JP3206461B2 - Home care support system - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a center device installed in a medical institution, a welfare institution, a health institution or the like and a patient terminal connected via communication means. The present invention relates to an improvement of a home care support system in which a specialist at a center performs examination, advice, guidance, and follow-up on a patient by transmitting biological information.

[0002]

2. Description of the Related Art An example of a home care support system is disclosed in Japanese Patent Application Laid-Open No. 7-7560. In the configuration of Japanese Patent Laid-Open No. 7-7560, a device for measuring patient's biological information such as a patient's blood pressure, pulse, and electrocardiogram is connected to a videophone terminal. The information is transmitted to the terminal on the hospital side, and is reproduced on the terminal on the hospital side, and a medical examination is performed based on the content.

[0003]

When measurement of biological information such as blood pressure and electrocardiogram is performed in a hospital, the patient is worried about wearing the device because a doctor or nurse wears the measuring device. Never have. However, when measuring at home, since the patient himself wears the measuring device, he is concerned about whether or not the measurement device is sufficiently worn.
In particular, when the user is unfamiliar with the measuring device, the tendency is strong.

It is conceivable to judge the wearing state from the measured biological information, but this requires considerable experience and advanced medical knowledge. For example, the patient himself / herself accurately judges the wearing state of the measuring device from an electrocardiogram. Can not. In addition, when transmitting the information to the center while measuring, that is, when measuring while the patient side terminal and the center side device are connected online, a doctor or the like at the center side reports the wearing state of the patient to the videophone. It is possible to give appropriate advice on wearing by monitoring by the system or analyzing the transmitted biological information, but the timing when the patient measures and the timing when both terminals are connected do not always match. Absent. In such a case, as typified by periodic measurement, there is an example in which measurement is performed by closing the patient side, and measurement data is transmitted to the center by polling from the center-side device or the patient-side terminal.

Thus, in the case of measurement at home,
When the patient himself / herself is concerned about the wearing of the device and starts the measurement, there is a problem that the anxiety affects the measurement result and accurate data cannot be obtained.

[0006]

The patient's feeling of anxiety in the above-mentioned problem is caused by the fact that the patient has to grasp the wearing state of the biological information measuring device without a clear judgment standard. The present invention notifies a patient of a wearing state of a biological information measuring device, thereby enabling a patient to measure biological information in a more comfortable state without having unnecessary feeling of anxiety, and correct a center side of a hospital or the like. It is intended to enable appropriate medical examination, advice, guidance, follow-up, and the like based on biological information.

That is, the information registered in the patient terminal in advance
Biological information measurement device
Instructions for selecting the music presented for each of the mounting and measurement states
Music selection means for accepting
Or memorize the selected songs for each measurement state
Music table storage means, the mounting state of the biological information measuring device provided in the center side device or the patient side terminal or
There is a mounted state determined by the means for determining the measurement state
Or is the music corresponding to the measurement state a music table storage means?
By providing the playing means for obtaining the music data and playing the music , the wearing state or the measuring state can be accurately grasped by the patient himself, thereby facilitating accurate measurement of biological information.

[0008]

BEST MODE FOR CARRYING OUT THE INVENTION

<Embodiment 1> FIG. 1 shows a device configuration diagram of a home care system in Embodiment 1. A patient side terminal 10 is installed on the patient side, and a terminal 20 as a center side device is installed on the center side. The terminals are connected via a communication line 30.

The communication line 30 is assumed to be an ISDN line, but may be a dedicated line, a public line, a CATV, a radio, or the like. On the patient side, an electrocardiograph
51, sphygmomanometer 52 is installed. The patient-side terminal 10 is used for inputting biological information measured by the videophone 40 and the television camera 41, the telephone 60, the electrocardiograph 51 and the sphygmomanometer 52 to the patient-side terminal 10 for conversation with the center side. Sensor adapter 50 is connected. In the patient-side terminal 10, interfaces 11 to 15 with each connected device are connected by a bus 19, and are controlled by a CPU 16. The CPU 16 has a wearing state determination unit 1 for determining the wearing state of the electrocardiograph 51 and the sphygmomanometer 52.
7.A judgment value table 17-1 in which judgment values serving as judgment criteria of the wearing state judging unit 17 are stored, a music table 18 in which music used when notifying the patient of the wearing state is stored, and necessary for playing the music. Song data table that stores data to be
18-1 is installed.

