JP3934997B2 - Medical support system, medical support method and medical support program - Google Patents

Medical support system, medical support method and medical support program Download PDF

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Publication number
JP3934997B2
JP3934997B2 JP2002172466A JP2002172466A JP3934997B2 JP 3934997 B2 JP3934997 B2 JP 3934997B2 JP 2002172466 A JP2002172466 A JP 2002172466A JP 2002172466 A JP2002172466 A JP 2002172466A JP 3934997 B2 JP3934997 B2 JP 3934997B2
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medical
display
data
reservation
medical practice
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JP2004021380A (en
Inventor
令子 中新
雅司 芳賀
宣昭 赤間
薫 鈴木
陽子 須川
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株式会社日立製作所
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Description

[0001]
BACKGROUND OF THE INVENTION
The present invention provides a medical assistance system. , Medical assistance methods and medical assistance Regarding the program.
[0002]
[Prior art]
2. Description of the Related Art In recent years, an information system that can refer to various types of patient information has been proposed in order to support the medical practice of medical personnel such as doctors and nurses. As a conventional technique of such an information system, there is a medical assistance system described in Japanese Patent Laid-Open No. 2001-1118014.
[0003]
This medical care support system provides a medical care plan display screen in which medical care performed on a patient is displayed in time series. The medical plan display screen displays past results and future plans of medical care performed on the patient. The contents displayed as the schedule are created based on the medical records of similar cases extracted. Utilizing such a medical assistance system makes it easy to create a medical treatment plan and the like. Moreover, since it becomes easy for a medical worker to visually confirm progress and a schedule, it becomes possible to create a medical treatment plan and its execution reliably and accurately.
[0004]
[Problems to be solved by the invention]
However, when actually performing medical care, it was necessary to refer to the medical charts over time, to examine the grounds at the time when the medical care plan was made, and to confirm changes from the current situation. Also, in the case of medication, it has been difficult to confirm the effect, the period during which the effect lasts, or the timing of medication. In other words, even if a wide variety of scattered information is displayed on one screen, only one way of viewing was possible, so it was desired to be able to refer to the medical progress and plan in multiple ways. In preparing a medical plan, it has been desired to develop a system that can easily reserve an operating room and confirm it.
Therefore, the problem to be solved by the present invention is to make it easy to create a plan and confirm past and present situations mainly when performing medical care for a patient.
[0005]
[Means for Solving the Problems]
As a means for solving the above-mentioned problem, there is a medical assistance system that supports one medical practice performed by a medical worker on a patient and scheduling for each other medical practice performed before and after the execution of the one medical practice. A control device, a storage device, a display device, and an input device. A medical support device that performs communication with the computer, and a server that enables communication via a network. , The medical assistance device is configured with a server that can communicate via a network, the storage device stores patient information in which the contents of a medical record are recorded for each patient, and the server is used for the medical practice. Managing reservation data for a room or device to be operated, and when the medical worker selects a patient to be treated from the patient selection screen displayed on the display device using the input device, The control device from the storage device, The selected To the patient Affect Medical chart In Record The medical day that has been Medical practice Time required for treatment and Medical practice Items as medical practice information Extract and date Said Medical treatment Act With item Partitioned cell of Have array In the medical treatment plan table, it is composed of a text display that displays the contents of the items of the medical practice, and a bar display that represents the start date and period related to the treatment of the medical practice Medical treatment display , Based on the extracted medical practice information, the position data related to the medical day including coordinate data indicating the display position in the medical care plan table, and the period required for the treatment of the medical practice Create clinical practice data having period data and content data related to the contents of the clinical practice items, and display the clinical practice display based on the position data and the period data stored in the clinical practice data By displaying a cell in the medical treatment plan table to be displayed, displaying the content data at a text display position, and displaying the period data at a bar display position. Create a date and practice Act With item Partitioned cell The The medical plan table In the same sequence as Array did Create reservation table When Medical practice Reservation status information relating to a room or device used for the acquisition is acquired from the server, and based on the acquired reservation status information, a cell that can be reserved and a cell that cannot be reserved can be identified Create a reservation table, the created treatment plan table and the reservation table are displayed on the same screen of the display device, or in parallel, in front Input device The medical treatment display displayed on the display device according to the operation of the medical staff via Move operation The coordinate data of the position data is moved along with the movement of the medical treatment display. update The medical practice display is displayed in the cell corresponding to the updated coordinate data position, and the cell in the reservation table of the same clinical practice item on the same date as the cell corresponding to the updated coordinate data position is displayed. If the reservation is confirmed and all the updated cells match the reservation available date and the reservation is confirmed, the confirmed reservation status information is transmitted to the server and the update is performed. A medical chart based on the displayed medical practice To do.
[0006]
DETAILED DESCRIPTION OF THE INVENTION
(First embodiment)
A first embodiment of the present invention will be described in detail with reference to the drawings.
FIG. 1 is a block diagram showing the overall configuration of a medical assistance system in the present embodiment. FIG. 2 is a flowchart showing processing of the medical assistance system. 3 to 9 are diagrams showing examples of screens provided by each process of the medical assistance system.
[0007]
As shown in FIG. 1, the medical assistance system 1 includes a display unit 2 that displays a medical progress and schedule table, and other electronic information, a control device 3 that controls the display unit 2, and the like. The medical care support device 6 is configured to include an input means 4 for receiving the data input and a storage device 5 capable of storing various data. As the display means 2, a monitor using a liquid crystal display, a CRT (Cathode-Ray Tube) or the like can be used. The control device 3 includes a CPU (Central Processing Unit), a RAM (Random Access Memory), a ROM (Read Only Memory), and the like, and implements various processes by developing and starting a predetermined program. Examples of the input unit 4 include a keyboard, a mouse, and a pen tablet, but may include a touch panel using a liquid crystal display and a card reader. The storage device 5 is a device that reads and writes data on a portable recording medium such as an HDD (Hard Disk Drive) device or a DVD (Digital Video Disk).
