JP4627218B2 - Medical information management system - Google Patents

Description

  The present invention relates to a medical information system that manages medical information as electronic data.

A medical information management system that manages electronic medical information such as an electronic medical record on a network is known. In such a medical information management system, information necessary for diagnosis such as medical charts, medical images, interpretation reports, and examination results is digitized and stored in an integrated manner, and necessary information is displayed on a screen by a predetermined operation. A technique is known (for example, Patent Document 1).
Japanese Patent Laid-Open No. 10-97582

  In such a medical information management system, not only can various kinds of information as described above be called up with a simple operation, but also a task (posting) of pasting acquired examination data such as an image on an electronic medical record can be done with a simple operation. It is hoped that. Furthermore, it is necessary to carry out inspection data to be pasted in such a transfer operation without confusion.

  The present invention provides a medical information management system capable of transferring examination data with a simple operation in view of the above-described problems of the prior art, and a medical information management system capable of suppressing mistakes in examination data to be pasted in a transcription operation. The technical challenge is to provide

In order to solve the above problems, the present invention is characterized by having the following configuration.
(1) Perform a transfer operation for transferring the examination data to the electronic medical record based on an examination screen for obtaining examination data of the patient and a trigger signal for saving the examination data obtained on the examination screen. A medical information management system for managing medical information as electronic data, wherein the medical data corresponding to the examination data is transferred to the electronic medical record by the transcription operation control means. Name display control means for displaying an action name on the electronic medical chart, the name display control means when the left and right fundus examination images or visual field examination images of the same patient are acquired at different timing on the same day The medical practice name displayed on the basis of the examination of one eye that has been transferred to the medical record is the same as the examination data for the other eye. By being transcribed, the medical action name corresponding to both eyes is changed and displayed on the electronic medical record .

  According to the present invention, inspection data can be transferred by a simple operation. In addition, it is possible to suppress mistakes in inspection data to be pasted in the transfer operation.

  Embodiments of the medical information management system of the present invention will be described below with reference to the drawings. FIG. 1 is a diagram showing an outline of a medical information management system. The medical information management system according to the embodiment of the present invention digitizes medical information and collectively manages it by a server, and is constructed by a hospital LAN. Reference numeral 10 denotes a management server, and 11 denotes a server body. Reference numeral 12 denotes a CPU mounted on the server main body 11, which is responsible for main arithmetic processing of the medical information management system. Reference numeral 13 denotes a hard disk mounted on the server, which stores all system data and all medical information data. All of these data are centrally managed by the management server 10. Each client connected to the management server 10 described later only displays data. A program 14 stored in the hard disk 13 integrates and controls the medical information management system.

  A client 20 is connected to the management server 10 via the hub 15. The client 20 includes the following. A reception client that performs procedures such as reception of patients who come to the hospital, an inspection client that manages patient inspection data, and a diagnostic client that describes, manages, and browses medical records. It is an accounting client that calculates medical expenses for patients who have been examined and makes appointments for the next examination. In practice, the reception client and the accounting client may be shared.

  Each client 20 is connected to the management server 10 and has a personal computer (hereinafter abbreviated as PC) for managing and browsing patient information and the like in the main body. Such a generally used PC can be used as a medical information processing apparatus. A monitor 22 is connected to the PC 21 and displays various work screens to be described later. Reference numerals 23 and 24 are input means connected to the PC 21, 23 is a keyboard, and 24 is a mouse. A LAN cable 25 connects the management server 10 and each client 20 via the hub 15 to form a network. A control unit 21a is built in the PC 21 and controls the execution of the program of the system, various processes (determination, storage, calling, etc.), display, and the like, and includes a CPU, a memory, and the like. A hard disk 21b is built in the PC 21 and stores programs, data, and the like of this system. The control means 21a and the hard disk 21b are also prepared in the PCs 21 of other clients. These programs cooperate with the management server 10 to construct a server / client system as if the medical information stored in the management server 10 is virtually managed, viewed, and changed on the PC 21.

  In the inspection client, the PC 21 is connected to various inspection devices, and patient inspection data obtained by the inspection device is stored in the hard disk 21b. As the inspection device, for example, a fundus photograph of the eye to be examined is taken by the fundus camera 30. Data obtained by the inspection device is sent to the hard disk 13 of the management server 10 via the PC 21.

  Reference numeral 24 a in the examination client is another monitor connected to the PC 21. If the PC is compatible with dual monitor display, two monitors can be used simultaneously on one PC. Dual monitor display refers to display of different information on each monitor. For example, a chart screen can be displayed on the monitor 24, an inspection screen can be displayed on the monitor 24a, and a chart screen and an informed consent screen can be displayed on each monitor. Furthermore, the same screen can be displayed on each monitor, or the same screen can be divided and displayed on each monitor.

  In the above description, the server and the client are connected by the LAN cable, and the medical information management system is constructed by the LAN. However, the present invention is not limited to this. You may build by WAN. For example, hospitals may be connected via an internet line and used for centralized medical information management and telemedicine between hospitals. Further, the LAN does not have to be limited to the connection by the LAN cable. A wireless LAN using radio waves that do not affect medical devices, for example, a wireless LAN using PHS, may be constructed and used.

  Next, the screen configuration of the medical information management system according to the embodiment of the present invention will be described in order. The medical information management system described below is operated by moving the cursor displayed on each work screen with a pointing device such as a mouse and selecting (clicking) a button or icon on the screen. Similarly, the cursor is moved, an input field is selected, and characters and codes are input and operated by a character input device such as a keyboard.

