JP4946277B2 - Response request system and method - Google Patents

Description

  The present invention relates to an answer request system in which a patient requests an answerer to answer an answer using a computer.

  As a background art of the present invention, there is a second opinion support system disclosed in Japanese Patent Laid-Open No. 2003-303240.

The second opinion support system of this background art receives data relating to the first doctor and the patient via a predetermined communication line from a hospital system storing data relating to the patient and data relating to the first doctor who diagnosed the patient. Receiving means, sorting means for sorting the received data into first data disclosed to a second doctor different from the first doctor, and second data not disclosed to the second doctor; Transmitting means for transmitting only one data to the second doctor.
JP 2003-303240 A

  The background art is configured as described above, and a doctor who receives a second opinion request from a patient transmits information necessary for second opinion diagnosis to the second opinion doctor using the second opinion support system. There is no need to start the examination again from the beginning of the second opinion doctor, and it is possible to receive the second opinion while reducing the economic and mental burden.

  However, the second opinion support system in the background art can only be implemented when the patient's attending physician asks the patient whether or not to receive a second opinion at an appropriate time, or when the patient becomes aware of it and offers the second opinion to the attending physician. The second opinion is not implemented unless the attending physician prompts the second opinion in a timely manner, and the patient does not request the second opinion from the attending physician. Even if the patient knows that a second opinion can be made, it is difficult to ask the doctor at what timing. For example, it is too early if a diagnosis is made by a doctor or the like, and conversely, it is too late immediately before surgery. By the way, in some countries, the second opinion system is well understood by both doctors and patients, and it is natural for doctors to ask patients about the second opinion. On the other hand, in Japan, the second opinion is not sufficiently recognized as a natural right of patients. Therefore, there is a background that a patient who is concerned about the collapse of the trust relationship with the attending physician cannot speak to the attending physician even if he has sufficient knowledge about the second opinion. Even if the physician understands the second opinion, there has not yet been a situation where the patient is encouraged to take the second opinion in a series of medical processes such as interview, examination, diagnosis, treatment, and surgery.

  Even if the patient feels anxiety, for example, when the variance occurs in the clinical path presented by the doctor in advance, the attending physician will fully capture the patient's anxiety and recommend a second opinion as a method to resolve the anxiety In addition, it is extremely difficult to completely capture the emotions of others and the current workload per doctor. From the point of view that patients can receive treatment without anxiety, rather than simply performing treatment, a mechanism that adequately answers in-patient questions and unclear points Is not functioning well. The case where the variance is generated in the clinical path is synonymous with the case where the medical action constituting the clinical path is not performed as planned or planned. It includes that the medical practice is performed after the schedule / plan, that it has not yet been implemented, and that it is performed before the schedule / plan.

  The present invention has been made to solve the above-described problems, and an object thereof is to provide an answer request system that prompts a patient to implement a second opinion in a timely manner and accepts the second opinion. A broader object of the present invention is to provide an answer request system that accepts an answer request in a timely manner and presents an answer so as to dispel the anxiety of the patient. In other words, the second opinion request is one of the response requests from patients.

Answer request system according to the present invention, the patient terminal that the patient used comprises a clinical pathway acquisition requesting means for requesting acquisition of clinical pathway identifying the patient, reply request server, among the plans constituting the clinical pathway a variance detecting means for detecting an event that has become unscheduled as variance, in response to a request of the clinical pathway from the patient terminal, the patient terminal that has requested the acquisition of clinical pathway the clinical pathway of the relevant patient identifying the variance and a clinical pathway transmitting means for transmitting to the patient terminal, a clinical pathway display means for displaying the clinical pathway received by revealing the variance, and the variance selection means for accepting a selection of the displayed said variance, The selected variance information is sent to the answer request server. The response request server includes a person-in-charge storage unit that records a schedule and a medical worker in association with each other, and a schedule related to the transmitted variance information based on the person-in-charge storage unit An answerer identifying means for identifying the associated medical staff as an answerer, and an answerer sending means for sending the identified answerer as a default answerer to the patient terminal, the patient terminal is transmitted, and the answer request accepting means for accepting an input or answer request comprising the selection of the default answer personnel and answers requests what it receives, the respondents personnel and answers request contents received in the reply request server further comprising a reply request transmitting means for, the answer request server, the respondents personnel and answers request contents received and request reply An answer request recording means for recording in association with user further includes a reply request content transmitting means for transmitting the reply request contents respondents representative terminal in which the respondents person who received use, the respondents person terminal, transmitting a reply request content display means for displaying said received reply request contents, the answer receiving means for receiving a reply to the reply request contents received, and the received information for identifying the answer request reply to the reply request server to first and a reply transmitting means, said answer request server, the reply received, the answer recording means for recording in association with the answers requests that are recorded, patients were asked answer recorded the answer using the patient terminal further includes a second answer transmission means for transmitting to the patient terminal, and further comprising an answer display means for displaying the answers received to It is.

The clinical path expresses a schedule / plan of medical practice performed by a medical staff on a daily basis for a patient, an execution record, and the like. Conventionally, a tabular clinical path written on paper has been used, but now an electronic version is used. Medical practice includes meals, bathing, etc. in addition to treatments such as injection and blood sampling, examinations, and the like.
Variance means to deviate from the plan / plan on the clinical path, in other words, to be out of the schedule of the clinical path.

  Being out of schedule includes not only when the scheduled date and time have passed, but also when the schedule is implemented earlier than scheduled. It is desirable that there is a scheduled implementation period at the scheduled date and time. For example, about 1 hour from the scheduled execution date and time is set as the scheduled execution period, and if it is performed during this period, it is set as planned. You can set the scheduled execution period for any scheduled item, but depending on the scheduled item, the scheduled item may take a long time, and the scheduled item may vary greatly in time. A configuration may be adopted in which a default scheduled execution period is provided and a user sets as necessary.

