JP3462788B2 - Disease name check method - Google Patents

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a disease name check method for inspecting whether or not a disease name corresponding to a prescribed drug is registered in the medical care data of a patient described in a medical treatment fee statement at a medical institution.

[0002]

2. Description of the Related Art In a medical institution, an insurance medical action performed on a patient is described in a medical treatment remuneration statement (hereinafter referred to as a receipt), which is submitted to the insurance institution to receive a benefit payment. At that time, the receipt is required to describe the name of the disease on which the medical procedure is based. For example,
When the medicine a is prescribed for the treatment of the disease A and calculated, the disease A is described in the disease name column of the receipt. If there is a medication that does not describe the corresponding disease name, the prescription may not be covered by the insurance payment, or the receipt itself may not be accepted.

[0003] Therefore, conventionally, for the drugs to be insured, a database is created in which the names of the diseases for which the drugs can be used, so-called indications of disease, have been created based on the information described in the package insert, and the receipt has been created. A method was used to search medical data such as prescriptions to be described in 1. and check by the system whether or not there is an indicated disease name for the registered drug. In addition, there is a system that, when there is no name of an indication disease for a drug, calls attention to that fact and displays the name of the indication disease registered in the database as a reference.

2 and 3 show examples of conventional systems for checking disease names. The system is roughly composed of a part for registering medical care contents and a disease name check part for inspecting registered medical data for the presence or absence of an adaptive disease name. These are configured by a computer, and processes are performed by executing a program stored in advance. Then, FIG. 2 shows a portion for registering medical care contents. Normally, the medical care data is input by a code representing the medical care action, and the database in which the medical care codes usable at the medical institution are registered is the medical care code master 3
It is 0.

The record format of the medical care code master 30 is shown in FIG. Each record has a medical care code 31 for identifying the record, a master code 32, a name 33 of the medical practice, a classification 34 of medical practice such as treatment or injection, and a score / price price 35 which is the basis of calculation of the insurance score. And a unit 36 such as gram or milliliter for a medicine. Here, the medical care code 31 representing each medical care action is a code of several digits composed of kana and numbers and is unique to each other. Also, medical care code 3
1 can be changed for each medical institution, that is, for each system so that the operator can easily use it. The master code 32 is
It is a code assigned by a public institution for all medical treatments covered by insurance. The operator uses the medical care code 31 instead of the master code 32 to input the medical care action.

The medical care code master 30 is a database in which only the medical care codes to be used at the medical institution are extracted from all the master codes 32 to be covered by insurance, and a unique medical care code 31 is added and registered. . Therefore, all the internal processing for creating the receipt uses the medical care code 31, and the master code 32 is referred only.
A medical care code 31 of a disease name is also registered in the medical care code master 30. In the case of a disease name record, a medical care code 31, a master code 32, and a disease name name 33 that represent the disease name
Although the data of is included, the other categories 34 and points
The drug price 35 and the unit 36 are not used. In addition, as the disease name master code 32, a code based on the International Disease Classification (ICD-10) is registered.

Then, the operator refers to the medical chart and inputs the medical care content described therein using the medical care code 31 from the input device as shown by the route R11. The medical care content registration unit 10 searches the medical care code master 30 using the input medical care code 31 (R12), reads the corresponding record, and registers it in the medical care data file 20 (R13). At that time, the number of medical care points is calculated based on the data of the quantity and the number of times inputted at the same time, and registered in the medical care data file 20 as a group of data. Similarly, the disease name is also registered using the medical care code 31.

The record format of the medical care data file 20 is shown in FIG. Each record is composed of a patient code 21 for identifying a patient, a prescription number 22 for identifying the record, a content flag 23, a medical care code 24 and additional information 25. Of these, the data after the content flag 23 may be included in plural in one record. For example, when a plurality of medicines are combined and administered to a patient, this is collectively registered as one prescription.
As a result, the medical care codes of all the combined medicines are stored in one record, and that record is given one prescription number. Therefore, each record is also called prescription data. Also, when registering the disease name, 1
One record is composed and a prescription number is given.

