JP2024069124A - Clinical support system and clinical support device - Google Patents

Abstract

[Problem] To support a patient in deciding whether or not to request support from a medical professional. [Solution] A clinical support system includes an acquisition unit, an analysis unit, a determination unit, and a display control unit. The acquisition unit acquires patient information related to a patient, medical interview information indicating the patient's responses to medical interviews, and conversation information in which the patient's conversation is recorded. The analysis unit generates patient characteristic information indicating psychological and social aspects of the patient through analysis processing using the patient information, the medical interview information, and the conversation information. The determination unit determines at least one supporter to request support from, based on the patient characteristic information, a medical care event of the patient, and a request condition for requesting support at the medical care event. The display control unit displays a screen including information on the supporter determined by the determination unit. [Selected Figure] Figure 2

Description

The embodiments disclosed in this specification and the drawings relate to a clinical support system and a clinical support device.

Traditionally, doctors and other medical professionals are expected to provide medical care based not only on biological aspects such as test results, but also on the social and psychological aspects of the patient. To this end, medical professionals collect information on psychological and social aspects through communication with patients. Medical professionals are then expected to provide medical care in collaboration with various other specialists based on the information they have collected.

However, it was sometimes difficult for medical professionals to determine when and which professionals to seek help from based on the information they had collected.

JP 2014-503894 A

One of the problems that the embodiments disclosed in this specification and the drawings attempt to solve is to support the decision of whether or not to request professional assistance. However, the problems that the embodiments disclosed in this specification and the drawings attempt to solve are not limited to the above problem. Problems that correspond to the effects of each configuration shown in the embodiments described below can also be positioned as other problems.

The clinical support system according to the embodiment includes an acquisition unit, an analysis unit, a determination unit, and a display control unit. The acquisition unit acquires patient information related to a patient, medical interview information indicating the patient's responses to medical interviews, and conversation information in which the patient's conversation is recorded. The analysis unit generates patient characteristic information indicating psychological and social aspects of the patient through analysis processing using the patient information, the medical interview information, and the conversation information. The determination unit determines at least one supporter who will request support based on the patient characteristic information, the patient's medical care event, and a request condition for requesting support in the medical care event. The display control unit displays a screen including information about the supporter determined by the determination unit.

FIG. 1 is a block diagram showing an example of the configuration of a clinical support system according to this embodiment. FIG. 2 is a block diagram showing an example of the configuration of a clinical support device according to this embodiment. FIG. 3 is a diagram illustrating an example of a data configuration of the analysis target information. FIG. 4 is a diagram showing an example of a data configuration of medical event information. FIG. 5 is a diagram illustrating an example of a data configuration of the support request information. FIG. 6 is an explanatory diagram showing an example of the medical treatment schedule screen according to this embodiment. FIG. 7 is a flowchart showing an example of a support request process executed by the clinical support device according to this embodiment. FIG. 8 is a flowchart showing an example of supporter determination processing executed by the clinical support device according to this embodiment. FIG. 9 is a diagram showing an example of the first classification screen showing classification items up to the intermediate classification according to the third modification. FIG. 10 is a diagram showing an example of the second classification screen according to the third modification.

The clinical support system and clinical support device according to this embodiment will be described below with reference to the drawings. In the following embodiment, parts with the same reference numerals perform similar operations, and duplicated descriptions will be omitted as appropriate.

(Present embodiment)
Doctors and other medical professionals are expected to provide holistic medical care that is based not only on biological aspects, but also on the psychological and social aspects of the patient. More specifically, medical professionals are expected to decide on a treatment plan that includes various aspects, rather than deciding on a treatment plan based solely on biological aspects such as the results of diagnostic imaging and clinical tests.

For example, patients with chronic diseases such as lifestyle-related diseases may not be cured by biological treatment that only involves administering medicines. For example, in the case of lower back pain, it is preferable for medical professionals to not only prescribe a medicinal patch, but also to provide advice based on the patient's lifestyle, such as the type of work they do.

Medical professionals can expect greater improvement if they provide treatment that encourages lifestyle improvements rather than simply administering medication. In addition, by deciding on a treatment plan that takes into account whether the patient has children and their employment status, patients will be able to improve their adherence (patients being actively involved in their treatment and medication and receiving treatment in line with their decisions) during and after treatment, leading to better quality of life and better outcomes. Furthermore, patients will be able to concentrate on their treatment with peace of mind as they will receive explanations and treatment that are tailored to their own personality.

In this way, medical professionals can provide better medical care by determining treatment plans based on biological, psychological, and social aspects. In other words, medical professionals are expected to provide so-called holistic medical care that includes not only biological aspects, but also psychological and social aspects. Medical professionals also collect information about psychological and social aspects through communication with patients.

However, medical professionals communicate with patients based on their own training and experience. Medical professionals may find it difficult to collect information on psychological and social aspects of patients. Medical professionals must also decide which of the pieces of information on psychological and social aspects to record in electronic medical records. Furthermore, medical professionals are required to utilize this information while maintaining an overall overview.

In recent years, medical care is no longer provided by doctors alone, but is provided in collaboration with a variety of other specialists. Doctors and other medical professionals request support depending on the stage of treatment and the patient's condition. This allows each specialist to carry out activities according to their own specialty. For example, social workers provide advice on aspects of patients' daily lives. Furthermore, cancer nurses provide care appropriate for cancer treatment.

As such, medical professionals need to request assistance depending on the stage of medical treatment and the patient's condition. However, medical professionals can sometimes have difficulty determining when and from which specialist to request assistance. Therefore, there is a demand for technology that can help them decide whether or not to request assistance from a specialist.

FIG. 1 is a block diagram showing an example of the configuration of a clinical support system 1 according to this embodiment. The clinical support system 1 includes a hospital information system (HIS) 10, a radiology information system (RIS) 20, a picture archiving and communication system (PACS) 30, a laboratory information system (LIS) 40, a patient terminal 50, a patient measurement terminal 60, a clinical support device 70, and a display device 80. Each system and device is connected to each other via a network 90 so that they can communicate with each other. The configuration shown in FIG. 1 is an example, and the number of each system and device may be changed as desired. Devices not shown in FIG. 1 may also be connected to the network 90.

