JP3609778B2 - Medical information provision / acquisition system and method, and computer program by two-way communication network - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to a medical information provision / acquisition system and method, and a computer that causes a computer to function as such a system, for example, by a computer bidirectional communication network (Internet etc.) under a TCP / IP (Transmission Control Protocol / Internet Protocol) environment. It belongs to the technical field of the program.
[0002]
[Prior art]
Conventionally, in medical facilities or medical institutions (hereinafter referred to as “hospitals” as appropriate), various types of medical information are processed using individually constructed local area networks (LAN) or stand-alone small general-purpose computers. For example, medical accounting systems that perform automatic medical treatment (receipt) calculation processing are widespread. In addition, introduction of various order systems such as an inspection request (order) system and a pharmacy system for transferring data of an inspection request and a drug prescription request to each department in the hospital is progressing. With these systems, various processing operations in the hospital are speeded up, and the quality of medical processing is improved. Recently, the introduction of electronic medical records instead of written medical records has also progressed, and the quality of medical treatment has been improved.
[0003]
However, although such importance is proposed, the construction of advanced medical information systems has not progressed due to the recent deterioration of the medical economic situation. This is because a large initial investment is required, and the subsequent system maintenance management, version upgrade, electronic data backup (long-term storage) and maintenance also require a great amount of labor and cost. In other words, the system scale and processing scale are large. For example, the cost increase such as version upgrade due to multi-functionalization (fattening / Fat Client) equipped with various applications is particularly large. In addition, when such an advanced medical information system is introduced into an individual hospital, it may be difficult to effectively use each hospital because it is not easy to acquire a utilization technique.
[0004]
The applicant of the present application has not yet developed a “medical information system” that can save a great deal of labor and cost for this huge initial investment, system maintenance management, version upgrade, electronic data backup (long-term storage) and maintenance. Proposed with published patent applications (2000-309419 and 2000-309420). This "medical information system" provides advanced medical information processing programs by ASP (Application Service Provider) to provide advanced medical information processing of many hospitals by communication network in order to reduce the scale of advanced medical information system of hospitals. It can be implemented through centralized processing and data storage.
[0005]
[Problems to be solved by the invention]
However, from the viewpoint of so-called “privacy protection”, it is not preferable to use patient data unconditionally on other communication hospitals (hospitals outside the medical history) or system operators on a communication network. That is, in the medical information system of the above-mentioned conventional example, it is an infringement of privacy that is not allowed by the constitution to leave the use of patient data to the freedom of the system operator or each hospital without considering its confidentiality at all. There is a problem that can lead to a situation.
[0006]
In particular, in a communication system that processes patient data on such a communication network, collection and use of a large number of patient data for research and clinical trials (GCP) (hereinafter referred to as “collection and use of statistical information” as appropriate) Is desired. However, in this case, it is difficult in practice to achieve both easy and reliable creation or collection of statistical information from a large number of patient data for each target study or clinical trial and ensuring the confidentiality of patient data. There is a problem that it is.
[0007]
The present invention has been made in view of the above-described problems, and is an interactive method that enables efficient use of a large number of patient data for research purposes or clinical trial purposes while improving the confidentiality of patient data of each patient. It is an object to provide a medical information provision / acquisition system and method using a communication network, and a computer program that causes a computer to function as at least part of such a system.
[0008]
[Means for Solving the Problems]
In order to solve the above problems, a medical information provision / acquisition system using a two-way communication network according to the present invention provides a plurality of facility processing apparatuses respectively installed in a plurality of medical facilities and a two-way communication network for the plurality of facility processing apparatuses. A medical information provision / acquisition system using a two-way communication network comprising a central processing unit connected via a plurality of the central processing units classified by purpose including at least one of research and clinical trials List transfer means for transferring list information indicating a list of a plurality of target names corresponding to types of input templates to the facility processing apparatus side, and a plurality of template information indicating the plurality of types of input templates, respectively. Template storage means for separately storing in advance, and the facility processing device is configured to transfer the transferred list. Access means for presenting one objective name selected from a list displayed based on information or uniquely selected and accessing the central processing unit for statistical processing related to patient data; and The central processing unit is template information indicating an input template of a type corresponding to the access, and the template information corresponding to the presented one purpose name is based on the presented one purpose name. An extraction means for extracting from the template storage means, a template creation means for creating template information corresponding to the one purpose name, and a template for inputting patient data necessary for the statistical processing corresponding to the access are shown. Template information, extracted by the extraction means or by the template creation means First transfer means for transferring the formed template information to the facility processing apparatus, and the facility processing apparatus includes an input means for inputting the patient data with the input template based on the transferred template information; A second transfer means for transferring the inputted patient data, and at least one of the facility processing apparatus and the centralized processing apparatus further includes a code giving means for giving an anonymized patient identification code for each patient. The central processing unit further includes statistical processing storage means for storing the patient data transferred by the second transfer means in association with the anonymized patient identification code and for each purpose.The central processing unit performs statistical processing on patient data input and transferred by the input template or patient data stored in the statistical processing storage unit according to the purpose and based on the first patient identification code. Further equipped with processing meansYeah.
[0009]
According to the medical information provision / acquisition system using the two-way communication network of the present invention, the facility processing apparatus performs access for statistical processing related to patient data by the access means. In response to this access, the central processing unit transfers the template information indicating the template for inputting patient data necessary for statistical processing to the facility processing unit side by the first transfer unit. In response to this, the facility processing apparatus inputs the patient data with the input template based on the transferred template information by the input means, and further, the central processing apparatus receives the input patient data by the second transfer means. Forward to the side. For example, only patient data is extracted from the patient data included in the input template and transferred. Here, the anonymized patient identification code is assigned to each patient by the code providing means provided in at least one of the facility processing apparatus and the centralized processing apparatus. The central processing unit stores the patient data transferred by the second transfer unit in association with the anonymized patient identification code by the statistical processing storage unit. Therefore, using the input template provided from the central processing unit via the bidirectional communication network, each facility processing unit can reliably input patient data in a unified format. In addition, the centralized processing apparatus can efficiently collect patient data that is anonymized and has a uniform format via the bidirectional communication network.
