JP2022016085A - Online medical examination system - Google Patents

Abstract

To provide an online medical examination system equipped with particulars necessary for actual operations of online medical examination.SOLUTION: An online medical examination system M has a mediation server A having mediation server communication means 47. When receiving a patient health information display request signal, which is a signal requesting display of patient health information, which is information on a patient's health, in a plurality of types (body weight, blood pressure and embryo status) from a doctor terminal D, which is a doctor's computer, the mediation server A transmits a patient health information acquisition request signal, which is a signal requesting acquisition of patient health information related to the corresponding type, to health information servers H1,H2, which are computers for accumulating patient health information, receives patient health information from the health information servers H (receives patient health information concerning the body weight and the blood pressure from the health information server H1 and patient health information concerning the embryo status from the health information server H2), and transmits the received patient health information to the doctor terminal D.SELECTED DRAWING: Figure 1

Description

The present invention relates to an online medical care system capable of remote medical care.

As a medical care support system, the one described in Japanese Patent No. 6607543 (Patent Document 1) is known.
In this system, patient information is acquired by the user terminal and transmitted to the diagnostic support device, and the diagnostic support device classifies the type of user from the received patient information, and the information that can be viewed is classified according to the type. The content is provided to the user terminal, and the medical treatment schedule is determined by real-time communication between the user terminal and the medical institution terminal. The medical treatment schedule is based on real-time communication between individual user terminals and medical institution terminals, which is started after the end time of viewing the information content with a group medical treatment time by real-time communication of multiple user terminals to the medical institution terminals. Determined for individualized care.

Japanese Patent No. 6607543

The above system lacks the necessary items for actually operating online medical care, such as settlement of medical care costs.

Therefore, a main object of the present invention is to provide an online medical care system equipped with matters necessary for actual operation of online medical care such as settlement of medical care costs.

The invention according to claim 1 comprises an intermediary computer having a communication means, wherein the intermediary computer requests the display of patient health information, which is information on the health of the patient, from the doctor computer, which is a doctor's computer. When a health information display request signal is received in a plurality of types, a patient health information acquisition request is requested from a plurality of health information computers, which are computers for accumulating the patient health information, to acquire the patient health information related to the corresponding type. It is characterized in that each signal is transmitted, the patient health information according to the type is received from each health information computer, and each received patient health information is transmitted to the doctor computer.
The invention according to claim 2 is characterized in that, in the above invention, the intermediary computer integrates the patient health information received from a plurality of the health information computers.
According to the third aspect of the present invention, in the above invention, the intermediary computer has a storage means for storing the patient health information received from each of the health information computers, and the patient health information can be obtained from the doctor computer. When the end signal relating to the end of the display is received, the patient health information is erased from the storage means.
The invention according to claim 4 is the invention, wherein the intermediary computer receives medical billing information, which is billing information about the cost of medical treatment by displaying the patient health information, from the doctor computer, and the patient in the medical treatment. The present invention is characterized in that a medical treatment request information settlement request signal for requesting payment for the medical treatment request information is transmitted to a patient computer, which is a computer of the above.
In the invention according to claim 5, in the above invention, the intermediary computer receives from the health information computer the storage request information which is the billing information about the cost of storing the patient health information, and the patient related to the storage. It is characterized in that a storage request information settlement request signal for requesting payment for the storage request information is transmitted to a patient computer, which is a computer of the above.
The invention according to claim 6 is a claim for the cost of the video communication from a video computer in which the intermediary computer connects the doctor computer and the patient computer, which is the patient's computer, to each other so as to be capable of video communication. It is characterized in that it receives video communication billing information which is information and transmits a video communication billing information settlement request signal requesting payment for the video communication billing information to the patient computer related to the video communication. ..
The invention according to claim 7 is the above-mentioned invention, wherein the doctor computer connects the doctor computer and the patient computer, which is a patient computer, to a video computer capable of video communication with each other. The pre-stage patient health information display request signal for which display is requested is transmitted under the doctor ID, which is information for identification related to the doctor computer, and the video computer is used for the pre-stage patient health information display request signal. When the authentication using the doctor ID is correctly performed, the patient health information display request permissible signal that allows the patient health information display request signal to be transmitted to the intermediary computer is transmitted to the doctor computer, and the doctor computer transmits the patient health information display request permissible signal. Upon receiving the patient health information display request permissible signal, the patient health information display request signal is transmitted to the intermediary computer.

The main effect of the present invention is to provide an online medical care system equipped with matters necessary for the actual operation of online medical care such as settlement of medical care costs.

It is an overall block diagram of the control system and related elements which concerns on this invention. It is a flowchart about the process executed in the control system and related elements of FIG. It is a flowchart about the online medical treatment process of FIG. FIG. 3 is a flowchart relating to the cooperative authentication process, the patient health information display process, and the end process of FIG. It is a schematic diagram of the display of the patient health information performed in the patient health information display process of FIG.

Hereinafter, an example of the embodiment according to the present invention will be described with reference to the drawings as appropriate, together with a modified example thereof.
The form is not limited to the following examples and modified examples.

≪Overview etc.≫
FIG. 1 is an overall block diagram of an online medical care system M (medical care system) and related elements according to the present invention.
The medical care system M according to the present invention includes one intermediary server A (intermediary server computer) as an intermediary computer.
Further, depending on the way of thinking, the medical care system M further includes a plurality of patient terminals P1, P2 ... (a patient computer, which may be referred to as a patient terminal P for any one), and a plurality of patient communication devices Q1. , Q2 ... (Similarly, patient communication device Q), one video server V (video server computer) as a video computer, and health information servers H1, H2 (here, two) as health information computers. Health information server computer, health information server H), multiple doctor terminals D1, D2 ... (doctor computer, doctor terminal D), payment server E as one payment computer (payment server computer), one credit At least one of credit server C (credit server computer) as a computer is appropriately included.
The number of at least any of the various computers is not limited to the above. Further, the medical care system M may be configured without including the intermediary server A.

