the vital sign is judged to be "abnormal value (warning)" as a result of the judgment based on the vital judgment standard, for example, the display unit. Display a message such as "Do you want to remeasure?" On 3b and a warning of posture when acquiring vitals, and confirm with the subject whether or not there is remeasurement vital information.

Here, when the target person, the caregiver, or the like selects “no remeasurement vital information”, the judgment result information of the abnormal judgment is recorded in the information recording unit 4 (DB), and the judgment result information is displayed in the display unit 3b. Is displayed in.

Further, the information recording unit 4 records the value of the vital sign, which is the determination result of the abnormal determination, so as to be included in the vital information 8. As a result, both the vital information in which the score value information is determined to be a normal value and the vital information in which the score value information is determined to be an abnormal value are accumulated in the vital information 8. That is, it is possible to accumulate not only the presence / absence of abnormality in the score value information described above but also the presence / absence of abnormality in the vital sign value. By collecting at least 30 of these, the intra-individual variation peculiar to the individual is also reflected, and a normal distribution can be created to capture the abnormal value of vital signs in the target individual.

Subsequently, an example of the flow of using the software and the diagnostic support device of the present invention will be described. The contents shown here are merely examples of the flow, and the procedure for using the present invention is not limited to the following contents.

First, the caregiver or the nursing assistant provides the life support work to the target person and inputs the life support record information 81. In addition, the caregiver or nursing assistant measures each vital sign and inputs the measurement result.

The input life support record information 81 is converted into life support factor information 83 and becomes diagnostic contribution candidate information 84. The diagnosis contribution candidate information 84 is recorded in the nursing record information 82, and serves as reference information when the nurse screens the diagnosis contribution information 85.

Further, the score value result information 103 is calculated based on the input vital sign value. Each information is recorded in the information recording unit 4. The total value of the score value result information 103 becomes the display information of the list display screen 120.

In addition, a vital heat type table is created based on the entered vital sign values. The vital heat type table is updated each time a value of vital signs is entered. The vital heat type table becomes the display information of the list display screen 120.

In addition, the results of caution / abnormality in the individual vital sign values and the results of caution / abnormality in the score value result information 103 based on individual items are different from the list display screen 120. It can be displayed and confirmed on the list screen.

Further, the input life support record information 81 can be confirmed by displaying a detailed life support record on a support progress record screen different from the list display screen 120. This makes it possible to easily share information on life support records between caregivers or nursing assistants.

Here, the vital heat type table does not necessarily have to be configured to be updated each time a value of vital signs is input, and the conditions for updating can be changed as appropriate. However, as a basic setting, it is updated every time the value of vital signs is input, so that the latest normal state can be easily reflected.

In addition, the nurse inputs the nursing information provided to the target person into the nursing information recording unit 82. The nurse can display and confirm the detailed nursing record on the nursing record screen different from the list display screen 120. This makes it possible to easily share information on life support records between caregivers or nursing assistants.

In addition, the nurse confirms the nursing record information 82 and the diagnosis contribution candidate information 84 on the nursing record screen, and screens the diagnosis contribution information 85 that serves as reference information for the doctor's diagnosis. The information of the screening result is displayed as "nursing record (diagnosis contribution information 85)" on the list display screen 120.

By checking the "nursing record (diagnosis contribution information 85)", vital fever type table information, and score result information on the list display screen 120, the doctor can easily and easily see the information necessary for the diagnosis of the subject. You can check. Further, by inputting the doctor record information 90, the doctor can record the instruction of the prescription drug on the list display screen 120 and convey the information of the coping prescription to the nurse or the like.

In addition, by checking the list display screen 120, information about the target person can be easily shared among the caregiver, the nursing assistant, the nurse, and the doctor.

The software and the diagnosis support device of the present invention generate a list display screen 120 including vital heat type table information 86 and diagnosis contribution information 85 based on various information input by a caregiver, a nursing assistant, or a nurse. By checking the list display screen 120, the caregiver, the nursing assistant, the nurse, and the doctor can easily obtain the information that they need from the information on the screen.