In addition, in the medical information provision / acquisition system using the two-way communication network according to the present invention, the central processing unit includes a plurality of input templates classified according to purposes including at least one of research and clinical trials. Template storage means for preliminarily storing the template information, and extraction means for extracting from the template storage means template information indicating the type of input template corresponding to the access, and the first transfer means, Since the template information extracted by the extraction means is transferred to the facility processing device, each facility processing device side uses the input template provided from the central processing device via the bidirectional communication network. Can be input reliably with input templates for different purposes such as research and clinical trials.
In addition, in the medical information provision / acquisition system using the two-way communication network according to the present invention, the central processing unit displays list information indicating a list of a plurality of target names corresponding to the plurality of types of input templates. A list transfer means for transferring to the central processing apparatus, wherein the access means presents one target name selected from the list displayed based on the transferred list information to the central processing unit. And the extraction means extracts template information corresponding to the presented one purpose name, so that each facility processing device side receives patient data such as research and clinical trials presented by each facility processing device. You can input with certain purpose templates.
In addition, since the access means can perform access by presenting one target name uniquely (or without selecting from a list displayed based on the list information), the central processing unit can extract the means. Thus, template information indicating the type of input template corresponding to the presented purpose is extracted. Therefore, on each facility processing apparatus side, patient data can be surely input with an input template for each purpose such as research or clinical trial presented by each facility processing apparatus.
In addition, since it further includes a template creation means for creating a template for input corresponding to the presented purpose, each facility processing device side receives patient data such as research or clinical trials presented by each facility processing device. You can input with certain purpose templates.
In addition, the statistical processing storage means stores the patient data input and transferred by the input template according to the purpose, so that the anonymized patient data is classified by purpose such as research or clinical trial.
And statistical processing by purpose thereafter can be performed quickly and easily.
In addition, the central processing device further includes processing means for statistically processing patient data input and transferred by the input template or patient data stored in the statistical processing storage means for each purpose. Therefore, anonymized patient data can be efficiently statistically processed for each purpose such as research and clinical trials by processing means.
[0010]
In addition, the input of patient data with such an input template is in principle performed on a patient basis. For example, it may be performed in real time or after the treatment for each patient's medical treatment, or may be performed at the time of discharge or after the treatment every hospitalization of the patient, or may be performed regularly or irregularly.
[0011]
On the other hand, the facility processing apparatus may be configured such that necessary patient data can be designated and retrieved from the patient data stored in the statistical processing storage means so as to be referred to.
[0016]
Furthermore, in this case, the facility processing apparatus further includes display means for displaying the list based on the transferred list information, and selection means for selecting the one target name from the displayed list. Also good.
[0017]
If comprised in this way, it will become possible to use the template for input corresponding to the objective of research, clinical trials, etc. exactly. At this time, the selection means may be configured to select a desired target name from a list displayed as a menu screen by, for example, a cursor operation using a keyboard, a mouse, or the like.
[0026]
In another aspect of the medical information provision / acquisition system using a bidirectional communication network according to the present invention, the central processing device sends a predetermined type of medical application program to the plurality of facility processing devices via the bidirectional communication network. Providing means is further provided, and the input means inputs the patient data with the input template in a form extracted from patient data obtained by execution of the medical application program.
[0027]
According to this aspect, the centralized processing apparatus provides a predetermined type of medical application program such as an electronic medical record system, a navigation care map or critical path system, an ordering system, an accounting system, etc. Are provided via a two-way communication network. In response to this, the facility processing means inputs the patient data with the input template in the form extracted from the patient data obtained by the execution of the medical application program by the input means. Therefore, patient data can be efficiently input using the input template, and finally, anonymized patient data can be efficiently collected for statistical processing.
[0028]
In this aspect, the central processing unit includes a fetching unit that fetches the medical application program by connecting the line, and a third transfer unit that transfers the medical application program fetched by the fetching unit to the facility processing apparatus. Are further provided.
[0029]
If comprised in this way, the confidentiality in the patient data transmitted / received on a bidirectional | two-way communication network can be improved reliably, transferring a medical application program to each facility processing apparatus via a centralized processing apparatus.
[0030]
In another aspect of the medical information provision / acquisition system using the two-way communication network of the present invention, the facility processing apparatus is different for each medical facility and for each patient, and has no relevance / compatibility with the patient identification code. There is further provided other code assigning means for assigning the patient identification code.
[0031]
According to this aspect, the central processing device and the facility processing device assign a patient identification code that is not mutually related or compatible to the same patient data, and manage and process this data. The confidentiality of patient data can be further enhanced.
[0032]
In another aspect of the medical information provision / acquisition system using the bi-directional communication network of the present invention, a plurality of the centralized processing devices are arranged on the bi-directional communication network, and each of the plural units executes the same process. It operates as a distributed processing system consisting of an active system and a standby system.
[0033]
According to this aspect, the confidentiality in the patient data exchanged on the bidirectional communication network can be reliably improved by the distributed processing system.
[0034]
In order to solve the above problems, a medical information provision / acquisition method using a bidirectional communication network according to the present invention includes a plurality of facility processing devices installed in a plurality of medical facilities and a bidirectional communication network connected to the plurality of facility processing devices. A medical information provision / acquisition method using a two-way communication network in a medical information provision / acquisition system using a two-way communication network having a central processing unit connected via a network, wherein the central processing unit is used for research and clinical trials. A template storage unit is provided that preliminarily stores a plurality of template information indicating a plurality of types of input templates classified according to purposes including at least one of them, and stores them in advance according to a plurality of purpose names. List information indicating a list of the plurality of target names corresponding to the plurality of types of input templates A list transfer step of transferring to the facility processing apparatus side is executed, and one target name selected or uniquely selected from the list displayed based on the transferred list information by the facility processing apparatus is selected. Template information indicating an input template of a type corresponding to the access by the central processing unit, executing an access step for presenting and accessing the central processing unit for statistical processing related to patient data; And extracting the template information corresponding to the presented one purpose name from the template storage means based on the presented one purpose name, and creating the template information corresponding to the one purpose name Template creation process to be performed, and input of patient data necessary for the statistical processing corresponding to the access. Template information indicating a template for use, and a first transfer step of transferring the template information extracted in the extraction step or created in the template creation step to the facility processing device, and executed by the facility processing device , Executing an input step of inputting the patient data with the input template based on the transferred template information, and a second transfer step of transferring the input patient data, the facility processing apparatus and the concentration At least one of the processing devices further executes a granting step of giving an anonymized patient identification code for each patient, and the patient data transferred by the second transfer step is anonymized by the central processing unit. A statistical process storing step that associates with the patient identification code and stores for each purpose;And further performing a processing step of statistically processing the patient data input and transferred by the input template or the patient data stored for each purpose according to the purpose and based on the first patient identification code.To do.