According to the medical care system M and related elements, the online medical care is carried out as follows.
That is, the patient terminal P and the doctor terminal D are connected to each other by the video server V so as to be capable of video communication. The intermediary server A, which receives a command from the doctor terminal D to display the patient health information via the video server V, transmits the patient health information to the doctor terminal D. The mediation server A receives patient health information from the patient terminal P, the patient communication device Q, and the health information server H. The intermediary server A receives the transmission of the current medical treatment fee from the doctor terminal D who has completed the processing of the current medical treatment by video communication with the patient terminal P and reference to the patient health information, and the patient terminal P setstles the medical treatment fee. Upon receiving the information, the credit server C and the payment information are communicated with each other via the payment server E to settle the medical expenses. The intermediary server A accumulates the medical treatment fee for each doctor terminal D every predetermined period (for example, one month), and settles the medical treatment fee based on the accumulated medical treatment fee to the doctor terminal D side.

≪External aspects, etc.≫
The patient terminal P1 is a computer capable of executing a patient-side program (patient-side application), and is a smartphone in this case. The patient terminal P1 may be a tablet, a mobile phone, a personal computer, or the like.
The patient terminal P1 includes a patient terminal display means 2 for displaying information and the like, a patient terminal input means 4 for accepting input of information and the like, a patient terminal call means 5 for making a call, and a patient terminal storage for storing information and the like. The means 6 includes a patient terminal communication means 7 for communicating information and the like, a patient terminal camera 8 capable of acquiring at least one (video) of a still image and a moving image, and a patient terminal control means 9 for controlling these. Here, the patient terminal display means 2 and the patient terminal input means 4 are displays with touch sensors, the patient terminal communication means 5 is a built-in microphone and speaker, and the patient terminal storage means 6 is a memory, and the patient. The terminal communication means 7 is a communication unit capable of connecting to the Internet IN through the mobile phone network and the patient communication device Q, the patient terminal camera 8 is a built-in camera unit, and the patient terminal control means 9 is a CPU. At least any one of the means except the patient terminal control means 9 may be an external one connected via an interface (not shown).
The patient-side application is stored in the patient terminal storage means 6 and executed by the patient terminal control means 9.
The patient terminal P1 is used by the patient. The patient is the examinee who receives medical treatment, and here is a maternity woman. The patient is not limited to the maternity woman.
The patient terminal P2 and the like belonging to another patient are the same as the patient terminal P1.

The patient communication device Q1 is a communication device, and here, a router capable of premises wireless communication and Internet connection. The premises wireless communication is, for example, Wi-Fi (registered trademark).
A weight scale W1, a sphygmomanometer B1, and a delivery monitoring device L1 as medical devices are connected to the patient communication device Q1 so as to be communicable by premises wireless communication.
The medical device acquires patient health information among patient information. The patient health information is information on the health of the patient and includes a plurality of types. The patient health information may be biological information, physiological information, or subjective information such as the degree of good physical condition.
The weight scale W1 acquires weight information indicating the weight of the patient as patient health information according to the measurement of the patient (patient health information related to the type of weight).
The sphygmomanometer B1 acquires blood pressure information indicating the blood pressure of the patient as patient health information according to the measurement of the patient (patient health information related to the type of blood pressure).
The delivery monitoring device L1 acquires fetal information indicating the heart rate and heart rate waveform of the fetus of the patient as patient health information according to the measurement of the patient (patient health information related to the type of fetal state). The fetal information (fetal state) may be either a heart rate or a heart rate waveform, or other items may be added.
Here, the manufacturer of the weight scale W1 and the sphygmomanometer B1 is company α, and the manufacturer of the delivery monitoring device L1 is company β.
Further, the credit card information CC1 which is the patient settlement information among the patient information is input by the patient terminal input means 4 and stored in the patient terminal storage means 6.
The patient communication device Q2 and the like belonging to another patient are the same as the patient communication device Q1, and the same applies to the weight scale W1, the sphygmomanometer B1, the delivery monitoring device L1, and the credit card information CC1 (of these, the patient communication device). Only Q2 is shown).
The patient health information may be information indicating the patient's heart rate, heart rate waveform, sleep state, or the like, and the medical device may acquire these. For example, blood pressure and heart rate information may be acquired by the sphygmomanometer B1, and a plurality of patient health information may be acquired by a common medical device. The credit card information CC1 is not stored in the patient terminal storage means 6, and may be input each time as needed.

The health information server H1 belongs to company α, and has an information server storage means 16, an information server communication means 17, and an information server control means 19.
The information server storage means 16 is the same as the patient terminal storage means 6, and is a hard disk here.
The information server communication means 17 is a communication device capable of connecting to the Internet IN.
The information server control means 19 is the same as the patient terminal control means 9, and is a CPU here. The information server control means 19 can execute the health information program stored in the information server storage means 16.
The health information server H2 is the same as the health information server H1 except that it belongs to company β.
The health information server H may have at least one of a display means and an input means.