  FIG. 2 is a diagram showing an authority setting screen (maintenance screen) for setting access authorities for a plurality of authority groups in the medical information management system. Start the setting program for the medical information management system. In FIG. 2A, 100 is a master maintenance window for performing maintenance of the medical information management system of the present embodiment. Each department, room and their correspondence, user group, authority level of each individual, and authentication information of each user (Login name, password, etc.) can be set using this window. As shown in the figure, setting items such as departments and rooms are suspended in a tree display 101 in the window 100. For example, when it is desired to newly register a department from the tree display 101, the department can be set by operating the mouse 24 to move the cursor displayed on the screen and selecting “department”. A possible department setting window 120 can be opened on the screen. In this way, departments that are a plurality of first authority groups are set.

  In the department setting window 120, a plurality of departments in hospitals such as medical departments such as ophthalmology, internal medicine, otolaryngology, medical affairs, and pharmacies are prepared in advance, and various button icons ( Add necessary departments using Add, Update, Delete, etc.). Similarly, when “room” is selected from the tree display 101, a room setting window (not shown) is displayed, and various rooms can be newly registered. As the room, for example, a reception, a doctor's room, an examination room, and accounting are prepared. In this way, a plurality of rooms that are second authority groups that are positioned lower than the department that is the first authority group are set.

  Next, the department and room set above are associated. Similar to the setting method described above, when “Department / Room Association” is selected from the tree display 101, a Department / Room Association window (not shown) is displayed. In this window, the previously set department and room lists are displayed. Select the room you want to register for each department with the mouse 24, and confirm the registration of the association using the button icons (add, delete, etc.) Let Examples of the association include an association of an examination room, an examination room, a dark room, and the like to a department called ophthalmology, and an example of associating reception and accounting with a department called medical affairs. In this way, the department that is the first authority group is associated with the room that is the second authority group.

  Next, when “user group” in the tree display 101 is selected, a user group setting window (not shown) is activated. The user group name (classification) and its authority can be set in the same manner as the above-mentioned department setting. FIG. 2B is a table showing the authority set by a user group setting window (not shown) and the authority of each user group for the work screen (acceptance screen, examination screen, examination screen, etc.) of this system. In FIG. 2B, “◯” indicates that reading and writing are possible, “Δ” indicates that only reference is possible, and “X” indicates that access is not possible.

  In the present embodiment, as shown in the figure, when the name of the user group is “doctor”, the setting is such that reading and writing can be performed on the chart creation screen and the examination screen. Further, when the name of the user group is “doctor (diagnosis)”, the user group is set such that reading / writing is possible on the chart creation screen and access to the examination screen is not allowed.

  Such a setting is not limited to a doctor, and the user authority of the system can be arbitrarily set by adding the name of the user group as necessary and setting the corresponding authority for each user group. The authority on the work screen is changed by clicking each item to change the authority state of the item. Alternatively, a pull-down menu may be provided for each item, and a change method for selecting authority may be used.

  After confirming the association between departments and rooms and the user group, user registration and authority setting are performed. When “staff” is selected in the tree display 101, a staff (user) setting screen 130 is activated. Each staff member's name, login name, and password are registered using the registration field 131. In the staff type column 132, a preset staff type is selected from a pull-down menu. The staff type is an item for facilitating the classification later, unlike the user group previously set. Reference numeral 133 denotes a user group selection column described above. Select a user group from the pull-down menu. These settings are registered by pressing button icons (confirm, apply, cancel, etc.). Thereby, the authority on a system can be finely allocated for every user. For example, even if it is a “doctor” on the user group, the authority of examination can be limited by setting, so that a doctor who can use the examination room and a doctor who cannot use the examination room can be registered separately.

  The association between the department and room and the user group is performed by a department / room setting window (not shown) displayed by selecting a department / room setting item 102 formed in the tree display 101. In this window, a list of previously registered user groups and associated departments / rooms are displayed. Select the user group you want to set from the list of user groups, select the combination of department and room you want to correspond from the list of departments / rooms, edit the registration list with button icons (addition, deletion, etc.) not shown, Further, the corresponding setting is confirmed by a button icon (save, cancel, apply, etc.) not shown. As an example of correspondence, for example, the user group “doctor” may correspond to the room “examination room” in the department “ophthalmology” and the room “dark room” in the department “ophthalmology”. Through the operations described above, the authority of the department or room is added to each individual (user) and registered in the medical information management system.

  As a result, the authority granted by the user group can be restricted for each department / room. For example, when a certain user is registered as “doctor” as the staff type, “ophthalmology” as the department, “exam room” and “dark room” as the room, even if the user is a doctor, It is not possible to write just by referring to the chart of "". Full access (read / write) is possible only to the ophthalmic chart, and only the examination room and the dark room have the authority to log in (described later). Conventionally, any user who has the authority of a doctor can have full access to a patient's chart in any department, but according to the present invention, the authority is limited even in departments and rooms. Personal information, such as medical records, is never edited and the security of the system is improved.

  Moreover, even if the doctor belongs to the same department, a difference is added to the access level to the laboratory, so that the laboratory is not used unnecessarily. For example, if two doctors belong to both ophthalmology and internal medicine, one doctor can access both the ophthalmology and internal medicine laboratories, while the other doctor can access only the internal medicine laboratory. It can be set to be inaccessible to the laboratory. The same applies to access to the medical chart, and even a doctor who belongs to the same department can set whether the authority of the medical chart is readable / writable or only for reference.

  As explained above, in addition to detailed authority settings for each type of staff such as doctors and nurses by assigning authority to each user in “user group” and assigning “department” and “room” Permission can be set for each department or room. This improves the security level of the medical information management system by finely restricting the browsing of personal information such as medical records.