[0035]
According to the medical information provision / acquisition method using the bidirectional communication network of the present invention, the central processing unit is connected via the bidirectional communication network as in the case of the medical information provision / acquisition system using the bidirectional communication network of the present invention described above. By using the input template provided from the above, each facility processing apparatus can reliably input patient data in a unified format. In addition, the centralized processing apparatus can efficiently collect patient data that is anonymized and has a uniform format via the bidirectional communication network.
In addition, in the medical information provision / acquisition method using the two-way communication network of the present invention, template information indicating an input template of a type corresponding to access is extracted from the template storage means, and the extracted template information is extracted from the facility processing. Because the data is transferred to the device, each facility processing device uses the input template provided from the central processing device via the two-way communication network. Can be input reliably.
In addition, in the medical information provision / acquisition method using the two-way communication network of the present invention, list information indicating a list of a plurality of target names corresponding to a plurality of types of input templates is transferred to the facility processing apparatus side and transferred. Since template information corresponding to one target name selected from the displayed list information is extracted from the displayed list information, each facility processing device side is provided with patient data, such as research or clinical trials presented by each facility processing device. Can be input reliably with the input template for each purpose.
[0036]
Note that the medical information provision / acquisition method using the bidirectional communication network of the present invention may have various aspects similar to the various aspects of the above-described medical information provision / acquisition system using the bidirectional communication network of the present invention.
[0037]
In order to solve the above problems, the computer program of the present invention is a central processing unit provided in the above-described medical information providing / acquisition system (including various aspects thereof) using the bidirectional communication network of the present invention. And function as at least one of the facility processing apparatuses.
[0038]
According to the computer program of the present invention, at least one of the central processing device and the facility processing device provided in the medical information providing / acquisition system using the bidirectional communication network of the present invention described above is stored in an information recording medium storage program or communication. The program can be executed by downloading / installing through a network. More specifically, the computer program causes the computer to function as an access means, an input means, a second transfer means, a code assigning means, etc. in the facility processing apparatus, respectively, or a first transfer means constituting a centralized processing apparatus, It can function as a storage unit for statistical processing, a sign providing unit, and the like. For example, it can be distributed as package software using an information recording medium or shareware obtained by downloading / installing via a communication network, and the versatility of the present invention is improved. In other words, the implementation can be performed easily and reliably.
[0039]
Such an operation and other advantages of the present invention will become apparent from the embodiments described below.
[0040]
DETAILED DESCRIPTION OF THE INVENTION
Next, a medical information provision / acquisition system and method using a two-way communication network according to the present invention and a computer program for causing a computer to function as such a system will be described in detail with reference to the drawings.
[0041]
(1) Configuration of the embodiment
First, the configuration of a bidirectional communication network according to an embodiment of the present invention will be described with reference to FIGS.
[0042]
In FIG. 1, the bidirectional communication network of this example is a multimedia communication network, for example, and a digital fixed communication line network 1 and a digital mobile communication network 2 connected by various communication protocol conversion gateway (GW) devices. (These two communication networks are collectively referred to as “communication line network” as appropriate).
[0043]
The digital fixed communication network 1 includes a medical information central processing center communication device 3 as an example of “central processing device”, a plurality of medical institution communication devices 4 as examples of “facility processing devices”, and “patient communication”. A communication terminal 5 (small general-purpose computer 5a) used by a patient as an example of a “terminal” is connected. The cell base station 2a of the digital mobile communication network 2 is connected to a communication terminal 5 (cell phone 5b capable of Internet access) used by a patient as another example of a “patient communication terminal” through a wireless section (air interface). ) Is housed.
[0044]
The medical information central processing center communication device 3 includes a medical institution processing shared communication system 3a and a medical institution data central processing communication system 3b.
[0045]
The medical institution communication device 4 includes a medical institution communication system 4a installed in a relatively large medical facility and a medical institution small general-purpose computer 4b installed in a relatively small medical facility. The medical institution communication system 4a may be provided with a medical institution processing shared communication system 4c described below.
[0046]
FIG. 2 is a block diagram showing a configuration example of the medical institution processing shared communication system 3 a in the medical information central processing center communication device 3.
[0047]
In FIG. 2, a medical institution processing shared communication system 3a in this example includes a line connection device 10 (for example, a hub device, a digital termination connection device (DSU), an intrusion prevention device) for connection to an ISDN (digital fixed communication network 1). A router (not shown) that implements a firewall application), a web server 11 that is a main computer for executing basic communication processing on the Internet, a DNS server 12 for a distributed name management system (DNS), SSL server 13 for encrypted communication protocol (SSL) for performing encrypted transfer of customer medical data, FTP server 14 for FTP (File Transfer Protocol) file transfer, communication control for executing communication control Location 15, and stores various data, and is configured with an interface (I / F) unit 17 for housing the database device 16, and an external LAN to perform the search (the tracking).
[0048]
Note that the medical institution processing shared communication system 3a in this example performs maintenance such as a drive device (not shown) and database management for reading a program from a CD-ROM and installing it in necessary units such as the communication control device 15. A single small general-purpose computer is provided.
[0049]
The external LAN executes a small general-purpose computer by a LAN server (not shown) in each sequence of RPC (Remote Procedure Call remote call), for example, and is constructed as a client server system (master-slave method).