In addition, when diagnosing a doctor, simply checking the items of diagnosis contribution information 85 makes it easy to obtain useful information for diagnosis without having to interview nurses or check and analyze separate life support record information. You can get it.

Hereinafter, further application examples of the contents of the diagnostic support device to which the present invention is applied will be described.

[Linkage with electronic medical records and medical systems]
The diagnostic support device to which the present invention is applied may be linked with an electronic medical record introduced in a hospital. Since the electronic medical record records the patient information of the hospital where the patient was set up, by linking it with the information managed by the software to which the present invention is applied, the subject's more detailed underlying disease status and medical history Medical history, medication records, follow-up information, etc. will be available.

Further, it is also conceivable to combine a diagnostic support device to which the present invention is applied with a remote image diagnosis system. For example, it is possible to connect a device such as a camera capable of acquiring image information to a diagnosis support device and transmit the image information of the target person to the hospital side for remote diagnosis. In addition, at that time, by sending the information of the heat type table of the subject to the terminal etc. on the hospital side, it is possible for the doctor to make a diagnosis from a remote place while checking the abnormality of the vital value of the subject. Become.

Further, in a hospital, by giving a specific nurse a tablet terminal or the like having the function of the present invention, it is possible for the nurse to use it as an auxiliary tool when making a diagnosis on behalf of a doctor. Furthermore, it will be useful for nurses with tablet terminals to visit and care for elderly people who have moved into homes or facilities.

In addition, for items used by staff such as long-term care facilities, it is possible to improve the diagnostic level for a specific target person by accumulating information specific to the resident.

[Application to disease prevention technology]
It is conceivable to use a diagnostic support device to which the present invention is applied to a preventive technique for a typical disease whose onset can be predicted by fluctuations in vital signs such as brain disease, pneumonia, heart failure and dehydration. When each of the above-mentioned diseases develops, the vital signs peculiar to the disease often fluctuate, and by setting the fluctuation of the vital signs peculiar to the disease as a determination condition, it is possible to prevent the onset.

[Utilization for PHR (Personal Health Records) and medical big data]
In recent years, the development of information and communication technology called ICT (Information and Communication Technology) has been remarkable, and information terminals such as smartphones, Internet communication environments using wireless LAN, and inexpensive and large-capacity databases such as cloud servers have been developed. With the rise of, it has become possible to send and receive large amounts of data at high speed. As a result, all kinds of data, so-called big data, are collected from all over the world, and services for various purposes are provided using the necessary data.

Japan's Ministry of Health, Labor and Welfare will realize a "comprehensive community care system" that comprehensively secures medical care, long-term care, prevention, housing, and living support in order to support the elderly in the super-aging society as a whole by 2025. It is said. However, most of the underlying medical information is shredded at each business site.

For example, information sharing between medical institutions is not uncommon for the state of using facsimiles and the lack of continuity of health data between facilities, which is prehistoric for the era called the Fourth Industrial Revolution. It looks like it. Although medical information cooperation networks have been tried at more than 170 locations nationwide, they have not been able to cover the entire country and population, and have problems such as low operating costs and low utilization rates, and are integrated into a common platform. It has not been done yet.

Therefore, the Ministry of Health, Labor and Welfare of Japan stated, "Each citizen manages his / her own lifelong health, medical care, and long-term care information in chronological order, and by utilizing that information himself / herself, high quality that matches his / her health condition. We are considering the PHR concept of "aiming to receive services" (from the "Discussion on the Ideal Way of Medical ICT in the Cloud Era" by the Ministry of Internal Affairs and Communications and the Ministry of Health, Labor and Welfare). PHR is an abbreviation for Personal Health Records, which is a mechanism that allows an individual to collect or store medical information and health information about himself / herself for a lifetime and utilize it.

According to this, "Because it is necessary to refer not only the latest information but also past information, the person can manage his / her lifelong information and utilize it for the service he / she wants to use when he / she wants to use it." If this PHR concept is realized, even if there is no platform integration, "digitization of care prevention notebook" and "digitization of medical examination / examination information in municipalities and workplaces, vital data / life-related information" Various operations such as "centralized management" will be possible through medical care, nursing care, health, and personal information linkage.