  The clinical path of the corresponding patient for which the variance is specified is, for example, the data for the clinical path and the data for specifying the schedule that is the variance, or the clinical path data for the corresponding patient provided with a field indicating the presence or absence of the variance.

  As described above, in the present invention, in response to a request for a clinical path from a patient, the clinical path and variance are transmitted to the patient terminal, and the variance is displayed while the clinical path is displayed on the patient terminal, and this variance is displayed. The response request server receives and receives the response request, the response request server sends the response request to the response staff terminal, further receives the response to the response request, and receives the response from the response staff on the patient terminal. The patient notices the occurrence of the variance on the displayed clinical path, and can request the response person who specified the response request if necessary, and immediately respond to the occurrence of the variance that causes anxiety to the patient. By giving an answer opportunity to the person in charge of answering to the patient, the patient can receive medical care with peace of mind.

In addition , since the person in charge of the answer request becomes the person in charge of the answer related to the schedule related to the variance, the medical staff who is related to the patient's schedule is requested as the person in charge of the answer without knowing the person related to the schedule It has the effect that it can be done. The default answerer is a standard answerer, and the patient can designate another answerer. For example, even if you know your doctor or nurse, you often don't know your pharmacist or nutritionist.

  When a plurality of medical workers are associated with one schedule, one medical worker is determined according to the priority order of the medical workers for each scheduled type set in advance. Alternatively, a plurality of medical workers associated with one schedule are presented on the patient terminal, and the person in charge of the answer is determined by receiving selection of the medical workers from the patient.

The answer request system according to the present invention further includes means for accepting an input or selection regarding the time limit of the answerer's answer to the answer request at the time of the answer request, if necessary, and input by the answer request sending means Alternatively, the response person's answer deadline for the answer request accepted is also sent to the answer request server, and the answer person's answer deadline for the answer request received by the answer request recording means is recorded, and the answer request server When the response deadline has passed, or when the answer request has not been answered within the prescribed period, the means for urging the answerer terminal of the answerer who has not yet responded to the answer request Newly included.
The prompting to the answerer terminal is performed by sending a message to the answerer terminal by e-mail or sending a message to the answerer terminal at the time of login.

  As described above, in the present invention, when the response request is made, the patient specifies the answer deadline, and when the answer deadline has passed, when the answer deadline has passed, Since it prompts the responder terminal, a reminder is made if the responder forgets that the answer request has been made, and the patient can receive the answer to the answer request more reliably. It has the effect.

In the answer request system according to the present invention, the answerer terminal identifies the answerer and the means for accepting the minimum answering period, which is the answering period required at least until the answerer's answer request, as necessary. And a means for transmitting the minimum required response period of the information and answer person to the answer request server, wherein the answer request server records the minimum answer period of the answer person in association with the answer person, and at least A means for transmitting a response required period to a patient terminal, and a minimum required response period for the corresponding response person in the above-mentioned "means for accepting input or selection regarding the time limit for answering a reply person at the time of reply request" An input or selection is accepted for an answer deadline that satisfies the above condition.

  As described above, in the present invention, when an answer deadline is specified in an answer request, input or selection is accepted for an answer deadline that satisfies the condition of the minimum required answer period of the responder, and an answer deadline that does not satisfy the condition of the minimum answer required period Since the patient cannot specify a response deadline that does not require at least the time required for the response to be answered, the patient will not be able to specify an answer deadline. Therefore, it is possible to prevent the reply request from being refused because of the short time in advance, and to suppress useless reply requests.

Answer request system according to the present invention is the patient terminal answers request second opinion using from the patient, the answer request content transmission unit, the patient diagnosis and / or true physician that the relevant patient records recorded and which test results are also intended to be transmitted to the respondents representative terminal.

As described above, in the present invention, the content of the response request is the second opinion, and the information necessary for the second opinion is transmitted to the responder terminal. It has the effect that a second opinion can be made in a timely manner.
The second opinion is an opinion or judgment of a doctor other than the attending physician regarding the diagnosis or treatment policy, and may mean seeking such opinion or judgment.

  It is desirable that the variance serving as a trigger for accepting the second opinion response is a specific scheduled type. Schedule types include treatment (prescription, injection, treatment, etc.), examination (endoscope, physiological examination, etc.), nursing, etc. In particular, it is preferable that the schedule type influences the diagnosis, not all the schedule types. Such a second opinion possible schedule type is set in advance. It is desirable that the response request server has a configuration in which the second opinion possible schedule type is determined from the results. Specifically, a scheduled type in which the number of second opinions is a predetermined number is set as a second opinion possible scheduled type.

  It is also desirable to set a date on which the second opinion can no longer be implemented. For example, the day of surgery, the start date of medication, etc. Specifically, a field for the last day of the second opinion request is provided in the schedule, and processing is performed when the field has a value. Depending on the schedule type, a value of the scheduled date and time of the schedule may be input in the field of the last date of the second opinion request. Actually, since the second opinion itself also takes time, the day that goes back by the required period corresponds. The response request server identifies this date as the second opinion request last date, and is displayed or displayed on the clinical path of the patient terminal, and accepts the second opinion request on the last date of the second opinion request or on a date before that. desirable. The reply request server may send a message introducing the second opinion to the patient terminal on the last day of the second opinion request, or even a predetermined date before that, and accept the request for the second opinion. By doing so, even if there is no acceptance of the second opinion triggered by variance, it is possible to give the patient an opportunity to accept the request for the second opinion.