[0010] The center terminal 20 is connected to a videophone 70 and a television camera 71 for conversation with a patient.
The center side terminal 20 has an interface with connected devices.
There are 21-23. FIG. 6 shows the contents of the music table 18 of the music used when notifying the mounting state. The mounting state is represented by five types of “not mounted”, “normally mounted”, “measurement start”, “warning”, and “measurement end”. "Not worn" indicates that the biological information measuring device such as the electrocardiograph 51 is not properly worn,
"Normal mounting" indicates that the device is mounted correctly, "Measurement start" indicates that measurement of biological information is started after confirming normal mounting, and "Warning" indicates that a mounting error has occurred after measurement has started. , "Measurement end" indicates that the biological information has been correctly acquired and the measurement has been completed.

The tune to be played according to each mounting condition is selected by the patient and the determined tune is stored in the tune table 18.
Register in. The music table 18 and the music data table 18-1 of the selected music are transmitted from the center terminal 20 to the patient terminal 10 and managed by the patient terminal 10. An example in which an electrocardiogram is measured by the electrocardiograph 51 in the biological information measuring device will be described as an example, and the determination of the wearing state will be described on the assumption that the measured biological information, that is, the electrocardiogram value is analyzed here.

The judgment is made based on a judgment value table 17-1 as a judgment standard of the wearing state judgment unit 17, and the contents are shown in FIG. The judgment value table 17-1 has a maximum value 17-1-2 and a minimum value 17 for judging that the measured electrocardiogram value is normal.
-1-3, measurement time corresponding to the amount of ECG data to be acquired
Trial maximum value 17-1 that indicates how many times ECG values outside the range of 17-1-4, maximum value 17-1-2 and minimum value 17-1-3 are measured before it is determined that the wearing state is abnormal. -5 are managed. The electrocardiogram is internally converted to a value from 0 to 255 and handled. The maximum value 17-1-2 and the minimum value 17-1-3 of the converted value are set. Here, the normal value is set in the range of 32 to 192, and when a value smaller than 32 or a value larger than 192 is measured, it is determined to be abnormal. The measurement time 17-1-4 is set to 300 seconds, and the measurement of the electrocardiogram is repeated until this is satisfied. Trial maximum value 17-1-5
Is set to 10, and if an abnormal value exceeding this number is measured, it is regarded as a mounting abnormality.

[0013] In home medical care, a videophone 4 is sent from a center to a home patient at a certain time every day to check the situation.
A call is made by 0,70. At this time, measurement by the electrocardiograph 51 is instructed. The patient who received the instructions was
Attach 51-1 to the specified position and start measurement. The measured electrocardiogram value is sent from the sensor adapter 50 to the wearing state determination unit 17 via the sensor interface 14.

The operation of the mounting state determining unit 17 will be described with reference to flowcharts (FIGS. 2, 3, and 4). The wearing state determination unit 17 first reads each of the above-mentioned values serving as a criterion for determination from the determination value table 17-1 (step 101 in FIG. 2).
The current number of trials for counting the number of trials is set to 0 (step 102 in FIG. 2). After completing the initial settings, start reading ECG values (steps in FIG. 2).
103). First, it is determined whether the read electrocardiogram is within the range between the maximum value 17-1-2 and the minimum value 17-1-3 (step 10 in FIG. 2).
Four).

If it is within the range, the music piece b18 of "normal mounting"
A performance of -1-3 is performed (step 105 in FIG. 2), and the patient is notified that the electrocardiograph 51 is correctly worn. At the same time, the "normal mounting" command is notified to the center terminal 20 (step 106 in FIG. 2). If it is outside the range, the current trial count is counted up (step 10 in FIG. 2).
7). If the current number of trials is within the trial maximum of 17-1-5, read the ECG again (step 10 in FIG. 2).
8, 103), when the trial maximum value exceeds 17-1-5, the music piece a18-1-2 of "not mounted" is played (steps 108, 1 in FIG. 2).
09), the patient is notified that the electrocardiograph 51 is not correctly worn. At the same time, the "not mounted" command is notified to the center terminal 20 (step 110 in FIG. 2). When the patient plays the “unworn” tune a18-1-2, he / she mounts the electrocardiograph.
Confirm that the song "B 18-1-3" of "Normal installation" flows,
Repeat the above operation.