The doctor terminal D1 is a computer capable of executing a doctor-side program, and is a personal computer here. The doctor terminal D1 may be a tablet, a mobile phone, a smartphone, or the like.
The doctor terminal D1 has the same configuration as the patient terminal P1 including a modification example, that is, the doctor terminal display means 22, the doctor terminal input means 24, the doctor terminal call means 25, and the doctor terminal storage means 26. A doctor terminal communication means 27, a doctor terminal camera 28, and a doctor terminal control means 29. Here, the doctor terminal display means 22 is a flat display, the doctor terminal input means 24 is a keyboard and a pointing device, and the doctor terminal communication means 25 is an external microphone and speaker, and the doctor terminal storage means 26. Is a hard disk, the doctor terminal communication means 27 is a communication unit that can be connected to the Internet IN, the doctor terminal camera 28 is an external camera unit, and the doctor terminal control means 29 is a CPU. The arrangement (whether built-in or external) of each means except the doctor terminal control means 29 is not limited to the above.
The doctor terminal D2 and the like are the same as the doctor terminal D1 and belong to a hospital different from the doctor terminal D1. A plurality of doctor terminals D may be provided in one hospital.

The video server V is the same as the health information server H1 including the modification example except that it belongs to the online medical video distribution company γ, that is, the video server storage means 36 and the video server communication means 37. , And the video server control means 39.
The video server control means 39 can execute the distribution program stored in the video server storage means 36.

The mediation server A is the same as the health information server H1 including the modification except that it belongs to the mediation company δ that mediates between the patient and the doctor, that is, the mediation server storage means 46 (mediation computer storage). Means, storage means), a mediation server communication means 47 (mediation computer communication means, communication means), and a mediation server control means 49 (mediation computer control means).
The mediation server control means 49 can execute the mediation program stored in the mediation server storage means 46.

The payment server E is the same as the health information server H1 including the modification example, except that it belongs to the payment intermediary company ε.
The credit server C is the same as the health information server H1 including the modification example, except that it belongs to the credit card issuing company ζ company.
The payment server E may be omitted, and the credit server C may make a direct payment. Further, at least one of the companies α to ζ (particularly the company γ of the video server V and the company ε of the intermediary server A) may be the same company. At least two of the various servers (particularly the video server V and the intermediary server A) may be the same server. Any one server may be divided into a plurality of servers. At least one of the companies α to ζ may be an individual rather than a corporation.

≪Internal aspects or operation examples≫
Hereinafter, the internal aspects or operations of the medical care system M and related elements mainly between the patient terminal P1 and the doctor terminal D1 will be described. The operation between the other patient terminal P2 and the like and the doctor terminals D1, D2 ... Is the same as the operation between the patient terminal P1 and the doctor terminal D1.
FIG. 2 is a flowchart relating to the operation of the medical care system M and related elements.

First, the patient performs the procedure for starting use (step S1, hereinafter "step" is appropriately omitted). Here, the procedure for starting the use of each health information server H (procedure for starting the use of medical equipment) and the procedure for starting the use of the video server V (procedure for starting the use of online medical treatment) are performed.

That is, the patient accesses each health information server H (use start application page) from the patient terminal D1 (internet browser embedded in the patient-side application), and the weight scale W1 and the sphygmomanometer B1 (health information server H1) and delivery. Information necessary for starting transmission and storage of each measurement data of the monitoring device L1 (health information server H2) is input. Here, the information is the address, name, date of birth (age), type of each medical device, and serial number of the user (patient). At least one of the types and numbers of the information can be changed as appropriate, and the same applies to the following various types of information. Further, the Internet browser may not be incorporated in the patient-side application, and the same applies to the following various Internet browsers.
When the usage start procedure is performed, each health information server H issues a device user ID, which is identification information for each medical device user (patient), and stores the information in the information server storage means 16 in association with the information. .. In addition, each health information server H notifies the patient terminal P1 that the start of use of the medical device has been accepted. The device user ID may be issued for each medical device (for each weight scale W1 and sphygmomanometer B1 in the health information server H1).

Each health information server H can provide patient health information to patients (medical device users) by a dedicated health information management application for browsing health information, etc., independently of online medical care. can.
For example, the health information server H1 of company α transmits the transition of the patient's weight and blood pressure related to the patient terminal P1 in response to the request from the patient terminal P1 and displays it on the patient terminal P1 that executes the health information management application. be able to. Similarly, the health information server H2 of β company can display the transition of the heart rate of the fetus and the heartbeat waveform at an arbitrary time point on the patient terminal P1.

On the other hand, similarly, the patient accesses the video server V from the patient terminal D1 and inputs the information necessary for starting the use of the online medical treatment. Here, the information is the patient's address, name, date of birth, health insurance card information, one or more doctors (hospitals) scheduled to be examined, and each device user ID.
When the procedure for starting the use of online medical care is performed, the video server V issues a patient ID, which is identification information for each patient, and stores the patient ID in association with the information in the video server storage means 36. Further, the video server V notifies the patient terminal P1 that the start of use of the online medical treatment has been accepted. Further, the video server V transmits a new issue of the patient ID to the mediation server A, and the mediation server A stores the received patient ID in the mediation server storage means 46. Further, the video server V transmits the newly issued patient ID and each device user ID corresponding thereto to the mediation server A, and the mediation server A mediates the received patient ID and each device user ID. It is stored in the server storage means 46.
At the time of the first actual consultation, at least one of the procedures for starting use may be performed from the doctor terminal D1. Further, the intermediary server A may replace at least one of the health information server H and the video server V, or may accept the usage start procedure together with at least one of the health information server H and the video server V. In this case, the mediation server A may send the device user ID and the patient ID to at least one of the health information server H and the video server V. Further, for security, a password may be issued for at least one of the device user ID and the patient ID. The password can be processed in the same manner as the device user ID and the patient ID. In at least one of the following processes, password input (authentication) may be required. Other authentication, such as biometrics, may be performed in place of or with the password.