In addition, in order to create an environment where big data can be easily used in cooperation with each ministry and agency, we will unify the data format (API, etc.) and combine it with the "PHR concept" to make it easier to retrieve necessary data. There is a plan called "Medical ID" concept that makes it easier to identify and continue personal data, and "Revision of the Personal Information Protection Law" that anonymized information can be used for development and treatment without personal permission. There is.

In this concept, the following is mentioned regarding vital data. "The so-called secondary use, in which the person's health, medical care, and long-term care information is anonymized and then analyzed and utilized as big data, is also considered as an important factor in considering the sustainability of the PHR service. In particular, regarding vital data, various devices and services currently exist in the market, but when integrating with PHR and utilizing data, the effect of health management will be effective. It is desirable to unify the API with the data granularity and the platform that collects PHR, with a view to secondary use for purposes such as analysis. "

In the future, it is conceivable to link the diagnostic support device to which the present invention is applied to this PKR concept. When integrating this device and utilizing vital data, the major difference from existing technology is that when performing health management, "tailor-made diagnosis" tailored to each individual's characteristics rather than comparing with general data. This is the point of using so-called "individualized medicine". Furthermore, analysis of medical big data will open the way for preventive medicine, and "artificial intelligence" will be useful for its support. In the future, it is considered that the diagnostic support device to which the present invention is applied will greatly contribute to the realization of the PHR concept.

[Educational software for doctors and nurses]
In addition, the diagnostic support device of the present invention can also be used as an educational tool for medical professionals. By combining the pathological condition identification flowchart database in addition to the present invention, it is possible to create educational software that combines questions and answers based on this information. It is also possible to record and rank the scores of multiple healthcare professionals using educational software to create an evaluation table for doctors and nurses.

[Reference tool for nurses when prescribing medicine]
It can also be used as a reference tool for nurses when prescribing medicine. For example, the information on the medication history of the subject is recorded in the personal information of the subject. As a result, data on "what kind of medicine was prescribed at what kind of symptom" is accumulated, and the pharmacist can use it as reference information when taking the medicine. In addition, depending on the type of drug, it can be applied to take the drug without going through a pharmacist. The pharmacist can easily check the medication history.

[Medication management and delivery service]
Furthermore, by linking the recording of medication history information with the delivery service, it is possible to automatically deliver the medicines that the subject regularly needs at the required time.

[Link with health check data at work or school]
It is also conceivable that the diagnostic support device of the present invention records and utilizes information on regular health examinations at work or school. In this case, since the vital information acquisition period is vacant, cautions, warnings, and abnormality determinations are appropriately set. This will be useful for the health management of the subject. It is also a means of acquiring vast amounts of clinical data. Furthermore, by linking with information on health examinations conducted by public institutions, comprehensive health management of the subjects becomes possible.

[Local health management in remote areas]
The diagnostic support device of the present invention can also be used for on-site health management in remote areas. For example, the diagnostic support device of the present invention is installed in the country concerned on an overseas business trip, a ship in the pelagic fishery, an overseas dispatch destination of the Self-Defense Forces, and the like. This makes it possible to manage the health of the target person even in countries where the medical level is low or where there is no medical equipment. In addition, by combining with the remote diagnosis as described above, a diagnosis by a doctor can be performed.

[Confirmation of disease outbreak status by region]
The diagnostic support device of the present invention can contribute to preventive medical care in regional medical care by linking with information on the occurrence of diseases by region. For example, linking with information on influenza epidemics can lead to preventive measures in areas where diagnostic support devices are used. In addition, the information of the subjects in the endemic area can be utilized as clinical data.

[Detection of air environment]
Furthermore, the air environment detection mechanism and the diagnostic support device of the present invention can be combined. The air environment detection mechanism can detect the concentration of formaldehyde or PM2.5, determine the degree of air pollution in the area from the concentration, and alert the device user. In addition, it can be used as an information acquisition tool for alerting local residents and improving the environment by linking with administrative services.

[Utilization for adjusting indoor environment]
Based on the information recorded in the diagnostic support device of the present invention, it can be considered to be used in a healthcare home where the room temperature and humidity can be adjusted by an air conditioner. It is possible to control the environment to a room temperature and humidity suitable for the subject who is determined to have an abnormal value of vital signs, and to control the temperature to an appropriate set temperature which makes it easy to maintain a healthy state.