[0050]
FIG. 3 is a block diagram showing a configuration example of the medical institution data central processing communication system 3b in the medical information central processing communication center apparatus 3.
[0051]
The medical institution data centralized processing communication system 3b in this example is configured to include a line connection device 10 to a communication control device 15 similar to the medical institution processing shared communication system 3a shown in FIG. It further includes a database device 18 for processing the medical information of the institution and executing search processing by tracking, and a maintenance terminal 19 for maintenance work.
[0052]
FIG. 4 is a block diagram showing a configuration example of the medical institution communication system 4a in the medical institution communication apparatus 4.
[0053]
In FIG. 4, the medical institution communication system 4a in this example executes various types of medical information processing (patient data, medical office work, medical images, etc.) in the medical institution, and is connected to a communication network (Internet access). The web server 25 is configured to accommodate a LAN server 26 that executes a remote call (RPC) system and various terminals (small general-purpose computer, printer, scanner).
[0054]
Note that the configuration of each of the small general-purpose computers described above is known. For example, a connection device, a microcomputer, a flash memory, an information recording medium drive device, a monitor device, an input operation device, a hard disk device, various external devices, for example, a SCSI (Small Computer System Interface) that captures image data from a digital camera ) Interface, USB (Universal Serial Bus) interface, and the like.
[0055]
Further, the configuration of the mobile phone 5b shown in FIG. 1 is known as a PDC system and a PHS system. For example, a frequency switch / synthesizer, a wireless transmission / reception unit equipped with a received electric field strength (RSSI) detection unit, a modulation / demodulation unit, a time division demultiplexing unit, a codec (encoding / decoding) unit, a microprocessor (MPU), The configuration includes an external interface (I / F) unit, a memory, a keypad, a display unit such as an incoming display light emitting diode and a liquid crystal display, a transmitting microphone, a receiving speaker, and an imaging unit.
[0056]
Further, in the communication network of FIG. 1, illustration of an editing server (for editing transfer data to the mobile phone 5b), a VoIP (Voice over Internet Protocol) gateway device, etc. for performing multimedia stream transmission is omitted. Each apparatus of FIG. 1 is equipped with a communication application program (for example, a web browser and a mailer application loaded with utility software for program transfer (transfer and download / install) by ASP) described in detail later.
[0057]
(2) Basic communication operation in the embodiment
Next, a basic communication operation in the configuration of the present embodiment will be described with reference to FIG.
[0058]
A recent communication network is constructed as a so-called multimedia communication network under a TCP / IP environment (for example, the Internet), and includes IP packet data communication and ITU-T (International Telecommunication Union-Telecommunication Standardization Sector) / G3. Standard facsimile communication, Internet fax communication, general-purpose telephone call, VoIP / ITU-T / H. (V.323 protocol) voice telephone communication is being executed.
[0059]
The digital fixed communication network 1 is an IP network using ISDN or the like whose configuration and transmission method are known, and has a network configuration in which a packet switching station or the like is installed in a circuit network. Also, the digital mobile communication network 2 applies, for example, the ARIB-27 / 28 standard (PDC method / PHS method), and the cell base station 2a is a known mobile device accommodated by a mobile communication control station (MCC) (not shown). It is a line network. The mobile network may be a TIA standard IS95 / IMT-2000 N / W-CDMA system and is not particularly limited.
[0060]
For example, an IP packet with a transmission rate of 64, 384 kbit / s, 1.5 Mbit / s is transmitted, and a packet exchange procedure X. 31 (I.430 / I.431, Q.921 / Q.931, X.25 protocol).
[0061]
Note that other high-speed transmission methods (for example, ADSL / non-target digital transmission) may be applied, and a high-speed communication network (for example, a gigabit high-speed data communication network) may be used. In particular, the adoption of a gigabit high-speed data communication network is effective when, for example, a three-dimensional simulation of a medical image having a large amount of transferred data is executed by computer bi-directional communication.
[0062]
In addition, each apparatus in FIG. 1 includes communication connection processing by TCP / IP known as Internet communication, language processing function by HTML (HyperText Markup Language) (JPEG still image or MPEG moving image processing by text, audio, data compression), and Two-way transfer communication using a hyperlink function using HTTP (Hypertext Transport Protocol), file transfer using FTP, and an external application using CGI (Common Gateway Interface) are executed. For this purpose, each device is equipped with a web browser (application) for performing e-mail communication and Internet surfing.
[0063]
The data read by the database engine (tracking) in the database device generates data to be transmitted in the format of CDF (push type information distribution) or push-pull type information distribution by XML (Extensible Markup Language), for example. In addition, relational database processing is performed by SQL (Structured Query Language).
[0064]
Furthermore, save bitmap image files for data processing of medical information (contents) photos and illustrations. For example, together with TIFF (Tagged Image File Format), create an image at the time of creation regardless of the model and font used. High-definition image data is generated and processed by, for example, a PDF (Portable Document Format) file that can be converted while being maintained. In addition, a dynamic home page is created through ASP (Active Server Pages).
[0065]
Each of these apparatuses performs file transfer by a well-known IP packet by bidirectional communication through a TCP / IP link. The transfer process on the Internet in this communication network is executed by an object instruction in HTTP (instruction to a radio button, anchor, push button, etc. by a coordinate input device such as a click / mouse). In this case, a transmission end description character (FIN) or a transmission acknowledgment character (ACK) for opening a TCP connection is stored in the file format, and the file transfer is executed based on the identification.
[0066]
In the mobile phone 5b, when the mobile phone 3 moves into the service area of the cell base station 2a, the control channel (CCH) is scanned and monitored to supplement the control channel with the maximum received electric field strength. After this location registration, a communication sequence (in this case, Internet access) for a well-known call (outgoing) or incoming call (incoming) is executed.
[0067]
Each apparatus shown in FIG. 1 executes various processes in the present embodiment according to a communication protocol or program executed by a CPU (including a CPU of a web server). The communication protocol and program execute a dedicated communication protocol for executing medical information processing and a computer program for constructing a medical information provision / acquisition system, in addition to the general-purpose communication protocol and program.