After confirming the "normal mounting", when a "data reception start" command is transmitted from the center terminal 20 to the patient terminal 10 indicating that the preparation for receiving an electrocardiogram value is completed (step 111 in FIG. 3). Then, the user plays the music piece c18-1-4 of "measurement start" (step 112 in FIG. 3) to notify the patient that the measurement of the electrocardiogram has started. At the same time, a "measurement start" command is notified to the center-side terminal 20 (step 113 in FIG. 3) to inform that the measurement of the electrocardiogram value has started from the confirmation of the wearing state.

When the measurement is started, the current trial number is set to 0.
(Step 114 in FIG. 3), and set the effective measurement time for counting the measurement time to 0 (Step 11 in FIG. 3).
Five). The current time is saved at the start time in order to determine the time during which a normal ECG was measured (step in FIG. 4).
116), and read the electrocardiogram (step 117 in FIG. 4). If the read electrocardiogram is in the range between the maximum value 17-1-2 and the minimum value 17-1-3, the electrocardiogram value is transmitted to the center along with the normal flag (steps 118 and 119 in FIG. 4). The normal measurement time is calculated by subtracting the start time from the current time (FIG. 4).
Step 120), and adds it to the effective measurement time (Step 121 in FIG. 4). If the effective measurement time has not reached the measurement time 17-1-4, the measurement of the electrocardiogram is continued (step in FIG. 4).
122,116-122). Even if the measurement time 17-1-4 has been reached, if there is no "data reception end" command from the center side, the measurement of the electrocardiogram is continued (steps 123 and 116-123 in FIG. 4). When a "data reception end" command is notified from the center side, the music piece "e18-1-6" of "end of measurement" is played, and the patient is notified that the measurement of the electrocardiogram is ended, and the electrocardiograph 51 is notified. Is completed (step 124 in FIG. 4).

The read electrocardiogram has a maximum value of 17-1-2 and a minimum value.
If it is out of the range of 17-1-3, the ECG is transmitted to the center side together with the abnormality flag (steps 118 and 125 in FIG. 4). Count up the current number of trials (Step 12 in Figure 4)
6) Repeat the ECG measurement until the trial maximum reaches 17-1-5 (steps 127, 116-117, 125-12 in FIG. 4).
7). If the current number of trials exceeds the maximum trial value of 17-1-5, the user plays the "warning" tune d18-1-5 (steps 127 and 128 in FIG. 4) and gives the patient an electrocardiograph 51 during measurement. Notifies that a problem has occurred in the mounting state. Together,
A "warning" command is notified to the center terminal 20 (step 129 in FIG. 4). The patient confirms the wearing of the electrocardiograph 51 and performs the measurement again. <Second Embodiment> In a second embodiment, a case will be described in which the determination of the mounting state of the biological information measuring device is performed by the terminal 20 as the center-side device.

FIG. 7 shows a device configuration diagram in the second embodiment. Description of the parts common to the first embodiment will be omitted, and only different parts will be described. In the second embodiment, in order to determine the mounting state on the center side, the mounting state determining portion of the mounting state determining unit 17 and the determination value table 17-1 are provided in the center side terminal 20, and the corresponding music piece is played. The part that reports the wearing state is provided as a wearing state reporting unit 19 on the patient side terminal 10.

When the measurement by the electrocardiograph 51 is started at the patient terminal 20, the measured electrocardiogram is transmitted to the center terminal 20 via the communication line 30. The wearing state determination unit 17 of the center-side terminal 20 determines the wearing state from the transmitted electrocardiogram values based on the determination value table 17-1 as in the first embodiment,
The notification is made to the mounting state notification unit 19 of the patient terminal 10. The wearing state notifying unit 19 of the patient side terminal 10 plays the music registered in the music table 18 according to the wearing state notified from the wearing state determining unit 17 of the center side terminal 20, and notifies the patient of the wearing state. I do. <Other Embodiments> In the description of the first and second embodiments, the electrocardiograph 51 has been described as an example of the biological information measuring device. However, other biological information measuring devices such as a sphygmomanometer and a blood glucose meter are described. A device is also available. At this time, the mounting state determination unit 17 and the determination value table 17-1 may be provided for each device, or only the determination value table 17-1 may be provided for each device, and the mounting state determination unit 17 May be shared.