The answer request system according to the present invention newly includes means for transmitting the diagnosis of the attending doctor to the patient terminal used by the patient who requested the answer by the answer request server, and the diagnosis and answer request of the attending doctor received by the patient terminal. Means for comparing and displaying the diagnosis by the second opinion doctor who is the person in charge of answering the above.

  In this way, in the present invention, the patient terminal has not only the diagnosis of the second opinion doctor but also the diagnosis of the attending doctor, and the patient's diagnosis is compared with the diagnosis of the attending doctor and the diagnosis of the second opinion doctor. Has an effect that the final judgment can be smoothly and spontaneously determined by referring to the diagnosis of the attending physician and the diagnosis of the second opinion doctor.

The answer request system according to the present invention newly includes means for accepting designation of the patient terminal to transmit the answer request to the attending physician and / or family doctor and transmitting it to the answer request server as necessary. A means for transmitting the response request to the terminal used by the attending physician of the designated patient and / or the terminal used by the family physician of the designated patient is newly included.

  As described above, in the present invention, it is possible to specify that the response request is transmitted not only to the responder terminal of the responder but also to the primary doctor's terminal and / or the family doctor's terminal. Since the response request is transmitted to the terminal, it is possible to notify the attending physician and family doctor of the implementation of the second opinion if the patient desires. When the attending physician or family doctor knows the implementation of the second opinion, for example, the second opinion doctor can obtain information necessary for diagnosis from the attending physician or family doctor, and can perform a more appropriate diagnosis.

In the answer request system according to the present invention, if necessary, the answer request server is configured to request the answer request and / or the answer count from the patient terminal and / or the answer count request from the patient terminal. A response request count and / or a means for transmitting the response count to the patient terminal that requested the response count are newly included.

  As described above, in the present invention, if the patient requests, the answerer receives the answer request number and / or the answer number received from the answer request server, so that the patient makes an answer request from a plurality of answerers. This has the effect that it can be used as a criterion for selection.

It can also be displayed on the patient terminal together with the person in charge of the answer in order of the number of answer requests, the descending order of the number of answers, and ascending order.
It is also possible to divide the number of replies by the number of replies for each answerer and obtain the answer rate at the answer request server or patient terminal and display it on the patient terminal. The response rates can also be displayed together with the respondents in descending order and ascending order.

Furthermore, the average answer period for each answer person can be obtained by the answer request server and displayed on the patient terminal.
Furthermore, it can also total for every schedule classification. By doing so, the patient himself / herself can grasp how many patients requested the second opinion by the variance of his / her clinical path.

The answer request system according to the present invention includes, as necessary, a means for the answer request server to count the answer requests and / or answers for the answer requests made from the hospital where the corresponding patient is provided for each answer person, and from the patient terminal. And a means for transmitting the response request count and / or the response count to the patient terminal that requested the response count for the response request made from the hospital where the corresponding patient is counted in response to the request count and / or the response count request. .

  As described above, in the present invention, since the number of response requests and / or the number of responses for each response person regarding the response request made from the hospital where the patient is present is counted and received at the patient terminal, When responding to a response request made from a hospital you are hospitalized, you can know the number of response requests received and the number of returned responses for each person in charge, and the patient selects the person in charge of answering from multiple person in charge It has the effect that it can be used as a judgment criterion. In particular, it is possible to know information on response requests made from the hospital where you are, and it is very convenient.

  In the communication between the answerer terminal and the answer request server, or the communication between the patient terminal and the answer request server, it is not always necessary to transmit information including information specifying the answerer and the patient. This is because once a connection is established between the answerer terminal and the answer request server, or between the patient terminal and the answer request server, the answer request server identifies the patient and answerer who use the connection. This is because the person who uses the connection can be processed as the patient and the person in charge of answering.

  The patient terminal and the answerer terminal correspond to a user terminal and an external user terminal in the following embodiment. More specifically, in the embodiment, the patient terminal is a user terminal or an external user terminal to which the patient has logged in, and the answerer terminal is a user terminal or an external user terminal to which the answerer has logged in. However, the present invention is not limited to these examples.

Each answer request system can be grasped as a method, or can be grasped as a program of a component of the system.
These outlines of the invention do not enumerate the features essential to the present invention, and a sub-combination of these features can also be an invention.

  Embodiments of the present invention will be described in detail with reference to the drawings. The present invention can be implemented in many different forms. Therefore, it should not be interpreted only by the description of this embodiment. Also, the same reference numerals are given to the same elements throughout the present embodiment.

  In the present embodiment, the system will be mainly described. However, as will be apparent to those skilled in the art, the present invention can also be implemented as a program and method usable in a computer. In addition, the present invention can be implemented in hardware, software, or software and hardware embodiments. The program can be recorded on any computer-readable medium such as a hard disk, CD-ROM, DVD-ROM, optical storage device, or magnetic storage device. Furthermore, the program can be recorded on another computer via a network.

(First embodiment of the present invention)
[1. System configuration]
FIG. 1 is a system configuration diagram constructed inside and outside a hospital including an answer request system according to the present embodiment.
A computer in which the response request server 110 is constructed, a computer in which the clinical path server 120 is constructed, a computer in which the electronic medical record database 130 for recording electronic medical records is constructed, and a medical database 140 for recording medical data are constructed. The computer is connected to a local information communication network (LAN) built in the hospital (ZZZ hospital) and can communicate. In addition to these computers, user terminals 210, 220, 230, 240, 250, 260, 270, and 280 that are arranged in various places in the hospital and used by medical personnel such as doctors, nurses, pharmacists, and nutritionists are also hospitals. It is connected to the internal LAN and can communicate. External user terminals 310, 410, and 420 that are arranged in other hospitals (YYY hospital, VVV hospital) and used by medical staff of the hospital are connected to the LAN of the hospital and are connected to the hospital via a network such as the Internet. (ZZZ Hospital) can also communicate with the computer. In the present embodiment, each terminal is configured to be a terminal of each medical worker by logging in, and different medical workers can be used even with the same terminal. The bedside terminal 240 is a terminal used by a patient logging in, but a medical worker can also log in and use the bedside terminal 240.