[0008]
Among the functions realized by causing the control device 3 to activate a predetermined program (hereinafter referred to as a medical support program), what is characteristic of this embodiment is that a data processing is performed and a medical treatment plan screen 41 to be described later is performed. A creation means 11 for creating the data, an extraction means 12 for retrieving necessary information by searching for patient information or a similar medical plan, and a registration means 13 for registering new data in a database or the like. In addition, the storage device 5 has a patient database 14 in which the contents of medical plans and electronic medical records are registered for each patient, and a path database 15 that is used when extracting similar medical plans. The databases 14 and 15 are constructed in the storage device 5 as a result of the medical support program processing. Therefore, by installing and starting a medical support program on a computer terminal or the like, it is possible to function as the medical support device 6 and construct the medical support system 1. The medical support program can be stored in a recording medium so as to be readable, or can be put into a downloadable state using a network, and the effect of the present invention extends to such an action. .
[0009]
Here, main processes performed in the medical assistance system 1 will be described with reference to FIGS. 1 and 2. Details of each process will be described later.
When the medical assistance system 1 is operated by turning on the medical assistance device 6 or the like, a list of outpatients and inpatients is displayed as a patient selection screen 21 in step S1. Here, in step S2, when a medical worker such as a doctor or nurse selects a patient displayed in the list for examination, an index screen 31 for displaying patient information as an index is displayed in step S3. In step S4, which is processed almost simultaneously with this, a medical treatment plan screen 41 showing a medical treatment plan is displayed. By referring to this medical treatment plan, the medical staff can easily confirm the medical treatment plan, and can quickly carry out the necessary medical treatment. The index screen 31 and the medical care plan screen 41 are preferably displayed in parallel as shown in FIG. 1, but may be displayed so that they partially overlap, or the index screen 31 and the medical care plan screen 41 are switched. May be displayed.
[0010]
A medical record recorded by checking the medical plan screen 41 is registered in a medical chart screen (not shown in FIG. 1) selected and displayed from the index screen 31 in step S5, and a medical chart is created. And if a medical chart is created, the process about this patient will be complete | finished. Thereafter, each time a patient is treated, the processing from step S1 to step S5 is repeated as appropriate.
[0011]
A part of the medical plan and chart information may be transmitted as instruction data to another system or another computer terminal. Data transmitted as instruction data in this case includes reservations for laboratories, instructions for medicines to pharmacies and nurses, amounts of medical fees, and the like. The configuration enabling such processing is realized by connecting the medical assistance device 6 to another computer device disposed in a pharmacy or the like via a network.
[0012]
Further, each step in FIG. 2 will be described in detail with reference to an example of a provided screen.
The display of the patient list in step S1 is performed by the creation means 11 performing data processing according to the information input from the input means 4 shown in FIG. 1, and creating and displaying the patient selection screen 21 shown in detail in FIG. . This patient selection screen 21 has a list area 21a for displaying a list 22 of patients to be treated, and a patient information area 21b for displaying detailed information of patients selected in the list 22. Yes. Further, a menu area 21c for assisting the medical staff is prepared. This menu area 21c is a GUI (Graphical User Interface) in which commands for operations performed on the patient selection screen 21 are arranged as pull-down menus or buttons. ).
[0013]
The list area 21a has a list 22 with a plurality of tabs 22a. This list 22 has a configuration in which information about items 22b arranged in the horizontal direction is arranged for each patient. The item 22b includes items regarding information on the medical institution side such as “clinical department”, “acceptance date”, “patient number”, “doctor name” (including doctor type), “clinical classification”, and “name” ”,“ Sex ”,“ outpatient ”,“ hospital ward ”,“ hospital date ”,“ birth date ”, and other items regarding patient information. The tab 22a is used to display the list 22 according to the progress of reception and medical treatment, such as “waiting for medical examination”, “under medical care”, “medical examination completed”, “specimen urgent”, “reservation”, and “patient search”. This switching can be performed by clicking the tab 22a with the mouse. In addition, the list 22 includes a text box 22c indicating that patient information is displayed for each clinic such as “surgery 1” and for each department such as “internal medicine”, and a patient given to the patient. A search field 22d for searching for a patient by number is provided. That is, the patient information displayed in the list 22 can be switched for each medical room and for each department by inputting into the text box 22, and by selecting the tab 22a, for each reception and medical progress, a search field. The display for each patient number can be switched by 22d.
[0014]
The patient information area 21b includes “patient number”, “name”, “date of birth”, “sex”, “height”, “weight”, and the like for the patient selected by the mouse or the arrow key in the list area 21a. It has a display field 23 for displaying information such as “presence / absence of allergy” and “type of medical insurance”. If the patient's disease name is known, “disease name” or “disease history” may be displayed. All information should be displayed at once. However, in the case where there is a limitation due to the screen size, the display switching button 24 is provided to select the type and number of information displayed on the screen. As other buttons arranged in this patient information area 21b, in order to prevent others from referring to or operating when leaving the seat, the patient information displayed in this area is temporarily hidden and operated. An example is a screen lock button 25 for disabling the screen.
[0015]
In addition, a patient selection button 26a, a patient information button 26b, and a medical plan button 26c are shown in the menu area 21c of FIG. These buttons 26a, 26b, and 26c are used to display the corresponding screen on the foreground when other screens are displayed in an overlapping manner. The patient selection button 26a is used to display the list area 21a in the foreground. The patient information button 26b is used to display the patient information area 21b in the foreground. The medical plan button 26c is used to display the medical plan screen 41 on the forefront.
[0016]
The selection of the patient in step S2 of FIG. 2 is performed by selecting the patient information displayed for each line in the list area 21a. The selection operation is performed by directly clicking the displayed patient information with the mouse, using the arrow keys and return key of the keyboard, or selecting a menu button or command (hereinafter the same for each selection operation). . Here, when all the information cannot be displayed on one screen, such as when the number of patients is large or the number of items of information about the patients is large, the patient is selected using the scroll bars 27a and 27b.
[0017]
As illustrated in FIG. 4, the index screen 31 displayed in step S3 is a table in which indexes attached to identify the information are arranged in the medical record information stored for the patient (hereinafter referred to as the index screen 31). (Referred to as an index table) 32a. The index is a name attached to electronic data that summarizes information related to medical treatment according to its content, use, and timing, etc. The contents and use are `` questionnaire '', `` introduction letter '', `` findings at the first visit '' , “Progress record”, “report”, “surgery record”, “discharge summary”, and the like. By performing a selection operation on the index, electronic data associated with the index is read and displayed on the screen. For example, when the index of “introduction letter” is clicked as a medical record to be browsed, the patient brings it at the first visit, and the electronic data of the referral letter already stored in the patient database 14 shown in FIG. The creation means 11 displays the image on a viewer (not shown). Some indexes are hierarchically associated with a plurality of indexes. FIG. 4 shows an example in which, when the “progress record” index is selected, the index of the medical chart created for each medical treatment date is displayed as a lower-level index. Although not shown, it is desirable to prepare a tab “not yet executed” as the execution timing. The “Unimplemented” tab displays an index of medical practices to be implemented today and a medical practice index for which the scheduled execution time has passed in the sense of a warning.