On the other hand, the disease name check portion shown in FIG. 3 includes both databases of a drug master 40 and an adaptive disease name master 50 for determining the relationship between the components of the drug and the adaptive disease name. The drug master 40 is a product in which, for all drugs targeted for insurance medical care, the drug and the component group to which the drug belongs are registered in association with each other. In other words, drugs are grouped according to their components.
The record format is shown in (b). Each record is composed of a master code 41 that identifies a drug and a group code 42 that represents an ingredient. The master code 41 is common with the master code 32 of the medical care code master 30.

The adapted disease name master 50 is a registration of the above-mentioned components of the drug and the names of the diseases for which the components are effective. As shown in the record format in FIG. 4C, each record has a group code 51 representing a component, a flag 52, and a disease name code 53 representing an adaptive disease name.
It consists of and. In addition, the number of indication disease is 30 to 4 on average.
0 is registered. The disease name code is the International Classification of Diseases (I
It is a code based on CD-10) and is common with the master code 32 of the disease name registered in the medical care code master 30. Further, the flag 52 is for determining whether or not it is necessary to check the disease name for this drug, and depending on its value, indicates whether the check is unnecessary or the check target. Both the drug master 40 and the adaptive disease name master 50 databases constitute a disease name check database.

Therefore, the disease name check unit 13 first reads the prescription data of the disease name registered in the medical care data file 20 (R21), and searches the medical care code master 30 with the medical care code of the disease name registered therein. When the master code 32 of the disease name is obtained (R22), the master code 32
Is stored in the memory 14 (R23). That is, the data of the disease name registered by the operator as the medical care data of the patient is read out and temporarily stored in the memory 14. Here, the content is A.

Next, the prescription data of the prescribed medicine is read from the medical care data file 20, and the medical care code master 30 is searched by the medical care code registered in the medical care data file 20 in the same manner to obtain the medicine master code 32. Got
Furthermore, the master code 32 is searched for the drug master 40 to obtain the group code 42 of the drug (R24).
Then, the adaptive disease name master 50 is searched by the group code 42 (R25) and the corresponding disease name code 53,
That is, the master code of the indication disease name is obtained and stored in the memory 14
(R26). In other words, the data of the medicine prescribed to the patient is read out, the predetermined indication disease name of the medicine is searched, and it is temporarily stored in the memory 14. Here, the content is B.

Thereafter, the above A and B stored in the memory 14, that is, the master code of the disease name obtained from the medical care code of the disease name and the master code of the adaptive disease name obtained from the prescribed drug component group are compared. . If there is no match, the operator is warned as a disease name check error, and the disease name that serves as a reference for the disease name that can be described in the receipt is displayed or output to a printer. At this time, the disease name to be used as a reference is the memory 14
It is indicated by the content B stored in the table, that is, the master code of the disease name obtained from the prescribed drug. Therefore, a predetermined number of master codes are read from the beginning of the content B stored in the memory 14 (R27), the medical care code master 30 is searched with the code, and the corresponding illness name 33 is output as a list. (R28).

[0014]

It has already been described that a plurality of medicines are combined and the medicines are collectively registered as one prescription. A plurality of disease names can also be registered at once. For example, "acute"
By inputting a combination of the medical care code “Kisei”, which represents the modifier, and the medical care code “Kikanae,” which represents the disease name of “bronchitis”, the medical data file has a record as shown in FIG. The content is registered. By doing so, in this case, the disease name of "acute bronchitis" is output to the receipt.

However, when the medical care data input in this way is subjected to a disease name check, inconvenience may occur. For example, when the indication name of the drug administered to this patient is acute bronchitis and there is no bronchitis, when checking the disease name, the master code of this acute bronchitis and "acute" and " Bronchitis ”is compared with each master code. Acute bronchitis and bronchitis are similar at first glance, but because the master codes are different, a check error occurs because there is no matching disease name. Then, the indication disease name of the drug read from the database is presented as a reference disease name. An example is shown in FIG.
It shows in (a). The disease name "acute bronchitis" entered by the operator and described in the receipt is output as the disease name. On the other hand, “acute bronchitis” is also included in the indication names of the drug Voltaren tablets output for reference. Therefore, the operator is confused by not understanding the meaning of the error.