  The answer request server 110 receives a request from the patient using the patient's terminal, sends an answer request to the answerer's terminal, and sends the answer request from the answerer using the answerer's terminal. This is sent to the terminal. The response request server 110 supports the patient's response request (selection of doctor, selection of sentence examples when preparing the request text, response deadline, response type, transfer of the attending physician, transfer of doctors at home, schedule display of response request on the clinical path), doctor It has a function to support the answer of (no answer).

  The clinical path server 120 records the clinical path created by the doctor using the terminal for the corresponding patient, and transmits it to the terminal that requested the recorded clinical path in response to the request specifying the patient from the terminal. The clinical path server 120 has a function of supporting a doctor's creation of a clinical path.

  Various client programs are installed in the user terminals 210, 220, 230, 240, 250, 260, 270, and 280 as necessary. A service can be received from the response request server 110 by installing the response request client program in the user terminal. The same applies to the clinical path client program, the electronic medical record client program, and the medical client program. In this way, instead of installing various client programs in the user terminal, the same service can be received using ASP.

[2. Hardware configuration]
Each computer has a hardware configuration shown in FIG. 2 as a standard. That is, the computer has a CPU 11, RAM 12, ROM 13, HD (hard disk) 14, LAN card (NIC card) 15, mouse 16, keyboard 17, video card 18, display 18a, sound card 19, speaker 19a, drive (CD-ROM). Drive, DVD-ROM drive, etc.) 20 and bar code reader 21.

[data]
The structure of the main data is shown below. However, in order to perform data modeling according to a specific system environment by a so-called person skilled in the art, it is only an example.
Clinical path data includes schedule ID, schedule type (treatment (prescription, injection, treatment, etc.), examination (endoscope, physiological examination, etc.), nursing, etc.), issue date, issuer, contents, schedule date, instruction It consists of a reception date and time (instruction reception if there is a value) and an execution date and time (instruction reception if there is a value). A flag indicating whether or not an instruction is received and a flag indicating whether or not an instruction is received may be provided separately from the instruction reception date and time and the execution date and time.

The variance data includes a schedule ID. This schedule ID is specified by the response request server 110 by comparing the current date and time with the scheduled date and time.
The response request data consists of response request ID, patient ID, second opinion doctor, request contents, specified response deadline, specified response type, specified doctor transfer, presence of designated family doctor transfer, and presence / absence of schedule display in clinical path .

The doctor data includes a hospital, department, name, work history, number of operations, specialty, number of second opinions, contact information, and minimum response period.
The answer data includes an answer request ID, answer contents (diagnosis, treatment), answer date and answer type.

[3. Operation]
[3.1 Clinical path creation process]
FIG. 3 is a flowchart of the clinical path creation process according to this embodiment.
The doctor attempts to log in by entering the login ID and password on the login screen for creating the clinical path at the user terminal 210 (the doctor may use another user terminal). The user terminal 210 accepts a login from a doctor, and when the authentication based on the input information is successful, the user terminal 210 displays a patient selection screen on the display, and the doctor selects from the displayed patients.

  The user terminal 210 accepts the selection, and the user terminal 210 displays the initial screen shown in FIG. 4 in which the currently used doctor and the selected patient are specified and displayed (step 101). As information on the selected patient, the name, age, date of birth, blood type, height and weight are displayed in the upper center of the initial screen. The patient information is read from the electronic medical record database 130, for example. The name and affiliation of the doctor who is currently logged in is displayed on the upper right side of the initial screen. The attribute information of the already created clinical path is displayed in the created path display frame at the approximate center position in the initial screen. The attribute information of the clinical path includes a path name, a comment, a start date, an end date, and evaluation completed / not completed. The evaluation of the clinical path is, as a rule, entered by the doctor about the comparison between the planned clinical path and the result after completion of the planned medical path. Although medical care may proceed as planned in the clinical path, variance occurs due to the patient (for example, the patient's physical condition, patient's consent) and the hospital (for example, doctor's schedule, maintenance of treatment equipment, failure). On the initial screen of FIG. 4, the doctor instructs “Apply Path” and presses the “New” button to create a patient who has selected a new clinical path as a target.

  In response to a request for creating a clinical path from a doctor, the user terminal 210 requests a standard clinical path list from the clinical path server 120. Upon receiving a request from the user terminal 210, the clinical path server 120 reads a list of standard clinical paths currently recorded (step 111) and transmits it to the user terminal 210 that has requested it. The user terminal 210 displays the received standard clinical path list in a tree shape on the left frame of the standard clinical path selection screen of FIG. 5 (step 121). The related standard clinical path is stored in one folder, and the standard clinical path in the folder is expanded and displayed. The doctor selects a standard clinical path that matches the target patient's disease from the standard clinical path selection frame. The user terminal 210 requests the clinical path server 120 for the standard clinical path selected by the doctor. The clinical path server 120 reads the standard clinical path related to the request from the user terminal 210 (step 131) and transmits it to the user terminal 210. The user terminal 210 displays the received standard clinical path in the right frame of the clinical path selection screen. If the currently displayed standard clinical path is used for the target patient, the doctor presses an “apply with path” button on the upper right side of the clinical path selection screen. When the currently displayed standard clinical path is not used, the standard clinical path is selected again from the standard clinical path selection frame.