[0018]
The index table 32 a includes a tab 33 and a check box 34 a, and when the tab 33 is clicked, an index can be displayed separately for “new arrival”, “by category”, “history”, and “bookmark”. In addition, when the check box 34a that can be operated independently of the tab 33 is checked and the extraction button 34b is clicked, an index is displayed separately for “outpatient”, “hospital”, “self subject”, and “other subject”. it can. As described above, when the display content is changed based on the operation of the tab 33 or the check box 34a, or when the index screen 31 is displayed for the first time, the operation content is acquired as a search condition, and the extraction means 12 of FIG. Extracts the corresponding index from the patient database 14 according to the search condition, and the creation means 11 displays the result on the screen. That is, an index for information registered in the patient database 14 is displayed in the index table 32a.
[0019]
In FIG. 4, the index screen 31 is displayed so as to overlap the above-described patient selection screen 21 as a basic screen. However, this display form is an example, and the index screen 31 and the patient selection screen 21 may be displayed independently, or the patient selection screen 21 may be closed or reduced. Hereinafter, it is assumed that each screen is displayed so as to be superimposed on the patient selection screen 21 as a basic screen.
[0020]
Furthermore, specific examples of operations performed on the index screen 31 and screens that change depending on the operation will be described with reference to FIGS. 5, 6A, 7B, 7A, and 7B. .
FIG. 5 shows an example in which the information about “new arrival” is displayed as an index. On this index screen 31, an index of information that has not been read by medical personnel is arranged and displayed for each creation date. In this index table 32b, a confirmation button 35a for checking after reading an unread medical record and a latest button 35b for extracting the latest medical record are arranged. When a selection operation is performed on an index, information associated with the index is displayed on the screen as a medical record. When the doctor confirms the contents and clicks the confirmation button 35a, the medical record for the index is regarded as read (confirmed) and is deleted from the index table 32b. In this case, only the unread index is displayed in the index table 32b. Therefore, it is possible to manage unread and read medical records created for the patient, and it is possible to reliably transmit information that should be noted in medical treatment to a doctor. If an index is selected without using the confirmation button 35, the index may be deleted from the index table 32b after the index has been viewed.
[0021]
The data structure of the index for performing such management includes a text indicating a title that characterizes patient information stored in the patient database 14 for each file, data when the file is created, and an index. The information storage location pointer and a flag for distinguishing between “unread” and “read” can be mentioned. As the flag setting process, when information about an unread index is displayed on the screen, the registration unit 13 (see FIG. 1) changes the index flag from “unread” to “read”.
[0022]
FIGS. 6A and 6B show the index table 32c displayed by paying attention to “history”. The index table 32c of the index screen 31 is the same as described above in that the indexes are arranged and displayed for each creation date, but in addition to the check box 36a and the extraction button 36b, the period for acquiring the index is used as a search condition. It is characterized in that an acquisition period column 37 for inputting is provided. According to FIG. 6A, information created within “3 weeks” is displayed in an index according to the creation order. The creation order can be confirmed by referring to the creation date item in the index table 32c.
[0023]
In such an index table 32c, the index acquisition period can be changed. When changing, it is convenient to use an acquisition period setting screen that is displayed by clicking a text box in the acquisition period column 37. FIG. 6B shows a state in which the acquisition period setting screen 38 is displayed as a pop-up screen as an example of such a screen. The acquisition period setting screen 38 includes a text box 38a, a numeric keypad 38b, radio buttons 38c for setting acquisition units such as “week”, “month”, “times”, and radio buttons 38d for setting acquisition conditions. An OK button 38e for confirming the end of the setting and a cancel button 38f for selecting reworking are also provided. For the radio button 38d for setting the acquisition conditions, there are prepared options of “after the current hospitalization date”, “after the previous hospitalization date”, “after the previous hospitalization date”, and “all”. Here, “after this hospitalization date” is desirably activated (displayed in a selectable manner) only when the patient is currently hospitalized. Similarly, “after the previous discharge date” and “after the previous hospitalization date” are desirably activated (displayed so as to be selectable) when the patient has been hospitalized in the past.
[0024]
FIGS. 7A and 7B are examples of an index screen 31 for managing “bookmarks”. Managing bookmarks is to add a bookmark to a medical record such as a medical record being referenced so that it can be easily searched later. The creator of the medical record can refer to it later or see it by others. This makes it easier to check medical records. 7A and 7B illustrate a case where information on a medical chart 54 displayed on a medical chart screen 51, which will be described in detail later, is added. That is, when the bookmark addition button (bookmark addition button) 56b on the medical chart screen 51 is clicked, the index of the medical record to which the bookmark is attached is added as shown in FIG. 7B so that it can be confirmed later.
[0025]
Details of the medical treatment plan screen 41 displayed side by side with the index screen 31, and operations and processes on this screen will be described mainly with reference to FIGS.
As shown in FIG. 4, the medical treatment plan screen 41 is a cell specified by items displayed on the item display unit 42 and a date displayed on the date display unit 43 as a series of medical treatments to be performed on the patient. The medical treatment plan table 44 is arranged. The medical care plan table 44 is created by extracting medical records entered for a patient and medical records having a high degree of similarity. The medical plan screen 41 displays the medical plan stored in the past as a medical plan table 44, and if it has not been created in the past, the medical plan table 44 is created and displayed when the screen is displayed. To do. The medical care plan table 44 may be left blank and display only the framework if the necessary medical record data is not sufficient.
[0026]
As shown in detail in FIG. 8, the contents of the medical practice arranged in the item display unit 42 include “ward” at the time of hospitalization, “activity”, “vital”, “meal”, “ Examples include “radiation”, “physiology”, “specimen”, “therapeutic treatment”, “drug”, “injection”, “explanation of instructional education”, and the like. Other items are not shown, but can be displayed by operating the scroll bar 45a.