When registering patient's disease name data,
Registration is also performed after changing the name. For example, when it is desired to input acute bronchitis as the patient's disease name, it is assumed that only the bronchitis is registered in the medical care code master 30. At this time, as in the above example, there is also a method of inputting a combination of acute and bronchitis, but separately from this, call bronchitis with the medical care code "Kikane" and call its name acute bronchitis. Change it and then register. The record contents of the medical care data in that case are shown in FIG.
It shows in (c). Although the medical care code 24 is still “Kikane”, the content flag 23 becomes “2” indicating that the name has changed, and the new name is included in the additional information 25. As a result, "acute bronchitis" is output in the disease name column of the receipt.

However, even when the disease name check is applied to the medical care data thus input, the same inconvenience may occur. In the disease name check, first, the medical care code “Kikanae” indicating the disease name is read from the medical care data of the patient, and the master code is retrieved from the medical care code master 30. However, this is the original disease name, the master code for bronchitis. Therefore, for example, when there is acute bronchitis and there is no bronchitis in the indication name of the drug administered to this patient, the master code of this acute bronchitis is compared with the original master code of bronchitis. Become. As a result, a check error occurs because there is no matching disease name. Then, the indication disease name of the drug read from the database is presented as a reference disease name. The state is as shown in FIG. 8A as in the example described above. The disease name entered by the operator and described in the receipt is “acute bronchitis”. On the other hand, since “acute bronchitis” is also present in the indication name of the drug Voltaren tablet output for reference, the meaning of the error is not easily transmitted to the operator.

Further, when registering a disease name code in the medical care code master, the medical care code may be registered without inputting master code data. This is performed when the medical care code is urgently registered when it is desired to write the disease name on the receipt for the time being. For example, when the disease name of acute bronchitis is registered in the medical care code master, as shown in FIG. 6, the medical care code 31 is set to “kiyukika”, the name 33 is set to “acute bronchitis”, and data other than that is nothing. Register in the medical care code master 30 without inputting. In the case of a disease name, it is not necessary to input the score / medicine price 35 and the unit 36 even though they are not used. Moreover, since the name 33 of the medical care code master 30 is described in the receipt, there is no problem because the acute bronchitis, which is the disease name intended by the operator, is correctly output. FIG. 5D shows the record contents of the medical care data when the patient's disease name is registered using this code. However, when the disease name check is applied to the medical data input in this way, the following inconvenience may occur.

In the disease name check, first, the medical care code "Kiyukika" indicating the disease name is read out from the medical care data of the patient,
The record corresponding to it is searched from the medical care code master 30. However, since the master code of acute bronchitis is not registered in the read record, the obtained master code is null data. Therefore, for example, even if there is acute bronchitis in the indication disease name of the drug administered to this patient, there is no master code to be compared with the master code of this acute bronchitis, so there is no matching disease name and there is a check error. turn into. Then, the indication disease name of the drug read from the database is presented as a reference disease name. The situation is as shown in FIG. The Rece disease name is “acute bronchitis” entered by the operator, but “acute bronchitis” is also included in the reference disease names of the pharmaceutical Voltaren tablets output for reference. For this reason, the meaning of the error is difficult to convey to the operator.

[0020]

[Means for Solving the Problems] The present invention examines whether or not a drug prescribed to a patient is registered in the medical treatment data of the patient, and if the drug name is not registered, the drug is not registered. The disease name registered in the medical care data of the patient and the disease name registered in the medical care data of the patient are presented, and the name of the disease name registered in the medical care data of the patient is changed from the originally registered name. In some cases, the above problem is solved by presenting the disease name with information indicating that the name has been changed.