  Upon receiving the application of the selected standard clinical path, the user terminal 210 displays a clinical path edit screen and prompts the doctor to select the application start date of the target standard clinical path. Upon receiving the application start date input from the doctor, the user terminal 210 incorporates the date into the target standard clinical path based on the application start date, and displays the clinical path edit screen of FIG. 6 (step 141). The clinical path is not displayed in the center frame until the application start date is received from the doctor. The user terminal 210 accepts various setting changes on the clinical path editing screen. For example, a plan is excluded on a specific day such as a holiday or a holiday, and a schedule item (inspection, prescription, etc.) is moved. In addition, when the information (local X-ray image) to be acquired in the examination has already been inspected and recorded on the electronic medical record, a mark already performed is displayed on the scheduled item. By selecting this mark, it is also possible to display information acquired by the recorded examination.

  When the editing of the clinical path is completed, the doctor presses the “application start” button on the upper right side of the clinical path editing screen. The user terminal 210 accepts this pressing, and transmits it to the clinical path server 120 as the clinical path of the target patient is completed. The clinical path server 120 records it as one of the target patient's clinical paths (step 151).

[3.2 Clinical path operation processing]
Next, operation using the created clinical path will be described.
The created clinical path corresponds to the work of the patient while referring to nurses other than doctors, nutritionists, pharmacists, laboratory technicians, rehabilitation nurses and the like. A medical worker logs in and selects a patient using the user terminal 230 (which may be another user terminal), and requests the clinical path server 120 to refer to the clinical path. The clinical path server 120 reads out the clinical path of the target patient and transmits it to the requested user terminal 230. The user terminal 230 displays the received clinical path of the corresponding patient. In addition, when a plurality of clinical paths exist in the corresponding patient, the medical staff selects from the list of the clinical paths of the corresponding patient before requesting, or the user terminal 230 receives all the clinical paths and displays the switching. enable. The user terminal 230 displays a clinical path based on today's date. The reference date can be moved to the past or the future. Also, the display period of the clinical path can be switched between “3 days”, “1 week”, and “2 weeks”.

The clinical path on this system has functions such as an instruction receiving function, an execution function, an outcome function, a variance function, and an evaluation function as well as a function that is referred to by the medical staff.
The instruction receiving function accepts an input indicating an instruction received from a medical worker using a user terminal for a scheduled item arranged on the clinical path, and receives the instruction reception date and time, the medical worker identification information (health worker ID or name) and a function to be left in the record of the clinical path server 120 together with the schedule item.

  The implementation function accepts an input from a medical worker who has received an instruction about a scheduled item placed on the clinical path using a user terminal, and the implementation date / time, medical worker identification information (medical worker identification information) ID or name) and a function to be left in the record of the clinical path server 120 together with the schedule item.

  The outcome function accepts the goal input at each point on the clinical path via the user terminal, and accepts the accepted goal as the health worker identification information (health worker ID or name. The health worker here is usually a doctor) And the date to be recorded in the clinical path server 120 together with the date.

  The variance function is a function that reveals the planned items arranged on the clinical path that have not been implemented even after the scheduled date and time, with an icon, etc., and accepts the input of the reason for the generated variance via the user terminal This is a function of recording the accepted reason in the clinical path server 120 together with medical worker identification information (medical worker ID or name) and variance. In addition, since it becomes one of the variances when it is implemented before the scheduled date and time, it may be the target of the variance function.

The evaluation function compares the planned number of days of the clinical pass with the actual number of days taken, accepts input as scheduled, early achievement, late achievement, or interruption via the user terminal, and inputs the reason Is received through the user terminal and recorded in the clinical path server 120 together with the medical worker identification information (health worker ID or name).
Each of these functions also provides a display of recorded information.

  In the present embodiment, the recording is performed in the clinical path server 120. However, the recording may be performed in the electronic medical record database 130, and the clinical path server 120 may read out from the electronic medical record database 130 as necessary. Further, in the present embodiment, the instruction receiving function and the execution function are provided as the clinical path function, but may be configured separately as an ordering system and linked to the clinical path system. The electronic medical record system can also be implemented by including the function of the ordering system and the function of the clinical path system.

  FIG. 7 is a flowchart of the input process to the clinical path according to the present embodiment. The medical staff uses the user terminal 230 (which may be another user terminal) to log in and select a patient in the same manner as when creating a clinical path. The path is read (step 201). The clinical path server 120 determines whether or not there is a schedule item whose execution date exceeds the current date or date / time in the read schedule items on the clinical path (step 211). The scheduled items that are missing are identified (step 212). The clinical path server 120 identifies the scheduled item that has passed the read clinical path and transmits it to the user terminal 230 that requested it. The user terminal 230 receives and displays the clinical path as usual (step 221), and displays the scheduled items that have passed the specified deadline on the displayed clinical path (step 222). As a revealing method, there are a method of changing a character color, a typeface, a background color, a font, displaying an icon, providing a line of variance and displaying “variance” in a column of the date of occurrence of variance. The realization of each function after the clinical path display related to the patient is realized by the user terminal receiving the input of each function, transmitting the input to the clinical path server 120, and the information received by the clinical path server 120 together with the clinical path. It is done by recording. In addition, in this operation, only negative variance is specified, but even when it is implemented earlier than the scheduled item implementation date, the scheduled item can be specified and identified as negative variance. May be revealed.

