JP2021179961A - Remote diagnosis and medication teaching system - Google Patents

Abstract

To provide a remote diagnosis and a dispensing system with a high convenience.SOLUTION: A remote-diagnosis and medication-teaching system have a patient terminal and a management device. The patient terminal has a medical interview information input unit for presenting a question for a medical interview and acquiring an answer to the question as medical interview information. The management device has a remote-diagnosis and medication-teaching management unit for selecting a doctor who can provide a remote diagnosis to the patient or a pharmacy that can provide a remote medication guidance to the patient on the basis of the medical interview information.SELECTED DRAWING: Figure 1B

Description

The present invention relates to a telemedicine and medication guidance system.

Various methods have been proposed for remotely performing medical treatment and the like using information and communication technology.

For example, in Patent Document 1, a patient performs self-questioning and self-measurement of blood pressure using a terminal device and sends the result to the server, and when the server determines that the interview or measurement result is abnormal, a doctor determines it. A system that enables remote diagnosis is described.

Patent Document 2 describes a system in which a call center operator talks with a patient over a telephone to ask a question, and a doctor suitable for the patient is called according to the result of the question.

Patent Document 3 describes a dispensing pharmacy capable of dispensing a drug listed in prescription data, and a system for searching and displaying dispensing costs for each dispensing pharmacy.

Japanese Unexamined Patent Publication No. 10-31430 JP-A-2019-185518 Japanese Unexamined Patent Publication No. 2018-156165

However, we still provide a system that focuses on facilitating the use of information on telemedicine and medication instruction, and actively supporting the use of these applications to improve the user experience in telemedicine and medication instruction. It has not been.

In this regard, applications, etc. that can be used on smartphones, PCs (Personal Computers), etc. by digitizing the "medicine notebook" that was conventionally provided on paper (hereinafter, these are collectively referred to as "medicine notebook application"). In recent years, it has become possible to manage the dispensing history of patients.

However, existing medication notebook apps were primarily aimed at managing information about offline dispensing. Therefore, sufficient proposals have not yet been made on a method for effectively utilizing the medicine notebook application in the above-mentioned telemedicine and remote medication instruction.

The present invention has been made to solve such a problem, and an object of the present invention is to provide a highly convenient telemedicine and medication guidance system.

According to one embodiment, the telemedicine and medication guidance system has a patient terminal and a management device, and the patient terminal presents a question for interview and uses the answer to the question as interview information. The management device has a medical inquiry information input unit to be acquired, and the management device selects a doctor who can provide telemedicine to the patient or a pharmacy which can provide remote medication guidance based on the medical inquiry information. It has a guidance management department.
According to one embodiment, the medical inquiry information input unit asks a second question specialized for the estimated medical examination subject or disease name after the first question for estimating the medical examination subject or disease name. Present.
According to one embodiment, the patient terminal further has an inquiry information storage unit that stores at least a part of the input answer, and the inquiry information input unit is stored by the inquiry information storage unit. The answer is the initial value of the interview information.
According to one embodiment, the concierge terminal is provided in place of or in addition to the patient terminal, and the concierge terminal accepts the input of the inquiry information acquired from the patient by the concierge.・ Has a reading section.
According to one embodiment, the interview information input / viewing unit collates the personal identification information acquired by the concierge from the patient with the medical record stored in the management device of the patient. Confirm your identity.
According to one embodiment, the pharmacy terminal further includes a pharmacy terminal used by the pharmacy, and the pharmacy terminal has a dispensing information input / viewing unit that outputs a list of the patients who have delivered the drug.
According to one embodiment, the management device further includes a dispensing information management unit for storing contents explaining a method of taking a drug and the like.
According to one embodiment, the pharmacy terminal is further provided with a pharmacy terminal used by the pharmacy, and the pharmacy terminal has a dispensing information input / browsing unit that receives a question from the patient who has browsed the content and gives medication instruction. ..
According to one embodiment, the dispensing information management unit records the state of the medication instruction and stores it together with the content.
According to one embodiment, the telemedicine and medication instruction system further includes a medical institution terminal used by the doctor, and the medical institution terminal records the state of the telemedicine performed with the patient. It has a medical information input unit.
According to one embodiment, the patient terminal has means for viewing at least one of the telemedicine instruction record and the telemedicine record.
According to one embodiment, the remote medical care and medication guidance system presents a question for interview, obtains the answer to the question as inquiry information, and selects the patient based on the inquiry information. It has a medical inquiry information input unit that selects a doctor or a pharmacy to be consulted from a doctor who can provide remote medical care or a pharmacy that can provide remote medication guidance.
According to one embodiment, the remote medical care and medication guidance system has a patient terminal, a management device, and a pharmacy terminal, and the pharmacy terminal transfers information on a drug delivered to the patient to the management device. The patient terminal transmits, and the patient terminal transmits the comparison result between the delivered drug and the drug received by the patient to the management device, and the management device sends information about the shipped drug. A shipping notification including the above is transmitted to the patient terminal, and a receipt notification including the comparison result is transmitted to the pharmacy terminal.
According to one embodiment, the remote medical care and medication guidance system has a management device and a medical institution terminal or a pharmacy terminal, and the management device stores prescription information or dispensing information related to a patient. , The medical institution terminal or the pharmacy terminal performs online medical treatment or online medication instruction while referring to the prescription information or dispensing information.
According to one embodiment, the telemedicine and medication guidance system comprises providing the online medical examination to explain the health examination or the test result online.
According to one embodiment, the telemedicine and medication guidance system includes the online medication guidance providing online provision of non-pharmaceutical medications or dietary guidance.
According to one embodiment, the telemedicine and medication instruction system identifies the individual patient by image recognition or reading of identification information, wherein the patient includes an animal.
According to one embodiment, the remote medical care and medication guidance system has a management device, and the management device stores patient information, interview information, diagnostic information, prescription information, or dispensing information related to a patient. Upon request of the medical institution terminal or the pharmacy terminal, the patient information, the inquiry information, the diagnosis information, the prescription information or the dispensing information are provided based on the prior authorization of the patient.

INDUSTRIAL APPLICABILITY According to the present invention, it is possible to provide a highly convenient telemedicine and medication guidance system.

It is a block diagram which shows an example of the hardware composition of the telemedicine and medication instruction system 1. It is a correlation diagram of a typical user who uses a telemedicine and medication instruction system 1. It is a block diagram which shows an example of the functional structure of the telemedicine and medication instruction system 1. It is a block diagram which shows an example of the functional structure of the telemedicine and medication instruction system 1. It is a block diagram which shows an example of the functional structure of the telemedicine and medication instruction system 1. It is a block diagram which shows an example of the functional structure of the telemedicine and medication instruction system 1. It is a block diagram which shows an example of the functional structure of the telemedicine and medication instruction system 1. It is a flowchart which shows an example of the operation of the telemedicine and medication instruction system 1.

Hereinafter, specific embodiments to which the present invention is applied will be described in detail with reference to the drawings.

FIG. 1A is a diagram showing an example of a hardware configuration of a telemedicine and medication guidance system 1 according to an embodiment of the present invention. The remote medical care and medication guidance system 1 includes a patient terminal 10 used by a patient, a concierge terminal 20, a management device 30, a medical institution terminal 50 used by a medical institution, and a pharmacy terminal 70 used by a pharmacy. The management device 30 is communicably connected to the patient terminal 10, the medical institution terminal 50, and the pharmacy terminal 70 via the network 90.

FIG. 1B is a correlation diagram of a typical user who uses the system 1. The patient who uses the patient terminal 10 conducts a preliminary interview by himself / herself or with the support of the concierge who uses the concierge terminal 20. After that, the doctor who uses the medical institution terminal 50 is accessed to receive medical treatment remotely. When the doctor prescribes the drug, the doctor sends the prescription data to the pharmacist who uses the pharmacy terminal 70. The prescription data may be sent directly from the doctor to the pharmacy (pharmacist) or via the concierge. The pharmacist prepares the drug, delivers the drug to the patient, and provides remote medication guidance. In this paper, the services provided by pharmacies (pharmacists) to patients, including drug preparation and medication guidance, are referred to as dispensing. Each record of interview, medical treatment, prescription, and dispensing is stored in the management device 10. Each of the patient terminal 10, the medical institution terminal 50, and the pharmacy terminal 70 can access necessary information on the management device 10.

The patient terminal 10, the concierge terminal 20, the medical institution terminal 50, or the pharmacy terminal 70 is typically an information processing device such as a smartphone, a tablet, a wearable device, or a PC (personal computer). The management device 30 is an information processing resource typically accessible via a network 90 such as a server computer, a cloud computing environment, an edge computing environment, and a fog computing environment. These information processing devices (information processing environment) include hardware such as a CPU (central processing unit), a storage device, a communication device, a display device, and an input device, and the CPU reads and executes a program stored in the storage device. By doing so, it is possible to realize a predetermined function as shown below.