The hospital information system 10, the radiology information system 20, the medical image management system 30, and the clinical test information system 40 are realized, for example, by computer equipment such as a server or a workstation.

The hospital information system 10 stores electronic medical record information 11 and medical interview information 12. The electronic medical record information 11 is information that records the progress of a patient's medical treatment. For example, the electronic medical record information 11 includes information for identifying the patient, personal information such as the patient's age, sex, and family structure, the name of the disease the patient suffers from, the name of the prescribed medication, and the treatment period. The medical interview information 12 is information that indicates the patient's responses to the medical interview. For example, the medical interview information 12 includes responses to the patient's current symptoms, responses to the patient's living environment, and responses to a personality assessment.

The radiology information system 20 stores image interpretation report information 21. Image interpretation report information 21 is information that contains findings by a doctor or the like who interpreted image information 31 captured by a medical image diagnostic device.

The medical image management system 30 stores image information 31. The image information 31 has images captured by a medical image diagnostic device. The medical image diagnostic device is, for example, an X-ray CT (Computed Tomography) device, an MRI (Magnetic Resonance Imaging) device, an X-ray diagnostic device, an ultrasound diagnostic device, or the like. The image information 31 is in accordance with the DICOM (Digital Imaging and Communications in Medicine) standard.

The clinical test information system 40 stores clinical test result information 41 and clinical test report information 42. The clinical test result information 41 is information showing the results of a clinical test. The clinical test report information 42 is information containing findings on the clinical test results.

The patient terminal 50 is a terminal used by the patient. The patient terminal 50 is realized, for example, by a smartphone, a tablet terminal, a wearable terminal, or a personal computer. The patient terminal 50 also stores conversation information 51 in which the patient's conversation is recorded. For example, the conversation information 51 is information on a conversation between a patient and a medical professional such as a doctor, a nurse, or a counselor. The conversation information 51 may also include casual conversation in addition to conversations related to medical treatment. Specifically, the conversation information 51 includes audio information in which the conversation is recorded, and information in which the audio is converted into text. The conversation information 51 may also include video information such as a video or still image including the conversation. When video information is included, the conversation information 51 includes a video showing the patient's facial expression.

The patient measurement terminal 60 is a terminal that measures the patient's vital signs. The patient measurement terminal 60 is realized, for example, by a wearable terminal. The patient measurement terminal 60 measures vital signs such as blood pressure, pulse, body temperature, and respiration. The patient measurement terminal 60 may also record conversations. The patient measurement terminal 60 then stores personal health information 61 that includes the measurement results of the vital signs.

The patient measurement terminal 60 is not limited to a wearable terminal, and may be a body fat meter, an activity meter, or other devices. The patient measurement terminal 60 may measure body fat, activity, or other items. The clinical support system 1 may include multiple patient measurement terminals 60. In the clinical support system 1, the multiple patient measurement terminals 60 may each measure a different object.

The clinical support device 70 is a device that supports medical professionals such as doctors in clinical practice. The clinical support device 70 is realized by computer equipment such as a server or a workstation. The clinical support device 70 analyzes the biological, social, and psychological aspects of a patient based on information acquired from each system and device of the clinical support system 1. The clinical support device 70 also analyzes information that does not belong to the biological, social, or psychological aspects of a patient as other aspects. The clinical support device 70 also generates information indicating the biological, social, psychological, and other aspects of a patient. The clinical support device 70 may be installed in a facility or may be a server on the Internet.

The display device 80 is a device capable of displaying various types of information. The display device 80 is realized by a computer device such as a personal computer or a tablet terminal. The display device 80 displays various types of information generated by the clinical support device 70. For example, the display device 80 displays a medical treatment schedule screen G1 (see FIG. 6). The display device 80 is an example of a display control unit.

Then, by looking at the information displayed on the display device 80, doctors and other medical professionals can decide whether or not to request assistance from a professional.

Next, we will explain the clinical support device 70.

Figure 2 is a block diagram showing an example of the configuration of a clinical support device 70 according to this embodiment. The clinical support device 70 has a network interface 710, an input interface 720, a display 730, a memory circuit 740, and a processing circuit 750.

The NW interface 710 is connected to the processing circuit 750 and controls the transmission and communication of various data between each device connected via the network 90. For example, the NW interface 710 is realized by a network card, a network adapter, a NIC (Network Interface Controller), etc.

The input interface 720 is connected to the processing circuit 750 and converts the input operation received from the operator (medical worker) into an electrical signal and outputs it to the processing circuit 750. Specifically, the input interface 720 converts the input operation received from the operator into an electrical signal and outputs it to the processing circuit 750. For example, the input interface 720 is realized by a trackball, a switch button, a mouse, a keyboard, a touchpad that performs input operations by touching the operation surface, a touch screen in which a display screen and a touchpad are integrated, a non-contact input circuit using an optical sensor, and a voice input circuit. Note that in this specification, the input interface 720 is not limited to only those that have physical operation parts such as a mouse and a keyboard. For example, an electrical signal processing circuit that receives an electrical signal corresponding to an input operation from an external input device provided separately from the device and outputs this electrical signal to a control circuit is also included as an example of the input interface 720.

The display 730 is connected to the processing circuit 750 and displays various information and image data output from the processing circuit 750. For example, the display 730 is realized by a liquid crystal display, a CRT (Cathode Ray Tube) display, an organic EL display, a plasma display, a touch panel, etc.

The memory circuitry 740 is connected to the processing circuitry 750 and stores various data. The memory circuitry 740 also stores various programs that the processing circuitry 750 reads and executes to realize various functions. For example, the memory circuitry 740 is realized by a semiconductor memory element such as a RAM (Random Access Memory) or a flash memory, a hard disk, an optical disk, etc.

The memory circuitry 740 stores analysis target information 741, medical event information 742, and support request information 743.

Figure 3 is a diagram showing an example of the data configuration of the analysis target information 741. The analysis target information 741 is information acquired by each system or device of the clinical support system 1, and is specified as the target for analysis as biological aspects, social aspects, psychological aspects, or other aspects of the patient.