  FIG. 8 shows an instruction input screen for receiving an instruction to the clinical path according to the present embodiment. In the state where the clinical path of the corresponding patient is displayed on the user terminal 230, select “Receive Instruction” or “Execute” from the menu (right-click menu) displayed by receiving a specific input from the medical staff. . The user terminal 230 accepts the selection, and displays the scheduled items for the day in a tabular format including the presence / absence of execution, the presence / absence of instructions, and the presence / absence of confirmation for each scheduled item (right window in FIG. 8). The instruction reception or execution is performed by selecting from among a plurality of displayed schedule items in order to specify a schedule item to be received or executed. Upon receiving or receiving the instruction here, the user terminal 230 sends the scheduled item received or executed, the medical worker identification information, and the date / time of receiving the instruction or the execution date / time to the clinical path server 120. The clinical path server 120 Receive and record. When the clinical path is referred to after recording, an instruction is received and the updated clinical path is displayed on the user terminal 230.

  FIG. 9 is a clinical path variance input screen according to the present embodiment. In a state where the clinical path of the patient is displayed on the user terminal 230, “variance input” is selected from a menu (right-click menu) displayed by receiving a specific input from a medical worker. The user terminal 230 accepts the selection and displays a variance input screen (right window in FIG. 9). The variance includes a positive variance that is earlier than the scheduled item implementation date and a negative variance that is later than the scheduled item implementation date. In the variance input screen, the type of variance can be selected with a variance selected from the multiple displayed variances, and the status of the fluctuation magnitude of the scheduled date and the implementation date ("small fluctuation", "medium fluctuation") , “Deviation”), and the upper and lower text boxes arranged on the right side of the variance input screen accept the reason and remarks, respectively. Upon receiving the variance input, the user terminal 230 transmits the variance input variance type, variation status, reason, remarks, and medical worker identification information to the clinical path server 120, and the clinical path server 120 receives the variance input. Record. When the clinical path is referred to after recording, the updated clinical path for the variance is displayed on the user terminal. A document containing the recorded variance type, variation status, reason, remarks, and health care worker identification information is recorded in the clinical path server 120 so that it can be browsed, and the document on which the variance is generated is included in the scheduled items related to the document on the clinical path. Is displayed (see FIG. 10). FIG. 10 also shows an outcome input screen on the upper right side. This outcome input screen is displayed by selecting “Outcome Input” from the menu (right-click menu) displayed by accepting a specific input in the outcome line of the clinical path displayed in a tabular format. On this outcome input screen, the achievement goal can be entered as text, and the result for the established achievement goal can be entered at a later date. In response to the outcome input here, the user terminal 230 transmits the outcome, the result, and the medical worker identification information that are input to the outcome, to the clinical path server 120, which receives and records them. When the clinical path is referred to after recording, the updated clinical path for the outcome is displayed on the user terminal.

  FIG. 11 is a clinical path evaluation screen according to this embodiment. When the “path evaluation” button at the top of the clinical path display screen is pressed while the clinical path of the patient is displayed on the user terminal 210, the user terminal 210 displays the evaluation screen. The doctor who formulated the clinical path uses the user terminal 210 to select the effect items “on schedule”, “early achieved”, “achieved late”, and “interrupt”, and select the reason from another screen that lists the reasons. Select the number of days required from the list box. At the time of this selection, a list of variances and an outcome list that are deeply related to the evaluation are displayed in a list format at the bottom of the evaluation screen. In response to the evaluation input here, the user terminal 210 transmits the evaluation input effect item, the reason, the number of days required, and the medical worker identification information to the clinical path server 120, and the clinical path server 120 receives and records it. To do. When the clinical path is referred to after recording, the updated clinical path for the evaluation is displayed on the user terminal.

  It is desirable that the information related to the outcome function, variance function, and evaluation function can be referred to only by the login of a partly authorized person rather than being able to be referred to at the user terminal by the login of all medical staff. . In particular, the information related to the evaluation function is reference information for correcting a standard clinical path used in each hospital. In other words, it is highly necessary to correct the clinical path where the evaluation function has many variances. In addition, when the information related to the evaluation function is referred to for each established doctor, it can also be used as doctor evaluation information. In other words, a doctor who produces a negative variance has a negative evaluation on the assumption that the standard clinical path is normal, and conversely, a doctor who produces a positive variance has a normal standard clinical path. This is a positive evaluation. Of course, not only doctors but also medical staff who receive instructions to support doctors are the main causes, which may lead to negative variances, including positive and negative variances as well as other information A comprehensive evaluation is required. Thus, when using information related to the evaluation function as a doctor's evaluation, the user terminal or the clinical path server 120 may have a report function for outputting information related to the evaluation function for each doctor who has been formulated. preferable. It is also desirable to have a report function that aggregates and outputs for each doctor who has formulated information related to the evaluation function. At this time, aggregation is performed for each effect item, for example, for a doctor, 10 “as scheduled”, 20 “early achieved”, 2 “successfully achieved”, 0 “discontinued” 1st quarter total The result is 32 cases. In other words, each doctor has a function of tabulating with respect to one item of information related to the evaluation function.

[3.3 Response request processing]
FIG. 12 or FIG. 14 is an operation flowchart of the answer request system according to the present embodiment. As shown in FIG. 1, a bedside terminal 240 used exclusively by each patient is provided around each patient's bed. The following explanation is based on the assumption that each patient has a bedside terminal 240, but there are terminals that can be used by the patient for each hospital room, each floor, each ward, and each hospital. Even if it is used, the answer request system according to the present embodiment can be used.