[Nursing care record software and long-term care request software]
The diagnostic support device to which the present invention is applied may be linked with the long-term care recording software or the long-term care request software. By managing the information of the long-term care record input to the long-term care record software in the information management department, data such as "what kind of care is appropriate at what kind of symptom" is accumulated. As a result, uniform services can be provided to the care recipients regardless of the skill level of the caregiver or nursing assistant. Yet another aspect of interlocking with the long-term care recording software will be described later.

When linked with the long-term care request software, it can be used as a support tool for calculating long-term care costs. As a result, the costs incurred for the provided long-term care content can be easily confirmed, which can lead to improvement of work efficiency.

[Watching function]
In addition, when linked with a nursing care facility or a watching system for the elderly living alone, when an abnormality in vital values is determined or when an abnormality is found in the behavior of the target person, the person to be watched (for example) , Family, etc.) can be notified. For example, a motion sensor is installed in the house so that when a resident does not move in the toilet for a certain period of time, an alert is automatically sent to the security company and family members. In that case, the vital information record of the person to be watched over may be simultaneously transmitted as data.

[Utilization of application software]
Further, as described above, it is conceivable that the function of the diagnostic support device of the present invention is provided as application software so that it can be used in a mobile terminal or a tablet terminal. As a result, the functions of this device can be easily used, and the convenience can be improved. In addition, it contributes to the improvement of the penetration rate of this device and can lead to the acquisition of a wider range of clinical data.

[Animal health management]
It is also considered that the diagnostic support device of the present invention is used for animals. It can contribute to the health management of not only humans but also pets and zoo animals and the protection of wild animals. In addition, by accumulating clinical data and diagnostic information of animals, medically and academically useful information can be obtained.

As described above, the software of the present invention can efficiently grasp the medical information of the subject from each other among the caregiver, the nursing assistant, the nurse and the doctor, and is accurate in diagnosing the doctor. It is possible to provide high diagnostic support.
In addition, the diagnostic support device of the present invention can efficiently grasp the medical information of the target person among the caregiver, the nursing assistant, the nurse and the doctor, and can accurately diagnose the doctor. High diagnostic support is possible.

1 Diagnosis support device 1a Software 2 Calculation unit 2a Calculation unit 3 Tablet terminal 3a (Tablet terminal) Input unit 3b (Tablet terminal) Display unit 3c (Tablet terminal) Information transmission / reception unit 4 Information recording unit 4a Information recording unit 5 Reference Calculation means 5a Standard calculation means 6 Judgment processing means 6a Judgment processing means 7 Personal information 8 Vital information 9 Estimated time information 10 Attitude information 11 Temperature information 12 Judgment result information 13 Remeasurement vital information 14 Average value calculation means 15 Standard deviation calculation means 16 Normal distribution calculation means 18 Judgment standard information 21a Vital measuring instrument 21b Thermometer 22a Smartphone terminal 22b Personal computer terminal (PC terminal)
23 Information input means 24 Information recording means 24a Information recording means 30a Internet 32a Information management server 32b Software 32c Software 32d Software 50a User terminal 50b External terminal 60a User terminal 60b External terminal 70b Management terminal 81 Life support record information 82 Nursing record information 83 Life Supporting factor information 84 Diagnosis contribution candidate information 85 Diagnosis contribution information 86 Vital fever type table information 87 Disease information 88 History information 89 Temporary drug information 90 Doctor record information 100 Information processing means 100a Information processing means 101 Scoring standard setting means 102 Scoring Criteria information 110 Most frequent value calculation means

Claims (14)