[0021]

EXAMPLE The configuration of the example is basically as shown in FIGS. 2 and 3, and the operation of registering medical care data is the same as the conventional system. Then, as described above with respect to the operation of the disease name check unit 13, first, the prescription data of the disease name registered in the medical care data file 20 is read (R21), and the medical care code master 3 is used with the medical care code of the disease name registered therein.
If 0 is searched and the corresponding master code 32 is obtained (R2
2) The master code 32 is stored in the memory 14 (R23). Here, the content is A. That is, the data of the disease name registered by the operator as the medical care data of the patient is read out and temporarily stored in the memory 14. At this time, in the embodiment, the data of the disease name is stored according to the pattern input by the operator. As shown in the flow chart of FIG. Then, it is used when outputting it in the receipt check result as the disease name.

That is, in FIG. 1, the prescription data containing the data of the disease name is read from the medical care data file 20 (step S11), and the record in which the first medical care code is registered is acquired from the medical care data file (step S12). If the data ends here, the process ends. On the other hand, regarding the acquired record, the content flag 23 is checked (at step S13),
It is inspected whether the medical care code is a code whose name has not been replaced. Such a code is called a general simple code in the embodiment. If the code is a general simple substance code, the process proceeds to step S16. If the name has been replaced, "2" is set in the content flag 23, so the flow advances to step S21 to store the symbol "⋄" together with the disease name data.

On the other hand, if the code is a general simple substance code, the medical care code master 30 is searched by the medical care code and the record of the name of the injured disease is read (S16). Then, it is checked whether or not the master code is registered in the record (at step S17). If the master code is not registered, the process proceeds to step S22, and the symbol "*" is stored with the disease name data this time. In the case of the medical care code for which the master code is registered, a second record is acquired (S18) to check whether or not a code for the disease name is further registered for the same prescription data. At this time, if the next valid record can be obtained, that is, "acute" +
It indicates that it is disease name data such as "bronchitis" that is a combination of a plurality of disease name codes. For those, the symbol "◇" is stored together with the disease name data.
3). Then, the data of the remaining disease name is stored with the symbol "◆" added (at step S20). This remaining disease name data is not replaced with a name, is given a master code when the medical care code master is registered, and is not a combination of a plurality of disease names. It is registered in the prescription data.

Thereafter, as shown in FIG. 3, the disease name checking unit 13 reads out the medical care code of the prescribed medicine from the medical care data file 20 (R21), and similarly searches the medical care code master 30. The drug master code 32 is obtained (R22), and the drug master 40 is searched with the master code 32 to obtain the drug group code 42 (R24). Then, the adaptive disease name master 50 is searched by the group code 42 (R25).
The corresponding disease name code 53, that is, the master code of the adapted disease name is obtained and stored in the memory 14 (R26). That is, the data of the medicine prescribed to the patient is read out, the indication disease name of the medicine is searched, and it is stored in the memory 1
4 is temporarily stored. Here, the content is B.

Then, the disease name checking unit 13 uses the memory 1
The above-mentioned A and B stored in No. 4, that is, the disease name registered by the operator is compared with the indication disease name obtained from the prescribed drug. Then, if there is no match, a warning is issued as a disease name check error, and the disease name that is registered by the operator and output to the receipt and the disease name that can be registered corresponding to the prescribed drug are also referenced. It is presented to the operator by displaying or printing as.

Here, an example of presenting the reference disease name will be specifically described. It is assumed that the indication disease name of the pharmaceutical Voltaren tablet prescribed to the patient is registered in the indication disease name master as shown in FIG. 7 (a). Then, as a first example, it is assumed that the operator registers “acute bronchitis”, which is a combination of the modifier “acute” and the disease name “bronchitis”, as the patient's disease name. As shown in FIG. 5 (b), the registered contents of the medical care data file 20 include two items of acute and bronchitis in one prescription data.
One medical care code is included. Then, it is assumed that the master code is the one shown in FIG. The disease name checking unit 13 compares the master codes shown in FIGS. 8A and 8B, respectively, and there is no match, so outputs the reference disease name as shown in FIG. 8B. At this time, the disease name “acute bronchitis” registered by the operator is output following the heading of “Recess disease name”, but since it is determined to be a combination of a plurality of disease names in step S19 of FIG. The symbol "◇" is added to the output.