2A to 2E are block diagrams showing an example of the functional configuration of the telemedicine and medication guidance system 1 according to the embodiment. The remote medical care and medication guidance system 1 includes an information providing unit 101, a remote medical care / medication guidance application unit 102, a patient information input / storage unit 103, a dispensing information input / storage unit 105, an interview information input unit 107, and an interview information storage unit 109. , Evaluation information input unit 111, payment processing unit 113, patient information input / browsing unit 201, interview information input / browsing unit 203, diagnostic information input / browsing unit 205, prescription information input / browsing unit 207, dispensing information input / browsing unit. 209, Accounting Information Input / Browsing Unit 211, Patient Information Management Department 300, Dispensing Information Management Department 301, Questionnaire Information Management Department 303, Evaluation Information Management Department 305, Diagnosis Information Management Department 307, Prescription Information Management Department 309, Settlement Agent Processing Department 311, Remote medical care / medication guidance management department 313, Patient information browsing department 500, Questionnaire information browsing department 501, Dispensing information browsing department 503, Diagnosis information input / browsing department 505, Prescription information input / browsing department 507, Accounting processing department 509, It has a patient information browsing unit 700, an interview information browsing section 701, a dispensing information input / browsing section 703, a prescription information browsing section 705, and an accounting processing section 709. A typical implementation example of each processing unit is shown below. However, it is basically arbitrary which of the hardware shown in FIG. 1 each processing unit is mounted, and for example, a certain processing unit may be distributed and mounted on a plurality of hardware.

<Patient terminal>
The patient terminal 10 includes an information providing unit 101, a remote medical care / medication guidance application unit 102, a patient information input / storage unit 103, a dispensing information input / storage unit 105, an interview information input unit 107, an interview information storage unit 109, and an evaluation information input. The unit 111 and the settlement processing unit 113 are included. These processing units can be realized as one function of the medicine notebook application that operates on the patient terminal 10. The medicine notebook application may be implemented in any form such as a local application or a web application. The present invention is not limited to the implementation in the medicine notebook application, and can be provided in any form such as a dedicated application specialized in telemedicine and medication instruction.

The information providing unit 101 provides various information to the patient. Typically, the medicine notebook application can provide a news distribution function and a doctor referral function.

News distribution function: The information providing unit 101 displays news received from the management device 30, another distribution server, or the like, advertisements provided by the sponsor, or the like on the screen.

Master doctor referral function: The information providing unit 101 can display the evaluation information acquired from the evaluation information management unit 305 (described later) together with the profile of the doctor who provides the telemedicine by the system 1. The doctor's profile may include, for example, a disease with a proven medical record.

The telemedicine / medication guidance application unit 102 accepts applications for telemedicine and medication guidance from patients. For example, the telemedicine / medication guidance application unit 102 detects that the "online medical treatment / medication guidance" menu provided in the medication notebook application is selected, and detects that the "online medical treatment / medication guidance" menu is selected, and the telemedicine / medication guidance management unit 313 of the management device 30. Request (described later) to start the telemedicine / medication guidance process.

The telemedicine / medication guidance application unit 102 can accept the following requests at the time of application.
Pharmacy designation: Accept pre-designation of pharmacies that provide remote medication guidance.
Doctor designation: Accept pre-designation of doctors who perform telemedicine. For example, a specific doctor can be selected from the doctor referral function of the information providing unit 101 and designated as a request destination for telemedicine.

In addition, the telemedicine / medication guidance application unit 102 may accept telemedicine and medication guidance only for specific chronic diseases and the like. For chronic diseases, it is possible to assume the content of medical treatment and the type of drug to be prescribed to some extent, so for example, doctors who are familiar with medical treatment for specific chronic diseases and pharmacies that stock specific drugs. Etc. are easy to assign. In other words, by limiting the target of telemedicine and medication guidance to chronic diseases, the burden of doctors having to deal with telemedicine of a wide range of diseases and the need for pharmacies to stock a large number of drugs. The burden on the patient can be reduced. In this case, the telemedicine / medication guidance application unit 102 detects that, for example, the "chronic disease-specific online medical treatment / medication guidance" menu provided in the medication notebook application has been selected, and a predetermined number of them. Display the name of the chronic disease. When it is detected that the patient has selected a specific chronic disease name, the telemedicine / medication guidance application unit 102 sends the telemedicine / medication guidance management unit 313 (described later) of the management device 30 to the telemedicine / medication guidance management unit 313 (described later). Request the start of the medication instruction process.

The patient information input / storage unit 103 accepts the input of patient information. Patient information includes, for example, patient's health insurance card information (including identification information linked to the health insurance card such as health insurance card number or my number), payment information (credit card information, etc., cashless payment). Includes information necessary for this purpose), attribute information (name, age, gender, address, etc.), result information of past medical examinations, history of pre-existing medical conditions, side effects, allergies, etc. The patient information input / storage unit 103 associates the input patient information with the patient ID and transmits the input to the patient information management unit 300 of the management device 30. The patient information management unit 300 stores the received patient information.

In addition, the patient may send documents including patient information (for example, health insurance card, credit card, results of past medical examinations, etc.) to the concierge by any means such as fax or e-mail. .. The patient information input / storage unit 103 may also be provided with means for uploading these images. The information included in the transmitted image is input from the patient information input / viewing unit 201 by the concierge. Alternatively, the patient information input / viewing unit 201 may input patient information digitized by an automated means such as OCR.

In addition, the patient can import various medical data and the like related to himself / herself from any data source and register them as patient information. For example, the patient information input / storage unit 103 requests a server (not shown) of an examination company to transmit examination data of a patient held by the server. At this time, if necessary, information (ID, passcode, etc.) indicating consent by the patient can be transmitted. The patient information input / storage unit 103 transmits the received test data to the patient information management unit 300 of the management device 30 and stores it.

In addition, the patient information input / storage unit 103 can accept the registration of the referral letter that the patient has been issued by the doctor in the past. The letter of introduction may be issued online or offline. The patient information input / storage unit 103 may accept the contents of the referral letter as text data. Alternatively, you may accept the input of online location information in which the contents of the letter of introduction are stored. Alternatively, input of data in which these information are encoded (QR code (registered trademark), etc.) may be accepted. Alternatively, the input of the image of the letter of introduction may be accepted. The information included in the image may be input from the patient information input / viewing unit 201 by the concierge, or may be input by the patient information input / viewing unit 201 as data by an automated means such as OCR.

Preferably, the patient information input / storage unit 103 can give the doctor described in the referral letter an access permission to the patient's personal information in advance. That is, in the management device 30, restrictions are provided so that various personal information can be accessed only when a passcode issued based on the patient's will is input. The patient information input / storage unit 103 issues a passcode for accessing each processing unit of the management device 30 to the medical institution terminal 50 of the doctor. The passcode may be a one-time passcode that can be accessed only once, or a passcode that can be accessed permanently or for a predetermined period of time. This allows the physician mentioned in the referral letter to access the patient's medical information at any time, for example, in the event of an unforeseen event.

Further, the patient information input / storage unit 103 can duplicate the patient information managed by the patient information management unit 300 and store the patient ID issued by the patient information management unit 300 in the patient terminal 10. Further, the saved information can be edited and transmitted to the patient information management unit 300 again. The patient information management unit 300 stores the received patient information.

The dispensing information input / storage unit 105 is a main function of the medicine notebook application, and stores and displays the dispensing information of the patient. The dispensing information is a history of dispensing performed by a pharmacy to a patient so far, and includes, for example, a patient ID, a dispensing date, a name and amount of a drug, a record of medication instruction, and the like. Dispensing information is typically input from the dispensing information input unit 705 of the pharmacy terminal 70 each time dispensing is performed, and is stored in the dispensing information management unit 301 of the management device 30. The dispensing information input / storage unit 105 can duplicate the dispensing information related to its own patient ID from the dispensing information management unit 301 and store it in the patient terminal 10 or display it on a display device.

In addition, the dispensing information input / storage unit 105 browses various contents (videos, texts, etc. prepared in advance for explaining the medication method, etc. to the patient) for medication instruction stored in the dispensing information management unit 301. Alternatively, it may be provided with means for sending and receiving a message to and from the dispensing information input / reading unit 703 of the pharmacy terminal 70 to receive remote medication instruction.

Further, the dispensing information input / storage unit 105 may be provided with a means for transmitting a drug receipt notification to the management device 30 when the drug delivered from the pharmacy is received. For example, near the scheduled arrival date of a drug, the telemedicine / medication guidance management unit 313 of the management device 30 sends a notification including a message such as "Did you receive the drug?" And a list of the delivered drugs. do. The message or list can be in any format including text, images, photographs, moving images or sounds. The dispensing information input / storage unit 105 displays the received notification on the screen and prompts the user to collate the contents of the shipping list with the actually received drug. The user himself / herself confirms whether the contents of the shipping list and the received drug match in terms of type and number, and notifies the telemedicine / medication guidance management department 313 of the confirmation result. Typically, the dispensing information input / storage unit 105 displays buttons such as “matching” and “wrong” on the screen, and notifies the telemedicine / medication guidance management unit 313 of the contents of the button selected by the user. .. When "wrong" is selected, the dispensing information input / storage unit 105 may provide a function of having the patient input the received drug information and uploading it to the telemedicine / medication guidance management unit 313. The received drug information can be entered in any format including text, images, photographs, moving images, audio and the like.