Alternatively, the medical device use start procedure may be performed at a time different from the online medical device use start procedure (for example, at the time of purchasing the medical device). That is, the medical device use start procedure may be performed before the online medical device use start procedure, or may be performed after the online medical device use start procedure. In these cases, the patient associates his / her patient ID with the device user ID by inputting to the patient terminal P1 and transmits the association to the intermediary server A.
In addition, the patient can purchase or rent a part or all of the medical device from the company δ related to the intermediary server A. In this case, the procedure for starting the use of the medical device and the association between the patient ID and the device user ID may be performed by Company δ (on the intermediary server A).

Further, each doctor terminal D is given a doctor ID in the same manner as the patient ID at the time of introduction to the hospital or the like. The doctor ID is processed in the same manner as the patient ID. The doctor ID has the same modification as the patient ID.

Next, the patient accumulates health information (S2).
That is, the patient sequentially (for example, every predetermined period (1 day, etc.)) measures the blood pressure with the sphygmomanometer B1 and weighs with the weight scale W1. The blood pressure information related to each blood pressure and the weight information related to each body weight are obtained at a predetermined timing (for example, after each measurement or when a predetermined time arrives) via the patient communication device Q1 and the Internet IN, and the health of company α. It is transmitted to the information server H1. The health information server H1 stores blood pressure information and weight information in the information server storage means 16 for each reception date and time and device user ID (source). The blood pressure information and the body weight information may be stored for each measurement date and time instead of the reception date and time. The measurement date and time may be included in the blood pressure information and the body weight information. Patient identification may be performed by registration with company α at the time of acquisition of the sphygmomanometer B1 or the like, or may be performed by the serial number of the sphygmomanometer B1 or the like included in the blood pressure information or the like, or the video server V or the like. It may be done by the patient ID obtained from.
In addition, the patient also measures the fetal heart rate and heart rate waveform with the delivery monitoring device L1 during a specific period (for example, from 8 months of pregnancy to delivery). The fetal information related to the fetal heart rate and the heart rate waveform is similarly transmitted to the health information server H2 of β company.
The medical device may be capable of communicating with the patient terminal P1 in place of the patient communication device Q1 or together with the patient communication device Q1. Further, the patient health information may be acquired from the patient terminal P1. The patient terminal P1 may obtain health information by communication with a medical device, or may obtain patient health information by input using the patient terminal input means 4 of the patient. The patient communication device Q1 may be omitted.

The patient reserves the next online medical examination while accumulating patient health information (S3). The patient may make an appointment before accumulating patient health information.
That is, the patient accesses the video server V (reservation page) from the patient terminal P1 and makes a reservation by designating the hospital, the start time, and the medical treatment time. The video server V issues a medical treatment ID related to such a reservation, and stores the patient ID, the medical treatment hospital, the medical treatment start time, and the medical treatment time in the video server storage means 36 in association with the medical treatment ID.
The medical treatment hospital here is the hospital to which the doctor terminal D1 belongs.
The medical treatment hospital may be a hospital to which the doctor terminal D2 or the like belongs, that is, the patient can select a hospital to receive online medical treatment. Further, at least one of the medical treatment hospital and the medical treatment time is fixed, and the input may not be accepted. Further, at least one of the medical treatment hospital, the medical treatment start time, and the medical treatment time may be input by selecting an option such as pull-down, character input, voice input, or other input. Is also good. The same applies to the input of other items. Furthermore, the patient ID may be input or may be automatically transmitted. In addition, reservations may be accepted multiple times. Further, the reservation may be automatically made after a predetermined period (for example, one month) at the start of use or at the time of the previous medical examination. Further, the medical treatment ID may be issued at the start of online medical treatment. In this case, a medical treatment reservation ID may be issued at the time of medical treatment reservation and stored in association with the medical treatment ID.

Then, in response to the arrival of the medical treatment start time, the patient accesses the video server V (medical treatment page) from the patient terminal P1, and the doctor accesses the video server V (internet browser incorporated in the doctor's side program) from the doctor terminal D1 (internet browser incorporated in the doctor's side program). Access the medical treatment page) and perform online medical treatment (S4).

FIG. 3 is a detailed flowchart of S4. The following processes related to S4 can be executed in parallel.
The video server V transmits and receives video to and from each other in S4 (S101).
That is, the video server V transmits the video (patient video) acquired by the patient terminal camera 8 to the doctor terminal D1. The doctor terminal D1 displays the patient image on the doctor terminal display means 22.
On the other hand, the video server V transmits the video (doctor video) acquired by the doctor terminal camera 28 to the patient terminal P1. The patient terminal P1 displays a doctor's image on the patient terminal display means 2.
The doctor can see the patient from the patient image. The patient can see the doctor's appearance from the doctor's video.
The video server V may start displaying or switch the display of at least one of the patient video and the doctor video by inputting to a button or the like, or may omit acquisition and transmission. The video server V may display the doctor image on the doctor terminal display means 22 or may display the patient image on the patient terminal display means 2.

Further, the video server V transmits and receives audio to and from each other in S4 (S102).
That is, the video server V transmits the voice (patient voice) acquired by the patient terminal calling means 5 to the doctor terminal D1. The doctor terminal D1 outputs the patient voice in the doctor terminal calling means 25.
On the other hand, the video server V transmits the voice (doctor voice) acquired by the doctor terminal calling means 25 to the patient terminal P1. The patient terminal P1 displays the doctor's voice in the patient terminal calling means 5.
The doctor's voice can be used to listen to the patient, ask questions, and ask questions, and the doctor's voice can be used to listen to the doctor's guidance, ask questions, and ask questions. can.
The video server V may start output or switch the presence / absence of output of at least one of the patient voice and the doctor voice by inputting to a button or the like, or may omit acquisition and transmission.