  Next, each work screen configuration used in the medical information male management system will be described. FIG. 3 shows a login screen. Using this login screen, each user enters a login name (user name, user ID or account) and password, and logs in to use the system functions. FIG. 3 shows a login screen. Reference numeral 200 denotes a login window. Reference numeral 201 denotes an input field for inputting a login name and a password. 202 is a selection column for selecting a department and 203 for a room from each pull-down menu. In the selection columns 202 and 203, only preset accessable authority groups are displayed so as to be selectable. The control is performed by the control means 21a. In other words, only users registered in advance by the system settings described above can log in.

  FIG. 3A shows a screen for inputting a login name in login. As shown in the figure, if only the login name is entered in the input field 201, the selection fields 202 and 203 are inactive and do not accept an operation. Here, as shown in FIG. 3B, when the registered login name and password are entered in the input field 201, the selection fields 202 and 203 are active for accepting operations as shown in FIG. 3B. It becomes possible to select the department and room previously set for each user from the pull-down menu. That is, only authority groups that can be accessed by inputting authentication information such as a login name and a password are displayed in a selectable manner.

  For the choice of department and room, only the items registered in the correspondence between the user group and department / room in the system settings described above are displayed. For example, in the user group “doctor”, when the department and room corresponding to the user group “ophthalmology” are the room “examination room” and the department “ophthalmology” is the room “dark room”, the selection field 202 is displayed at the time of login. Only ophthalmology is displayed, and only the examination room and the dark room are displayed in the selection column 203.

  By taking such a configuration of the login screen, it is possible to easily select a department or a room to log in. In addition, since only the department and room that can be logged in are displayed as options, the complexity of selection during login is reduced. Furthermore, since the user cannot log in to a department or room to which the user is not authorized, the security level of the medical information management system is improved.

  Next, the configuration of the reception screen when each department logs in to the medical information management system will be described. When a user having the authority of the department “reception” logs in, a reception window 300 shown in FIG. 4 is activated. Reference numeral 301 denotes a navigator button which is displayed in common with the medical information management system and serves as a launcher in which functions provided for each screen such as reception, examination, examination, and accounting are changed. The work screens such as reception and inspection each have a plurality of display screens, and are switched and displayed by a navigator button or the like. The navigator button 301 on this screen is especially specialized for reception management. Functions such as displaying a patient list can be activated with the click of a button. Display of these work screens and switching of screens by using buttons displayed on the screen, that is, display control is performed by the control means 21a.

  Reference numeral 310 denotes a patient list, and patients for which reception processing has been completed are sequentially registered in the list. In 311, each item of the patient list 310 is displayed. Examples of items include personal information such as patient number, patient name, and age, presence / absence of reservation, patient status indicating the progress of medical practice such as reception, examination, medical examination, accounting, and the like. The patient number is identification information given to each patient when creating the patient chart. A patient information display unit 800 displays identification information and detailed information of the patient selected in the patient list 311. The patient identification information is, for example, name, sex, date of birth, etc., and the detailed information is, for example, the attending physician, the first visit date, the last visit date, etc. The patient information display unit 800 is provided in common at the top of each work screen.

  Reference numeral 312 denotes a patient status indicating the current status of the patient. 313 is a status mark list, and as shown in the figure, the degree of filling of the symbol mark “circle (circle)”, whether the patient's current state is “accepting” or “suspended”, etc. It is easy to understand. For example, the status mark 312a in the column of the patient 311a is a status mark indicating “acceptance” and is in the “diagnosis” column of the patient status 312, so that the medical condition of the patient 312a is determined to be “diagnosis acceptance”. The patient status 312 is also displayed on the examination and examination screens described later. The patient status is centrally managed by the system. For example, when the examination is entered from the reception state, the status is in examination. The patient status being examined is reflected on all the screens that refer to the patient, and the status mark in the examination item of the patient status becomes a graphic representing “under examination”. There are automatic triggers and manual triggers for changing patient status. As the automatic trigger, for example, an operation for saving a medical chart in a medical examination, an operation for saving examination data in an examination, and an allocation can be considered. As the manual trigger, for example, it is possible to change the trigger when the examiner clicks the patient status after performing a visual acuity test in the examination. That is, the trigger assigns an operation for confirming a medical action such as medical examination or examination. The authority to change patient status is limited by the department and room set previously.

  In the above description, the status mark is represented by a circle (circle) figure as a symbol mark, and the status is expressed by the degree of filling of the figure, but the present invention is not limited to this. The symbol mark may be a polygon such as a triangle or a rectangle, an ellipse, or the like. In addition, a change in status due to a symbol mark may be represented by a change in shape or color. For example, it may be a red circle when inspected, a black circle when inspected, a triangle when inspected, and a circle when inspected. Furthermore, it is good also as a graphic which makes it easy to grasp a status mark visually. For example, it is possible to simulate a “waiting” in which a person is sitting on a chair if a medical examination is being accepted, or to simulate a “end” in which only a chair is present and no person is present.

  In this way, the patient status is centrally managed by the system, and by linking each other in each room, the current situation of the patient can be easily grasped from other departments.

  Reference numeral 900 denotes a status icon indicating the medical condition of the patient selected on the reception screen. The status icons 900 are all displayed on the screen relating to medical care such as reception, examination, medical examination, and accounting, and are formed in a part of the above-described patient information display unit 800 to indicate the progress of patient medical care. Based on this, the icon indicates a medical practice that still remains (unfinished yet). Examples of the status icon display include an accounting icon 900a, a medical examination icon 900b, a vision test icon 900c, a mydriatic icon 900d, a fundus imaging icon 900e, and the like. These icons are charts that make it easy to visually grasp the medical practice, for example, “purse” for the accounting icon 900a and “pupil” for the mydriatic icon 900d. When the cursor is placed on or clicked on the status icon 900, the title of the icon is displayed in a pop-up.