The interview information input unit 107 accepts the input of the interview information by the patient. The interview refers to the question asked prior to receiving telemedicine and medication instruction, and the interview information refers to the answer to the question. The interview information includes, for example, "What are your symptoms today?" (Chief complaint), "What kind of illness have you had in the past?" (History), "Have you had allergies in the past?" Includes answers to questions such as "Are you there?" (History of allergies). The question is typically transmitted from the interview information management unit 303 of the management device 30. The interview information input unit 107 displays these questions on the screen of the patient terminal 10 and can acquire an answer that the patient selects or freely inputs. The inquiry information input unit 107 transmits the acquired inquiry information to the inquiry information management unit 303 of the management device 30. The interview information management unit 303 stores the received interview information in association with the patient ID of the sender.

The interview information storage unit 109 is a means for storing reusable interview information among the interview information input by the patient in the past. For example, information such as medical history and allergic history does not change frequently, and it is highly likely that the same information will be input each time an interview is made. Therefore, these interview information can be reused. The interview information storage unit 109 stores the reusable inquiry information input by the patient at the time of the interview, and at the next inquiry, the reusable answer is input to the answer input field of the inquiry information input unit 107. It can be in the state of being input in advance. As a result, the time and effort required to input the interview information can be significantly reduced.

The patient can also edit the stored interview information as appropriate. That is, when accepting the input of the interview information, the inquiry information input unit 107 allows the editing of the initial value input in advance. The interview information storage unit 109 stores the edited interview information, and can reuse the edited interview information as an initial value at the next inquiry. As a result, the patient can update or deepen the contents of the interview information.

In the present embodiment, the interview information storage unit 109 is provided in the patient terminal 10, but the present invention is not limited to this, and may be provided in, for example, the management device 30. In this case, the reusable interview information is stored in association with the patient ID. As a result, even when the same patient uses a plurality of different patient terminals 10, a part of the interview information can be reused.

The evaluation information input unit 111 accepts the input of the evaluation to the doctor by the patient. Typically, the evaluation information input unit 111 causes the doctor in charge of the medical treatment to input the evaluation to the doctor in charge of the medical treatment, for example, in the form of selecting the evaluation value from several stages after the telemedicine is completed. You may enter any comments you like. The evaluation input by each patient is transmitted as evaluation information to the evaluation information management unit 305 of the management device 30. The evaluation information is accumulated and processed by the evaluation information management unit 305, and is used by the above-mentioned information providing unit 101 and the like. Further, the evaluation information input unit 111 may notify the medical institution terminal 50 of the content of the input evaluation. Such feedback allows doctors to improve the content of their medical care.

Further, the evaluation information input unit 111 may input the evaluation for the pharmacy, the evaluation for the concierge, and the evaluation for the application (medicine notebook application, etc.) that realizes the patient terminal 10 by the same method. These evaluations are notified to the pharmacy terminal 70, the concierge terminal 20, and the like, and are fed back to each user. If the evaluation information input unit 111 is equal to or higher than a predetermined standard (for example, 3 or more in 5 stages) for an application (medicine notebook application, etc.) that realizes the patient terminal 10, the evaluation information input unit 111 of the application in the application distribution platform. Patients may be encouraged to fill in an assessment as well.

The settlement processing unit 113 acquires the accounting amount for telemedicine, medication instruction, etc. from the settlement agency processing unit 311 of the management device 30. That is, the settlement agency processing unit 311 of the management device 30 automatically calculates the amount to be paid by the patient to the medical institution or the pharmacy in relation to the telemedicine, the medication instruction, and the like, and notifies the settlement processing unit 113. The settlement processing unit 113 receives the acquired accounting amount from the patient. For example, the payment processing unit 113 has a function of executing a payment by a patient using a credit card, a debit card, electronic money, another payment agency service, or the like. Since such so-called online cashless payment is a known technology, the description of a specific implementation method is omitted in this paper.

<Concierge terminal>
The concierge terminal 20 has a patient information input / browsing unit 201, an interview information input / browsing unit 203, a diagnostic information input / browsing unit 205, a prescription information input / browsing unit 207, a dispensing information input / browsing unit 209, and an accounting information input / browsing unit. Including part 211. These processing units can be realized as one function of the concierge application running on the concierge terminal 20. The concierge application may be implemented in any form such as a local application or a web application. The concierge can assist various operations while communicating with each user (patient, doctor or pharmacist), for example, in a call center or the like.

The patient information input / viewing unit 201 accepts the input of patient information heard from the patient by the concierge. Hearing from the patient means obtaining information from the patient via telephone, video call, electronic transmission of text or images, or other remote communication means or face-to-face. The patient information that can be input includes, for example, health insurance card information (health insurance card number, etc.), payment information (credit card information, etc.), attribute information, and the like. The patient information input unit 201 associates the input patient information with the patient ID and transmits it to the patient information management unit 300 of the management device 30. The patient information management unit 300 stores the received patient information.

In addition, the concierge can import various medical data related to patients from any data source and register them as patient information. For example, the patient information input / viewing unit 201 requests a server (not shown) of an examination company to transmit examination data of a patient held by the server. At this time, if necessary, information (ID, passcode, etc.) indicating consent by the patient or doctor can be transmitted. Here, the patient information input / reading unit 201 shall hold in advance information indicating the consent of the patient or the doctor, or shall hear from the patient or the doctor. The patient information input / viewing unit 201 transmits the received examination data to the patient information management unit 300 of the management device 30 and stores it.

In addition, the patient information input / reading unit 201 can accept the registration of the referral letter that the patient has been issued by the doctor in the past. The letter of introduction may be issued online or offline. The patient information input / reading unit 201 may accept the content of the referral letter as text data. Alternatively, you may accept the input of online location information in which the contents of the letter of introduction are stored. Alternatively, input of data in which these information are encoded (QR code (registered trademark), etc.) may be accepted. Alternatively, the content of the referral letter may be heard from the patient by receiving an image of the referral letter. The description content of the referral letter may be input from the patient information input / viewing unit 201 by the concierge, or the patient information input / viewing unit 201 may input the image as data by an automated means such as OCR.

Preferably, the patient information input / reading unit 201 can give the doctor described in the referral letter access permission to the patient's personal information in advance. That is, in the management device 30, restrictions are provided so that various personal information can be accessed only when a passcode issued based on the patient's will is input. The patient information input / viewing unit 201 issues a passcode for accessing each processing unit of the management device 30 to the medical institution terminal 50 of the doctor. The passcode may be a one-time passcode that can be accessed only once, or a passcode that can be accessed permanently or for a predetermined period of time. This allows the physician mentioned in the referral letter to access the patient's medical information at any time, for example, in the event of an unforeseen event.

In addition, the patient information input / viewing unit 201 can view specific patient information stored in the patient information management unit 300 of the management device 30. The patient information that can be viewed includes the patient ID issued by the patient information management unit 300. It may provide an editing function and a duplication function of the accumulated patient information. As a result, patient information can be updated and new patient information can be easily input.

The interview information input / reading unit 203 accepts the input of the interview information heard by the concierge from the patient. The question used in the interview is transmitted from the inquiry information management unit 303 of the management device 30. The interview information storage unit 107 displays these questions on the screen of the concierge terminal 20 and accepts the input of the answer by the concierge. The inquiry information input unit 203 transmits the acquired inquiry information together with the patient ID to the inquiry information management unit 303 of the management device 30. The interview information management unit 303 stores the received interview information.

Further, the inquiry information input / reading unit 203 can browse the specific inquiry information stored in the inquiry information management unit 303 of the management device 30. It may provide an editing function and a duplication function of the accumulated interview information. As a result, the interview information can be updated and new interview information can be easily input.

The diagnostic information input / reading unit 205 accepts the input of the diagnostic information that the concierge has heard from the doctor. Hearing from a doctor means obtaining information from a doctor via telephone, video call, electronic transmission of text or images, or other remote communication means or face-to-face. The diagnostic information is information indicating the result of telemedicine including the diagnosis name and the like, and includes, for example, a patient ID, a medical treatment date, a diagnosis name and the like. When a test that can be performed remotely such as blood pressure, body temperature, and blood glucose level is performed, the test result may be included. The diagnostic information input unit 205 transmits the input diagnostic information to the diagnostic information management unit 307 of the management device 30. The diagnostic information management unit 307 stores the received diagnostic information.

Further, the diagnostic information input / browsing unit 205 can browse the specific diagnostic information stored in the diagnostic information management unit 307 of the management device 30. It may provide an editing function and a duplication function of the accumulated diagnostic information. As a result, the diagnostic information can be updated and new diagnostic information can be easily input.