[0027]
For example, in the item “activity” of the item display section 42, a medical practice display 46 including a text 46 a designating the state of “bed rest” and a bar 46 b indicating the duration of the medical practice is arranged. . In this case, it can be easily understood that the patient must be in a bed rest state from before the operation indicated by the start point of the bar 46b until the operation corresponding to the end point of the bar 46b is completed. Further, thereafter, a medical practice display 46 indicating that the patient's action is free on the floor and the period is arranged. In other words, it is possible to grasp at a glance that the patient is free to act on the floor (on the bed) after the operation. Then, with the passage of time, through “toilet walking allowed”, “in-campus free” is indicated by the medical practice display 46 continuously arranged, and finally “discharge” is understood. Here, a bar 46c indicating the current patient condition (currently performed medical care), a bar 46b indicating the past state (medical care performed in the past), and a bar 46d indicating the future state (medical care to be performed in the future) It is desirable to change the color, pattern, bar shape, etc., respectively. By changing the form of the bars 46b, 46c, and 46d in this way, confirmation of the progress status of a series of medical treatments becomes easier. In addition to or in place of changing the form of the bars 46b, 46c, and 46d, the form of the text 46a such as the color, character size, and thickness may be changed according to the progress status. .
[0028]
In addition, for example, in the “medicine” item of the item display section 42, in addition to the above-described stepwise change, it is possible to identify the time of taking the medicine and the duration of its effect. That is, the medical practice display 47 indicating the internal use of a certain medicine has a text 47a indicating the contents thereof and a bar 47b. The bar 47b indicates a first part 47c indicating the time of taking and a period during which the effect is sustained. And a second portion 47d shown. The first portion 47c and the second portion 47d can be visually identified by changing the color, pattern, thickness, shape, or the like.
[0029]
The date display section 43 displays status display fields 43a such as “pre-operative” and “post-operative” of the operation, a relative date field 43b for entering a relative date from hospitalization or treatment start, and an absolute date. It has an absolute date column 43c. Also for the date display unit 43, an area not shown can be displayed by operating the scroll bar 45b. Further, in accordance with the current time, the colors and patterns of the relative date column 43b and the absolute date column 43c are changed, and the bands 48 in which the color and pattern are changed are displayed on the top and bottom of the cell. As a result, the current date, the number of days since the start of medical care, and the current time can be reliably identified, and the progress of medical care can be easily confirmed. Note that the date shown in FIG. 8 is August 23, when the pattern of the absolute date column 43c is changed. In addition, it can be confirmed from the relative date column 43b that this day is the third day of hospitalization, and since the band 48 is near the center of the cell, it can be seen that the current time is daytime. By using such a display, it is possible to immediately confirm the current patient condition, the medical practice being performed, or the medical practice to be performed.
[0030]
The medical care plan screen 41 can be created by a doctor based on his / her own diagnosis, but in this embodiment, a clinical path is used. The clinical path is a standardized treatment and nursing procedure and is displayed in a time-series list. The contents are confirmed in the path name column 49a and the comment column 49b arranged above the medical plan table 44. be able to. This path can be changed by clicking the text box in the path name column 49a. In this case, a path of a similar case is displayed as an option on a pop-up screen (not shown) so as to be selectable. In this case, it is desirable to be able to refer to a simple explanation, a period of treatment, and costs for each option.
[0031]
The path can also be selected from the menu. The menu includes a pull-down menu and buttons. In FIG. 8, a path setting button 50a, a copy button 50b, a change button 50c, and a delete button 50d are arranged. Here, the change button 50c and the delete button 50d are different in color and pattern from other buttons in order to call attention from the viewpoint of preventing an erroneous operation. FIG. 8 shows a set registration button 50e for handling a set of specific medical treatments as a unit, a set button 50f for calling a registered set, and an order button 50g for calling a set of medical treatments in a smaller unit than the set. Is shown. Further, a button 50h for closing the medical care plan screen 41 is also prepared. However, in order to prevent an erroneous operation, the button 50h is arranged at a position away from the other buttons 50a, 50b, 50c, 50d, 50e, 50f, 50g. Has been.
[0032]
In the process of making the clinical path selectable, information such as the patient's sex, age, disease name, and disease state is acquired from the patient information and medical record, and the extraction means 12 shown in FIG. This is done by searching for In addition, it may be necessary to change the clinical path during medical treatment due to changes in the medical care process or deviations from the plan (this situation is called “variance”). Done. In this case, it is desirable to display information on the variation that caused the change in the path displayed as an option, and it is desirable to reflect such information also in the comment field 49b.
[0033]
Such a path is registered by a registration screen (not shown) and the registration means 13 shown in FIG. 1 and added to the path database 15 of the storage device 5. The bus registered here includes not only a typical medical treatment plan path but also a unique path created corresponding to the variance. In addition, when a path change is performed, it is desirable to be able to confirm as a history that the path has been changed. Specifically, in the medical care plan table 44, a text such as “Variance occurrence” is attached at the time of occurrence of a variance, or the color or pattern of a cell on or after that date is changed. . Furthermore, it is desirable that a chart 54 of the chart screen 51, which will be described later with reference to FIG.
[0034]
Next, the medical chart screen 51 displayed in step S5 will be described with reference to FIG. The medical chart screen 51 is a record created by a doctor for each patient and for each examination, and includes a medical chart 54 including an item display field 52 and a rectangular text box 53 associated therewith. Examples of items displayed in the item display field 52 include S (Subjective), O (Objective), A (Assessment), P (Plan), prescription, and next medical treatment. Reservations. In the text box 53, a doctor inputs necessary items. If there are too many item names to display or input at once, they can be displayed by operating the scroll bar 55. When a new chart 54 is created, necessary items are entered into an empty chart displayed when the new creation button 56a is selected from the menu. The menu includes the bookmark addition button (bookmark addition button) 56b, the print button 56c, the copy button 56d, the cancel button 56e, and the like, and various commands are prepared in a pull-down menu (not shown). Yes. When a plurality of charts are created for the patient, buttons for displaying the previous chart and the next chart and buttons for displaying the first or last chart are also arranged as buttons 57. Yes.
[0035]
Here, the data linkage performed between the medical chart screen 51 and the medical treatment plan screen 41 will be described with reference to FIG.