The analysis target information 741 is associated with a classification, an analysis item, and an analysis target item. The classification is a division such as biological aspects, psychological aspects, social aspects, and others. The biological aspects are a classification indicating the biological aspects of the patient. For example, the biological aspects are associated with biological analysis items such as various test results, diseases, and physical conditions of the patient. In addition, the biological aspects are not limited to biological aspects, and analysis items related to physical aspects, medical aspects, and pathological aspects may be associated with the biological aspects. The psychological aspects are a classification indicating the psychological aspects of the patient. For example, the psychological aspects are associated with analysis items of psychological aspects such as the patient's intentions and personality. In addition, the psychological aspects may include the patient's emotional state. The emotional state is an emotion such as depression or anger. The psychological aspects may include a prognosis of remaining life indicating whether or not the patient wants to know the remaining life, a treatment preference indicating how the patient chooses treatment options, the patient's thoughts and values, the patient's personality, and the like. The social aspects are a classification indicating the social aspects of the patient. For example, the social aspect is associated with analysis items of the social aspect such as work, human relationships, hobbies, and educational background. The others are associated with analysis items that do not belong to the biological, psychological, or social aspects. The analysis items are items for analyzing the patient. The analysis target items are information that specifies whether or not the analysis items are to be analyzed. That is, the clinical support device 70 analyzes the analysis items that are set as the analysis targets in the analysis target items. Also, the association between the classification of the analysis target information 741 and the analysis items shown in FIG. 3 is one example and may be changed as desired.

Figure 4 is a diagram showing an example of the data configuration of medical event information 742. Medical event information 742 is information in which a medical event is associated with the importance of the medical event. A medical event is an event in medical treatment. The importance is information indicating the degree to which a medical event is prioritized among medical events. Note that the medical events shown in Figure 4 are only an example, and any event may be a medical event. In other words, a medical event that is not included in the medical event information 742 shown in Figure 4 may be added to the medical event, or a medical event that is included in the medical event information 742 shown in Figure 4 may not exist. Also, the importance shown in Figure 4 is only an example, and may be changed arbitrarily. Note that the medical event information 742 does not have to have an importance.

FIG. 5 is a diagram showing an example of the data configuration of the support request information 743. The support request information 743 is information having a list of specialists who will provide support when the request condition is satisfied in the medical event. FIG. 5 also shows a part of the support request information 743. That is, the support request information 743 has information on other medical events, not limited to the medical event "under treatment". The support request information 743 shown in FIG. 5 also shows that when the request condition "condition change occurs" is satisfied in the medical event "under treatment", the specialists associated with the request condition "condition change occurs" become candidates for supporters. Priority is also associated with the information indicating each specialist. The priority indicates the degree to which support should be requested from the associated specialist. The clinical support device 70 also displays a list of specialists based on the priority. This makes it easier for the clinical support device 70 to request support from a more important specialist. The request conditions, specialists, and priority shown in FIG. 5 are only examples and may be changed arbitrarily. Note that the support request information 743 does not need to have priority.

The processing circuitry 750 controls the operation of the entire clinical support device 70. The processing circuitry 750 has, for example, a patient designation function 751, an information acquisition function 752, an analysis target designation function 753, a feature analysis function 754, a medical event determination function 755, a support determination function 756, a supporter identification function 757, an information generation function 758, an operation input function 759, a support request function 760, and a setting function 761. In the embodiment, each processing function performed by the components of the patient designation function 751, the information acquisition function 752, the analysis target designation function 753, the feature analysis function 754, the medical event determination function 755, the support determination function 756, the supporter identification function 757, the information generation function 758, the operation input function 759, the support request function 760, and the setting function 761 is stored in the memory circuitry 740 in the form of a program executable by a computer. The processing circuitry 750 is a processor that realizes a function corresponding to each program by reading and executing a program from the memory circuitry 740. In other words, when each program is loaded, the processing circuit 750 has each of the functions shown in the processing circuit 750 in FIG. 2.

In FIG. 2, the patient designation function 751, information acquisition function 752, analysis target designation function 753, feature analysis function 754, medical event determination function 755, support determination function 756, supporter identification function 757, information generation function 758, operation input function 759, support request function 760, and setting function 761 are realized by a single processor, but the processing circuit 750 may be configured by combining multiple independent processors, and each processor may execute a program to realize the functions. Also, in FIG. 2, a single storage circuit such as the storage circuit 740 is described as storing a program corresponding to each processing function, but multiple storage circuits may be distributed and the processing circuit 750 may read out the corresponding program from each storage circuit.

The term "processor" used in the above description refers to circuits such as a CPU (Central Processing Unit), a GPU (Graphical Processing Unit), an Application Specific Integrated Circuit (ASIC), a programmable logic device (e.g., a Simple Programmable Logic Device (SPLD), a Complex Programmable Logic Device (CPLD), and a Field Programmable Gate Array (FPGA)). The processor achieves its functions by reading and executing a program stored in the memory circuit 740. Note that instead of storing a program in the memory circuit 740, the processor may be configured to directly incorporate the program into its circuit. In this case, the processor achieves its functions by reading and executing a program embedded in the circuit.

The patient designation function 751 accepts the designation of a patient for whom a treatment plan is to be created. In other words, the patient designation function 751 accepts the designation of a patient for whom biological, social, and psychological aspects of the patient are to be analyzed. The patient designation function 751 accepts the designation of a patient, for example, from the display device 80. For example, the patient designation function 751 accepts information that can identify the patient, such as the patient's name or a patient code for identifying the patient. Alternatively, the patient designation function 751 accepts the designation of a patient by selection from a list of patients.

The information acquisition function 752 acquires patient information related to the patient, medical interview information 12 indicating the patient's responses to the medical interview, and conversation information 51 in which the patient's conversation is recorded. The information acquisition function 752 is an example of an acquisition unit. Here, the patient information is information obtained by monitoring the patient, such as electronic medical record information 11, radiology report information 21, image information 31, clinical test result information 41, clinical test report information 42, and personal health information 61. For example, when a patient is designated by the patient designation function 751, the information acquisition function 752 acquires the patient information, medical interview information 12, and conversation information 51 of the designated patient.