Although the determination of the mounting state has been described assuming that the measurement is performed by analyzing the measured biological information, the determination is made based on the result of determining the mounting state using a sensor that detects a contact state, or It is also possible to use them in combination. In the first embodiment, the description has been made assuming that the patient performs the measurement while interacting with the center side. However, the measurement may be performed independently on the patient side, and the measured biological information may be transmitted together after the measurement is completed. In this case, the measured biometric information is not stored in the center terminal 20 at any time, but is temporarily stored in the patient terminal 10 and is notified to the center terminal 20 at a certain time or at an instruction from the patient or the center. I do.

In the first embodiment, when the wearing state is confirmed, the measured biological information is not transmitted to the center side terminal 20 and “normal wearing” is performed.
Is transmitted to the center-side terminal 20 from the point in time when the measurement is started after the confirmation is made.
May be sent. In this case, the instruction such as “data reception start” or “data reception end” is performed in accordance with the start / end of the measurement.

In the first embodiment, the judgment value table 17-1 serving as a criterion of the wearing state judgment unit 17 is managed by the patient side terminal 10. The form may be downloaded from the center terminal 20 to the patient terminal 10 and used each time. Further, the determination state table 17-1 may not be created for each patient, and the wearing state may be determined based on the determination value table 17-1 of all patients having the same contents. In the case of creating for each patient, by setting the values of the judgment value table 17-1 according to the characteristics of the patient, the wearing state can be determined according to the individual state of the patient There is.

In both the first embodiment and the second embodiment, the method of notifying the wearing state is an example in which the music is performed by playing a music piece set in advance for each wearing state, but a message is registered for each wearing state. In addition, it may be in the form of flowing, or any other notification means such as electronic sound that can be distinguished according to the state. The music data and message source may be shared on the center side, or the music data and message source for each patient may be centrally managed on the center side.

[0025]

As described above, when the patient measures the biological information while at home, the user is notified of the wearing state of a biological information measuring device such as an electrocardiograph or a sphygmomanometer, so that unnecessary tension on the patient side is obtained. It is possible to measure biological information such as electrocardiogram and blood pressure without causing a feeling of anxiety or anxiety.

[Brief description of the drawings]

FIG. 1 is a device configuration diagram of a first embodiment.

FIG. 2 is a flowchart (1/3) showing a process of a wearing state determining unit;

FIG. 3 is a flowchart (2/3) showing a process of a wearing state determination unit.

FIG. 4 is a flowchart (3/3) showing a process of a wearing state determining unit.

FIG. 5 is a diagram showing contents of a determination value table;

FIG. 6 shows the contents of a music table.

FIG. 7 is a device configuration diagram according to a second embodiment.

Continuation of the front page (58) Field surveyed (Int. Cl. ⁷ , DB name) A61B 5/00-5/0295 G08B 25/04 H04M 11/04

Claims (3)

(57) [Claims] 1. A patient terminal for a home care support system, wherein a center device and a patient terminal are connected via communication means, and the measured patient biometric information is transmitted from the patient terminal to the center device. And present a plurality of pre-registered songs so that they can be selected.
Presented for each wearing state and measuring state of the body information measuring device
Music selection means for receiving a music selection instruction; and a music selection means selected for each mounting state or measurement state of the biological information device.
A music table storage means stores an association music was, determination means for determining the mounted state or measurement state of the biological information measuring device, it has been mounted state or measurement condition determination in the determination unit
Is obtained from the music table storage means, and
A home care support system comprising: playing means for playing a song . 2. A home care support system in which a center side device and a patient side terminal are connected via communication means, and the measured patient's biological information is transmitted from the patient side terminal to the center side device. It has means for judging the wearing state or the measuring state of the information measuring device, and means for notifying the wearing state or the measuring state to the patient side terminal, and the patient side terminal can select a plurality of pieces of music registered in advance. Present and raw
Presented for each wearing state and measuring state of the body information measuring device
Music selection means for receiving a music selection instruction, and biological information
Select the track selected for each device mounting or measuring state
Music table storage means to be stored in association with the installation state or measurement state notified from the center side device
Is obtained from the music table storage means, and
A home care support system comprising: playing means for playing a song . Wherein said determining means, home care support system according to claim 1 or claim 2, characterized in that to determine the mounted state or measurement condition by analyzing the measured biological information.