Based on the vital information that is the value of the measured vital signs, the vital heat type table information that graphs the vital information in chronological order and
Life support record information, which is information on the content of life support, and diagnostic contribution information that contributes to the diagnosis of a doctor screened based on nursing record information including at least one information of an individual's medical condition or observation result, and It is software to support the diagnosis of a doctor for an individual by generating list screen information that aggregates and displays.
Information processing equipment,
An information input means that accepts at least a part of the vital information measured from the same individual, the measurement date and time information of the vital information, the life support record information, the nursing record information, and the diagnosis contribution information.
A structured processing means for converting all or a part of the plurality of input life support record information into life support factor information that can be used as the diagnosis contribution information.
When accepting the input of the diagnosis contribution information, the risk life support factor generation means for generating the life support factor information satisfying a predetermined condition as the diagnosis contribution candidate information of the diagnosis contribution information to be input,
The input vital information, the measurement date and time information of the vital information, the life support record information, the nursing record information, and the life support factor information are associated with the individual identification information capable of identifying an individual. Information recording means to record and
A vital heat type table processing means for generating the vital heat type table information of all or a part of the plurality of recorded vital information, and a vital heat type table processing means.
At least, a display information processing means for generating the list screen information including the individual identification information, the vital heat type table information corresponding to the individual identification information, and the diagnosis contribution information in the display information.
Software to function as a means of including. The information recording means records disease information including information on the type of disease including the name of the disease and information on pathological factors defined for each type of disease.
Further, the information processing device
When accepting the input of the diagnostic contribution information
The disease information having a pathological factor related to the nursing record information or the life support record information and the life support factor information satisfying a predetermined condition, which is the basis of the screened diagnosis contribution information, is extracted. Then, from the extracted disease information, information on a pathological factor different from the related pathological factor is generated as the diagnostic contribution candidate information or the diagnostic contribution information, and a deficient pathological factor generating means.
The software according to claim 1, wherein the software is used as a means including the above. The life support record information is at least
Includes information on food volume, drinking water volume, urination volume, defecation volume, urine status, stool status and bathing status.
As the life support factor information, by the structured processing means,
The amount of food is converted into a comparison result with the ratio of eating a meal in a predetermined number of days or a threshold value for the calories of the meal.
The amount of water consumed is converted into a comparison result with a threshold value for the amount of water consumed in a predetermined number of days.
The urination volume is converted into a comparison result with a threshold value for the urination volume in a predetermined number of days.
The defecation volume is converted into a comparison result with a threshold value for the defecation volume in a predetermined number of days.
The urine condition is converted into an abnormal urine condition when comment information on hematuria, urine turbidity, urine odor and other urine is input.
The condition of the stool is converted into an abnormal condition of the stool when comment information on loose stool, bloody stool and other stools is input.
The software according to claim 1 or 2, wherein the bathing state is converted into bathing cancellation when information on the reason for stopping bathing is input. The nursing record information includes temporary drug information which is information on a temporary drug administered to an individual.
The software according to claim 1, claim 2 or claim 3. The information recording means records drug information, which is drug information, and temporary drug information, which is information on temporary drugs to be administered to an individual.
The display information processing means
In the vital fever type table information, the display of the vital signs to be changed on the day when the temporary drug having the effect of changing the vital sign value is administered to the individual, and the display of the vital signs on other days. The software according to claim 1, claim 2, claim 3 or claim 4, which includes information displayed differently from the above and generates the list screen information. The information processing apparatus is further subjected to a reference calculation means for calculating at least one selected from the average μ and the standard deviation σ of all or a part of the plurality of recorded vital information.
Based on a predetermined numerical range set based on at least one selected from the average μ and the standard deviation σ, it is determined whether or not the input predetermined vital information is an abnormal value, and the above-mentioned The predetermined numerical range includes at least the vital determination means set based on the normal distribution with the average μ as the peak value, and
It is software to function as a means including
The vital signs include vital signs that follow a normal distribution.
The vital information includes a value determined by the vital determination means to be an abnormal value.
The vital information for at least 30 pieces reflects the intra-individual variation peculiar to the individual.
The normal distribution is created from at least 30 vital information.