  When the medical practice is determined, an icon corresponding to the status icon 900 is displayed. As the medical practice progresses, the status icon 900 is deleted when the medical practice represented by the icon ends. This trigger is the same as in the patient status 312 described above. That is, the status icon 900 is displayed linked to the patient status 312. The status icon 900 is arranged near the patient information display unit 800. For this reason, the remaining medical treatment (patient status) of the patient displayed on the patient information display unit 800 can be easily understood without bothering to look at the patient list 311.

  Note that the status icon 900 may be added during the medical practice. For example, when the medical practice is changed midway, for example, when a reexamination or an additional examination is performed during the examination. In this case, an additional trigger is saving an additional inspection item. In addition, when the mydriatic icon 900d is displayed, a countdown of a time that is a measure of mydriasis is displayed in the patient list 311. When the countdown reaches a predetermined time at which mydriasis will occur, the mydriatic icon 900d blinks, and the display color of the mydriatic changes in the patient list 311 (for example, red), giving the examiner the time. Inform.

  This status icon displays the remainder of the patient's medical situation, so it can be easily seen visually. Further, by displaying the patient status as an icon, the patient status can be known without opening the patient list. In particular, the patient's status can be easily understood even when the medical record or examination data is opened, that is, when the patient list is not opened.

  Reference numeral 910 denotes an information icon that can describe and display additional information of the patient selected on the screen. Examples of the information icon 910 are a patient memo icon 910a, a physical information icon 910b, a first visit date list icon 910c, an allergy other information icon 910d, and a medical history icon 910e. The information icon 910 does not open the first paper or second paper of the patient when a work screen such as a medical record, an examination capture window, etc. is opened at the time of medical treatment, for example, when describing a patient's medical chart or at the time of examination. In both cases, detailed information can be acquired. The information icon 910 is a screen (such as a reception window) on which patient identification information and detailed information are displayed, and additionally displays detailed patient information that is not displayed there. Information information 910 is updated with information from body information icon 910b, allergy and other information icon 910d, etc., from the first paper of the patient chart, and medical history icon 910e first visit date list icon 910c, updated from the second paper. Is done. A doctor, an examiner, or the like arbitrarily writes information in the patient memo icon 910a. When one of the information icons 910 is selected with a cursor or the like, a window in which detailed patient information is described is displayed. Information corresponding to each icon 910a-e is obtained in the window. In addition, infectious disease and contraindication information is added to the allergy other information icon 910d.

  Patient information displayed by the information icon 910 can be written as well as read. As for patient reading and writing, authority is limited to whether reading is possible, reading and writing are both possible, or browsing is not possible, depending on the authority. For example, detailed information can be read and written with the authority of a doctor, laboratory technician, etc., but only with the authority of a nurse. Moreover, it is a restriction that it cannot be viewed with the authority of the administrative staff. This restriction is based on the login authority described above. The display / non-display of the information icon which is patient additional information in the identification information display column is performed based on the authority of the logged-in user (user).

  The information icon 910 has an alert function that can be checked by others depending on the importance of the information. For example, the window displayed by the patient note icon 910a can note any information about the patient, and if the information is important, the cursor can check the important checkboxes in the window. When the memo is saved after checking the check box, the patient memo icon 910a blinks, and it is possible to prompt another person to check the patient memo.

  Such information icons make it easy to share detailed patient information and improve the security of personal information.

  The status icons and information icons described above are preferably arranged close to each other. By being placed nearby, patient status and detailed information can be ascertained simply by looking at a portion of the window.

  In the embodiment described above, the method of calling attention is blinking in the status icon and the information icon, but the present invention is not limited to this. Attention may be urged by reversing the color of the icon or by providing a speaker on the PC to sound an alarm.

  Next, the inspection screen will be described. FIG. 5 is a diagram showing a screen when logging into the examination room. When the user logs in with the authority of the department “inspection”, the inspection window 400 is activated. Reference numeral 401 denotes a navigator button, which is the same as that described above. The navigator button 401 has a configuration specialized for inspection. Reference numeral 410 denotes a patient list, reference numeral 411 denotes each item of the patient list 410, reference numeral 412 denotes a patient status, reference numeral 413 denotes a status mark list, which is the same as 310 to 313 in the reception window 300. 800 is a patient information display section, 900 is a status icon, and 910 is an information icon. These have the same configuration and function as those described above.

  Here, the navigator button 401 will be described. The navigator button 401 of the examination window 400 is provided with a pull-down menu 402 and various buttons 403 whose items are rooms such as a medical office top and a reception top. The various buttons 403 include buttons having launcher functions such as a patient list button 403a and an imaging button 403b. When each room is selected from the pull-down menu 402, a navigator button is set according to each room. For example, when the patient list button 403a is selected with a cursor, the patient list is displayed, and when the imaging button 403b is selected, an imaging screen (capture screen) is displayed.

  Various buttons 403 can be assigned file operation and detailed information display functions according to system settings. For example, it is preferable to assign the function of the toolbar icon 451 to the navigator button 401. In this case, since it is not necessary to display a toolbar icon at the top of the imaging screen described later, the imaging screen can be enlarged to a position where the toolbar icon 451 is located. Further, the function of an icon arranged on the screen such as a toolbar icon is not limited to being added to the navigator button. You can also assign menu functions in the window. Furthermore, in the dual monitor display in the examination room or the like, it is possible to set the navigator buttons so that the primary monitor and the secondary monitor are arranged differently.