Further, the video server V displays a link (health information link) for displaying patient health information on the doctor terminal display means 22. In response to the input to the health information link by the doctor using the doctor terminal input means 24 (S103), the mediation server is authenticated by the cooperation between the video server V and the mediation server A shown in FIG. 4 (upper part) (S104). A displays patient health information as shown in FIGS. 4 (central) and 5 (S105).

That is, when the video server V receives the input to the health information link (patient health information display command, previous stage patient health information display request signal, S201 in FIG. 4) from the doctor terminal D1 (S103), the doctor during online medical treatment It is judged whether or not the patient health information can be displayed (whether or not the display of the patient health information is permitted) in light of the ID and the patient ID, and whether or not the authentication related to the display of the patient health information is OK or NG. (S202). When inputting to the health information link, the doctor ID may be transmitted to the video server V together with the input.
If the authentication is OK, a signal to that effect (authentication OK signal, patient health information display request permissible signal) is transmitted to the doctor terminal D1 (S203).
If the authentication is NG, the video server V does not perform the subsequent processing without transmitting a signal to that effect (authentication NG signal) or transmitting a signal related to authentication.

Upon receiving the authentication OK signal, the doctor terminal D1 requests the intermediary server A for secondary authentication in order to receive the patient health information (S204). The signal relating to the request for secondary authentication corresponds to the patient health information display request signal requesting the display of patient health information. The authentication OK signal may be directly transmitted to the intermediary server A.
Here, the request for secondary authentication includes an encrypted patient ID and the content of a health information link (URL: Uniform Resource Locater) corresponding to the patient ID. Further, the communication of the secondary authentication request is encrypted by HTTPS or the like. At least one of information encryption and communication encryption may be performed in another process.

When the intermediary server A receives the secondary authentication request, it collates the patient ID and confirms whether the health information link corresponds to the patient ID (S205). If the confirmation results are all good, the intermediary server A cooperates. The authentication process S104 is completed, and the process (S105) for providing the patient health information to the doctor terminal D1 is performed (S206 to).
If the secondary authentication request is inappropriate, the patient's health information is not transmitted to the doctor terminal D1 or the like without performing the subsequent processing without authentication.

That is, the intermediary server A transmits a request (patient health information acquisition request) with each device user ID corresponding to the authenticated patient ID to each health information server H (S206, patient health information acquisition request signal). ). It is not necessary to execute the request for acquiring patient health information related to the medical device that is not used (the device user ID is not issued), such as before using the delivery monitoring device L1. Similarly, the patient health information acquisition request relating to the type not designated as the type to be displayed on the doctor terminal D1 may not be issued (until it is designated as the type to be displayed).
When each health information server H receives the device user ID from the intermediary server A, each health information server H transmits the corresponding patient health information to the intermediary server A (S207). That is, when the health information server H1 receives the device user ID related to company α, it transmits the corresponding patient's weight and blood pressure (over a predetermined period) to the intermediary server A. Further, when the health information server H2 receives the device user ID related to the company β, the health information server H2 transmits the heart rate and heart rate waveform (over a predetermined period) of the corresponding patient's fetus to the intermediary server A.
In the communication between the intermediary server A and each health information server H, an encrypted path that authenticates the other party is formed. This cryptographic path is formed here by TLS (Transport Layer Security). Further, the control of communication between the intermediary server A and each health information server H is performed by limiting the IP (Internet Protocol) addresses of each other (both IP address restriction control). Further, the call of data in the communication between the intermediary server A and each health information server H is made by using the RESTful interface in order to improve the accessibility to various information. The RESTful interface is a REST (Representational State Transfer). ) Is a web system calling interface built according to the principle. In the communication between the intermediary server A and each health information server H, other than these, encryption path formation, restriction control, and data call may be performed. Further, at least one of such encryption path formation, restriction control, and data call may be performed between other servers.

When the mediation server A receives the patient health information from each health information server H, the mediation server A temporarily stores the patient health information in the mediation server storage means 46 for the patient health information display processing S105 this time.
The intermediary server A integrates various patient health information received from each health information server H. That is, the mediation server A integrates the weight and blood pressure received from the health information server H1 and the transition of the fetal heart rate received from the health information server H2 and the heart rate waveform at an arbitrary time point.
Then, the mediation server A transmits the integrated patient health information belonging to the specific period to the doctor terminal D1 (S208). The specific period is a period within a predetermined period.

When the doctor terminal D1 receives the patient health information belonging to the specific period from the intermediary server A, the doctor terminal D1 temporarily stores the patient health information in the doctor terminal storage means 26, and as illustrated in FIG. 5, the doctor terminal display means for displaying the patient health information. Displayed at 22 (S209).
That is, the doctor terminal control means 29 causes the doctor terminal display means 22 to display the type designation unit 22a for designating the presence / absence of display on the doctor terminal display means 22 for each type of patient health information, and for each type of patient health information. Accepts display specifications. Here, the display of the body weight and the blood pressure is specified by the check box ON, and the non-display of the fetal heart rate is specified by the check box OFF. Further, the display of the fetal heartbeat waveform is a separate screen, and the fetal heartbeat waveform display button 22b, which is a button for shifting to the separate screen, is displayed.
Further, the doctor terminal control means 29 displays the period designation unit 22c that designates the period of the displayed patient health information. Here, the start date and end date of the period are specified by the pull-down menu.