FIG. 10 schematically shows a process in which when the doctor determines that the examination is necessary as a result of examining the patient and the fact is described in the medical record 54, the contents are reflected in the medical treatment plan table 44 as the medical treatment display 46. It shows.
When the doctor creates the medical chart 54 on the medical chart screen 51 (see FIG. 9), the creating means 11 creates medical practice data 61 including position data 61a, content data 61b, period data 61c, and attached data 61d. When the information about the internal medicine is input to the prescription of the medical record 54, the prescription date (medical treatment date) is stored as the position data 61a, and the period data 61c indicates that the internal medicine is “for 7 days”. 7 days from now. Data indicating “internal use” is stored in the content data 61b, and data indicating “three times” is stored in the attached data 61d. Then, an object 47 created based on the medical practice data 61 is displayed in the medical plan table 44. That is, the text 47a displays the data stored in the content data 61b. The bar 47b is composed of a first portion 47c arranged at three locations per day based on the attached data 61d and a second portion 47d connecting between the first portion 47c and the period data 61c from the start point indicated by the position data 61a. It will be the length of 7 days shown.
[0036]
In addition to taking medicine, the contents of prescriptions such as examination and surgery, the date and time of medical treatment, the date and time of the next medical appointment, and the explanation of the medical condition are also reflected in the medical treatment plan table 44 from the medical record 54. In the case of examination contents and examination date, a medical practice display 46 is created by attaching the examination contents text 46a to the bar 46d indicating that the examination has been performed, and the examination item and the cell specified by the examination date (date) are displayed. The medical practice display 46 is embedded and displayed. When the inspection has been performed, the bar 46b indicating that the inspection has been performed is selected. In addition, if it is described in the medical record 54 that the medical condition has been explained, a medical practice display with a text “Dr The medical treatment display is embedded in the specified cell and displayed.
[0037]
As described above, the medical assistance system 1 displays a list of information created in the past as an index and displays a table of medical treatment plans side by side when performing a medical examination of a patient. When an index is selected, the necessary medical records are displayed side by side with the index screen. The necessary information can be easily accessed and confirmed. Thereby, it becomes possible to perform a medical treatment to a patient efficiently. At this time, since the medical treatment plan table is automatically updated by creating a medical chart, the latest medical treatment plan can always be confirmed. Further, by using the medical practice display 46, which is a display of the medical practice, it is possible to easily grasp the date, content, and progress of the practice. By changing the form of the bars 46b, 46c, 46d, and 47b, which are displays about the medical practice, in accordance with the medical practice and its progress, the contents and progress can be easily grasped. In particular, the bar 47b as a display indicating a medical practice is composed of a first part 47c where the medical practice is performed and a second part 47d indicating a period during which the effect is sustained, so that the administration time of the medicine, etc. Confirmation can be performed reliably.
[0038]
Although the chart screen 51 provided in the chart creation in step S5 is displayed on the display means 21 in parallel with the index screen 31, it may be displayed so as to partially overlap the index screen 31 and the medical plan. The screen 41 may be switched and displayed. Further, after the patient is selected in step S2, the medical treatment plan screen 41 in step S4 may be displayed before the index screen 31 in step S3 is displayed. Further, the index screen 31 and the medical chart screen 51 may be displayed side by side when the index screen 31 is displayed, or the medical care plan screen 51 may be displayed side by side when the medical care plan screen 31 is displayed. Furthermore, the medical chart screen 51, the index screen 31, and the medical treatment plan screen 41 may be displayed simultaneously. When the three screens 31, 41, 51 are displayed side by side at the same time, access to more information is facilitated, so that it is possible to further improve the efficiency of medical care.
[0039]
In addition, when an “not yet performed” tab is prepared on the index screen 31 and there is an index that is listed as not yet performed, a medical activity display bar corresponding to the medical activity is displayed in red on the medical plan screen 51. It is desirable to display the displayed medical practice display in a form that calls attention. Such a display contributes to prevention of a medical practice that has not been performed and quick response.
[0040]
(Second embodiment)
A second embodiment of the present invention will be described in detail with reference to the drawings. In addition, the description which overlaps with said 1st embodiment is abbreviate | omitted.
In this embodiment, the medical support system that displays a patient selection screen, an index screen, a medical plan screen, and a medical chart screen according to each step in FIG. It is characterized by the fact that the information can be browsed.
[0041]
When the chart 54 schematically shown in FIG. 11 is created, the creating unit 11 creates the medical practice data 62 and creates the medical treatment plan table 44 based on the medical practice data 62. The medical practice data 62 at this time is composed of position data 61a, content data 61b, period data 61c, attached data 61d, and medical chart data 61e which is information for specifying the medical chart 54. The chart data 61e includes a combination of the date of examination and patient data, and an identification code assigned to each chart 54 by the medical care support system 1.
[0042]
The medical practice display 63 created from the medical practice data 62 and displayed on the medical treatment plan table 44 is composed of text 63a and a bar 63b indicating the contents of the medical examination. When this medical practice action display 63 is clicked with the mouse, the chart data 61e of the medical practice data 62 is transferred to the extracting means 12. The extraction unit 12 searches the patient database 14 to extract the data of the corresponding chart 54 and displays it on the chart screen 51 via the creation unit 11. Therefore, by clicking the medical practice display 63, it is possible to immediately confirm the situation at the time of determination, such as the basis of the medical practice displayed in the medical treatment plan table 44.
[0043]
It should be noted that when the mouse pointer is over a specific medical practice display, simple information such as the name of the medicine and the date of examination may be displayed as a pop-up screen. Alternatively, when the mouse is double-clicked, the corresponding chart 54 is displayed, and when the mouse is single-clicked, simple information can be displayed.
[0044]
(Third embodiment)
A third embodiment of the present invention will be described in detail with reference to the drawings. FIG. 12 is a diagram showing the configuration of the medical assistance system in the present embodiment. 13, FIG. 14, and FIG. 16 are diagrams showing examples of screen display, and FIG. 15 is a diagram schematically showing the structure of medical practice data. In the following description, the description overlapping with the first and second embodiments will be omitted.
This embodiment is characterized in that appointments such as examinations can be easily made in a medical assistance system that displays a patient selection screen, an index screen, a medical treatment planning screen, and a medical chart screen. For this reason, as shown in FIG. 12, the medical assistance system 71 includes a plurality of medical assistance devices 6, a server 72 that is a computer that performs schedule management such as surgery, and a computer terminal 73 such as an operating room in a medical institution. It is constructed by connecting to the network 74.