[0068]
(3) Intensive medical information processing in the embodiment
Next, intensive medical information processing in each part of FIGS. 1 to 4 will be described.
[0069]
The medical information central processing communication center device 3 performs various kinds of medical information processing, which has been conventionally processed for each hospital, on the Internet (communication line network) by the bidirectional communication. The medical institution processing shared communication system 3a of the medical information central processing communication center device 3 manages daily medical treatment processing by the medical institution communication device 4 for each hospital.
[0070]
This medical treatment management includes, for example, electronic medical record creation processing (standardized format / template), X-ray image data generation, medical fee (receipt) automatic calculation (processing medical accounting system) processing, examination request, drug prescription request data transfer It performs processing (order system) such as an inspection request (order) system and a pharmacy system. The programs for performing these various processes are stored and transferred in advance to the medical institution processing shared communication system 3a, and are taken in from a website such as a software house on the communication network or an ASP provider, and connected to the line. Transfer to the medical institution communication device 4 by (link). That is, it is an ASP business (business model) that provides advanced medical treatment programs such as the latest format for creating electronic medical records.
[0071]
The stylized format / template can be provided from the medical information central processing communication center device 3 to the medical institution communication device 4 through a line connection (link) with a website of a university medical institution or the like.
[0072]
The medical processing program to be transferred is taken in by the medical institution communication device 4, but can be resident in the LAN server 26 in the medical institution communication system 4 a shown in FIG. 4. In addition, it is resident only for a certain period of time, or is taken in every time a document is created by this standardized format for creating an electronic medical record. When the document creation is completed, all the information is transferred to the medical information central processing communication center apparatus 3 automatically or through batch processing, and sequentially stored in the medical institution data central processing communication system 3b.
[0073]
Also, in the medical institution small general-purpose computer 4b arranged in a relatively small hospital, every time processing is started, the program is downloaded / installed from the medical institution processing shared communication system 3a and used to complete the writing. Transfers all this information to the medical information central processing communication center device 3 automatically or through batch processing, and releases the program. In other words, the same operation as the client / server system is executed.
[0074]
The medical institution processing shared communication system 3a may be arranged in a hospital as the medical institution processing shared communication system 4c as shown in FIG. This is a case where the medical institution communication systems 4a of a plurality of hospitals are managed by the headquarters of this medical corporation.
[0075]
The medical institution data central processing communication system 3b of the medical information central processing communication center apparatus 3 extracts and stores medical information processed by the medical institution processing shared communication system 3a and uses it for various processes. For example, the above-described electronic medical chart creation processing (standardized format / template), X-ray image data generation, medical fee (receipt) automatic calculation (processing medical accounting system) processing, inspection request, inspection request for transferring drug prescription request (order) 3) The processing data of the system, the pharmacy system, etc. is stored in the database device 18 in FIG. 3 for each hospital, and thereafter, the medical institution communication device 4 reads and refers to it as needed.
[0076]
The medical information central processing communication center device 3 provides the hospital side (medical institution communication device 4) with mailbox processing, reservation processing, minimum data processing, and statistical data processing.
[0077]
Mailbox processing is to transfer data between hospitals (medical institution communication device 4). For example, patient referral letters, test result materials, reports, prescription history, and the like. In this data transfer, for example, the data transfer is executed by a module by processing such as the database device 16 in FIG. The reservation processing is information such as medical treatment reservation and examination reservation through a module by processing such as the database device 16 in FIG. 2, and holds information on reservations that the hospital has opened to other hospitals, and the hospital side ( Browsing from the medical institution communication device 4) is possible. This is used, for example, for receiving communication from a hospital that can specialize in the patient's condition (disease).
[0078]
The minimum data processing is the minimum data, which is the minimum necessary patient data in the practical sense for treatment and medical care for emergency / emergency patients, etc. stored in hospitals, etc. in emergency, emergency, disaster etc. Are stored in the database device 18 and the like, and many hospitals (medical institution communication devices 4) browse as necessary (for example, when an emergency / emergency patient is brought in). For example, when creating an electronic medical record for each patient, this minimum data is taken in by the medical institution data central processing communication system 3b from the medical institution processing shared communication system 3a, and the database device 18 updates / adds the necessary items from the data. .
[0079]
Statistical data processing is to process analysis data that does not specify a patient. This statistical data processing is created by, for example, a program (standardized format / template) provided from the medical institution processing shared communication system 3a, and is taken in by the medical institution data centralized processing communication system 3b and stored in the database device 18. The statistical data is taken in and referred to by the created hospital (medical institution communication device 4), or is disclosed to other hospitals (for example, disclosed by browsing the home page of the medical information central processing communication center device 3).
[0080]
Next, the medical information central processing communication center apparatus 3 can also be used by the patient side (communication terminal 5). The use of the patient side (communication terminal 5) includes various data of the individual patient (information such as the above-described electronic medical record, X-ray image data, medical fee (receipt), examination request, drug prescription request, etc.). This information browsing has confidentiality such as individual patients and public institutions (for example, investigation of infectious diseases, etc.). Therefore, for this information browsing, an identification code (ID) and a password are assigned in advance, and browsing (disclosure) is performed through the access.
[0081]
In addition, the medical institution communication device 4 accesses the medical information central processing communication center device 3 by using an identification code (ID) and a password except for the contents (statistical data) of a publicly disclosed homepage. For example, even in a membership system, access is executed through an identification code (ID) and a password.
[0082]
In this way, various processing programs are transferred from the medical information central processing communication center device 3 to the medical institution communication device 4. In other words, it is implemented through the provision of advanced medical treatment programs by ASP, centralized processing, data storage, and the like. As a result, the system scale and processing scale of the medical institution communication device 4 for each hospital can be reduced. In particular, it is no longer necessary to construct and operate the latest advanced medical information system which is expensive. In other words, medical information processing by the latest version upgrade program is always possible, and cost reduction such as version upgrade by multi-functionalization (fattening / Fat Client) loaded with various applications can be achieved.