Then, the doctor terminal control means 29 causes the patient health information display unit 22d to display the weight and blood pressure within the period in the form of a line graph as the patient health information designated to be displayed. The display format may be other than the line graph format. The patient health information display unit 22d may be displayed by a pop-up. The intermediary server A may draw patient health information (create a page) in place of the doctor terminal D1 or together with the doctor terminal D1. The line graph may be displayed separately for each type of patient health information.
The doctor terminal control means 29 switches the display content of the patient health information according to each designated state of the type designation unit 22a and the period designation unit 22c. Each designated state of the type designation unit 22a and the period designation unit 22c is changed by input by the doctor terminal input means 24 to each. For example, when the fetal heart rate check box is turned ON, the fetal heart rate as patient health information is displayed in a line graph format. Further, by inputting to the fetal heartbeat waveform display button 22b, another screen for displaying the fetal heartbeat waveform related to the line graph format is launched. On the separate screen, a pull-down menu for specifying the date of the fetal heartbeat waveform to be displayed and a back button for returning to the original screen are displayed, and input is accepted for each.
When the designation of the display exceeds the specific period, the doctor terminal D1 may request the mediation server A to transmit the patient health information belonging to the excess period, and the mediation server A may respond to the request. Further, the doctor terminal D1 may request a display period each time, and the intermediary server A may respond to this. The intermediary server A may transmit only a part of the integrated patient health information to the doctor terminal D1, or may respond to a request for the type of patient health information to be displayed on the doctor terminal D1 and the patient health information related to the type. May be transmitted to the doctor terminal D1 each time. Further, the mediation server A may transmit the patient health information to the doctor terminal D1 via the video server V. In this case, the video server V may create a screen (page) related to patient health information in place of the doctor terminal D1 or together with the doctor terminal D1.

At the same time, the doctor terminal control means 29 displays the patient image 22e and the profile display unit 22f related to the patient's profile.
When displaying the patient health information on the patient health information display unit 22d, it is not necessary to display at least one of the patient image 22e and the profile display unit 22f. The profile display unit 22f may be displayed only when a display request is input, or may be omitted at all times. The patient health information may be temporarily transmitted to the patient terminal P1 and displayed on the patient terminal display means 2 based on the input to the information presentation button by the doctor terminal input means 24 or the like. Alternatively, the patient may launch a health information management application in parallel with the online medical treatment, and obtain and refer to his / her own patient health information from each health information server H during the online medical treatment.

In such online medical treatment processing S4, the patient conveys information, etc. to the doctor, and the doctor diagnoses the patient by referring to the information from the patient, the state of the patient image, the patient health information, etc., and gives guidance to the patient, etc. I do.
The doctor will issue a prescription for medication, etc. for the patient as necessary. The prescription is input to the doctor terminal D1 and transmitted to the patient terminal P1 via at least one of the video server V and the mediation server A. The patient can obtain the necessary medicine or the like by presenting the received prescription to the pharmacy or the like.

When the doctor achieves the purpose of this medical treatment, the doctor finishes the online medical treatment (lower part of FIG. 4, S106 of FIG. 3). For example, the doctor presses the end button displayed on the doctor terminal display means 22 (input of end).
The fact that the online medical treatment has ended is transmitted to the video server V (S210) and the intermediary server A (S211, end signal). It should be noted that this may be transmitted to the intermediary server A via the video server V.
The doctor terminal D1 erases the temporarily stored patient health information (S212) based on the input of the end, and ends the online medical treatment process S4.
On the other hand, when the video server V receives that the online medical treatment is completed, the video server V ends the connection between the patient terminal P1 and the doctor terminal D1 and ends the online medical treatment process S4. The patient terminal P1 ends the online medical treatment process S4 by disconnecting from the video server V. When the patient health information is provided from the doctor terminal D1 to the patient terminal P1, the patient health information may be deleted from the patient terminal P1.
Further, when the intermediary server A receives that the online medical treatment is completed, it erases the patient health information temporarily stored and ends the online medical treatment process S4 (S213).

After finishing the online medical treatment, the doctor inputs the information regarding the payment related to the online medical treatment this time and starts the payment processing S5 (FIG. 2).

That is, the doctor inputs the current insurance medical treatment fee points, etc. into the doctor terminal D1, and the doctor terminal D1 calculates the medical treatment fee (medical treatment billing amount) from the insurance medical treatment fee points, etc., and uses the medical treatment ID as basic billing information. Send to the intermediary server A. The doctor terminal D1 may transmit the insurance medical treatment fee points and the like to the intermediary server A, and the intermediary server A may calculate the medical treatment fee. Further, the doctor may directly input the medical treatment fee into the doctor terminal D1. The insurance medical fee points and the like may be input on the payment page provided by at least one of the intermediary server A and the video server V.
The mediation server A stores the doctor ID, the medical treatment ID, and the medical treatment fee in the mediation server storage means 46 in association with each other.