In the vital determination means, the lower limit value and the upper limit value of the following equation (1) expressed using the average μ, the standard deviation σ, and n and m which are numbers larger than 0 are used. As a value, it is determined whether or not the input predetermined vital information is an abnormal value based on at least one of the lower limit value and the upper limit value.
The display information processing means generates the list screen information by including the information of the average μ and the predetermined numerical range on each input date in the vital heat type table information, claim 1, claim 2, claim 2. 3. The software according to claim 4 or 5.
μ-nσ ・ ・ ・ Equation (1)
μ + mσ ・ ・ ・ Equation (2) The information recording means further
When the individual is diagnosed with a specific disease,
The information on the subjective symptom and the objective symptom acquired from the individual and the pattern information of the change of the vital information determined by the vital determination means as an abnormal value among the vital information of the individual are used as the identification information of the individual. The software according to claim 6, which is associated and recorded as the history information of the same individual. Further, the information processing device
Based on the predetermined scoring condition, the input predetermined vital information is scored to calculate the score result information which is the value of the score, and the predetermined scoring condition peaks at least the average μ. The scoring processing means set based on the normal distribution
A score determination means for determining the degree of risk of abnormality by dividing all total points or some points of the score result information into at least two stages or more based on a predetermined score determination condition.
It is software to function as a means including
The predetermined scoring condition is
For at least one measurement selected from body temperature, blood pressure, pulse and pulse pressure, the following equation expressed using the mean μ, the standard deviation σ, and n and m, which are numbers greater than 0, ( The software according to claim 6 or 7, wherein the value of 1) is the lower limit value and the value of the formula (2) is the upper limit value, and at least one of the lower limit value and the upper limit value is used as a reference.
μ-nσ ・ ・ ・ Equation (1)
μ + mσ ・ ・ ・ Equation (2) The display information processing means
Claim 1, claim 2, claim 3, claim 4, claim that the display information includes all total points or a part of the score result information in a predetermined number of days to generate the list screen information. 5. The software according to claim 6, claim 7 or claim 8. The display information processing means further
Claim 1, claim 2, claim 3, claim 1, which includes all or a part of the life support record information, and all or a part of the nursing record information, and generates the list screen information. 4. The software according to claim 5, claim 6, claim 7, claim 8 or claim 9. The display information processing means
Claim 1, claim 2, claim 3, claim 4, claim 5, claim 6, which generates nursing record screen information including all or a part of said nursing record information different from the list screen information. The software according to claim 7, claim 8, claim 9, or claim 10. The display information processing means
Claim 1, claim 2, claim 3, claim 4, claim 5, claim 5, which generates life support record screen information including all or part of said life support record information different from the list screen information. 6. The software according to claim 7, claim 8, claim 9, claim 10 or claim 11. The information input means accepts input of doctor record information, which is diagnostic information for an individual doctor, and receives input.
The information recording means records the input doctor record information in association with the individual identification information.
The display information processing means further
The display information includes the doctor record information, and the list screen information is generated. Claim 1, claim 2, claim 3, claim 4, claim 5, claim 6, claim 7 or claim 8. Described software. Based on the vital information that is the value of the measured vital signs, the vital heat type table information that graphs the vital information for a predetermined period, the life support record information that is the information of the contents of the life support, and the individual's A list screen information that aggregates and displays the diagnosis contribution information that contributes to the diagnosis of the doctor screened based on the nursing record information including at least one information of the medical condition or the observation result is generated, and the doctor for the individual. It is a diagnostic support device to support the diagnosis of
An information input means that accepts at least a part of the vital information measured from the same individual, the measurement date and time information of the vital information, the life support record information, the nursing record information, and the diagnosis contribution information.
A structured processing means for converting all or a part of the plurality of input life support record information into life support factor information that can be used as the diagnosis contribution information.
When accepting the input of the diagnosis contribution information, the risk life support factor generation means for generating the life support factor information satisfying a predetermined condition as the diagnosis contribution candidate information of the diagnosis contribution information to be input,
The input vital information, the measurement date and time information of the vital information, the life support record information, the nursing record information, and the life support factor information are associated with the individual identification information capable of identifying an individual. Information recording means to record and
A vital heat type table processing means for generating the vital heat type table information of all or a part of the plurality of recorded vital information, and a vital heat type table processing means.
At least, a display information processing means for generating the list screen information including the individual identification information, the vital heat type table information corresponding to the individual identification information, and the diagnosis contribution information in the display information.
A diagnostic support device including a display means capable of displaying the list screen information generated by the display information processing means.

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