[0083]
Further, the processing by the standardized format / template generation can be executed by the transfer program, and the medical information processing is easily performed. Furthermore, the processing data can be stored in the medical information centralized processing communication center device 3, and it is not necessary to store a huge amount of data over a long period of time on the hospital side (medical institution communication device 4). System audit for maintaining the reliability of data storage becomes easy. In addition, alliances with medical institutions, utilization of information at a plurality of hospitals under a medical corporation, and information exchange between hospitals can be easily performed.
[0084]
(4) Anonymized patient data collection process using a template
Next, “anonymized patient data collection processing using a template” based on the above configuration operation will be described.
[0085]
This “collection process of anonymized patient data using a template” means that patient data can be easily used as statistical information while ensuring confidentiality on the aforementioned two-way communication network for each purpose of research or clinical trial. It is created and collected reliably, and its effective use is enabled.
[0086]
FIG. 5 is a conceptual diagram for explaining such a process of collecting patient data. FIG. 6 is a diagram illustrating the operation side (medical information central processing communication center apparatus 3) and the hospital side (medical institution) in the process shown in FIG. It is a transmission sequence diagram with the communication apparatus 4). 7 is a flowchart showing a processing procedure on the hospital side (medical institution communication device 4) in FIG. 6, and FIG. 8 shows a processing procedure on the management side (medical information central processing communication center device 3) in FIG. It is a flowchart to show.
[0087]
5 to 8, first, patient data needs to secure confidentiality at the start of statistical information processing. Therefore, the administration side (medical information central processing communication center device 3) or the hospital side (medical institution communication device 4) assigns an identification code (appropriately described as “patient ID”) for each patient, and the patient for each data processing. The ID is input and identified, and the process is started (step S1 in FIG. 7, step S21 in FIG. 8).
[0088]
In this case, the administration side and the hospital side may independently assign patient IDs that are not related or compatible with each other.
[0089]
Next, the management side (medical information centralized processing communication center device 3) accepts access of statistical information processing from the hospital side (medical institution communication device 4) by an identification code (ID) and a password (step S2, FIG. 7). FIG. 8 step S22). This statistical information processing is divided into research and clinical trial purposes, for example, “historical history, allergy, notification request, organ donor request”, etc., and the standardized format / template is prepared in the database device 18 or the like in advance. doing.
[0090]
The stylized format / template list is transferred and presented to the hospital side (medical institution communication device 4) by the administration side (medical information central processing communication center device 3), and this display is performed (step S3 in FIG. 7). , S4, FIG. 8 step S23).
[0091]
The hospital side (medical institution communication device 4) designates a desired stylized format / template, and the operation side (medical information central processing communication center device 3) takes in this instruction, and the stylized format is received. / The template is transferred (step S5 in FIG. 7, steps S24 and S25 in FIG. 8).
[0092]
Next, the hospital side (medical institution communication device 4) captures and displays the standardized format displayed on the screen as an input to the standardized format / template corresponding to the target research or clinical trial for each medical treatment in the hospital. -Enter patient data for each mat / template item. This is a necessary item such as “historical history, allergy, notification request, organ donor request” (step S6 in FIG. 7). Only the input data of the stylized format / template is extracted (that is, the template is removed), and only the patient data portion is transferred from the hospital side (medical institution communication device 4) to the management side (medical information central processing communication center). The data is transferred to the apparatus 3), and thereafter referred to by the hospital side (medical institution communication apparatus 4) as necessary (steps S7 and S8 in FIG. 7).
[0093]
Next, the administration side (medical information central processing communication center device 3) collects and stores patient data for each target research or clinical trial. Specifically, patient data (transfer data) from which a template is removed from the hospital side (medical institution communication device 4) is captured and stored by the administration side (medical information central processing communication center device 3). In this case, patient data is collected and stored according to the target research or clinical trial. Thereafter, the collected / stored patient data is transferred according to a request from the hospital (medical institution communication device 4) (steps S26, S27, and S28 in FIG. 8).
[0094]
In this way, in the collection process of patient data, in a system that processes intensive medical information on a communication network, patient data can be easily and reliably created as statistical information for each purpose of research or clinical trial while ensuring confidentiality. It can be collected and stored and used.
[0095]
In this embodiment, classification is made in advance according to the purpose of research and clinical trials, and the stylized format / template is prepared on the administration side. However, such stylized format / template is provided on the hospital side. It is also possible to create appropriately according to the access from. Further, at the time of access from the hospital side, the purpose of research or clinical trial may be presented, and the management side may extract or create template information indicating the type of input template corresponding to the presented purpose.
[0096]
Next, with reference to FIG. 9, a specific example of the input process of patient data in this embodiment using a template will be further described.
[0097]
As shown in FIG. 9A, the basic information such as a concealed patient identification number and medical department name is input as text on the screen 201a of the display device when patient data is input in the medical institution communication device 4 or the like. In addition to the column 211 to be displayed, a button 210 for calling a template is displayed. When the operator operates this button 210 with a mouse or the like, a template selection window screen 220 is displayed in the screen 201b of the display device as shown in FIG. 9B. Here, a window screen for selecting a desired one from a plurality of templates prepared in advance according to the types such as “historical history”, “allergy”, “organ donor request”, etc. as a purpose in research and clinical trials 220 is displayed. Then, when the operator selects a template corresponding to one of the template names in the window screen 220 with a mouse or the like (assuming that “allergy” is selected here), FIG. The selected template is displayed in the screen 201c of the display device as shown in FIG. In this specific example, a text input field 230 is provided for each item such as “sex” and “age”. The plurality of items are set in advance for each type of template.
[0098]
As described above, according to the present embodiment, the patient data input process corresponding to the concealed patient identification number can be executed easily and reliably.
[0099]
The patient data input process using the template as described above may be executed in the medical institution communication apparatus 4 under the control of the medical institution small general-purpose computer 4b. Alternatively, a template library may be provided on the medical information central processing center communication device 3 side, and the medical institution communication device 4 may be appropriately accessed via the digital fixed communication network 1 or the like. Furthermore, it may be executed on a browser in the medical institution communication device 4 under the control of the medical information central processing center communication device 3 via the digital fixed communication network 1 or the like.