The prescription information input / reading unit 207 accepts the input of the prescription information that the concierge has heard from the doctor. The prescription information is a record of a drug prescribed by a doctor based on findings in telemedicine, and is an electronic prescription, and includes, for example, a patient ID, a prescription date, a name and amount of the drug, and the like. The prescription information input / viewing unit 207 transmits the input prescription information to the prescription information management unit 309 of the management device 30. The prescription information management unit 309 stores the received prescription information. After that, the prescription information viewing unit 705 of the pharmacy terminal 70 refers to the prescription information stored in the prescription information management unit 309 and uses it for dispensing to the patient.

Further, the prescription information input / reading unit 207 can browse the specific prescription information stored in the prescription information management unit 309 of the management device 30. It may provide an editing function and a duplication function of the accumulated prescription information. As a result, the prescription information can be updated and new prescription information can be easily input.

The dispensing information input / reading unit 209 accepts the input of prescription information that the concierge has heard from the doctor. The dispensing information is a record of dispensing performed by a pharmacy to a patient, and includes, for example, a patient ID, a dispensing date, a name and amount of a drug, a record of medication instruction, and the like. The dispensing information input unit 209 transmits the input dispensing information to the dispensing information management unit 301 of the management device 30. The dispensing information management unit 301 stores the received dispensing information.

Further, the dispensing information input / viewing unit 209 can browse specific dispensing information stored in the dispensing information management unit 301 of the management device 30. It may provide an editing function and a duplication function of the accumulated dispensing information. This makes it possible to update the dispensing information and easily input new dispensing information.

The accounting information input / reading unit 211 accepts the input of accounting information that the concierge has heard from a doctor or a pharmacy. The accounting information includes the accounting amount for telemedicine at a medical institution or the accounting amount for dispensing including remote medication instruction at a pharmacy. The accounting information input unit 211 transmits the input accounting information to the settlement agency processing unit 311 of the management device 30. After that, the settlement agency processing unit 311 adds up these amounts and charges the patient.

<Medical institution terminal>
The medical institution terminal 50 includes a patient information viewing unit 500, a medical inquiry information viewing unit 501, a dispensing information viewing unit 503, a diagnostic information input / viewing unit 505, a prescription information input / viewing unit 507, and an accounting processing unit 509. These processing units can be realized as one function of a doctor's application operating on the medical institution terminal 50. The doctor's application may be implemented in any form, such as a local application or a web application.

The patient information viewing unit 500 acquires patient information stored in the patient information management unit 300 of the management device 30 and associated with the patient ID to be treated, and displays it on the screen. The patient information includes, for example, health insurance card information (health insurance card number, etc.), attribute information, and the like. By using the patient information browsing unit 500, the doctor can perform telemedicine while browsing the patient information. The patient information viewing unit 500 can also duplicate the information acquired from the patient information management unit 300 and store it in the medical institution terminal 50.

In addition, doctors can import various medical data related to patients from any data source and register them as patient information. For example, the patient information viewing unit 500 requests a server (not shown) of an examination company to transmit examination data of a patient held by the server. At this time, if necessary, information (ID, passcode, etc.) indicating consent by the doctor can be transmitted. The patient information viewing unit 500 transmits the received test data to the patient information management unit 300 of the management device 30 and stores it. Of course, the test data stored in the patient information management unit 300 can be viewed by the patient information viewing unit 500.

The inquiry information viewing unit 501 acquires the inquiry information stored in the inquiry information management unit 303 of the management device 30 and associated with the patient ID to be treated, and displays it on the screen. The patient shall have registered the interview information in advance before receiving telemedicine and medication instruction. By using the inquiry information viewing unit 501, the doctor can perform telemedicine while viewing the inquiry information input prior to the medical treatment. It is also possible for the interview information viewing unit 501 to duplicate the information acquired from the interview information management unit 303 and store it in the medical institution terminal 50.

The diagnostic information input / viewing unit 505 accepts the input of diagnostic information by a doctor. The diagnostic information is information indicating the result of telemedicine including the diagnosis name and the like, and includes, for example, a patient ID, a medical treatment date, a diagnosis name and the like. When a test that can be performed remotely such as blood pressure, body temperature, and blood glucose level is performed, the test result may be included. The diagnostic information input / viewing unit 505 transmits the input diagnostic information to the diagnostic information management unit 307 of the management device 30. The diagnostic information management unit 307 stores the received diagnostic information.

Alternatively, the doctor may send a document containing the diagnostic information related to the telemedicine to the concierge by any means such as fax or e-mail. The diagnostic information input / viewing unit 505 can also be provided with means for uploading these images. The diagnostic information included in the transmitted image is input from the diagnostic information input / viewing unit 205 by the concierge. Alternatively, the diagnostic information input / viewing unit 205 may input diagnostic information digitized by an automated means such as OCR.

Further, the diagnostic information input / viewing unit 505 acquires the diagnostic information stored in the diagnostic information management unit 307 of the management device 30 and associated with the patient ID to be treated, and displays it on the screen. .. By using the diagnostic information input / reading unit 505, the doctor can perform telemedicine while browsing the past diagnostic information of the patient. The diagnostic information input / viewing unit 505 can also duplicate the information acquired from the diagnostic information management unit 307 and store it in the medical institution terminal 50.

The dispensing information viewing unit 503 acquires the dispensing information stored in the dispensing information management unit 301 of the management device 30 and associated with the patient ID to be treated, and displays it on the screen. The dispensing information management unit 301 stores the history of dispensing performed by the pharmacy to the patient, for example, the dispensing date, the name and amount of the drug, the record of the medication instruction, and the like. By using the dispensing information browsing unit 503, the doctor can perform telemedicine while browsing the past dispensing information of the patient. The dispensing information viewing unit 503 can also duplicate the information acquired from the dispensing information management unit 301 and store it in the medical institution terminal 50.

The prescription information input / reading unit 507 accepts the input of prescription information by a doctor. The prescription information is a record of a drug prescribed by a doctor based on findings in telemedicine, and is an electronic prescription, and includes, for example, a patient ID, a prescription date, a name and amount of the drug, and the like. The prescription information input / viewing unit 507 transmits the input prescription information to the prescription information management unit 309 of the management device 30. The prescription information management unit 309 stores the received prescription information. After that, the prescription information viewing unit 705 of the pharmacy terminal 70 refers to the prescription information stored in the prescription information management unit 309 and uses it for dispensing to the patient.

Alternatively, the doctor may send a document including prescription information related to this telemedicine, for example, a prescription to the concierge by any means such as fax or e-mail. The prescription information input / viewing unit 507 can also be provided with means for uploading these images. The diagnostic information included in the transmitted image is input by the concierge from the prescription information input / viewing unit 207. Alternatively, the prescription information input / viewing unit 207 may input diagnostic information digitized by an automated means such as OCR.

Further, the prescription information input / viewing unit 507 acquires the prescription information stored in the prescription information management unit 309 of the management device 30 and associated with the patient ID to be treated, and displays it on the screen. .. The prescription information management unit 309 stores prescriptions that doctors have created so far. By using the prescription information input / reading unit 507, the doctor can perform telemedicine while browsing the patient's past prescription information. The prescription information input / viewing unit 507 can also duplicate the information acquired from the prescription information management unit 309 and store it in the medical institution terminal 50.

The accounting department 509 calculates the insurance points for this telemedicine and sends it to the computer of the insurer (health insurance association, etc.). Further, the accounting processing unit 509 calculates the accounting amount, that is, the amount billed to the patient based on the insurance points, and transmits it to the settlement agent processing unit 311 of the management device 30. Since there are many publicly known technologies for the automatic calculation of insurance points and accounting amounts, the description of specific processing details will be omitted in this paper.

Alternatively, the doctor may send a document containing information on the accounting amount for the telemedicine, such as an image of an invoice or a receipt, to the concierge by any means such as fax or e-mail. The accounting unit 509 may also provide means for uploading these images. The accounting amount included in the transmitted image is input by the concierge from the accounting information input / viewing unit 211. Alternatively, the accounting information input / viewing unit 211 may input the accounting amount digitized by an automated means such as OCR.

<Pharmacy terminal>
The pharmacy terminal 70 includes a patient information browsing unit 700, a medical inquiry information browsing section 701, a dispensing information input / browsing section 703, a prescription information browsing section 705, and an accounting processing section 709. These processing units can be realized as a function of a pharmacist application running on the pharmacy terminal 70. The pharmacist application may be implemented in any form, such as a local application or a web application.

The patient information viewing unit 700 acquires patient information stored in the patient information management unit 300 of the management device 30 and associated with the patient ID to be treated, and displays it on the screen. The patient information includes, for example, health insurance card information (health insurance card number, etc.), attribute information, and the like. By using the patient information browsing unit 700, the pharmacist can prepare a drug, provide remote medication guidance, and the like while browsing the patient information. The patient information viewing unit 700 can also duplicate the information acquired from the patient information management unit 300 and store it in the pharmacy terminal 70.