  The navigator button 401 is customized on a system setting screen (not shown). Start the navigator button setting window (not shown) for each room such as reception and examination room, select the function to be added to the navigator button on the screen from the list in the window, and add and delete with the add button and delete button not shown If the setting is determined, the setting is saved by a confirmation button not shown.

  In a navigator button having a launcher function that cannot change the conventional button arrangement, the button cannot be customized. Therefore, a function that is not added to the button can only be activated from a toolbar or another icon. However, with such a navigator button setting function, the function of the arranged icon can be moved to a position that does not interfere with the screen, and the screen can be used widely.

  In the examination window, a status icon 900 information icon 910 is formed in the patient information display unit 800, as in the above-described reception screen.

  Reference numeral 440 denotes an examination list, which displays examination items of the selected patient. In the inspection list 440, the inspection name and the quantity thereof are displayed. Examples of examination names include fundus photography and NCT (non-contact intraocular pressure measurement).

  FIG. 6 shows an imaging window 450 that is activated when the “imaging” button of the navigator button 401 in the examination window 400 is selected. In this window, a tool icon 451 is arranged at the bottom of the patient information display unit 800. The tool icon 451 includes icons for performing file operations such as a save icon 451a, a delete icon without a sign, and a print icon. The inspection data is transferred using an operation of clicking the save icon 451a as a trigger (described later).

  On the examination screen, the examination result is captured after examining the patient. For example, a fundus photo is taken by the fundus camera 30 and the image data is taken into the PC 21 of the examination client displaying the examination screen. The taken examination data is transferred to the PC 21 of the examination client on which a medical chart (diagnosis screen) is displayed.

  Next, the configuration of the examination screen (medical chart creation screen) will be described. When a user having the authority of the room “examination room” logs in, an examination window 600 shown in FIG. 7 is activated. Reference numeral 601 denotes a navigator button for examination. 800 is a patient information display section, 900 is a status icon, and 910 is an information icon. These have the same configuration and function as those described above. Reference numeral 640 denotes a medical chart, which includes three screens 641 to 643. 641 is a new chart display, which describes and browses patient information on the day of examination and SOAP (main complaint, physical findings, evaluation, plan). Reference numeral 642 denotes a past medical chart display, which can refer to a patient's past medical chart. Reference numeral 643 denotes a medical history, which displays a date, a finding at that time, a disease name, and the like extracted from a past medical record as a list. In the chart 640, when a past chart is changed, a change history remains, and the display of the change history and display / non-display can be switched by a switch button (not shown) of the navigator button as necessary. The chart 640 switches the display screen by vertical scrolling according to the input of a cursor or a keyboard. The new chart display 641 can scroll past charts by scrolling. The chart 640 displays a graphic that simulates a binder (stopper) of an actual chart so that it can be easily understood visually.

  The medical chart 640 can use not only the layout described above but also other layouts. Only the new chart display 641 can be displayed on the full screen, or the new chart display 641 can be displayed in a spread view. In the spread display, it is possible to obtain a sense of use similar to that of an actual medical record, and it is possible to make the spread page look like a page by using a cursor or the like. The page is turned by the next page button or the previous page button of the navigator button 601. At this time, the binder display 644 makes it easy to visually grasp the spread display of the chart. The patient examination data described in the chart 640 is created by data transfer from the laboratory. An approval system for writing medical records accompanying posting will be described later.

  The entry assist function for describing medical records will be explained. When an unillustrated icon “input assist” is selected from the “menu” of the navigator button 601 on the examination screen, an input template window 700 shown in FIG. 8 is activated. In the window 700, an item icon 701 for selecting an entry item from the SOAP and a description format (where, when, how, etc.) column 702 for describing a medical record are displayed. For example, if “main complaint” is selected from the item icon 701, words suitable for the main complaint are displayed in the description format column as shown in the figure, and options appear for items such as the site, timing, and degree of the main complaint. When an appropriate combination is selected from these, a sentence composed of words combined in the description column 703 is entered. When the text to be entered is determined, the description in the medical chart is confirmed with a button icon (confirmation etc.) in the window 700. This input template function can reduce omissions when filling in the chart.

  Such a template described in the medical chart is also used for determining a prescription drug. When the “SP set selection” button of the navigator button 601 is selected in the examination window 600, an SP set window (not shown) is activated, and a list of prescription drug templates according to the diagnosis of the doctor is displayed. As an example of the list of templates, a combination of an intraocular pressure-lowering agent and a blood flow improving agent can be cited as a glaucoma treatment set. This template list can be customized by the user.

  Next, the structure of the accounting screen will be described. When a user having the authority of the department “Accounting” logs in, an accounting window (not shown) is activated. This accounting window is substantially the same as the reception window 300. The accounting window has a patient list, a navigator button, a patient information display unit, a status icon, an information icon, and the like as in the other windows. In the accounting, the medical cost is calculated for the patient status whose “consultation” item is “confirmed”. The calculation is based on the insurance points attached to each examination, medical examination, and treatment in the medical record listed on the day of medical treatment.

  The trigger for “confirmation” to be “confirmed” is preferably, for example, an operation in which a doctor saves a medical record. Further, such an automatic trigger may not be used. The patient status may be manually changed to “confirmed” with a cursor or the like.

  Next, the operation of the medical information management system according to the embodiment of the present invention will be described for each item based on the configuration described above.