[0100]
(5) Application example of the embodiment
Next, an application example of this embodiment will be described.
[0101]
When a patient goes to a medical institution (hospital) from the medical information central processing center communication device 3 shown in FIG. 1, guidance information (hospital guidance and map information) indicating the location and medical subject is transferred by a request from the communication terminal 5. Then, convenience on the customer side is improved. In addition, telephone inquiries at medical institutions (hospitals) will be reduced, and it will be possible to cope with labor savings. The map information is created by the medical information central processing center communication device 3 independently, or is taken in via the line connection (link) from the map providing website on the communication network (communication line network) and provided to the communication terminal 5 You can also
[0102]
In this case, in providing map information through a link, the medical information central processing center communication device 3 (see FIGS. 2 and 3) is connected to the time synchronization NTP (Network Time Protocol) server on the Internet and the NFS for the distributed file system ( (Network File System) A server is arranged.
[0103]
In addition, when various kinds of centralized processing by the medical information central processing center communication device 3 shown in FIG. 1 is a pay membership system, the fee is collected on a monthly fee, annual fee or usage weight system (for example, packet amount). When payment is made with electronic money (digital cash) or the like with the network 1 system arranged in the communication network (communication line network), labor saving between the two (operation side and hospital side) advances. Electronic money settlement (electronic commerce is settled on a communication network by, for example, EDI (Electronic Data Interchange) protocol.
[0104]
Furthermore, in the inquiry from the patient side (communication terminal 5), for example, if data conversion transfer in English is performed, the convenience on the patient side is improved, and an easy and reliable response on the patient side especially in case of emergency It becomes possible. This language conversion may be executed by line connection (link) with a language conversion website on the communication network. As an example of improving the convenience on the patient side in the same way as this multilingual correspondence, it is convenient to provide the patient with traffic congestion information and weather conditions to the inquiry hospital. This traffic congestion information is taken in by the medical information central processing center communication device 3 from the road traffic information communication system / VICS (Vehicle Information and Communication System) and transferred to the communication terminal 5. The weather information may be obtained by using a meteorological material comprehensive processing system / COSMETS (Computer System for Metalogical Services).
[0105]
(6) Modification of the embodiment
Next, a modification of this embodiment will be described.
[0106]
The communication network in FIG. 1 is not particularly limited to the TCP / IP system. Various data communication methods can be applied. For example, it is also possible to construct an FDDI (Fiber Distributed Data Interface) / LAN (client server system) in which a plurality of Ethernet (registered trademark) (LAN) are connected by a high-speed communication network.
[0107]
Further, instead of the digital fixed communication network 1 in FIG. 1, an analog fixed communication network with an arrangement of a communication control unit (NCU) or a modem (modem) can be used.
[0108]
Furthermore, in the above-described embodiment, in order to keep the medical information of the patient confidential, the transfer data encryption by SSL and the access by the identification code (ID) and the password have been described. However, the transfer program and the medical data are prevented from being destroyed. There is a need to do. For example, wiretapping (acquisition of malicious data on the communication path), denial (denial of communication at the communication partner), remodeling (modification of transmission data by a third party on the communication path), impersonation (No. 1) For this reason, measures to prevent destruction of customer information by conventional encryption systems (public key encryption systems / public key encryption systems / RSA, MH) are used. It is preferable to take.
[0109]
Furthermore, although the communication network shown in FIG. 1 has been described with an example in which one medical information central processing center communication device 3 is arranged, it is necessary to avoid transmission interruption (impossible medical information processing) due to a system down. The configuration for this is a known distributed processing system, and a plurality of medical information central processing center communication devices 3 are installed in a communication line network.
[0110]
In the communication network shown in FIG. 1, the medical information central processing center communication device 3 has been described with the medical institution processing shared communication system 3a and the medical institution data central processing communication system 3b. In particular, the medical institution processing shared communication system 3a and the medical institution data central processing communication system 3b may be integrated into a single communication system. These are adopted in consideration of transmission capacity (traffic amount) and data processing amount.
[0111]
Further, the medical information central processing center communication device 3 performs, for example, a telephone call or facsimile communication with a hospital or a patient as necessary. In this case, a VoIP server (Computer Telephone Integration CTI) that accommodates a FAX server and a VoIP telephone is added to the medical institution processing shared communication system 3a shown in FIG. 2 and the medical institution data centralized processing communication system 3b shown in FIG. Will be provided.
[0112]
Such applications and modifications are within the technical scope that can be easily created by those skilled in the art, and these are included in the scope of the present invention.
[0113]
The present invention is not limited to the above-described embodiments, and can be appropriately changed without departing from the spirit or idea of the invention that can be read from the claims and the entire specification, and medical treatment involving such changes. An information providing / acquisition system and method, and a computer program are also included in the technical scope of the present invention. Needless to say, medical care targeted by the medical information provision / acquisition system of the present invention includes not only hospital medical care but also nursing medical care and home medical care.
[0114]
【The invention's effect】
As described above in detail, according to the present invention, in a system for processing intensive medical information on a communication network, patient data is easily and reliably created as statistical information for each purpose of research or clinical trial while ensuring confidentiality. Thus, it can be collected and stored, and it can be effectively used.
[Brief description of the drawings]
FIG. 1 is a block diagram of a configuration example of a bidirectional communication network in an embodiment of the present invention.
FIG. 2 is a block diagram showing a configuration example of a medical institution processing shared communication system in the embodiment of FIG. 1;
FIG. 3 is a block diagram showing a configuration example of a medical institution data central processing communication system in the embodiment of FIG. 1;
4 is a block diagram showing a configuration example of a medical institution communication system in the embodiment of FIG. 1. FIG.
FIG. 5 is a conceptual diagram for explaining an anonymized patient data collection process using a template according to the present embodiment.
FIG. 6 is a transmission sequence diagram in the present embodiment.
FIG. 7 is a flowchart showing a processing procedure on the hospital side in the present embodiment.