[0045]
When the chart 54 is created on the chart screen 51 of FIG. 9, the creation unit 11 creates medical practice data (not shown) and creates a medical treatment plan table 44 based on the medical practice data. At this time, when the medical practice data includes information for instructing the operation or examination, the medical assistance device 6 acquires the reservation status of the operating room and the examination apparatus from the server 72 via the network 74. Then, a reservation table 75 as shown in FIG. 13 is created. The created reservation table 75 is displayed so as to overlap the medical treatment plan table 44. 13 schematically shows an item display field 42, a date display field 43, and medical practice displays 78, 79, and 80, and has the form shown in FIG. 8 in detail. Shall.
[0046]
The reservation table 75 is a table in which cells 76 and 77 specified by items such as surgery and examination and date are arranged, and the cells 76 corresponding to days when the operating room cannot be used are processed in a dark color and used. The cells 77 corresponding to the possible days are painted lightly or only framed. Items and dates that are the same as the items in the item display column 42 and the date display column 43 of the medical treatment plan table 44 are selected. Therefore, when the reservation table 75 is displayed over the medical treatment plan table 44, as shown in FIG. 14, the medical action indications 78 and 79 whose contents can be clearly confirmed and the contents hidden behind the cell 76 of the reservation table 75 are displayed. It is classified into the medical practice display 80 that cannot be confirmed at all or is difficult to see. Using such a reservation table 75, reservations can be made for the medical treatment indications 78 and 79 whose contents can be clearly confirmed, but it is immediately confirmed that no reservation can be made for the medical treatment indication 80 overlapping the cell 76 of the reservation table 75. it can. In the reservation table 75 of FIG. 14, the reservation status can be confirmed for each day, but one cell 76, 77 is divided into a plurality of times, and the day is divided into two time zones of morning and afternoon. The reservation status can be confirmed, or the reservation status can be confirmed in more detailed time zones.
[0047]
If it is necessary to change the schedule as a result of checking the reservation status in this way, it is possible to return to the chart screen 51 (see FIG. 9 etc.) and change the operation date or examination date. It is also possible to change the plan screen 41. This process will be described below by taking as an example the case of changing the operation date.
[0048]
The medical practice indications 78, 79, and 80 shown in FIG. 14 schematically show the display areas, but actually, as shown in FIG. 15, they are composed of text and bars indicating the contents. That is, the medical practice display 80 includes a text 80a indicating the operation that is the content of the medical practice, and a bar 80b indicating a period required for the surgery. The medical practice display 78 includes a text 78a indicating an examination that is the content of the medical practice, and a bar 78b indicating a period required for the examination. The medical practice display 79 includes a text 79a indicating medication and a bar 79b indicating the timing of medication or the duration of medication and the duration of its effect. In addition, as shown in the corresponding medical practice data 85, 87, and 84, the medical practice displays 78, 79, and 80 include position data 61a, content data 61b, period data 61c, attached data 61d, and medical record data as necessary. 61e (the same applies to the chart data 61e hereinafter). The position data 61 a includes coordinate data indicating a position in the medical treatment plan table 44. Other data (child item pointer 84 and the like) shown in FIG. 15 will be described later.
[0049]
The medical practice displays 78, 79, and 80 shown in FIG. 14 can be moved by dragging with the mouse, and the creation means 11 updates the coordinate data as the medical practice displays 78, 79, and 80 are moved, The medical practice display 78, 79, 80 is displayed at the position. In FIG. 14, since the surgical practice display 80 overlaps the cell 76 indicating that an appointment cannot be made, it can be seen that the surgery cannot be performed on this day. The next day (4/15) is reserved, so if the medical practice display 80 is moved, surgery can be performed. In addition, although the examination medical treatment display 78 can be reserved without being changed, it can be moved the day before. However, it cannot be moved the next day. Then, it can be seen that the medication schedule may be the initial setting day or the day before and after it.
[0050]
Here, when performing an operation, it is often necessary to perform an examination or medication in advance. As such a case, for example, in order to perform an operation, it is necessary to perform an examination by the previous day, but the examination needs to be administered to a patient several hours before that. For this reason, when the operation schedule is changed, it is necessary to consider whether or not the related medical practice is changed. In order to perform such examination easily, in this embodiment, a specific medical practice display 80 such as surgery is associated with medical treatment displays 78 and 79 of related treatments and other medical practice displays (not shown), A hierarchical structure is formed. An example of a hierarchical structure for performing such association is shown in FIG.
[0051]
The surgical practice display 80 is created based on the surgical practice data 84. The medical practice data 84 is in addition to the data 61a, 61b, 61c, 61d, 61e described above, such as position and content. Further, it has child item pointers 84a and 84b for associating the medical practice data 85 of the examination and the medical practice data 86 of the medicine to be administered as child items. In the child item pointer 84a, the position of the medical practice data 85 of the medical practice display 78 to be associated is stored as a pointer, and in the child item pointer 84b, the position of the medical practice data 86 of the medicine performed in association with the operation is used as a pointer. Stored.
[0052]
The medical practice data 85 of the examination is data for creating the medical practice display 78, and data about the positions 61a, 61b, 61c, 61d, 61e, the tolerance data 85a, and the medical practice display 78 of the examination. And item pointers 85b and 85c. The allowable range data 85a is data indicating the allowable range of the time interval from the operation to the examination. The allowable range is set in order to prevent the time interval from being too empty or too narrow in order to effectively use the inspection result. A similar data structure is used for the medical practice data 86 of the medicine for the operation.
[0053]
The medical practice data 87 associated with the medical examination display 78 of the examination is data for creating the medical practice display 79 of the medicine, such as position data 61a, 61b, 61c, 61d, 61e, and allowable range data. 87a, and child item pointers 87b and 87c associated with the medical practice display 79. The permissible range data 87a here is data that gives a time interval such as how many hours before medication should be performed prior to the examination. The child item pointer indicates the pointer of the medical practice data of such processing when there is a treatment to be performed prior to the medication.
The dietary restriction medical practice data 88 associated with the examination medical practice data 85 gives an instruction such as fasting before the examination, and has the same configuration as other medical practice data.