  The patient attempts to log in by inputting a login ID and password to the bedside terminal 240. The bedside terminal 240 requests the clinical pass server 120 for authentication with the input login ID and password. Assuming that the authentication is successful, the clinical path server 120 reads the clinical path of the patient (step 301). It is determined whether or not there is a schedule item that has been missed based on the current day among the read schedule items of the clinical path (step 302), and the corresponding schedule item is specified as a schedule item for variance (step 303). If there is a variance item from the clinical path server 120, it is identified and transmitted to the bedside terminal 240 that has requested the read clinical path. The bedside terminal 240 displays the received clinical path (step 311), and reveals the specified scheduled items of variance (step 312). Although the method of revealing the scheduled items of variance has already been revealed, in the present embodiment, the variance is displayed by displaying “variance” in a cell specified from the column of the date of occurrence of variance. If there is a variance-occurring document as described above, an icon indicating the record of the document is also displayed. The display of the clinical path can be different from the clinical path displayed to the medical staff. Specialized items are omitted as much as possible, and the character part is converted into information for a patient such as an icon and transmitted to the bedside terminal 240.

  The “variance” cell or the variance occurrence document can be pressed on the bedside terminal 240. When the patient presses on the bedside terminal 240, an answer request screen is displayed (step 321).

  There are a variety of medical professionals for whom responses are requested. This is because when a patient becomes anxious and wants to ask a question, not only a doctor but also a pharmacist about medicine and a dietitian may ask about meals. The patient's anxiety is alleviated by answering by the medical professional who wants the patient. If necessary, the answer of the medical staff may be transmitted to the doctor or may be transmitted to the patient after obtaining the permission of the doctor. In addition, when it is desired to ask another doctor to make a diagnosis again, it is possible to ask a doctor other than the attending doctor for a diagnosis answer. This is equivalent to performing a so-called second opinion. The target doctor may be in-hospital or out-of-hospital.

  In the following, the second opinion will be explained, but questions to medical personnel such as doctors, pharmacists, nutritionists, nurses, etc. other than the second opinion can be realized by the same process. Since questions other than the second opinion cannot be compared in principle, the diagnosis treatment of the attending physician in step 392 and the processing of the second opinion are particularly processing specific to the second opinion.

  FIG. 13 is a second opinion request screen according to the present embodiment. The name of the patient who is currently logged in is displayed on the upper left side of the second opinion. In addition, there are a second opinion doctor item group, a request text item group, an answer deadline item group, an answer type item group, and other item groups that can be specified by the check box.

  The second opinion doctor item group includes a “select doctor” button, a hospital, a department, and a name text box. By pressing the “select doctor” button in this text box, the bedside terminal 240 requests the reply request server 110 for the second opinion doctor information that is the person in charge of answering. In response to this request, the response request server 110 reads the second opinion doctor information (step 331), and transmits it to the requested bedside terminal 240. The bedside terminal 240 receives the second opinion doctor information and displays selectable second opinion doctor information on a doctor selection screen (not shown). Second opinion doctor information includes, for example, the doctor's hospital, affiliation, and name, the number of treatments for each disease, the number of operations for each disease, doctor history, specialty, academic society, award history, number of second opinions, and the current login. This includes the number of second opinions to the hospital where the patient is hospitalized. The reason why the number of second opinions is displayed in addition to the medical history of the doctor is to show the ease of requesting the second opinion, understanding of the second opinion, and experience of the second opinion. Further, the reason why the number of times of execution of the second opinion with respect to the hospital where the patient is hospitalized is to show the ease of request. That is, it is easy to use when there is a past record. By selecting the second opinion doctor from the doctor selection screen, the hospital, affiliation, and name of the selected second opinion doctor are displayed in the text box. The registration of the second opinion doctor registers the mutual doctors in cooperation with the hospital, registers the second opinion doctor who belongs to the community through the community of the second opinion, or registers the second opinion doctor through the association of doctors.

  The request text item group can be directly input by the patient to the text box in which the request text item is arranged, but a “select sentence example” button is arranged for further convenience. When the “select sentence example” button is selected, a sentence example registered in advance in the system (answer request server 110, bedside terminal) is displayed on a sentence example selection screen (not shown) in a selectable manner. When the patient selects a sentence example on the sentence example selection screen, the selected sentence example is inserted into the text box of the request body item group. There is a replacement item in the sentence, and by selecting the second opinion doctor before selecting the sentence example, the name of the selected second opinion doctor can be replaced with the replacement item in the sentence and inserted into the text box. it can. Registration of the sentence examples can be easily performed by the system administrator registering the information obtained by deleting the personal information from the request text of the already processed answer request.

  The desired response time limit item group is used when a response time limit is set for a response to a patient response request. When the “calendar display” is pressed, the calendar is displayed on a calendar selection screen (not shown) so that the date can be selected. When the patient selects a date on the calendar selection screen, the selected date is displayed in the text box for the desired response time limit. Enter the reason for setting the answer deadline in the reason text box. In addition, when each second opinion doctor sets the minimum number of required response days in advance and the setting is included in the second opinion doctor information, the desired response deadline is the minimum number of required response days for the second opinion doctor selected from that day on the calendar selection screen. It is desirable that the corresponding date cannot be selected. Even if a date that has not been set can be selected, it is preferable to output a warning screen stating that the date cannot be specified. By doing so, the patient can choose a new second opinion doctor instead of selecting a new second opinion doctor after being refused due to the deadline for answering, and the second opinion doctor also bothers to refuse due to the deadline for answering There is no need to take any steps.

  The answer type item group is for allowing the patient to select the type of means for answering from the person in charge of answering. Answer types include electronic texts, direct visits, indirect visits through video conferences, and telephone calls. By pressing the “answer type selection” button that is arranged, a pre-registered answer type can be selected and displayed on an answer type selection screen (not shown). The reason why the answer type is so selected can be entered in the reason text box. In addition, when setting the answer type that can be selected in advance by each second opinion doctor and including the setting in the second opinion doctor information, only the answer type related to the second opinion doctor is displayed on the answer type selection screen. It is desirable to have a configuration that Even if an answer type that has not been set can be selected, it is preferable to output a warning screen stating that “the answer type cannot be specified”. By doing so, instead of selecting a new second opinion doctor after being refused for the reason of the answer type, the patient can also select a new second opinion doctor, and the second opinion doctor also bothers to refuse the reason for the answer type There is no need to take any steps.