  First, login for using each client of the medical information management system will be described. The login window 200 of FIG. 3 is displayed as the same for each client. The user who logs in inputs the login name (user name) and password registered in the above description in the input window 201 in the login window 200. The input is registered in advance and authentication is performed to determine whether it is a user name and a password. If the authentication conforms, the department selection field 202 and the room selection field 203 are made active (selectable). If the authentication fails, an error dialog (not shown) is displayed.

  When the selection fields 202 and 203 become active, only rooms and departments that can be selected are displayed there based on the user's authority. The user selects a department and a room to log in from among these, and clicks an “OK” button in the login window 200 to log in to the medical information management system. When logging in to each client, possible combinations of the selection fields 202 and 203 are, for example, for a reception client, “Department” is medical, “Room” is reception, and for an inspection client, “Department” If the department is an ophthalmologist and the “room” is an examination room and an examination client, if the “department” is an ophthalmology and the “room” is an examination room and an accounting client, the “department” is medical and the “room” is accounting. It is done. The display of the selection fields 202 and 203 differs depending on the user authority.

  With the system settings and login of the embodiment described above, user authority in the medical information management system can be added by associating departments and rooms. In addition, authority can be easily set for each individual. In addition, the complexity can be reduced by selecting the department or room at the time of login while subdividing the authority.

  In the embodiment described above, login (personal authentication) is input of a user name and a password. However, the present invention is not limited to this. Devices such as an ID card and a wireless IC chip (RFID) are not limited to each client of the system. Even if a reader or a fingerprint or voiceprint, or a blood vessel pattern such as a retina, iris, or palm, or a reader for biometric authentication (biometric authentication) using the writing pressure or speed at the time of signature, etc. is provided, personal authentication may be performed. Good. In the present embodiment, only the authorized items are displayed in the department and room selection fields by entering the login name and password input fields. However, the present invention is not limited to this. Unauthorized items may also be displayed. In that case, it is sufficient that an unauthorized item is in an inactive state and cannot be selected or the display color and density are different from those of an authorized item.

  When a user whose “department” is medical and “room” is logged in, the reception window 300 in FIG. 4 is activated. At the reception desk, patients who visit the hospital are registered in the medical information management system, and procedures for receiving medical care such as examinations and medical examinations are taken. The patient is additionally registered in the patient list 310, and the status mark 312 of the patient status 311 is displayed. In connection with this, the status icon 900 indicates a medical practice to be taken by the patient. For example, it is assumed that this patient has received an ophthalmology and is scheduled to receive a visual examination, fundus imaging, and a medical examination at the time of reception. The status mark 312 is displayed in the state of “acceptance” in the “diagnosis”, “sight test”, “mydriasis”, “fundus imaging”, and “accounting” of the patient status 311. Assume that the status icon 900 includes an accounting icon 900a, a medical examination icon 900b, a vision test icon 900c, a mydriatic icon 900d, and a fundus imaging icon 900e. Here, the mydriasis is a procedure for opening the pupil of the patient, and is indispensable for fundus photography, and is performed before fundus photography.

  The patient then enters the laboratory. When a user (inspector, inspection engineer, or nurse) of “laboratory” is ophthalmology and “room” is in the inspection room logs in the inspection room, the inspection window 400 is activated. When the examiner who is the user looks at the patient list 410 and the patient status 411 in the examination window 400, it can be seen that the examination items of the patient are eyesight examination and fundus photography. The PC 21 as an inspection client is connected to an inspection device in an inspection room, for example, a fundus camera 30, and the like, and inspection data can be taken into the hard disk 21 b by an imaging function. An imaging function for capturing an image such as a photograph is realized by an imaging window 450 activated by pressing an imaging button 403b of the navigator button 403.

  The examiner measures the visual acuity of the patient with a visual chart or the like, and the result is entered in a template window (not shown) of the examination window 400. The template window is activated by selecting the “template” button of the navigator button 401 with the cursor. After the examiner fills in the result of the visual acuity test of the patient, the status mark 413 of the item “visual acuity test” in the patient status 412 is selected with the cursor to be confirmed. With this operation as a trigger, the eyesight inspection icon 900c of the status icon 900 is deleted.

  Subsequently, the examiner enters the fundus photography of the patient. Mydriatics are instilled to open the patient's pupil before fundus photography. When the examiner clicks “waiting for mydriasis” in the patient status 412, the countdown for a predetermined time (15 to 30 minutes) is started. When the predetermined time has elapsed, the patient's “mydriatic wait” flashes and alerts the examiner. At the same time, the mydriatic icon 900d flashes to call attention. When the examiner confirms mydriasis and clicks the status mark 413 with the cursor, the “waiting for mydriasis” is completed, and the mydriatic icon 900d is deleted by using it as a trigger.

  When the patient's mydriasis is complete, fundus photography is performed. A fundus photograph taken by the fundus camera 30 is displayed in an imaging window 450 of the examination window 400. When the examiner clicks the save icon 451a of the toolbar icon 451 with the cursor on the fundus photo, the fundus photo data is saved in the hard disk 13 on the management server 10 and is examined on the chart 640 opened on the examination client described later. A data transfer approval dialog 480 is displayed. Operations related to the storage of examination data trigger the posting. The status mark 413 of the “fundus camera” item of the patient status 412 is changed to “confirmed” with the operation of saving the fundus photo as a trigger. Similarly, the fundus photography icon 900e is deleted.

  When the examination data is stored, identification information (patient code) used in the system is given to the examination data by the control means 21a. The patient code includes the aforementioned patient number and the examination date examined by the patient. The inspection data obtained by the inspection device is temporarily stored in the PC 21 of the inspection client, but is stored in an intermediate file (folder) on the hard disk 13 by a storage operation.