Therefore, since the symbol "◇" is placed at the beginning of the disease name, the operator recognizes that it is a disease name input by a combination of a plurality of codes, so that the disease name indicated in the voltaren tablets is recognized as the disease name. Even if there is the same acute bronchitis, it does not look abnormal and correctly understands the meaning of error output.

As a second example, it is assumed that the operator replaces the name "bronchitis" of the medical care code "kikane" with "acute bronchitis" and then registers it in the medical care data of the patient. The registration contents of the medical care data file 20 are shown in FIG.
As shown in (c), the content flag 23 is set to "2". Then, it is assumed that the master code is the one shown in FIG. The disease name check unit 13 compares the master codes shown in FIGS.
Since there is no match, the reference disease name is output as shown in FIG. At this time, the disease name "acute bronchitis" registered by the operator is output following the heading of "Recess disease name", but since it is determined in step S15 in FIG. 1 that it is not a general simple code, the symbol still appears at the beginning of the disease name. "◇" is added and output.

In this case as well, the symbol "◇" is placed at the beginning of the disease name, so the operator must confirm that it is the disease name entered by replacing the original name, or the disease name entered by combining a plurality of codes. recognize. Therefore, even if there is the same acute bronchitis as the disease name in the indication disease for Voltaren tablets, the operator does not see it as abnormal and understands the cause of the error correctly.

As a third example, it is assumed that the patient's disease name is registered using a medical care code “Kiyukika” whose master code is not registered as shown in FIG. in this case,
The master code read by the disease name check unit 13 is shown in FIG.
It is null data as shown in (d). The disease name check unit 13 compares the master codes shown in FIGS. 9A and 9D, but there is no match, so outputs the reference disease name as shown in FIG. 9A. At this time, the disease name "acute bronchitis" registered by the operator is output following the heading of "Resis disease name", but since it is determined that the master code is not registered in step S17 of FIG. Is output with the symbol "*" added.

The operator has the symbol "*" at the beginning of the disease name.
By recognizing that there is a master code, the master code is not registered in the medical care code master of the disease name. Therefore, even if there is the same acute bronchitis in the disease name and the indication disease name, it is not regarded as abnormal and the content of the error is correctly understood.

The disease name not included in the three examples described above, that is, the disease name registered in the medical care data of the patient is neither the name replaced nor the combination of a plurality of codes. Also, when the corresponding master code is not registered in the medical care code master 30, the disease name registered by the operator is added with the symbol "◆" and output as shown in FIG. 9 (b). Of.

As described above, in this embodiment, the disease name registered by the operator as the patient's disease name and the indication disease name of the prescribed drug are simultaneously output. At that time, the disease name registered in the patient data file by the operator as a disease disease name, the name has been replaced, or a combination of multiple codes,
When a master code is not registered in the medical care code master, a symbol for identifying them is added to the head of the disease name and output.

[0034]

EFFECT OF THE INVENTION According to the present invention, when presenting a reference disease name that may be an indication disease name of a prescribed drug, the disease name registered in the medical care data of the patient is replaced with the name, or If a check error occurs due to a combination of multiple codes, or because the master code corresponding to the patient's disease name is not registered in the medical care code master database, indicate them. By presenting the patient's disease name registered with the information, the operator correctly understands the cause of the error even if the same disease name as the registered patient's disease name is included in the suggested disease names for reference. Is something that can be done.

[Brief description of drawings]

FIG. 1 is a flowchart showing a disease name check procedure according to an embodiment.

FIG. 2 is a diagram showing a medical care content registration portion of the embodiment.

FIG. 3 is a diagram showing a conventional disease name check portion.

FIG. 4 is a diagram showing a record structure of each master in the embodiment.

FIG. 5 is a diagram showing an example of registration of a medical care code master in the embodiment.