Further, the intermediary server A is the billing information for the medical treatment fee (medical treatment cost by displaying the patient health information) based on the medical treatment fee (insurance medical treatment fee points, etc., basic billing information) for the patient terminal P1. In order to request the settlement procedure of a certain medical treatment request information), the medical treatment request information settlement request signal is transmitted. When the patient terminal P1 receives the medical treatment request information settlement request signal, it displays the medical treatment date and time and the medical treatment fee, and accepts the input of the consent related to the settlement of the medical treatment fee by the consent button or the like, and when there is an input, the credit card information CC1 Is transmitted to the intermediary server A. The intermediary server A sends the credit card information CC1 and the medical expenses to the credit server C via the settlement server E, and settles the medical expenses. When the intermediary server A receives from the settlement server E that the settlement of medical expenses has been completed normally, the intermediary server A transmits to that effect to the patient terminal P1 and displays it.
The credit card information CC1 may be transmitted to the settlement server E without being transmitted to the intermediary server A, and information corresponding to the credit card information CC1 may be transmitted to the intermediary server A to settle the medical expenses. In this case, the credit card information CC1 does not reach the intermediary server A. Further, the medical expenses may be accumulated for each predetermined period (medical expenses settlement period, for example, one month) and settled collectively. Furthermore, the purchase price or rental fee of the medical device may be settled in addition to the medical expenses, or the prescription (medication fee) may be settled, and if there is a usage fee for the health information management application, the fee may be settled. The usage fee may be settled.

Further, the intermediary server A accumulates medical fees for each doctor ID every predetermined period (medical fee settlement period, for example, one month), and appropriately deducts the system usage fee and the like for settlement.
The medical treatment fee may be accumulated and settled for each doctor ID and patient ID, or may be settled for each medical treatment ID. Further, the system usage fee and the like may be settled separately regardless of the offset (deduction). The system usage fee may be divided into a usage fee of the video server V and a usage fee of the intermediary server A, and the usage fee of the payment server E (credit server C) may be considered separately. The payment to the doctor (hospital) may be made by the payment server E (credit server C) or may be another payment. Part or all of the above payment may be made on the video server V (gamma company).

It should be noted that the intermediary server A uses at least one of the health information servers H1 and H2 for storage billing information (for example, monthly use of the daily weight online storage service by the weight scale W1), which is billing information for the cost of storing patient health information. The fee) may be received, and the patient terminal P1 may be requested to receive a storage request information settlement request signal requesting payment for the storage request information, and process the payment, as in the case of the above-mentioned medical treatment request information. .. In this case, the settlement of the accumulation of health information between the patient and company α and β is processed in the same manner as the settlement of online medical care between the patient and company δ, and the patient pays the cost of accumulating health information. , Can be settled in the same way as medical expenses.
Further, when the video server V charges the patient for the service charge (cost) for the online medical treatment (video communication), the mediation server A receives the video communication billing information which is the billing information for the cost from the video server V. Then, as in the case of the medical treatment request information described above, the patient terminal P1 may be requested to request the video communication request information settlement request signal for requesting the settlement of the video communication request information, and the settlement may be processed. In this case, the payment of video communication between the patient and company γ is processed in the same manner as the payment of online medical care between the patient and company δ, and the patient pays the cost of video communication in the same way as the medical treatment cost. can do.
Further, the intermediary server A may unify at least any two of the medical treatment billing information, the storage billing information, and the video communication billing information (as new billing information including the total cost) for settlement processing. In this case, the intermediary server A can uniformly perform various payment processes related to the patient to the patient terminal P1, and the patient can collectively settle various expenses.

In this way, the medical care system M provides online medical care that allows reference to patient health information, and if sequential online medical care is required (achievement of medical care objectives such as confirmation of good progress after childbirth). Until there is), the process is repeated from S2 as appropriate.
Further, for the patient terminal P2, the patient communication device Q2, etc. related to different patients, the online medical treatment process that can refer to the patient health information of the patient is executed in the same manner as the patient terminal P1, the patient communication device Q1 and the like. To.

≪Action effect etc.≫
Such a medical care system M has the following effects.
That is, the medical care system M includes an intermediary server A having an intermediary server communication means 47, and the intermediary server A displays patient health information, which is information on the health of the patient, from the doctor terminal D, which is a doctor's computer. When the requested patient health information display request signal (secondary authentication request S204) is received in multiple types (weight, blood pressure, fetal state), the health information servers of companies α and β, which are computers that store patient health information. The patient health information acquisition request signal S206 for requesting the acquisition of the patient health information related to the corresponding type is transmitted to H1 and H2, respectively, and the patient health information is received from each health information server H (weight from the health information server H1). And the patient health information related to blood pressure is received, and the patient health information related to the fetal state is received from the health information server H2), and each received patient health information is transmitted to the doctor terminal D.
Further, the mediation server A integrates the patient health information received from the plurality of health information servers H1 and H2.
Therefore, in the medical care system M, the manager of the weight scale W for acquiring the body weight and the sphygmomanometer B for acquiring the blood pressure (company α) and the administrator of the delivery monitoring device L for acquiring the fetal state (company β) are different. Even so, the intermediary server A (company δ) can collectively provide the patient health information to the doctor terminal D online. Further, in the medical care system M, for example, when there are a plurality of managers of the weight scale W for acquiring the weight, such as the weight scale maker α1 company and the competing α2 company, the same type of patient health information is provided. On the other hand, even if there are a plurality of managers, the patient health information of each patient can be provided online to the doctor terminal D in an appropriately integrated form by the mediation of the mediation server A. By providing various patient health information online, the accuracy of online medical care is ensured to the extent that it can actually be operated online, the chances of actual patient visits are reduced, and the burden of patient visits and hospital duties is reduced. The risk of infection of patients, doctors and hospital staff during an epidemic of infectious diseases is reduced, and the patient's refusal to receive is suppressed.
In particular, maternity women are less likely to require actual emergency treatment than other patients, and checking the progress of patient health information is more important in view of the relatively large changes in the maternity body. Further, since consideration for infectious diseases is further required in view of the fact that it may affect not only the maternal woman but also the fetus, online medical treatment by the medical care system M is suitable.