The analysis target designation function 753 designates the analysis target items, which are the analysis items to be analyzed by the characteristic analysis function 754, from among the analysis items of the biological aspects, psychological aspects, and social aspects of the patient. In other words, the analysis target designation function 753 designates the analysis target items of the analysis target information 741.

More specifically, the analysis target designation function 753 accepts the designation of an analysis target to be analyzed using the patient information, interview information 12, and conversation information 51 acquired by the information acquisition function 752. For example, the analysis target designation function 753 accepts the designation of an analysis target from information received by the NW interface 710 or an operation accepted by the input interface 720. For example, the analysis target designation function 753 accepts the designation of an analysis target from the display device 80 via the NW interface 710. Then, the analysis target designation function 753 designates the analysis target items of the specified analysis target information 741 as the analysis target.

The characteristic analysis function 754 generates patient characteristic information indicating biological, psychological, social, and other aspects of the patient through an analysis process using the patient information, medical interview information 12, and conversation information 51. The characteristic analysis function 754 is an example of an analysis unit. The analysis process is a process of extracting, determining, analyzing, and generating new information from the patient information, medical interview information 12, and conversation information 51. The patient characteristic information is information indicating the characteristics of the patient in biological, psychological, social, or other aspects. The patient characteristic information is also the analysis result for each analysis item of the patient's biological, psychological, social, or other aspects.

More specifically, the feature analysis function 754 generates patient feature information for each of the analysis target items of the biological aspects, psychological aspects, and social aspects of the patient. From the information contained in the patient information, the feature analysis function 754 generates patient feature information that corresponds to the analysis target items of the biological aspects specified by the analysis target information 741. Specifically, the feature analysis function 754 generates patient feature information indicating comorbid diseases, physical condition, etc. contained in the patient information.

The characteristic analysis function 754 also generates patient characteristic information for the analysis target items of psychological and social aspects specified by the analysis target information 741 from among the patient information, the medical interview information 12, and the information contained in the conversation information 51. For example, the characteristic analysis function 754 generates patient characteristic information from the medical interview information 12 that corresponds to the analysis target items of psychological and social aspects specified by the analysis target information 741. Specifically, the characteristic analysis function 754 extracts responses to questions about personality judgment, work, human relationships, etc., contained in the medical interview information 12.

In addition, the feature analysis function 754 generates patient feature information including conversation content information and emotion information of the conversation by analyzing the conversation information 51. The conversation content information is information indicating the content of the conversation. The emotion information is information indicating the emotion of the patient when each word was spoken in the conversation.

More specifically, the feature analysis function 754 generates patient feature information including conversation content information and emotion information corresponding to the analysis target items of the psychological and social aspects specified by the analysis target information 741. For example, the feature analysis function 754 generates conversation content information indicating the content of the conversation by performing natural language processing on the conversation information 51. For example, if the conversation information 51 includes the utterance "My lower back hurts," the feature analysis function 754 generates the sentence "My lower back hurts."

The feature analysis function 754 also generates emotion information that indicates the emotion of the patient who spoke. Here, when symptoms are worsening, the patient often speaks with negative emotion. On the other hand, when symptoms are improving, the patient often speaks with positive emotion. For example, the feature analysis function 754 generates emotion information that indicates the emotion of the patient expressed by the tone of voice, hesitation, nuance, etc., when saying "My lower back hurts." In this way, the feature analysis function 754 generates patient feature information in which emotion information is associated with conversation content information.

For example, the feature analysis function 754 may utilize artificial intelligence such as AI (Artificial Intelligence). For example, the feature analysis function 754 generates emotion information indicating the emotion of the speaker of the conversation included in the conversation information 51 using a trained model generated by machine learning. The trained model is generated by supervised learning in which the conversation information 51 is input as teacher data on the input side, and emotion information indicating the emotion of the speaker is input as teacher data on the output side. Note that the trained model is not limited to this type of machine learning and may be generated by other methods.

The feature analysis function 754 may also generate information indicating the patient's emotional information and values by comparing the conversation information 51 with other information such as the patient information and the medical interview information 12. For example, if the patient answers that their work is medium intensity standing work in the medical interview information 12 and that their work is six hours standing work in the conversation information 51, the feature analysis function 754 can generate information indicating the patient's values indicating that the patient recognizes six hours as medium intensity.

In addition, as time passes, the social and psychological conditions of the patient change. Therefore, the characteristic analysis function 754 may generate patient characteristic information at regular intervals, or may generate patient characteristic information for each medical event, such as an examination or notification.

Note that the characteristic analysis function 754 may generate patient characteristic information indicating psychological and social aspects, rather than being limited to all of the biological, psychological, social, and other aspects of the patient.

The clinical event determination function 755 determines which of the clinical events in the clinical event information 742 the case corresponds to, based on patient information obtained by monitoring the patient, such as the electronic medical record information 11, the image interpretation report information 21, the image information 31, the clinical test result information 41, the clinical test report information 42, and the personal health information 61. Examples of clinical events include "first visit," "detailed examination," "notification," "start of treatment," "under treatment," "change of medication," "end of treatment," "discontinuation of treatment," and "terminal stage."

"First visit" is a medical event that indicates a first consultation. The medical event determination function 755 determines that a medical event corresponds to a "first visit" when there is no medical record of the medical department registered in the electronic medical record information 11 within a set period from the current time. For example, the medical event determination function 755 determines that a medical event corresponds to a "first visit" when there is no medical record within a set period from the last visit date, even if the patient has visited the same medical department in the past. In addition, the medical event determination function 755 determines that a medical event corresponds to a "first visit" when it is a first medical record.

A "Detailed examination" is a medical event that indicates that a detailed examination, such as an imaging diagnosis or a clinical test, is being performed. The medical event determination function 755 determines that the event corresponds to a "Detailed examination" when there is test order information.

"Notification" is a state in which a patient is notified of something bad. The medical event determination function 755 determines whether there is test order information, a history indicating that the test was performed, and clinical test report information 42 or image reading report information 21. The medical event determination function 755 then analyzes the clinical test report information 42 or image reading report information 21 to determine whether it corresponds to "notification". For example, the medical event determination function 755 performs natural language processing on the clinical test report information 42. The medical event determination function 755 then determines that it corresponds to "notification" when there is a term indicating cancer or a term that is thought to require special attention, such as malignancy or suspected malignancy. In addition, the medical event determination function 755 determines that it corresponds to "notification" when the image reading report information 21 contains information indicating a metastatic lesion. For example, in the case of a breast cancer patient, the medical event determination function 755 also determines that it corresponds to "notification" when it is pointed out that there is a shadow that seems to be cancer in the breast opposite to the breast with cancer, or in an organ other than the breast.