  In the above description, the acquisition of examination data is a fundus photograph and a visual acuity test. In other cases, for example, in the case of an objective visual examination using a refractometer or the like, it is activated in the background of the examination window. The result is automatically entered in a refline window (not shown). In addition, handwritten data such as a visual field is captured by a scanner window (not shown) activated by a scanner button of a navigator button. In the scanner window, examination data is stored and transferred in the same manner as in the imaging window. Further, although the inspection data is temporarily stored in the inspection client PC and then stored on the hard disk of the management server, the present invention is not limited to this. The management server 11 may be provided with a database for temporarily (or long-term) storing inspection data.

  The patient then enters the examination room. When a user (doctor) who has authority of the “room” examination room in the “department” ophthalmology logs in to the examination client, the examination window 600 is activated. When the doctor selects a patient to be examined from a patient list (not shown) and clicks the SOAP button of the navigator button 601, a medical chart 640 is displayed. There are 1st and 2nd papers in the medical record. The 1st paper contains basic information about the patient, such as physical information such as name, gender and height, allergies and contraindications. Medical records, examination data, findings, etc. are described. The patient code similar to the above is also given to the medical chart.

  When the chart 640 is opened, a transfer approval dialog 480 shown in FIG. 9 for requesting transfer approval of the inspection data inspected previously is displayed. A dialog 480 is a selection window for determining whether or not to transfer the acquired inspection data to the medical chart, and includes a data list 481 indicating items of inspection data and a read button 482 for reading the inspection data. The doctor selects the examination data to be taken in by a check box attached to each item and presses the take-in button 482 to approve the transfer. The inspection data is transferred from the intermediate file on the hard disk 13 to the medical record file by the transfer approval, and is displayed as an image on the medical record 640. The inspection data that has not been transferred is stored in the hard disk 13 as reference data, and can be referred to from the chart 640 as reference data. The control means 21a functions as reference inspection data storage means. The reference data can be browsed by a reference window (not shown) that is activated from a reference button (not shown) from the second chart. The reference button functions as reference inspection data calling means. At this time, the inspection data transferred to the medical chart can also be viewed in the reference window.

  The dialog 480 displays only examination data relating to the currently open patient chart. In other words, even if examination data of a plurality of patients is waiting to be transferred, the transfer is approved only for a patient in a medical chart that is currently open (or opened). The matching between the inspection data and the medical chart is performed by the control means 21a which is a determination means based on the patient code described above.

  In the above embodiment, in the transfer of examination data, the approval dialog is displayed on the examination screen and the transfer is performed after obtaining the user's approval. However, the present invention is not limited to this. When the examination screen (examination window) and the examination screen (examination window) are displayed on the dual monitor, the transfer approval dialog may not be displayed. When a dual monitor is used as described above, it is assumed that a doctor is performing an examination and a medical examination. Therefore, the transfer to the medical chart may be automatically performed without displaying the transfer approval dialog. Thereby, posting approval can be omitted and work efficiency can be improved.

  A series of operations for transcription will be described with reference to a flowchart. FIG. 10A is a transfer flowchart when the chart is opened on the examination screen when the examination data is saved, and FIG. 10B is a transfer flowchart when the chart is not opened. When the inspection data displayed on the inspection screen of the inspection client PC 21 is stored, the inspection data is stored in an intermediate file on the hard disk 13. Based on the signal, the control means 21a of the inspection client notifies the control means 21a of the examination client that the inspection is being performed. That is, the fact that the inspection data is stored in the intermediate file is notified. Next, the control unit 21a of the examination client determines whether or not the patient code of the currently opened medical record matches the patient code of the examination data. If they do not match, the inspection data is not transferred and the transfer operation is terminated. If they match, the inspection data is loaded into the chart and a dialog 480 is displayed. If there is approval for the transfer, the control means 21a transfers the inspection data to the medical record and finishes the transfer operation.

  When the chart is not opened when the examination data is saved, the control file 21a of the examination client checks the intermediate file on the hard disk 13 when the chart is opened on the examination screen of the examination client. The control means 21a determines whether there is inspection data already executed in the intermediate file. If there is no inspection data, the control unit 21a ends without performing the transfer operation. If there is examination data, the control means 21a compares the patient code between the data and the currently opened medical chart, and determines whether or not the patient code as the patient identification information matches. If they do not match, the process ends without performing a transfer operation. If they match, data is loaded from the intermediate file and the dialog 480 is displayed as before. If there is approval for posting, the inspection data is transferred to the medical record and the operation is completed. The inspection execution notification can be displayed on the chart screen or can be hidden. In addition, whether or not the inspection data is transferred, if it is selected in the dialog 480 whether or not to transfer it, it is stored in the hard disk 13 as reference data.

  In this way, patient examination data is accurately transferred or referred to the medical chart. The main examination data transcribed by the doctor can be confirmed on the chart 640 without bothering to activate the reference window. Moreover, all the inspection data inspected can be browsed as reference data. Thereby, efficient medical care can be performed.

  In the above description, the posting trigger is based on the storage of the inspection data on the inspection client side, and the automatic posting is performed. However, the present invention is not limited to this. A manual trigger may be used. In that case, inspection data to be transferred or not to be transferred may be selected by a dialog for prompting the transfer.

  By using the method for transferring the inspection data to the medical record as described above, the transfer to the medical record is automatically triggered by the storage on the inspection client side that handles the inspection data, and the complexity of the medical record transfer is reduced. The

In the medical chart described above, the examination data and the medical chart are linked to further improve the consistency of patient information. As a problem in which it is difficult to obtain consistency , for example, an examination whose medical practice name is fundus camera photography may be performed any number of times, but can only be charged for medical expenses once a month. Therefore, if the right eye and left eye fundus pictures are taken separately on the same day (for example, if the doctor takes additional fundus pictures of the left eye after taking the right eye fundus picture), the name of the medical practice Two “fundus photos (pieces)” are produced. For this reason, accounting cannot claim medical expenses only for the first eye taken.