Further, the intermediary server A has an intermediary server storage means 46 for storing patient health information received from each health information server H, and receives an end signal relating to the end of display of patient health information from the doctor terminal D. (S211), the patient health information is deleted from the mediation server storage means 46 (S213).
Therefore, the patient health information does not exist in the mediation server A except at the time of reference in online medical care, and the risk of leakage of the patient health information related to the patient's privacy always keeps the patient health information in the mediation server A. Compared to, it is sufficiently reduced. Therefore, the medical care system M has been given sufficient consideration for security while realizing sufficiently accurate online medical care in which various patient health information can be referred to.

Further, the intermediary server A receives medical billing information (medical expenses), which is billing information (medical expenses) for medical treatment costs by displaying patient health information, from the doctor terminal D, and sends the patient terminal P, which is a computer of the patient in the medical treatment, to the patient terminal P. , Sends a medical billing information settlement request signal requesting payment for medical billing information.
Therefore, the medical care system M realizes simple payment in online medical care. In particular, even if the video server V for transmitting and receiving the patient image and the doctor's image does not realize the payment for the patient, the intermediary server A realizes a simple payment.

In addition, the medical care system M includes a doctor terminal D, and a video server V that connects the doctor terminal D and the patient terminal P, which is a patient's computer, so as to be capable of video communication with each other. A pre-stage patient health information display request signal (S201) requesting the display of patient health information is transmitted to the server V under the doctor ID, which is information for identification related to the doctor terminal D, and the video server V sends the image server V. If the authentication (S202) using the doctor ID for the previous stage patient health information display request signal is correctly performed, the doctor terminal D is allowed to transmit the patient health information display request signal to the mediation server A. The display request permissible signal is transmitted (S203), and when the doctor terminal D receives the patient health information display request permissible signal, the doctor terminal D transmits the patient health information display request signal to the intermediary server A (secondary authentication request S204).
Therefore, when online medical care is primarily performed on the video server V and the video server V is already installed, the mediation server A and the video server as secondary implementing bodies that comprehensively provide patient health information. Cooperation with V can be easily and well achieved. In addition, the two-step authentication with the previous step further suppresses unauthorized access to patient health information and ensures better security performance.

≪Change example etc.≫
In addition to the above-mentioned modification examples, the medical care system M has the following modification examples as appropriate.
That is, at least any two computers in the medical care system M may be communicably connected via a dedicated line, a telephone network, or the like instead of the Internet IN, and in short, they may be connected by a communication network.
Further, each step in the process (each flowchart) of the medical care system M may be replaced with a step having substantially the same other contents, or may be divided into a plurality of steps having substantially the same contents. Alternatively, at least any two of them may be combined with each other, or the order may be changed as appropriate.
The medical care system M may provide the patient health information related to the plurality of health information servers H to the doctor online without transmitting and receiving the patient image and the doctor image.

46 ... Mediation server storage means (storage means), 47 ... Mediation server Communication means (communication means), A ... Mediation server (mediation computer), D ... Doctor terminal (doctor computer), H ... Health information server (Health information computer), M ... (online) medical care system, V ... video server (video computer).

Claims (7)

Equipped with an intermediary computer with communication means,
The intermediary computer is
When a patient health information display request signal requesting display of patient health information, which is information on patient health, is received from a doctor computer, which is a doctor's computer, in a plurality of types,
A patient health information acquisition request signal requesting acquisition of the patient health information according to the corresponding type is transmitted to a plurality of health information computers, which are computers for accumulating the patient health information, and the health information computers are said to have the same. Receive the patient health information related to the type,
An online medical care system characterized in that each received patient health information is transmitted to the doctor's computer. The online medical care system according to claim 1, wherein the intermediary computer integrates the patient health information received from the plurality of health information computers. The intermediary computer is
It has a storage means for storing the patient health information received from each of the health information computers.
The online medical care system according to claim 1 or 2, wherein when the end signal relating to the end of the display of the patient health information is received from the doctor computer, the patient health information is erased from the storage means. The intermediary computer is
Receive medical billing information, which is billing information about the cost of medical care by displaying the patient health information, from the doctor computer.
The online according to any one of claims 1 to 3, wherein a medical treatment request information settlement request signal for requesting payment for the medical treatment request information is transmitted to the patient computer, which is the patient's computer in the medical treatment. Medical care system. The intermediary computer is
From the health information computer, the storage request information, which is the billing information for the cost of accumulating the patient health information, is received.
6. Online medical care system. The intermediary computer is
The video communication billing information, which is billing information about the cost of the video communication, is received from the video computer that connects the doctor computer and the patient computer, which is the patient's computer, to each other so as to be capable of video communication.
The online according to any one of claims 1 to 5, wherein a video communication billing information settlement request signal for requesting settlement of the video communication billing information is transmitted to the patient computer related to the video communication. Medical care system. In addition,
With the doctor computer
A video computer that connects the doctor computer and the patient computer, which is the patient's computer, to each other so that video communication is possible.
Equipped with
The doctor computer transmits a pre-stage patient health information display request signal requesting the display of the patient health information to the video computer under the doctor ID which is information for identification related to the doctor computer.
When the video computer correctly authenticates the pre-stage patient health information display request signal using the doctor ID, the video computer allows the doctor computer to transmit the patient health information display request signal to the intermediary computer. Send patient health information display request tolerance signal,
The online according to any one of claims 1 to 6, wherein when the doctor computer receives the patient health information display request permissible signal, the doctor computer transmits the patient health information display request signal to the intermediary computer. Medical care system.

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