"Treatment start" is a medical event that indicates that this is the first treatment for an injury or illness. "Treatment in progress" is a medical event that indicates that this is the second or subsequent treatment for an injury or illness. For example, the medical event determination function 755 determines whether the event corresponds to "treatment start" or "treatment in progress" based on the number of drug therapy instructions or the number of appointments with the radiotherapy department.

"Drug change" is a clinical event indicating that the drug administered to the patient has been changed. "Treatment cessation" is a clinical event indicating that treatment for the patient has been halted. For example, the clinical event determination function 755 determines whether the event corresponds to a "drug change" or "treatment cessation" based on CTCAE (Common Terminology Criteria for Adverse Events) grade information, patient outcome report information, blood test result information, and the like, which are written in the electronic medical record information 11 or nursing report. The clinical event determination function 755 also determines whether the event corresponds to a "drug change" or "treatment cessation" based on the difference between the white blood cell count, neutropenia, and other blood marker reference values in blood tests performed during drug therapy or radiation therapy.

"End of treatment" is a medical event indicating that a patient's treatment has ended. For example, the medical event determination function 755 determines whether or not it corresponds to "end of treatment" based on the standard number of treatments included in the electronic medical record information 11. For example, the medical event determination function 755 determines whether or not it corresponds to "end of treatment" based on the number of drug therapy instructions. In addition, the standard number of radiation treatments after breast-conserving therapy is 25 times. Therefore, the medical event determination function 755 may determine whether or not it corresponds to "end of treatment" based on the number of appointments made with the radiation therapy department.

"Terminal stage" is a medical event that indicates that there is no hope of recovery from an injury or illness and that treatment has been discontinued or transitioned to palliative care only. For example, the medical event determination function 755 determines whether a metastatic lesion is detected in the electronic medical record information 11 and "treatment has been discontinued" or when treatment has been switched to painkiller treatment only, etc., and determines whether this corresponds to the "terminal stage."

The support determination function 756 determines whether the request conditions set for a medical event are met based on the patient characteristic information. Here, the supporter is a professional who supports medical staff in response to requests for support. Note that the supporter is typically a professional, but does not have to be a professional.

For example, suppose that a request condition "depressed state" is set for a medical event "under treatment" in the support request information 743. If the medical event determination function 755 determines that the medical event is "under treatment" and the patient is determined to be in a "depressed state" based on the patient characteristic information, the support determination function 756 determines that the request condition is met.

For example, suppose that the request condition "retirement" is set in the support request information 743 for the medical event "detailed examination." The support determination function 756 determines that the request condition is met when the medical event determination function 755 determines that the medical event is "detailed examination" and the patient is determined to be "retired" based on the patient characteristic information. Note that the request condition "retirement" is not limited to the medical event "detailed examination," and may be set for other medical events.

For example, suppose that a request condition of "introverted" is set in the support request information 743 for a medical event of "notification." If the medical event determination function 755 determines that the medical event is "notification" and the patient is determined to be "introverted" based on the patient characteristic information, the support determination function 756 determines that the request condition is met.

The medical event determination function 755 may determine that the medical event corresponds to multiple medical events. For example, the medical event determination function 755 may determine that the medical event corresponds to "under treatment" and "medication change". More specifically, the support determination function 756 determines which medical event is to be prioritized based on the importance of the medical event in the medical event information 742. For example, the support determination function 756 selects one medical event based on the importance of the medical event information 742. Then, the support determination function 756 determines whether the request condition set for the prioritized medical event is satisfied based on the patient characteristic information. Note that when the medical event information 742 does not have an importance, the support determination function 756 determines whether the request condition set for each medical event is satisfied.

The supporter identification function 757 determines at least one supporter requesting support based on the patient characteristic information, the patient's medical event, and the request conditions for requesting support at the medical event. The supporter identification function 757 is an example of a determination unit. More specifically, the supporter identification function 757 determines, based on the support request information 743, that a professional associated with the request conditions determined to be satisfied by the support determination function 756 is at least one supporter requesting support.

Furthermore, when the medical event determination function 755 determines which medical event should be prioritized based on the importance of the medical event, the supporter identification function 757 determines at least one supporter to request support from based on the patient characteristic information, the medical event, the importance of the medical event, and the request conditions. In other words, the supporter identification function 757 determines that the supporter is a professional associated with the request conditions.

The information generating function 758 generates information to be displayed on the display device 80. The display device 80 then displays the various pieces of information generated by the information generating function 758. For example, the information generating function 758 generates a medical treatment schedule screen G1 that shows the medical treatment schedule for the patient. The display device 80 then displays the medical treatment schedule screen G1 generated by the information generating function 758.

Figure 6 is an explanatory diagram showing an example of the medical treatment schedule screen G1 according to this embodiment. The medical treatment schedule screen G1 has patient summary information G11, schedule information G12, and vital sign information G13. The patient summary information G11 is information showing an overview of the patient. For example, the patient summary information G11 is information showing the patient's name, the patient's date of birth, the patient's blood type, the patient's height, the patient's weight, etc. The vital sign information G13 is information showing the vital signs for each day shown in the schedule information G12.

The schedule information G12 is information indicating a medical appointment. The schedule information G12 indicates a medical appointment indicating a medical appointment and a medical event for each day. When the support determination function 756 determines that the request condition is met, the information generation function 758 provides a supporter request button G14 for the medical event. The supporter request button G14 is a button that displays the supporter request information G15 indicating the supporter to be requested for support. The information generation function 758 may automatically present the supporter request information G15 even if the supporter request button G14 is not pressed. For example, when the information generation function 758 presents the medical appointment schedule screen G1, the information generation function 758 may present the supporter request information G15 on the condition that the support determination function 756 determines that the request condition is met. In other words, the information generation function 758 generates the supporter request information G15 including information on the supporter determined by the supporter identification function 757. The information generation function 758 is an example of an information generation unit. That is, the information generation function 758 generates supporter request information G15 that indicates the supporter to whom support should be requested.