[0054]
Such a hierarchical structure is created according to the above-described clinical path, and is created by the creating unit 11 and then registered in the path database 15 of the storage device 5 by the registering unit 13. The hierarchical structure in FIG. 15 is an example, and three or more medical practice data may be associated with one medical practice data, or medical practice data may be associated with four or more hierarchies. .
[0055]
When the surgical practice action display 80 moves to a reservable date and time, the creation means 11 acquires the medical practice data specified by the child item pointer read for the surgery. Then, the position data of the medical practice display 78 for the examination is examined, and the time difference (or the number of days difference) from the date and time obtained from the position of the medical practice display 80 of the operation after movement is calculated. If this time difference is within the allowable range defined in the allowable range data, the medical practice display 78 of the examination is kept as it is. On the other hand, for example, when the time difference is outside the allowable range, a display or sound for calling attention is output. On the other hand, the medical worker moves the examination action display 78 of the examination according to the reservation table 75 (see FIG. 13). If the time difference after the movement is within the allowable range, the time is accepted, and the process moves to processing for other items in the hierarchy and items in the lower hierarchy. If the time difference is outside the allowable range even after moving the examination action display 78 of the examination, the user is alerted again. Thereafter, the same processing is performed for the other items, and the items are arranged in the order and time intervals in which all related medical treatment indications are required.
[0056]
The reservation confirmation means 81 shown in FIG. 12 has the position of all the medical treatment indications rearranged in relation to the operation, the information on the vacant time zone and the timing of medication, It is determined that reservation is possible, and the reservation button 82 provided on the medical treatment plan screen 41 shown in FIG. 14 is activated. If even one does not meet the schedule, the reservation button 82 is not clicked. When the medical staff clicks the active reservation button 82, the operation reservation data and the examination reservation data are collectively transmitted to the management server 72. In the server 72, each reservation is made, and if necessary, the reservation status is transmitted to the computer terminal 73 in the operating room or the computer terminal 73 in the examination room and notified to the technician and other staff. Thereafter, when the medical assistance device 2 makes a reservation for surgery or examination, the time zone is processed as reserved.
[0057]
In this way, it is possible to support the doctor's judgment and improve the efficiency of the medical practice by making it possible to make a reservation and change the medical care plan accompanying it on the medical care plan screen 41. For example, it is possible to immediately confirm whether or not a reservation can be made by using the reservation table 75, and it is also possible to check the date and time when the reservation can be changed. In particular, even if there is a need to negotiate across multiple clinical items and administrative departments, such as appointments for surgery and the accompanying examinations, it is possible to make appointments in a single screen, so medical professionals Work efficiency can be improved. Moreover, even if the same medicine is used, there are a case where the patient is dosed in conjunction with the operation date or the like, and a case where the drug is continued without being linked, but the dose linked with the operation date can be easily confirmed.
[0058]
Here, the reservation table 75 is displayed so as to overlap the medical care plan table 44, but the color and pattern of the cells of the medical care plan table 44 may be changed in accordance with the reservation situation.
In addition, the medical action display is moved one by one. However, when one medical action display is moved, other medical action display associated with the child item pointer may be automatically moved. good. In this case, for the medical treatment display of the child item, the permissible range data is acquired, matching processing with the reservation table 75 is performed within this range, and the medical treatment display of the child item is arranged and displayed in a movable place. Similarly, it moves so that it may fall within the time interval shown by the tolerance | permissible_range data defined in each medical treatment display data about another medical treatment display. If there is at least one medical practice display that cannot be moved to a reservationable range, a warning is issued and the medical practice display that cannot be reserved is displayed in an identifiable manner.
[0059]
Furthermore, as shown in FIG. 16, the reservation table 75 can be displayed as the reservation screen 85 independently of the medical treatment plan screen 41. The reservation screen 85 in this case is a screen including a reservation status table created for the same item 90 and date 91 as the item display unit 42 and date display unit 43 of the medical treatment plan table 44. In this case, in addition to the above-described shading, presence / absence of color, etc., each cell may indicate whether reservation is possible by a symbol such as “O” and “X” or text such as “Yes” and “No”. good.
[0060]
The present invention is not limited to the above embodiments and can be widely applied.
For example, in the case where a medical plan for a single patient is created by a plurality of doctors, an approval button and a display field for displaying the name of the doctor who selected the approval button and an abbreviation identifying the doctor are displayed on the medical plan screen of FIG. It may be possible to check whether all doctors in charge have approved the medical treatment plan.
[0061]
In addition, an access right may be set for the operation on the medical plan screen, and items that can be input or modified by the doctor, items that can be input only by the nurse, and the like may be provided. As an example of this, doctors can access and input all information, but nurses can only change the bar for displaying medical treatments such as medications and explanations from not performed to performed. Can be given. In order to realize this processing, a database of medical workers is created in the medical assistance device 6 in which information (ID number or the like) for identifying the person and the access right are associated with the name of the medical worker. Then, at least one of the screens 21, 31, 41, 51, or another login screen is provided with an input field for inputting specific information such as an ID number, and the medical staff who has been matched by searching the database On the other hand, an operation based on the registered access right may be made possible.
[0062]
【The invention's effect】
According to the present invention, Since each data of the medical plan table and appointment table can be displayed on the same screen so that they can be distinguished, it is immediately confirmed whether or not an appointment can be made. Can Be able to become.
[Brief description of the drawings]
FIG. 1 is a diagram showing a configuration of a medical assistance system in an embodiment of the present invention.
FIG. 2 is a flowchart showing an example of processing of a medical assistance system.
FIG. 3 is a diagram illustrating an example of a patient selection screen.
FIG. 4 is a diagram illustrating a state in which an index screen and a medical treatment plan screen are displayed side by side.
FIG. 5 is a diagram illustrating an example of an index screen.
6A is a diagram showing another display form of the index screen, and FIG. 6B is a diagram for explaining the operation.
7A is a view showing another display form of the index screen and a chart screen, and FIG. 7B is a view for explaining the result of the operation.
FIG. 8 is a diagram illustrating an example of a medical treatment plan screen.
FIG. 9 is a diagram showing a state in which an index screen and a medical record screen are displayed side by side.
FIG. 10 is a diagram for explaining association between a medical record and a medical treatment plan table;
FIG. 11 is a diagram for explaining association between a medical record and a medical treatment plan table;
FIG. 12 is a diagram showing a configuration of a medical assistance system in an embodiment of the present invention.