FIG. 8 is a flowchart showing a processing procedure on the management side in the present embodiment.
FIG. 9 is a diagram showing a template for inputting patient data in the present embodiment.
[Explanation of symbols]
1 Digital fixed communication network
3 Medical Information Central Processing Center Communication Device
3a Medical institution processing shared communication system
3b Centralized data processing system for medical institutions
4 Medical institution communication equipment
4a Medical institution communication system
4b Medical institution small general-purpose computer
4c Medical institution processing shared communication system
5 Communication terminal
5a small general purpose computer
5b mobile phone
11, 25 Web server
12 DNS server
13 SSL server
14 FTP server
16, 18 Database equipment
26 LAN server

Claims (10)

Medical information provision / acquisition by a bidirectional communication network comprising a plurality of facility processing devices installed in a plurality of medical facilities and a central processing device connected to the plurality of facility processing devices via a bidirectional communication network A system,
The central processing unit is a list for transferring list information indicating a list of a plurality of purpose names corresponding to a plurality of types of input templates classified by purpose including at least one of research and clinical trials to the facility processing apparatus side. Transfer means, and a template storage means for storing a plurality of template information respectively indicating the plurality of types of input templates according to the purpose name and storing in advance.
The facility processing apparatus presents one objective name selected from a list displayed based on the transferred list information or selected uniquely, and performs statistical processing on patient data to the central processing apparatus Access means for performing access for
The central processing device is template information indicating an input template of a type corresponding to the access, and template information corresponding to the presented one purpose name is based on the presented one purpose name. Extraction means for extracting from the template storage means, template creation means for creating template information corresponding to the one target name, and a template for inputting patient data necessary for the statistical processing corresponding to the access First transfer means for transferring the template information extracted by the extraction means or created by the template creation means to the facility processing apparatus,
The facility processing apparatus includes input means for inputting the patient data with the input template based on the transferred template information, and second transfer means for transferring the input patient data,
At least one of the facility processing apparatus and the centralized processing apparatus further includes a code providing unit that provides an anonymized patient identification code for each patient,
The central processing unit includes statistical processing storage means for storing the patient data transferred by the second transfer means in association with the anonymized patient identification code and for each purpose, and the input template. And a processing means for statistically processing the patient data inputted and transferred or the patient data stored in the statistical processing storage means for each purpose and based on the patient identification code. Medical information provision / acquisition system using a communication network. The facility processing apparatus includes display means for displaying the list based on the transferred list information,
2. The medical information provision / acquisition system using a bidirectional communication network according to claim 1, further comprising selection means for selecting the one target name from the displayed list. 3. The medical information provision / acquisition system using a two-way communication network according to claim 1, wherein the patient data is input by the input unit for each patient. The bidirectional data according to any one of claims 1 to 3, wherein the input of the patient data by the input means is performed at at least one point in time of medical treatment, hospitalization, and discharge of the patient. Medical information provision / acquisition system via communication network. 5. The facility processing apparatus according to claim 1, further comprising reference means for designating and referring to necessary patient data out of patient data stored in the statistical processing storage means. A medical information provision / acquisition system using the two-way communication network according to any one of the above. The central processing device further includes providing means for providing a predetermined type of medical application program to the plurality of facility processing devices via the bidirectional communication network, respectively.
The said input means inputs the said patient data by the said input template in the form extracted from the patient data obtained by execution of the said medical application program, The any one of Claim 1 to 5 characterized by the above-mentioned. Medical information provision / acquisition system using the two-way communication network described in 1. The central processing apparatus further includes a fetching unit that fetches the medical application program by connecting to the line, and a third transfer unit that transfers the medical application program fetched by the fetching unit to the facility processing apparatus. The medical information provision / acquisition system by the two-way communication network according to claim 5. The facility processing apparatus further includes another code assigning unit that assigns another patient identification code that is different for each medical-related facility and for each patient and that is not related or compatible with the patient identification code. The medical information provision / acquisition system by the two-way communication network as described in any one of Claim 1 to 7. A plurality of the central processing units are arranged on the bidirectional communication network,
The medical information provision by the two-way communication network according to any one of claims 1 to 8, wherein the plurality of units operate as a distributed processing system including an active system and a standby system that execute the same processing, respectively.・ Acquisition system. Medical information provision / acquisition by a bidirectional communication network comprising a plurality of facility processing devices installed in a plurality of medical facilities and a central processing device connected to the plurality of facility processing devices via a bidirectional communication network A medical information provision / acquisition method using a two-way communication network in a system,
The central processing unit includes a template storage unit that stores a plurality of template information respectively indicating a plurality of types of input templates classified according to purposes including at least one of research and clinical trials according to a plurality of purpose names and stored in advance. With
The central processing device executes a list transfer step of transferring list information indicating a list of the plurality of target names corresponding to the plurality of types of input templates to the facility processing device side,
Statistical processing on patient data to the central processing unit by presenting one target name selected from the list displayed based on the transferred list information by the facility processing apparatus or uniquely selected Perform an access process to access for
Based on the presented one purpose name, the template information indicating the input template of the type corresponding to the access by the central processing unit and corresponding to the presented one purpose name An extraction step for extracting from the template storage means, a template creation step for creating template information corresponding to the one target name, and a template for inputting patient data necessary for the statistical processing corresponding to the access A first transfer step for transferring the template information extracted in the extraction step or created in the template creation step to the facility processing apparatus,
The facility processing apparatus performs an input step of inputting the patient data with the input template based on the transferred template information, and a second transfer step of transferring the input patient data,
Further executing an assigning step of giving an anonymized patient identification code for each patient by at least one of the facility processing device and the centralized processing device,
An assigning step for assigning an anonymized patient identification code for each patient by the central processing unit, and patient data transferred in the second transfer step in association with the anonymized patient identification code, and A statistical processing storing step for storing by purpose, and patient data input and transferred by the input template or patient data stored by purpose are statistically processed by the purpose and based on the patient identification code. And a medical information provision / acquisition method using a two-way communication network.

Images