The supporter request button G14 is also associated with the time when it is determined that the request conditions are met in the medical event. That is, the information generation function 758 generates supporter request information G15, which includes information about the supporter, in association with the time when it is determined that the request conditions are met. This allows the medical staff to know when to request support.

When the supporter request button G14 is pressed, the information generation function 758 generates supporter request information G15. Supporter request information G15 is information requesting support from a supporter. Supporter request information G15 has message information G151, supporter list information G152, and a support request button G153.

Message information G151 is information indicating the medical event for which the request condition is determined to be satisfied and the time of the medical event. The information generation function 758 generates message information G151 based on the medical event for which the support determination function 756 determines that the request condition is satisfied and the time of the medical event.

The supporter list information G152 is information for selecting a supporter from whom support is requested. The information generation function 758 generates supporter list information G152, which is a list of supporters identified by the supporter identification function 757. Here, the supporter identification function 757 identifies a supporter from a list of supporters registered for the request conditions based on the support request information 743. In other words, the information generation function 758 generates supporter list information G152 for selecting a supporter from whom support is requested from among the supporters registered for the request conditions. The supporter list information G152 has a check box for each supporter. The support request button G153 is a button for requesting support from a supporter selected by a check box in the supporter list information G152.

The information generating function 758 also generates supporter list information G152 indicating a list of supporters requesting support, based on the priority of the supporters contained in the support request information 743. For example, the information generating function 758 generates supporter list information G152 in which supporters are arranged in order according to the priority of the supporters. This allows medical personnel to understand which supporter is more important. Note that if the support request information 743 does not have a priority, the information generating function 758 may generate supporter list information G152 indicating a list of related supporters. In other words, the information generating function 758 may generate supporter list information G152 that is not arranged in order according to priority.

The operation input function 759 accepts various operations. For example, the operation input function 759 accepts an operation to select a supporter in the supporter request information G15. The operation input function 759 is an example of an input unit. The operation input function 759 also accepts an operation to press the support request button G153 in the supporter request information G15. That is, the operation input function 759 accepts an operation to press the support request button G153 from, for example, the display device 80.

The support request function 760 notifies the supporter selected by the operation input function 759 of the supporter request information G15 of the support request. The support request function 760 is an example of a notification unit. For example, the support request function 760 notifies the supporter of the support request by sending an email requesting support to the supporter's terminal. Alternatively, the support request function 760 notifies the support request by registering an event requesting support in the supporter's schedule. Note that these support request methods are merely examples, and the support request function 760 may request support by any method.

The setting function 761 sets various information for the medical event information 742 and the support request information 743. For example, the setting function 761 sets the importance of the medical event in the medical event information 742. The setting function 761 is an example of a first setting unit. The setting function 761 also sets the priority of the specialist who will be the supporter in the support request information 743. The setting function 761 is an example of a second setting unit. The setting function 761 may also set request conditions and specialists for the medical event in the support request information 743, not limited to the importance and priority. The setting function 761 also adds and deletes medical events to the medical event information 742 and the support request information 743. This allows the setting function 761 to arbitrarily set the importance and priority for each facility, such as a hospital.

The support assessment function 756 may estimate the time when the request conditions will be met based on the patient characteristic information. For example, if the patient wishes to have a child, the support assessment function 756 identifies the ovulation cycle based on the patient characteristic information. The support assessment function 756 then estimates the time when the request conditions will be met based on the ovulation cycle. This allows the support assessment function 756 to determine the appropriate timing for the request.

The setting function 761 may also set the request condition "emotions more negative than the threshold" for all medical care events. As a result, the support determination function 756 determines that the request condition "emotions more negative than the threshold" is met when the emotion value that quantifies the patient's negative emotion based on the patient characteristic information is lower than the threshold, and determines that the request condition is met. As a result, the information generation function 758 generates supporter request information G15 that indicates a supporter who is a professional other than the attending physician and who should be requested for support. For example, the information generation function 758 generates supporter request information G15 that indicates a supporter such as a psycho-oncology psychiatrist, clinical psychologist, cancer counselor, or cancer specialist nurse. Thus, medical professionals can request support from professionals other than the attending physician.

Next, we will explain the various processes performed by the clinical support system 1.

Figure 7 is a flowchart showing an example of a support request process executed by the clinical support device 70 according to this embodiment. The support request process is a process for requesting support from a supporter.

The patient designation function 751 accepts the designation of the patient to be displayed on the treatment schedule screen G1 (step S1).

The information acquisition function 752 acquires patient information such as electronic medical record information 11, radiology report information 21, image information 31, clinical test result information 41, clinical test report information 42, and personal health information 61 (step S2).

The information acquisition function 752 acquires the medical interview information 12 (step S3).

The information acquisition function 752 acquires the conversation information 51 (step S4).

The characteristic analysis function 754 generates patient characteristic information indicating biological, psychological, social, and other aspects of the patient through analytical processing using the patient information, medical interview information 12, and conversation information 51 (step S5).

The clinical support device 70 executes the supporter determination process described below (step S6).

The information generating function 758 generates the medical treatment schedule screen G1 (step S7). The information generating function 758 then transmits the generated medical treatment schedule screen G1 to the display device 80 (step S8). As a result, the display device 80 displays the medical treatment schedule screen G1.

The support request function 760 determines whether an operation to request support from a supporter has been accepted on the medical treatment schedule screen G1 displayed on the display device 80 (step S9). If there is no support request (step S9; No), the support request function 760 ends the support request process.

If there is a request for assistance (step S9; Yes), the assistance request function 760 requests assistance from a supporter (step S10).

The clinical support device 70 then ends the support request process.

Figure 8 is a flowchart showing an example of supporter determination processing executed by the clinical support device 70 according to this embodiment. The supporter determination processing is processing for determining whether or not to request support from a supporter. Note that the supporter determination processing shown in Figure 8 is processing for determining whether or not the medical event corresponds to "notification" based on the clinical test report information 42 and the image interpretation report information 21.