The inquiry information viewing unit 701 acquires the inquiry information stored in the inquiry information management unit 303 of the management device 30 and associated with the patient ID to be treated, and displays it on the screen. The patient shall have registered the interview information in advance before receiving online medical treatment and dispensing. By using the inquiry information viewing unit 701, the pharmacist can perform dispensing while viewing the inquiry information input in advance. It is also possible for the interview information viewing unit 701 to duplicate the information acquired from the interview information management unit 303 and store it in the pharmacy terminal 70.

Dispensing information input / reading unit 703 accepts input of dispensing information by a pharmacist. The dispensing information is a record of dispensing performed by a pharmacy to a patient, and includes, for example, a patient ID, a dispensing date, a name and amount of a drug, a record of medication instruction, and the like. The dispensing information input / viewing unit 703 transmits the input dispensing information to the dispensing information management unit 301 of the management device 30. The dispensing information management unit 301 stores the received dispensing information.

Alternatively, the pharmacist may send the document containing the dispensing information to the concierge by any means such as fax or e-mail. The dispensing information input / viewing unit 703 can also be provided with means for uploading these images. The dispensing information contained in the transmitted image is input from the dispensing information input / viewing unit 209 by the concierge. Alternatively, the dispensing information input / viewing unit 209 may input dispensing information digitized by an automated means such as OCR.

Further, the dispensing information input / viewing unit 703 acquires the dispensing information stored in the dispensing information management unit 301 of the management device 30 and associated with the patient ID to be treated, and displays it on the screen. .. The dispensing information management unit 301 stores the history of dispensing performed by the pharmacy to the patient, for example, the dispensing date, the name and amount of the drug, and the like. By using the dispensing information input / viewing unit 703, the pharmacist can perform dispensing while browsing past dispensing information. The dispensing information input / viewing unit 703 can also duplicate the information acquired from the dispensing information management unit 301 and store it in the pharmacy terminal 70.

Further, the dispensing information input / viewing unit 703 may be provided with a means for transmitting a drug delivery notification to the management device 30 when the drug is shipped to the patient. For example, the dispensing information input / viewing unit 703 accepts registration of a list of prepared drugs that are ready for shipping, and sends the registration to the telemedicine / medication guidance management unit 313 of the management device 30. The list can be in any format including text, images, photographs, moving images or audio. The telemedicine / medication guidance management unit 313 of the management device 30 sends a notification including a message such as "Did you receive the drug?" And a list of the delivered drugs to the patient terminal when the scheduled arrival date of the drug is approaching. Send to 10. Further, the dispensing information input / reading unit 703 may be provided with a means for receiving a notification of receipt of the drug from the patient. Typically, the telemedicine / medication guidance management unit 313 of the management device 30 notifies the dispensing information input / viewing unit 703 that the notification of receipt of the drug has been received from the patient terminal 10. If there is a discrepancy between the content of the shipping list and the content of the drug actually received by the patient, information on the drug received by the patient will be sent with the notification. The received drug information can be in any format, including text, images, photographs, moving images or audio. The pharmacist can check the information on the drug received by the patient, instruct the patient to return the drug, or reship the correct drug.

The prescription information viewing unit 705 acquires prescription information stored in the prescription information management unit 309 of the management device 30 and associated with the patient ID to be treated, and displays it on the screen. The prescription information management unit 309 stores prescription information that the doctor has given to the patient, such as the prescription date, the name and amount of the drug, and the like. By using the prescription information viewing unit 705, the pharmacist can perform dispensing while browsing the electronic prescription online. The prescription information viewing unit 705 can also duplicate the information acquired from the prescription information management unit 309 and store it in the pharmacy terminal 70.

The prescription information viewing unit 705 may have a function of transmitting prescription information acquired from the prescription information management unit 309 of the management device 30 by fax, e-mail, or the like. For example, the prescription information viewing unit 705 automatically acquires new prescription information by fetching to the prescription information management unit 309 or pushing from the prescription information management unit 309, and the acquired prescription information is sent to the fax or e-mail address of the pharmacy. Send by push type. This allows the pharmacy to receive new prescription information more reliably.

The accounting department 709 calculates the insurance points for this dispensing and sends it to the computer of the insurer (health insurance association, etc.). Further, the accounting processing unit 709 calculates the accounting amount, that is, the amount billed to the patient based on the insurance points, and transmits it to the settlement agent processing unit 311 of the management device 30. Since there are many publicly known technologies for the automatic calculation of insurance points and accounting amounts, the description of specific processing details will be omitted in this paper.

Alternatively, the pharmacy may send a document containing information on the accounting amount for this dispensing, such as an image of an invoice or a receipt, to the concierge by any means such as fax or e-mail. The accounting unit 709 may also provide means for uploading these images. The accounting amount included in the transmitted image is input by the concierge from the accounting information input / viewing unit 211. Alternatively, the accounting information input / viewing unit 211 may input the accounting amount digitized by an automated means such as OCR.

<Management device>
The management device 30 includes a patient information management unit 300, a dispensing information management unit 301, a medical inquiry information management unit 303, an evaluation information management unit 305, a diagnostic information management unit 307, a prescription information management unit 309, a settlement agency processing unit 311 and a remote medical care / remote medical care. Includes medication guidance management department 313. These processing units can be realized as a function of an application or service operating in the management device 30.

The patient information management unit 300 stores and provides patient information. The patient information is input from the patient information input / storage unit 103 or the patient information input unit 201 by the patient or the concierge. The patient information management unit 300 stores the input patient information. The patient information includes, for example, health insurance card information (health insurance card number, etc.), attribute information, and the like. When new patient information is registered, the patient information management unit 300 unique patient ID is issued and added to the patient information. Further, the patient ID is notified to the patient information input / storage unit 103 or the patient information input / viewing unit 201. Further, the patient information management unit 300 responds to a request from the patient, concierge, doctor or pharmacist, and has a patient information input / storage unit 103, a patient information input / reading unit 201, a patient information viewing unit 500, and a patient information viewing unit 700. The accumulated dispensing information is transmitted to.

The dispensing information management unit 301 accumulates and provides dispensing information. Dispensing information is input by the pharmacist from the dispensing information input / viewing unit 703 every time the pharmacy dispenses to the patient. The dispensing information management unit 301 accumulates the input dispensing information. In addition, it has been accumulated in the dispensing information input / storage unit 105, the dispensing information input / reading unit 209, the dispensing information viewing unit 503, or the dispensing information input / viewing unit 703 in response to a request from a patient, concierge, doctor, or pharmacist. Dispensing information is sent.

Further, when the remote medical care / medication guidance management unit 313 receives the drug receipt confirmation result from the patient, the dispensing information management unit 301 may accumulate the contents together with the dispensing information.

The interview information management unit 303 transmits questions related to the interview, stores and provides the interview information.

Transmission of question: The inquiry information management unit 303 sequentially transmits questions for inquiry to the inquiry information input unit 107 of the patient terminal 10 or the inquiry information input / reading unit 203 of the concierge terminal 20. Sequential transmission means that when an answer to a certain question is received, the next question is transmitted. You may send multiple questions at once.

The interview information management unit 303 may change the question to be transmitted next according to the answer. For example, first, a question for estimating the subject or disease name to be examined is sent, and the examination subject or disease name or the like is estimated based on the answer. For example, the interview information management unit 303 first sends a question "What are the symptoms today?". If "stomach hurts" is selected as the answer to this, the interview information management department 303 presumes that the subject to be examined is "gastroenterology internal medicine". Or, if the answer is "high blood glucose level", it is presumed that the disease name is "diabetes". Here, it is assumed that the interview information management unit 303 holds in advance the correspondence relationship between the answer and the subject to be examined, the name of the disease, etc. in the form of a table or the like. The question for estimating the subject to be examined or the name of the disease may be one or a plurality of questions.

If the medical examination subject or disease name or the like is estimated, the medical inquiry information management unit 303 then sends a question specific to the medical examination subject or disease name or the like. For example, if the subject to be examined is "Gastroenterology Internal Medicine", a question prepared for a patient in Gastroenterology Internal Medicine is sent. If the disease name is "diabetes", send a question prepared for diabetic patients. Here, it is assumed that the interview information management unit 303 holds in advance questions for each subject or disease name. The question for each subject or disease name may be one or may consist of a plurality of questions.

It should be noted that the generation and transmission of the question does not necessarily have to be carried out by the inquiry information management unit 303, and for example, the inquiry information input unit 107 or the inquiry information input / viewing unit 203 may perform this.

Memory and provision of interview information: The answer to the question, that is, the interview information is input by the patient from the interview information input unit 107 prior to the implementation of telemedicine and medication instruction. The interview information management unit 303 accumulates the input interview information at least until the telemedicine and medication instruction are completed. Further, in response to a request from the concierge, a doctor or a pharmacist, the stored inquiry information is transmitted to the inquiry information input / reading unit 203, the inquiry information viewing unit 501 or the inquiry information viewing unit 701.