FIG. 6 is a diagram showing an example of registration of a medical care code master in the embodiment.

FIG. 7 is a diagram showing an example of registered adaptive disease names and disease names in the embodiment.

FIG. 8 is a diagram showing an example of presentation of reference disease names in Examples.

FIG. 9 is a diagram showing an example of presentation of reference disease names in Examples.

[Explanation of symbols]

10 medical care content registration unit 11 input device 12 display device 14 memory 20 medical care data file 30
Medical care code master 40 Drug master 50 Adaptive disease name master 60
Injury name master

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Claims (3)

(57) [Claims] 1. A system for inputting and storing a medical care content including a disease name using a code, which is a method for checking a disease name to check whether or not an indication disease name of a drug prescribed to a patient is input, wherein the code is at least , A medical code that can be changed arbitrarily and that is used at the time of input, a name, and a fixed master code are registered in the medical code master database, and the relationship between the drug and its indicated disease name is registered. It is registered in the disease name check master database using the master code, and the indication of the drug prescribed to the patient is checked by referring to the disease name check master database to see if the disease name is registered in the patient's medical care data. If the disease name is not registered, the disease name registered for the drug and the disease registered in the patient's medical care data To be presented at the door, this time, the name of a disease that is registered to a patient's medical data
Is the name registered in the medical care code master database?
If it has been changed from
The disease name that is presented with the disease name and registered in the patient medical care data
If does not have a master code, add a second symbol
The disease name that has been registered and is registered in the medical care data of the patient.
If the name is a combination of multiple disease name codes
Is to present the name of the disease with a third symbol
How to check the disease name. [Claim 2] Enter the medical contents including the disease name using a code
Drugs prescribed to patients in a force and memory system
Check the disease name to check whether the applicable disease name of
Method, wherein the code is at least changeable and input
Medical code, name, and fixed master used at the time
Composed of code and medical code master database
Register and then establish the relationship between the drug and its indication
Disease name check master data by each master code
It is registered in the base and the medical care data of the patient
Enter the name of the medical code
Replace the name with any other name so that you can enter it,
The replaced name is used together with the medical care code for the patient's medical care data.
Make sure to register with the
Data on medications prescribed to the patient's practice
Master data of the indication name of the drug read from the data
Search for the disease name from the disease name check master database
On the other hand, the diagnosis of the disease name registered in the patient's medical care data
Check the medical care code master database with the medical care code.
I searched for the master code and searched these
If the master code is compared and there is no match, the previous
The indication name of the drug and the medical care data of the patient
Please indicate the registered disease name and
The disease name registered in the medical care data of the person is the medical care code
The name registered in the database has been changed.
If it is, present the disease name with the first symbol,
Master code is the disease name registered in the patient medical care data
If you don't have the name, indicate the disease name with the second symbol
However, if the disease name registered in the patient's medical
Third symbol if it is a combination of first name codes
A disease name check method characterized by presenting the disease name with a mark. [Claim 3] Register the name of the indication disease for each drug
Disease name check master database and at least
Medical code and name that can be changed at will and used when entering
Register a code consisting of a master code and a fixed master code.
Medical care code master database and patient medical care data
With a medical care data file storing
In the above, the medical data on the medicines prescribed to the patient
It is read from the medical treatment data file and the indication disease of the drug
Name from the disease name check master database
Processing, and the retrieved adaptive disease name and the medical care data file
Compare the patient's disease name data registered in the file
There is no matching process and the result of the comparison.
In that case, the searched indication of the drug and the medical care date
Of the patient's disease name registered in the file
And in the process of presenting the patient's disease name
The disease name of the patient registered in the data file
The name registered in the master database has been changed.
If the name is a
The disease name registered in the medical care data of the patient
If you do not have the code, add the second symbol and name the disease.
Multiple disease names presented and registered in the patient's medical care data
If it is a combination of the disease name codes of
The process of presenting the disease name with a symbol
Write a disease name check program that includes instructions to execute
The storage medium you remember.