The medical care event determination function 755 determines whether or not there is an examination order, such as a clinical test order or an image diagnosis order (step S21). If there is no examination order (step S21; No), the clinical support device 70 ends the support determination process.

If an examination order exists (step S21; Yes), the medical care event determination function 755 determines whether the examination requested by the examination order has been performed (step S22). If the examination has not been performed (step S22; No), the clinical support device 70 ends the support determination process.

If the examination has been performed (step S22; Yes), the medical care event determination function 755 determines whether or not there is an examination report such as the clinical examination report information 42 or the image interpretation report information 21 (step S23). If there is no examination report (step S23; No), the clinical support device 70 ends the support determination process.

If an examination report is available (step S23; Yes), the medical event determination function 755 analyzes the examination report (step S24).

The medical event determination function 755 determines the medical event based on the analysis results of the examination report (step S25). In the supporter determination process shown in FIG. 8, it determines whether or not the medical event corresponds to "notification."

The support determination function 756 determines whether or not a supporter is needed based on the patient characteristic information and the patient's medical care event (step S26). In other words, the support determination function 756 determines whether or not the request conditions set for the medical care event are met based on the patient characteristic information. If it is determined that a supporter is not needed (step S26; No), the clinical support device 70 ends the support determination process.

If it is determined that a support person is needed (step S26; Yes), the support person identification function 757 determines whether there are multiple professionals identified by the request conditions set for the medical event based on the support request information 743 (step S27).

If there are not multiple professionals (step S27; No), the clinical support device 70 proceeds to step S29.

If there are multiple professionals (step S27; Yes), the information generation function 758 identifies the priority of each professional based on the support request information 743 (step S28). As a result, for example, the information generation function 758 generates supporter request information G15 that allows the user to select a professional to request support from in the order of priority indicated by the priority.

The support provider identification function 757 determines, based on the support request information 743, a professional identified by the request conditions set for the medical event as the support provider to whom support should be requested (step S29).

The clinical support device 70 then ends the support determination process.

As described above, the clinical support system 1 according to this embodiment acquires patient information, interview information 12, and conversation information 51 related to the patient. The clinical support system 1 also generates patient characteristic information indicating the psychological and social aspects of the patient by performing an analysis process using the patient information, interview information 12, and conversation information 51. The clinical support system 1 also determines a supporter to whom support should be requested based on the patient characteristic information, the patient's medical event determined by the medical event determination function 755, and the request conditions set in the support request information 743. Then, when the clinical support system 1 determines that the request conditions are met, it displays the medical treatment schedule screen G1 for requesting support. This allows the medical professional to consider whether or not to request support from each specialist. Therefore, the clinical support system 1 can support the decision of whether or not to request support from a specialist.

Furthermore, the clinical support system 1 allows medical professionals to request support from a specialist suited to each individual patient at a time that suits the patient. This reduces the burden on medical professionals and allows them to provide comprehensive, high-quality medical care to patients through supporters.

(Variation 1)
In the present embodiment, it has been described that the information acquisition function 752 acquires the patient information, the interview information 12, and the conversation information 51. Furthermore, the information acquisition function 752 may acquire position information from the patient terminal 50, may acquire brain wave information from the patient measurement terminal 60, or may acquire both of these pieces of information.

The location information is information that indicates the location of the patient terminal 50. In other words, the location information is information that indicates the location of the patient. The feature analysis function 754 can extract the commuting time, for example, by measuring the travel time from the patient's home to the workplace based on the location information and map information at each time. In a similar manner, the feature analysis function 754 can extract the commuting time to the hospital. Furthermore, the feature analysis function 754 can extract, based on the location information, whether the patient is active or tends to stay at home.

The brainwave information is information that indicates the brainwaves of the patient. For example, the information acquisition function 752 acquires brainwave information that indicates the brainwaves of the patient when conversing with a medical professional. This allows the feature analysis function 754 to acquire the psychological state of the patient when conversing with a medical professional. For example, the feature analysis function 754 can extract whether the patient is relaxed or stressed.

This allows the feature analysis function 754 to analyze the patient in more detail. This allows the clinical support device 70 to make a more detailed determination as to whether or not support should be requested.

(Variation 2)
In this embodiment, the information generating function 758 generates the medical treatment schedule screen G1. Then, it has been explained that the display device 80 displays the medical treatment schedule screen G1. The information generating function 758 may display the medical treatment schedule screen G1 on the display 730 of the clinical support device 70, or may display it on another device.

(Variation 3)
When a medical professional requests support from a supporter, the medical professional explains to the supporter the necessary information for proceeding with treatment and care based on not only biological aspects but also psychological and social aspects of the patient. By receiving the explanation, the supporter can provide support according to the psychological and social aspects of the patient. Therefore, the information generating function 758 may generate a screen that classifies the psychological and social aspects of the patient into the patient's intentions, peripheral matters, QOL (Quality of Life), etc., without being limited to the medical treatment schedule screen G1. Then, the display device 80 may display the screen generated by the information generating function 758.

Here, the feature analysis function 754 generates patient feature information indicating biological, psychological, social, and other aspects of the patient through an analysis process using the patient information, the interview information 12, and the conversation information 51. Furthermore, the feature analysis function 754 may classify the biological, psychological, social, and other aspect information included in the patient feature information into predetermined items. Furthermore, the feature analysis function 754 may classify the biological, psychological, and social aspect information included in the patient feature information into, for example, the patient's intention, peripheral matters, and QOL. That is, the feature analysis function 754 may generate patient feature information classified into predetermined classification items for the patient's psychological and social aspects. Furthermore, the feature analysis function 754 may classify classification items such as the patient's intention, peripheral matters, and QOL into stages such as major classification, medium classification, and minor classification.

The information generation function 758 generates a screen that displays patient characteristic information in stages of major, medium, and minor categories for the patient's intentions, peripheral matters, and QOL. FIG. 9 is a diagram showing an example of a first classification screen G2 that shows classification items up to the medium category according to variant example 3. The first classification screen G2 has a display area that displays each of the classification items of the medium categories for medical indications, patient's intentions, peripheral matters, and QOL. The display area may display all of the classification items of the medium category, or may display those classification items of the medium category that are associated with information included in the patient characteristic information.