The evaluation information management unit 305 collects, processes, stores and provides evaluation information.
Collection and processing: Evaluation information is input from the evaluation information input unit 111 by a patient who has undergone telemedicine. The evaluation information may include, for example, a stepwise evaluation value (a score on a scale of 5 points, etc.). The evaluation information management unit 305 can process the evaluation values received from one or more patients by a predetermined algorithm and calculate the statistical evaluation values of the doctor. For example, a statistical evaluation value can be calculated by taking a simple average or a weighted average of evaluation values collected from a plurality of patients.
Accumulation and provision: The evaluation information management unit 305 accumulates the calculated evaluation information. In addition, the evaluation information is distributed to the information providing unit 101 of the patient terminal 10. When selecting a doctor in telemedicine, the patient can refer to the evaluation information displayed in the medicine notebook application.

The diagnostic information management unit 307 stores and provides diagnostic information. The diagnostic information is input by the doctor from the diagnostic information input / viewing unit 505 each time the doctor treats the patient online. The diagnostic information management unit 307 accumulates the input diagnostic information. Further, in response to a request from the concierge and the doctor, the stored diagnostic information is transmitted to the diagnostic information input / reading unit 205 and the diagnostic information input / reading unit 505.

The prescription information management unit 309 inputs prescription information from the prescription information input / viewing unit 507 by the doctor every time the doctor prescribes a drug to the patient. The prescription information management unit 309 stores the input prescription information at least until the dispensing is completed. Further, in response to a request from the concierge, a doctor or a pharmacist, the stored prescription information is transmitted to the prescription information input / reading unit 207, the prescription information input / reading unit 507, and the prescription information viewing unit 705.

The patient information management unit 300, the dispensing information management unit 301, the interview information management unit 303, the evaluation information management unit 305, the diagnostic information management unit 307, and the prescription information management unit 309 are processing units that manage advanced personal information related to patients. be. Generally, these personal information can be accessed by a medical institution terminal 50, a pharmacy terminal 70 or a concierge using a passcode (which can be one-time, time-limited or indefinite) issued each time or in advance at the patient's will. Limited to doctors, pharmacists or concierges entered from terminal 20. In addition to this, in the present embodiment, it is also technically possible to allow doctors, pharmacists, businesses, etc. included in the range approved in advance by the patient by contract or the like to access personal information using the passcode. Is possible. For example, the management device 30 is a mechanism for checking the authority or attributes of doctors, pharmacists, and businesses, and paths stored in advance in the management device 30 for doctors, pharmacists, businesses, etc. that meet predetermined conditions. It is possible to provide a function to access personal information by using a code. As a result, even if there are multiple businesses that provide online medical care and online medication guidance, by sharing patient personal information, online medical care and online medication guidance can be seamlessly transcended across the boundaries of the business operators. It becomes possible to deploy the service.

The settlement agency processing unit 311 receives the accounting amount for telemedicine from the accounting processing unit 509 of the medical institution. Similarly, the accounting amount for dispensing including remote medication instruction is received from the accounting department 709 of the pharmacy. When the settlement agent processing unit 311 receives the accounting amount for the series of telemedicine and medication instruction, the payment agent processing unit 311 transmits the total billing amount to the patient's settlement processing unit 113. The settlement processing unit 113 setstles the billed amount by cashless settlement. In this way, the settlement agency processing unit 311 can add up the accounting amounts for telemedicine, medication guidance, etc., and bill the patient collectively.

In addition, for example, when dispensing is not performed only by telemedicine (the prescription is not issued), the settlement agency processing unit 311 can charge the patient only the accounting amount for the telemedicine.

The Telemedicine / Medication Guidance Management Department 313 coordinates to provide a series of services from the reception of applications for telemedicine and medication guidance by patients to the provision of telemedicine and medication guidance, and payment, in an appropriate order. It is a processing unit that performs. The operation of the telemedicine / medication guidance management unit 313 will be described step by step using the flowchart of FIG.

Step 1 (S1): Application for telemedicine and medication guidance The telemedicine / medication guidance management unit 313 detects a request from the telemedicine / medication guidance application unit 102 of the patient terminal 10 and starts the telemedicine / medication guidance process. do.

If a doctor or pharmacy is designated at the time of application, the telemedicine / medication guidance management unit 313 determines whether or not the doctor or pharmacy can carry out telemedicine. Here, the logic for determining whether or not medical treatment is possible is not particularly limited in this embodiment, but the determination can be made according to, for example, a schedule preset by a doctor or a pharmacy, the maximum number of people accepted, the attributes of acceptable patients, and the like. If acceptable, the Telemedicine / Medication Guidance Management Department 313 determines the doctor or pharmacy designated by the patient as the request destination for telemedicine and medication guidance. If it is unacceptable, the Telemedicine / Medication Guidance Management Department 313 notifies the Telemedicine / Medication Guidance Application Department 102 that the designation of the doctor or pharmacy has not been accepted.

If a specific chronic disease name is specified at the time of application, the Telemedicine / Medication Guidance Management Department 313 extracts doctors who can treat the disease and pharmacies that can dispense the drugs used for the disease. Determine the request destination for telemedicine and medication guidance from the doctor or pharmacy. Here, it is assumed that the telemedicine / medication guidance management department 313 holds a list of doctors or pharmacies that can deal with a specific chronic disease name in advance.

If the doctor, pharmacy or chronic disease name is not specified at the time of application, the telemedicine / medication guidance management unit 313 can determine the doctor or pharmacy to which the telemedicine / pharmacy is requested according to an arbitrary logic. After receiving the inquiry information described later, the telemedicine / medication guidance management department 313 extracts a doctor or pharmacy that can handle the consultation subject or disease name estimated by the inquiry information management department 303, and selects the doctor or pharmacy. It may be decided as a request destination for telemedicine and medication guidance. Here, it is assumed that the telemedicine / medication guidance management department 313 holds in advance the correspondence relationship between the subject or disease name to be examined and the doctor or pharmacy who can handle it in the form of a table or the like.

In addition, regardless of whether a doctor, a pharmacy, or a chronic disease name is designated, the telemedicine / medication guidance management unit 313 may perform a preliminary examination as to whether or not to accept telemedicine and medication guidance. For example, if the interview information management unit 303 cannot infer the medical examination subject or disease name, etc. as a result of receiving the medical inquiry information described later, or if the doctor or pharmacy that can handle the inferred medical examination subject or disease name, etc. cannot be extracted. You can decline the application. In this case, the telemedicine / medication guidance management unit 313 can send a notification to the telemedicine / medication guidance application unit 102 indicating that the application has not been accepted. This makes it possible to reduce the risk of accidents such as misdiagnosis in cases that are not suitable for telemedicine / medication guidance.

The telemedicine / medication guidance management department 313 can extract a plurality of doctors or pharmacies as candidates for requesting telemedicine and medication guidance, and let the patient or concierge decide the request destination from the candidates. ..

When accepting the application for telemedicine / medication guidance, the telemedicine / medication guidance management department 313 grants the doctor and the pharmacy the right to access various personal information related to the patient. It is preferable that the processing unit that manages personal information requires the consent of the patient for inputting, viewing and editing personal information by anyone other than the patient (and concierge). Therefore, the medical institution terminal 50 or the pharmacy terminal 70 is restricted so that it can access various personal information managed by the management device 30 only when the passcode issued based on the patient's will is input. .. The telemedicine / medication guidance management department 313 determines that access permission to various personal information has been granted with the consent of the application for telemedicine / medication guidance, and issues a passcode for accessing each processing unit of the management device 30. Issued to the medical institution terminal 50 or the pharmacy terminal 70. The passcode may be a one-time passcode that can be accessed only once, or a passcode that can be accessed permanently or for a predetermined period of time. The latter is convenient because the doctor or pharmacy can continuously provide medical care or medication guidance to the patient.

In addition, when performing such processing, a provision stating that "access permission to various personal information shall be granted with the consent of the application for telemedicine / medication guidance" shall be provided in advance in the terms of use of System 1. Is preferable.

As processing units that are preferable to perform access control using such a passcode, for example, a patient information management unit 300 that manages patient information, a dispensing information management unit 301 that manages dispensing information, and an interview information management unit that manages interview information. 303, there is a diagnostic information management unit 307 that manages diagnostic information, and the like, but the present invention is not limited thereto.

Step 2 (S2): Reception of interview information The telemedicine / medication guidance management unit 313 activates the interview information input unit 107 of the patient terminal 10 to input the interview information. The input inquiry information is transmitted and accumulated in the inquiry information management unit 303 of the management device 30. In this case, the patient enters the interview information himself, but may do this with the advice of the call center concierge.

Alternatively, the concierge may listen to the interview information from the patient and input the interview information from the inquiry information input / viewing unit 203 of the concierge terminal 20. In this case, it is preferable that the concierge confirms the identity of the patient prior to hearing the interview information. For example, the concierge first interviews the patient's health insurance card number and name, and a record containing the same combination of health insurance card number and name exists in various personal information stored in the management device 30 and is valid. Check if it is actually used as information. If present, it is presumed that this insurance card number and name are genuine. For example, a record including a combination of a health insurance card number and a name heard from a patient and a patient ID is recorded in the patient information management unit 300, and a record including the patient ID is recorded in the dispensing information management unit 301. If so, it can be inferred that the patient's identity and existence are certain because it is known that the patient with the health insurance card number and name has been dispensed in the past. If there is another personal identification number (for example, My Number) managed by the management device 30 instead of the health insurance card number, the same processing may be performed using the number. Further, other personal authentication means such as biometric authentication may be combined. The inquiry information input / reading unit 203 can accept the input of the inquiry information only when the identity verification is cleared. On the other hand, if the identity cannot be confirmed, it is possible to notify that the reception cannot be performed.