  In the embodiment of the present invention, the above problem is solved by the following method. In fundus camera photography, it is assumed that the examination order is only one eye (for example, the right eye) and the examination data is transferred to the medical chart. The name of the medical practice at that time is “fundus camera photography (single)”. In this state, a new examination order is issued, a fundus photo of the other eye (left eye) is taken, and transferred to the medical record. Then, the control means 21a of the examination client checks the inspected information and the fundus on the medical record. The description of the photographic examination is “fundus camera photography (both)”. Conversely, when one eye is deleted from the fundus photos of both eyes transferred on the chart, the description of the chart is changed to “fundus camera photograph (piece)”. Thereby, the change of an inspection item is described correctly. Although the above description assumes that the medical practice name is fundus camera photography, it is not limited to this. The medical practice name may be different for one eye and both eyes, for example, visual field inspection, precision visual field inspection, or the like.

  As described above, the inspection data change is reflected in the medical chart, and the inspection client control means 21a transmits the inspected contents to the accounting client side. The accounting client control means 21a calculates the medical expenses according to the changed insurance points of the completed examinations.

  For this reason, mistakes in the transcription of medical records are reduced. In addition, since the medical expenses at the time of accounting are calculated based on the completed examination, errors in the medical expenses calculation are reduced.

  When describing SOAP in the medical chart, the entry assist function of the input template window 700 described above is used. The doctor will write the patient's examination data, findings and treatments in the medical record and make a diagnosis. In addition, prescribe therapeutic drugs as needed. Also in the prescription of the therapeutic agent, the prescription is performed in the SP set window (not shown) described above.

  When the doctor finishes the examination and selects “End Examination” on the navigator button 601, the contents of the medical chart are saved, and the operation status is used as a trigger to change the status mark of the “diagnosis” item of the patient status to the confirmed one. . Along with this, the diagnosis icon 900b is deleted.

  When the examination and examination of the patient are completed, only the accounting icon 900a is displayed on the status icon 900. In this state, medical expenses are calculated by accounting. In accounting, a user who is a “department” physician and whose “room” has accounting authority logs in to the accounting client and performs patient accounting. The patient's medical expenses are automatically calculated based on the insurance points given to the examinations and examinations recorded in the medical record, and charged to the patient. When the patient pays the medical expenses, the user of the accounting client confirms the “accounting” item of the patient status in an accounting window (not shown), and finishes the series of medical treatment for the patient.

  In the present embodiment, all the medical actions (examination, medical examination, accounting) that the patient should take at the time of reception are displayed in the examiner status and the status icon, but the present invention is not limited to this. The accounting status may be displayed after the medical examination is completed. When the examination is completed, accounting is performed. Thus, such a display method makes it easier to see the patient status and status icons.

  At the time of accounting calculation, the accounting client control means 21a checks the above-mentioned intermediate file. The intermediate file stores patient examination data and should be transferred to the chart or used as reference data. However, if the control means 21a of the accounting client finds examination data in which neither process is performed in the intermediate file, it is regarded as an examination that cannot be charged for medical expenses, and an error is sent to the control means 21a of the examination client. Along with this, the control means 21a of the examination client displays a message prompting the doctor to check on the examination screen. Thereby, omission of medical expenses and omission of transfer of examination data to medical records can be reduced.

  In accounting, the next reservation is made as necessary. For appointments, an approximate schedule is written in the medical record according to the doctor's instructions. In accounting, the patient's schedule and the reservation information (for example, what kind of examination will be performed next time) described by the doctor are reconciled. The accounting staff activates a reservation scheduler (not shown) that manages the schedule of doctors and laboratory technicians and the schedule of use of the test equipment, determines the patient's schedule, and determines the next reservation date, visit time, and the like.

It is a figure showing the outline of the medical information management system of the present invention. It is a figure which shows the screen which performs medical information management system setting. It is a figure which shows the login screen for logging in to a medical information management system. It is a figure which shows a reception window. It is a figure which shows an inspection window. It is a figure which shows an imaging window. It is a figure which shows an examination window. It is a figure which shows an input template window. It is a figure which shows a posting approval dialog. It is a figure which shows the transcription | transfer flowchart.

Explanation of symbols

10 management server 12 CPU
13 Hard disk 20 Client 21 PC
21a Control means 21b Hard disk 30 Fundus camera 100 Master maintenance window 200 Login window 300 Reception window 301, 401, 601 Navigator button 400 Examination window 450 Imaging window 600 Examination window 640 Chart 480 Transfer approval window 800 Patient information display section 900 Status icon 910 Information icon

Claims (1)

Transfer operation control for performing a transfer operation for transferring the test data to the electronic medical record based on a test screen for acquiring patient test data and a trigger signal for storing the test data acquired on the test screen A medical information management system for managing medical information by electronic data, and when the examination data is transferred to the electronic medical record by the transfer operation control means, a medical practice name corresponding to the examination data is Name display control means for displaying on the electronic medical chart, the name display control means for transferring to the electronic medical chart when left and right fundus examination images or visual field examination images of the same patient are acquired at different timing on the same day The medical practice name displayed on the basis of the examination of one eye that has been completed is transferred to the other eye with the examination data from the same eye examination. Medical information management system characterized by displaying on the electronic chart and change the medical care action name corresponding as both eyes by Rukoto.