The first classification screen G2 also has a medical indications button G21, a patient's intentions button G22, a peripheral matters button G23, and a quality of life button G24. The medical indications button G21, the patient's intentions button G22, the peripheral matters button G23, and the quality of life button G24 are buttons that accept an operation to display the second classification screen G3 (see FIG. 10) that shows classification items up to the minor classification included in the corresponding major classification.

When any of the medical indication button G21, the patient's intention button G22, the peripheral matters button G23, and the QOL button G24 is selected, the information generating function 758 generates the second classification screen G3 of the corresponding large category. FIG. 10 is a diagram showing an example of the second classification screen G3 according to the modified example 3. The second classification screen G3 has small classification items outside the medium classification items. The medium classification items and the small classification items are connected by leader lines. As a result, the second classification screen G3 clearly shows the relationship between the medium classification and the small classification, and also clearly shows which medium classification item the small classification item belongs to. In addition, when a small classification item is selected on the second classification screen G3, the information generating function 758 may display detailed information of the selected small classification item. Then, the display device 80 generates screens such as the first classification screen G2 and the second classification screen G3 that show the psychological and social aspects of the patient for each classification item based on the patient characteristic information.

In this way, the information generation function 758 generates a first classification screen G2 and a second classification screen G3 as screens in which patient characteristic information including the psychological and social aspects of the patient is classified into medical indications, the patient's wishes, peripheral matters, QOL, etc. Then, the display device 80 displays the first classification screen G2 and the second classification screen G3. Therefore, the supporter can provide support appropriate to the patient, taking into account not only biological aspects but also the psychological and social aspects of the patient. Therefore, the information generation function 758 can support the progress of medical care based on not only biological aspects but also psychological and social aspects.

According to at least one of the embodiments described above, it is possible to assist in deciding whether or not to request assistance from a professional.

Although several embodiments have been described, these embodiments are presented as examples and are not intended to limit the scope of the invention. These embodiments can be implemented in various other forms, and various omissions, substitutions, modifications, and combinations of embodiments can be made without departing from the spirit of the invention. These embodiments and their modifications are within the scope of the invention and its equivalents as set forth in the claims, as well as the scope and spirit of the invention.

1 Clinical Support System 10 Hospital Information System (HIS)
11 Electronic medical record information 12 Interview information 20 Radiology Information Systems (RIS)
21 Image interpretation report information 30 Medical image management system (PACS: Picture Archiving and Communication Systems)
31 Image information 40 Laboratory Information System (LIS)
41 Clinical test result information 42 Clinical test report information 50 Patient terminal 51 Conversation information 60 Patient measurement terminal 61 Personal health information 70 Clinical support device 80 Display device 741 Analysis target information 742 Medical event information 743 Support request information 751 Patient designation function 752 Information acquisition function 753 Analysis target designation function 754 Characteristics analysis function 755 Medical event determination function 756 Support determination function 757 Supporter identification function 758 Information generation function 759 Operation input function 760 Support request function 761 Setting function G1 Medical treatment schedule screen G11 Patient summary information G12 Schedule information G13 Vital sign information G14 Supporter request button G15 Supporter request information G151 Message information G152 Supporter list information G153 Support request button G2 First classification screen G3 Second classification screen

A clinical support system according to an embodiment includes an acquisition unit, an analysis unit, a determination unit, and a display control unit. The acquisition unit acquires patient information related to a patient, medical interview information indicating the patient's responses to a medical interview, and conversation information in which the patient's conversation is recorded. The analysis unit generates patient characteristic information classified into predetermined classification items regarding psychological and social aspects of the patient by an analysis process using the patient information, the medical interview information, and the conversation information. The determination unit determines at least one supporter to request support based on the patient characteristic information, a medical care event of the patient, and a request condition for requesting support in the medical care event. The display control unit displays a screen including information regarding the supporter determined by the determination unit and the psychological and social aspects of the patient for each classification item .

Claims (11)

an acquisition unit that acquires patient information related to a patient, medical interview information indicating the contents of the patient's responses to medical interviews, and conversation information in which the conversation of the patient is recorded;
an analysis unit that generates patient characteristic information indicating psychological and social aspects of the patient by performing an analysis process using the patient information, the interview information, and the conversation information;
A determination unit that determines at least one supporter to request support based on the patient characteristic information, a medical event of the patient, and a request condition for requesting support in the medical event;
a display control unit that displays a screen including information about the supporter determined by the determination unit;
A clinical support system equipped with: The display control unit displays information requesting support from a supporter.
The clinical support system according to claim 1 . the display control unit displays information including information about the supporter in association with the time when it is determined that the request condition is satisfied.
The clinical support system according to claim 1 . the display control unit displays information for selecting a supporter to be requested to provide support from among supporters registered for the request condition.
The clinical support system according to claim 1 . The analysis unit generates the patient characteristic information by classifying psychological and social aspects of the patient into predetermined classification items,
The display control unit displays psychological aspects and social aspects of the patient for each of the classification items based on the patient characteristic information.
The clinical support system according to claim 1 . The determination unit determines at least one supporter to be requested to provide support based on the patient characteristic information, the medical event, the importance of the medical event, and the request condition.
The clinical support system according to claim 1 . The display control unit displays a list of supporters to be requested to provide support based on the priority of the supporters.
The clinical support system according to claim 1 . An input unit that receives an input for selecting a supporter to be requested for support;
and a notification unit that notifies the supporter selected by the input unit of a support request.
The clinical support system according to claim 1 . A first setting unit that sets the importance of the medical event.
The clinical support system according to claim 6. Further comprising a second setting unit that sets the priority of the supporter.
The clinical support system according to claim 7. an acquisition unit that acquires patient information related to a patient, medical interview information indicating the contents of the patient's responses to medical interviews, and conversation information in which the conversation of the patient is recorded;
an analysis unit that generates patient characteristic information indicating psychological and social aspects of the patient by performing an analysis process using the patient information, the interview information, and the conversation information;
A determination unit that determines at least one supporter to request support based on the patient characteristic information, a medical event of the patient, and a request condition for requesting support in the medical event;
an information generating unit that generates a screen including information about the supporter determined by the determining unit;
A clinical support device comprising:

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