Step 3 (S3): Implementation of telemedicine The telemedicine / medication guidance management unit 313 notifies the patient terminal 10 and the medical institution terminal 50 of the doctor determined as the request destination that the telemedicine can be started. do. Telemedicine is carried out by the patient terminal 10 and the medical institution terminal 50, for example, making a video call or transmitting / receiving test data via a communication line. Since the specific method of performing telemedicine is disclosed in, for example, Patent Document 1, the description thereof will be omitted in this paper. The medical treatment may be conducted face-to-face as needed.

At this time, for example, the diagnostic information input / viewing unit 505 can record the state of telemedicine in a format such as moving image, voice, image, or text data. The recorded information is transmitted to the diagnostic information management unit 307 of the management device 30. The diagnostic information management unit 307 stores the received information for each patient. The patient can browse these contents as many times as he / she wants using the patient terminal 10.

At present, telemedicine cannot always deal with all diseases. When the doctor determines that telemedicine cannot be handled, the medical institution terminal 50 may electronically create a letter of introduction to a specialist and send it to the patient terminal 10. Patients can receive more specialized medical care by bringing the received referral letter to a specialist.

Step 4 (S4): Implementation of remote medication guidance When the remote medical care / medication guidance management unit 313 detects that the prescription information has been input by the doctor and stored in the prescription information management unit 309 of the management device 30, the request destination is Notify the pharmacy terminal 70 of the determined pharmacy that dispensing can be started. The pharmacist can use the electronic prescription stored in the prescription information viewing unit 705 while referring to the interview information recorded in the interview information viewing unit 701 and the past dispensing information stored in the dispensing information input / viewing unit 703. Prepare the drug based on this.

The telemedicine / medication guidance management unit 313 notifies the patient terminal 10 and the pharmacy terminal 70 of the pharmacy determined as the request destination that the remote medication guidance can be started. The remote medication instruction is carried out by the patient terminal 10 and the pharmacy terminal 70, for example, making a video call, a voice call, a text chat, or the like via a communication line. The telemedicine / medication guidance management unit 313 may record a video call, a voice call, or a text chat and store it in the dispensing information management unit 301. Further, the dispensing information management unit 301 may store a moving image or a text prepared in advance for explaining the medication method or the like to the patient. The patient can browse these contents as many times as he / she wants using the patient terminal 10.

The patient terminal 10 aggregates and displays the content containing the state of remote medical treatment stored in the diagnostic information input / viewing unit 505, the content containing the state of remote medication instruction stored in the dispensing information management unit 301, and the like. , May provide means for browsing. The patient can select and browse only arbitrary contents, or can continuously browse a plurality of contents from telemedicine to remote medication instruction.

The pharmacy arranges for the prepared drug to be delivered to the patient. At this time, the dispensing information input / viewing unit 703 of the pharmacy terminal 70 accepts the registration of the list of prepared drugs ready for shipping and transmits the registration to the telemedicine / medication guidance management unit 313 of the management device 30. The list can be in any format including text, images, photographs, moving images or audio. The telemedicine / medication guidance management unit 313 of the management device 30 sends a notification including a message such as "Did you receive the drug?" And a list of the delivered drugs to the patient terminal when the scheduled arrival date of the drug is approaching. Send to 10.

The patient can notify the pharmacy that the drug has been received. The dispensing information input / storage unit 105 of the patient terminal 10 may include an input means for transmitting a drug receipt notification. For example, the patient collates the drug shipping list displayed on the patient terminal 10 with the drug actually received. If they match, the patient inputs "matches" from the dispensing information input / storage unit 105. On the other hand, if there is an excess or deficiency or an error, the patient inputs the received drug information into the dispensing information input / storage unit 105. The received drug information can be entered in any format including text, images, photographs, moving images, audio and the like. The dispensing information input / storage unit 105 transmits the result of receipt confirmation (receipt notification) and the information on the drug received by the patient to the telemedicine / medication guidance management unit 313.

Upon receiving the receipt notification, the telemedicine / medication guidance management unit 313 notifies the dispensing information input / viewing unit 703 of the pharmacy terminal 70 to that effect. In addition, the fact that the receipt notification has been received is added to the dispensing information. This allows the pharmacy to ensure that the drug has been delivered to the patient. In addition, if there is an excess or deficiency or an error in the drug received by the patient, the pharmacist uses the dispensing information input / reading unit 703 of the pharmacy terminal 70 to specifically confirm the content and take appropriate measures. be able to. For example, the return envelope enclosed with the drug can be used to ask the patient to return the received drug to the pharmacy or to reship the correct drug.

Thus, according to this embodiment, the pharmacist creates a list and photographs of the medicines to be given to the patient when instructing the medication online, and the patient confirms that the type and number of the medicines received are correct. By sending a receipt notification, it is possible to prevent the wrong drug from being passed to the patient during online medical care and medication guidance. In addition, since the patient can check the video of the medication instruction any number of times, it is possible to prevent the patient from taking the wrong medication.

Here, the dispensing information input / viewing unit 703 of the pharmacy terminal 70 may have a function of generating and displaying a list of patients who have arranged the delivery of the drug. The list may include, for example, the presence or absence of receipt notification, the patient's contact information (telephone number, email address, etc.), and a link to the ability to send comments to the patient. This allows the pharmacy to check the receipt status of the drug in a list. In addition, for patients who do not receive a receipt notification, the receipt status can be easily confirmed by sending a comment starting from the list or by contacting them by telephone or e-mail.

Further, the dispensing information input / storage unit 105 of the patient terminal 10 may be provided with means for inputting a medication record, a question to a pharmacist, or the like as medication information. For example, the dispensing information input / storage unit 105 displays a menu such as "Click here for questions to the pharmacist" on the medicine notebook application when the patient inputs the notification of receipt of the medicine. When the menu is selected by the patient, the dispensing information input / storage unit 105 accepts input of medication information such as a question. The input medication information is transmitted to the dispensing information management unit 301 of the management device 30. The dispensing information management unit 301 stores the received medication information and transmits a reception notification to the dispensing information input / viewing unit 703 of the pharmacy terminal 70. Dispensing information input / storage unit 105 accepts input of medication information such as questions. The dispensing information input / reading unit 703 of the pharmacy terminal 70 displays new medication information on the screen and accepts input of comments for questions and the like. The input comment is transmitted to the dispensing information management unit 301 of the management device 30. The dispensing information management unit 301 stores the received comment and transmits a reception notification to the dispensing information input / storage unit 105 of the patient terminal 10. The dispensing information input / storage unit 105 displays a new comment on the screen and accepts the input of the reply comment. As a result, the system 1 functions as a platform for remote medication instruction by the pharmacist. In particular, it is a great advantage to be able to provide continuous and professional support to patients with specific chronic diseases.

Step 5 (S5): When the remote medical care / medication guidance management unit 313 detects that the dispensing information has been input by the pharmacy and stored in the dispensing information management unit 301 of the management device 30, the payment agent processing unit 311 is set. to start. Alternatively, the settlement agency processing unit 311 may automatically start the operation triggered by the reception of the accounting amount from the accounting processing unit 509 of the medical institution and the accounting processing unit 709 of the pharmacy. As a result, the billing amount for telemedicine and medication guidance is settled in a lump sum.

<Other embodiments>
The present invention is not limited to the above embodiment, and can be appropriately modified without departing from the spirit. For example, in the above-described embodiment, the user of the medical institution terminal 50 is assumed to be a doctor, and the user of the pharmacy terminal 70 is assumed to be a pharmacist, but the present invention is not limited to this, and any medical treatment in a medical institution or a pharmacy is not limited to this. Workers, businesses that provide medical / health-related services, and the like may be users of these terminals.

For example, the medical institution terminal 50 may be used by a doctor or a business operator performing an examination / examination to explain the results of a health examination or various examinations to a patient. In this case, doctors, businesses, etc. explain the results of health examinations and various tests online, and give various advice (including diet therapy and exercise therapy). At this time, doctors, businesses, and the like can refer to patient information, dispensing information, interview information, diagnostic information, prescription information, etc. stored in the management device 30, so that accurate explanations and advice can be provided. .. Further, if necessary, prescription information may be issued as shown in the above-described embodiment, and the pharmacist may take over to provide online medication instruction.