FIG. 13 is a diagram illustrating a screen configuration when a medical treatment plan table and a reservation table are displayed in an overlapping manner.
FIG. 14 is a diagram showing a screen on which a medical treatment plan table and a reservation table are displayed in an overlapping manner.
FIG. 15 is a diagram illustrating a case where a hierarchical structure is formed with data displayed in a medical treatment plan table.
FIG. 16 is a diagram illustrating a state in which a medical treatment plan screen and a reservation screen are displayed side by side.
[Explanation of symbols]
1 Clinical support system
2 Display means
3 Control device
4 input means
5 storage devices
6 medical assistance devices
21 Patient selection screen
31 Index screen
41 Medical plan screen
46 Clinical practice display
46b, 46c, 46d bar
47 Clinical practice display
47c first part
47d second part
51 chart screen
78, 79, 80 Medical practice display

Claims (5)

  1. A medical assistance system for supporting scheduling of one medical practice performed by a medical worker on a patient and another medical practice performed before and after the implementation of the one medical practice,
    A control device, a storage device, a display device, a diagnosis supporting device for chromatic and an input device,
    The medical assistance device is composed of a server capable of communicating via a network,
    The storage device stores patient information that records the contents of a medical record for each patient,
    The server manages reservation data of a room or device used for the medical practice,
    When the medical worker selects a patient to be treated from the patient selection screen displayed on the display device using the input device,
    The controller is
    From the storage device, the selected medical care date recorded in the chart of the patient, to extract the items of time and intervention required for the treatment of medical treatment as medical treatment information,
    In a medical treatment plan table having an array of cells partitioned by date and the item of the medical practice, a text display for displaying the contents of the item of the medical practice, and a start date and a period related to the treatment of the medical practice When displaying a medical practice display consisting of a bar display
    Based on the extracted medical practice information, position data relating to the medical day including coordinate data indicating a display position in the medical care plan table, period data relating to a period required for treatment of the medical practice, and the medical practice Create medical practice data with content data related to the contents of
    Based on the position data and the period data stored in the medical practice data, identify a cell in the medical treatment plan table for displaying the medical practice display, and display the content data at a text display position, By creating the medical treatment display by displaying the period data at the bar display position ,
    A cell which is defined by the date an item of intervention when you create a reservation table which are arranged in the same sequence and the medical plan table,
    Reservation table to enable identifying the cell of the cell day reservation accepted reservation whether day based on the use in intervention acquires reservation status information about the room or device from the server, the acquired reservation status information Create
    The created medical treatment plan table and the reservation table are displayed on the same screen of the display device in an overlapping manner or in parallel,
    Depending on the medical personnel of operation via the entering-force device, when the moving operation of the intervention display displayed on the display device between cells,
    The coordinate data of the position data is updated in accordance with the movement of the medical practice display, and the medical practice display is displayed in a cell corresponding to the position of the updated coordinate data,
    Check the availability of the reservation displayed in the cell in the reservation table of the same medical practice item on the same date as the cell corresponding to the position of the updated coordinate data, and the date that all the updated cells can be reserved If the reservation is confirmed in conformity with the information, the confirmed reservation status information is transmitted to the server, and a medical record is created based on the updated medical practice display ,
    A medical support system characterized by
  2. The controller is
    Information relating to the medical treatment plan table and information relating to the medical practice recorded as the medical chart are associated with each other and stored in the storage device,
    Based on the information representing the correspondence relationship stored in the storage device, causing the display device to display an index screen indicating the mutual correspondence relationship;
    The medical support system according to claim 1, wherein:
  3. A medical support method for supporting, by a computer, one medical action performed by a medical worker on a patient and scheduling for each other medical action performed before and after the execution of the one medical action,
    The computer has a control device, a storage device, a display device, and an input device,
    The computer is connected to a server capable of communicating via a network ;
    The storage device stores patient information that records the contents of a medical record for each patient,
    The server manages reservation data of a room or device used for the medical practice,
    When the medical worker selects a patient to be treated from the patient selection screen displayed on the display device using the input device,
    The controller is
    From the storage device, the selected medical care date recorded in the chart of the patient, to extract the items of time and intervention required for the treatment of medical treatment as medical treatment information,
    In the medical plan table that have the array of cells that are defined by the date and the items of the intervention, and text display to display the contents of the items of the intervention, the start date and duration of the treatment of the intervention When displaying a medical practice display consisting of a bar display representing
    Based on the extracted medical practice information, position data relating to the medical day including coordinate data indicating a display position in the medical care plan table, period data relating to a period required for treatment of the medical practice, and the medical practice Create medical practice data with content data related to the contents of
    Based on the position data and the period data stored in the medical practice data, identify a cell in the medical treatment plan table for displaying the medical practice display, and display the content data at a text display position, By creating the medical treatment display by displaying the period data at the bar display position ,
    A cell which is defined by the date and the item of intervention when you create a reservation table which are arranged in the same sequence and the medical plan table,
    Reservation table to enable identifying the cell of the cell day reservation accepted reservation whether day based on the use in intervention acquires reservation status information about the room or device from the server, the acquired reservation status information Create
    The created medical treatment plan table and the reservation table are displayed on the same screen of the display device in an overlapping manner or in parallel,
    In response to the operation of the medical staff via the input device , when moving the medical treatment display displayed on the display device between cells ,
    The coordinate data of the position data is updated in accordance with the movement of the medical practice display, and the medical practice display is displayed in a cell corresponding to the position of the updated coordinate data,
    Check the availability of the reservation displayed in the cell in the reservation table of the same medical practice item on the same date as the cell corresponding to the position of the updated coordinate data, and the date that all the updated cells can be reserved If the reservation is confirmed in conformity with the process, the confirmed reservation status information is transmitted to the server, and a chart is created based on the updated medical practice display ,
    A medical support method characterized by executing
  4. The controller is
    Information relating to the medical treatment plan table and information relating to the medical practice recorded as the medical chart are associated with each other and stored in the storage device,
    A process of causing the display device to display an index screen indicating the mutual correspondence based on the information representing the correspondence stored in the storage device;
    The medical support method according to claim 3 , wherein:
  5. A medical support program for causing a computer to execute the medical support method according to claim 3 or 4 .
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