Further, the pharmacy terminal 70 may be used by a pharmacist, a dietitian who provides dietary guidance, a business operator who provides supplements, health foods, and the like. For example, as a result of health examinations and various tests, it may be considered desirable to make improvement efforts using dietary supplements and health foods, even if treatment by medication is not necessary. In such cases, doctors and businesses will issue prescription information containing dietary guidance and recommendations for the use of supplements and health foods, which will be handed over to pharmacists, dietitians and businesses. Pharmacists, dietitians, businesses, etc. use the pharmacy terminal 70 to provide online dietary guidance and online guidance regarding the use of supplements and health foods. Alternatively, these online instructions may be provided to the patient at the discretion of the pharmacist, dietitian, business operator, etc., regardless of the prescription information. Supplements, health foods, etc. can be delivered to the patient in the same manner as the drug in the above-described embodiment, and the patient can confirm receipt. As a result, not only sick people who need medication but also relatively healthy patients can receive support from medical personnel and businesses.

In the above-described embodiment, the pharmacy terminal 70 receives prescription information from the medical institution terminal 50 and provides online medication instruction, but the present invention is not limited to this. For example, the pharmacy terminal 70 can directly provide online guidance or the like that does not require a prescription at the request of the patient. A specific example is shown. The patient information input / storage unit 103 acquires the results of health examinations and various tests from the business operator and displays them on the screen. At this time, the patient information input / storage unit 103 displays a "consult with a pharmacy" button on the screen, and when the button is selected, notifies the pharmacy terminal 70 to that effect. With this as an opportunity, the pharmacy terminal 70 can start online instruction with the patient terminal 10. As a result, even relatively healthy patients who do not need medical treatment by a doctor can connect to a pharmacy and receive health consultation. In addition, the patient information input / storage unit 103 offers options such as consulting with a pharmacy, receiving medical treatment by a doctor, receiving medical treatment by a doctor, and consulting with a pharmacy according to the results of health examinations and various tests. It may be presented to.

Further, in the above-described embodiment, it is assumed that the user of the patient terminal 10 is a patient himself, but the present invention is not limited to this, and for example, a child, a parent, or a caregiver of the user of the patient terminal 10 is not limited to this. It can also be applied when a guardian or the like receives telemedicine and medication guidance as a patient. Further, the present invention is not limited to human medical care and dispensing, and can be applied to, for example, pets, livestock and the like receiving telemedicine and medication instruction.

When targeting animals such as pets and livestock, it is read from images and features of the appearance (face, etc.) of the animal, or chips (typically embedded) attached to the animal, as part of the patient information. Possible identification information and the like can be used. As a result, the animal can be uniquely identified by image recognition, collation of the identification number, etc., which improves convenience and accuracy in online medical care and online medication instruction.

Further, in the above-described embodiment, an example is shown in which a doctor or a pharmacist browses patient information, interview information, dispensing information, prescription information, etc. using the medical institution terminal 50 or the pharmacy terminal 70. Not limited to. For example, a concierge who has obtained prior consent from a doctor or pharmacist may acquire and summarize this information using the concierge terminal 20 and provide it to the doctor or pharmacist by means such as FAX or e-mail.

Further, the present invention can be realized by hardware, and can also be realized by causing a CPU (Central Processing Unit) to execute a computer program. In this case, the computer program can be stored and supplied to the computer using various types of non-transitory computer readable medium. Non-transient computer-readable media include various types of physical storage media (tangible storage media). Examples of non-temporary computer-readable media include magnetic recording media (eg, flexible disks, magnetic tapes, hard disk drives), magneto-optical recording media (eg, magneto-optical disks), CD-ROMs (Read Only Memory), CD-Rs, It includes a CD-R / W, a semiconductor memory (for example, a mask ROM, a PROM (Programmable ROM), an EPROM (Erasable PROM), a flash ROM, and a RAM (random access memory)). The program may also be supplied to the computer by various types of temporary computer readable media. Examples of temporary computer-readable media include electrical, optical, and electromagnetic waves. The temporary computer-readable medium can supply the program to the computer via a wired communication path such as an electric wire and an optical fiber, or a wireless communication path.

10 Patient terminal 101 Information provision unit 102 Remote medical care / medication guidance application unit 103 Patient information input / storage unit 105 Dispensing information input / storage unit 107 Questionnaire information input unit 109 Questionnaire information storage unit 111 Evaluation information input unit 113 Payment processing unit 20 Concierge Terminal 201 Patient information input / browsing unit 203 Questionnaire information input / browsing unit 205 Diagnostic information input / browsing unit 207 Prescription information input / browsing unit 209 Dispensing information input / browsing unit 211 Accounting information input / browsing unit 30 Management device 300 Patient information management Department 301 Dispensing Information Management Department 303 Questionnaire Information Management Department 305 Evaluation Information Management Department 307 Diagnosis Information Management Department 309 Prescription Information Management Department 311 Payment Agency Processing Department 313 Remote Medical Care / Medication Guidance Management Department 50 Medical Institution Terminal 500 Patient Information Viewing Department 501 Questionnaire Information browsing unit 503 Dispensing information browsing section 505 Diagnosis information input / browsing section 507 Prescription information entry / browsing section 509 Accounting processing section 70 Pharmacy terminal 700 Patient information browsing section 701 Interview information browsing section 703 Dispensing information entry / browsing section 705 Prescription information browsing section Department 709 Accounting Department

Claims (18)

It has a patient terminal and a management device,
The patient terminal is
It has an inquiry information input unit that presents a question for inquiry and acquires the answer to the question as inquiry information.
The management device is
A telemedicine and medication guidance system having a telemedicine / medication guidance management department that selects a doctor who can provide telemedicine or a pharmacy that can provide remote medication guidance to the patient based on the interview information. The remote unit according to claim 1, wherein the inquiry information input unit presents a second question specialized for the estimated consultation subject or disease name after the first question for estimating the examination subject or disease name. Medical treatment and medication guidance system. The patient terminal is
Further having a medical inquiry information storage unit for storing at least a part of the input answer,
The online medical treatment and dispensing system according to claim 1, wherein the inquiry information input unit uses the answer stored in the inquiry information storage unit as an initial value of the inquiry information. Having a concierge terminal in place of or in addition to the patient terminal
The remote medical care and medication guidance system according to claim 1, wherein the concierge terminal has an inquiry information input / viewing unit that accepts input of the inquiry information acquired by the concierge from the patient. The first aspect of claim 1, wherein the interview information input / viewing unit confirms the identity of the patient by collating the personal identification information acquired by the concierge from the patient with the medical record stored in the management device. Telemedicine and medication guidance system. Further having a pharmacy terminal used by the pharmacy,
The pharmacy terminal
The telemedicine and medication guidance system according to claim 1, which has a dispensing information input / viewing unit that outputs a list of the patients who have shipped the drug. The management device is
The telemedicine and medication guidance system according to claim 1, further comprising a dispensing information management unit that stores content explaining a method of taking a drug. Further having a pharmacy terminal used by the pharmacy,
The pharmacy terminal
The telemedicine and medication guidance system according to claim 7, further comprising a dispensing information input / browsing unit that interactively performs the remote medication guidance with the patient who has browsed the content. The remote medical care and medication instruction system according to claim 8, wherein the dispensing information management unit records the state of the remote medication instruction and stores it together with the content. Further having a medical institution terminal used by the doctor,
The medical institution terminal is
The telemedicine and medication guidance system according to claim 1, further comprising a medical information input unit for recording the state of the telemedicine performed with the patient. The patient terminal is
The telemedicine and medication instruction system according to claims 9 and 10, further comprising a means for viewing at least one of the telemedicine instruction record and the telemedicine record. Present a question for interview, obtain the answer to the question as interview information, and
Telemedicine having a medical inquiry information input unit that selects a doctor or a pharmacy to be examined from a doctor who can provide remote medical care to the patient or a pharmacy which can provide remote medication guidance selected based on the medical inquiry information. And medication guidance system. It has a patient terminal, a management device, and a pharmacy terminal.
The pharmacy terminal transmits information on the drug delivered to the patient to the management device.
The patient terminal transmits the comparison result between the information on the delivered drug and the drug received by the patient to the management device.
The management device is a telemedicine and medication guidance system that transmits a shipping notification including information on the delivered drug to the patient terminal and a receipt notification including the comparison result to the pharmacy terminal. It has a management device and a medical institution terminal or a pharmacy terminal.
The management device stores prescription information or dispensing information related to the patient.
The medical institution terminal or the pharmacy terminal is a telemedicine and medication guidance system that provides online medical treatment or online medication guidance while referring to the prescription information or dispensing information. The telemedicine and medication instruction system according to claim 14, wherein the online medical treatment includes a medical examination or an explanation of a test result online. The telemedicine and medication guidance system according to claim 14, wherein the online medication guidance includes providing non-pharmaceutical products or providing dietary guidance online. The telemedicine and medication guidance system according to claim 1, 12, 13 or 14, wherein the patient includes an animal and identifies the individual patient by image recognition or reading of identification information. Has a management device,
The management device stores patient information, interview information, diagnostic information, prescription information, or dispensing information related to the patient.
Remote medical care and medication guidance that provide the patient information, the interview information, the diagnosis information, the prescription information, or the dispensing information in response to the request of the medical institution terminal or the pharmacy terminal based on the prior authorization of the patient. system.

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