  The other items specify whether or not to inform the attending physician and family doctor that a second opinion is requested, and whether or not the request date and response deadline for the requested second opinion are displayed on the clinical path. This is to specify. When notifying the attending physician and family doctor, all or part of the request information can be transmitted. For example, the second opinion doctor can be kept secret. It is desirable to inform the second opinion doctor as to whether or not to inform the attending physician and family doctor, and if the doctor knows that the second opinion has requested the second opinion, the attending physician will know. You can also ask questions and can recommend a second opinion smoothly. On the other hand, the second opinion can be implemented fairly because the second opinion doctor does not know the attending physician. If the enforcement of the second opinion is strengthened, the hospital and patient name should not be disclosed to the second opinion doctor.

  As described above, the bedside terminal 240 transmits the information set on the second opinion request screen as request information to the response request server 110. The response request server 110 records the received request information (step 341). The response request server 110 acquires the examination and diagnosis information of the patient who requested the response from the electronic medical record server 130 or the clinical path server 120 (step 342). In addition, information that is not normally referred to by the patient unless the attending physician gives permission to browse is configured to send unconditionally to the second opinion doctor, unless the permission from the attending physician, the information is not sent, and the second opinion is sent to the attending physician. In the case of setting not to notify, it is possible to adopt a configuration in which the information can be transmitted with the permission of the supervisor of the attending physician.

  The response request server 110 transmits the acquired patient information and request information to the corresponding second opinion doctor (step 351). In this embodiment, first, patient information and request information are recorded in a storage area for the corresponding second opinion doctor in the answer request server 110. Then, the corresponding second opinion doctor has recognized the login of the corresponding second opinion doctor from the response request server 110 in a state of logging in on the external user terminal 310 (may be another external user terminal or user terminal). The patient information and request information recorded as a trigger is transmitted to the external user terminal 310 where the corresponding second opinion doctor is logged in. The external user terminal 310 receives the recorded patient information and request information, and displays the second opinion request acceptance screen shown in FIG. 15 (step 361). Note that there are two known techniques for displaying a dedicated screen on a user terminal or an external user terminal. The first is to install and execute the client program of the answer request system, and the second is to use an ASP (Application Service Provider) on the user terminal or the external user terminal. The login of the second opinion doctor may be executed with respect to the answer request server 110, or may be executed with respect to a computer that provides other services of the present system such as the clinical path server 120. In the case of logging in other than the response request server 110, the log-in of the corresponding second opinion doctor is notified to the response request server 110 from the computer that executed the login. When the response request server 110 receives the response request, the response request server 110 requests other computers to notify the login of the second opinion doctor related to the response request. The other computer includes a computer constituting the system of another hospital when the present system is constructed for each hospital. Furthermore, when the response request server 110 transmits a response request to the outside of the medical staff to be managed by the self, the response request server for managing the medical staff transmits the request information, and the response information May be configured to perform proxy processing for receiving and answering time limit management. When the response request server that has performed the proxy process receives the response information, the response request server transfers the response information to the response request server 110.

  On the second opinion request acceptance screen, the name of the currently logged in doctor is displayed on the upper left side. The second opinion request acceptance screen shows the patient's hospital, treatment department, patient item group indicating the name, request text item group entered by the patient, response deadline item group, answer type item group, and the file constituting the patient information There is a group of patient information items. The request text item group has a “answer text creation” button, an answer text creation screen (not shown) is displayed, and a doctor creates a diagnosis result as an answer text. On the answer sentence creation screen, a doctor may input a text to create an answer sentence, but it may be configured to select a disease name and treatment from a list and answer. By doing so, it is possible to unify the disease name and treatment expression, and the diagnosis and treatment between the doctor in charge and the second opinion doctor described later can be performed smoothly.

  A “response not possible” button is arranged in the response time limit item group. This button is a button for refusing a response request because the response request deadline specified by the patient cannot be met, and a response that the response request cannot be received because the response request deadline cannot be met by pressing this button. A rejection screen (not shown) is displayed.

  A “response not possible” button is also arranged in the response type item group. This button is for rejecting a response request because the specified response type cannot be met, and a response rejection screen indicating that the response request cannot be received because the response type cannot be met by pressing the button. Is displayed. In addition to these “response not possible” buttons, an “response impossible” button is arranged on the upper right side of the request reception screen. This “response not possible” button is a button for refusing a response request for other reasons.

  If the corresponding patient has enabled the “Transfer to doctor” check box on the second opinion request screen, the message “Already transferred to doctor” is displayed on the second opinion request reception screen. The same applies to family doctors. Information transmission to the attending physician and family doctor is also transmitted at the timing of step 351. The doctor and family doctor can send and browse the request information in the same way as the second opinion doctor, and simply send an email to the pre-registered doctor and family doctor's email address. Also good.

  When the second opinion doctor describes the diagnosis result on the answer sentence creation screen and presses the “OK” button, the answer sentence created by the second opinion doctor is extracted (step 371) and transmitted to the answer request server 110. The response request server 110 records the response information in association with the corresponding patient (step 381). When the corresponding patient logs in at the bedside terminal 240, the response request server 110 transmits the response information to the bedside terminal 240 (step 383). The bedside terminal 240 displays the received answer information (step 391). The bedside terminal 240 has a function of comparing the diagnosis results (disease name, treatment) of the attending physician and the second opinion physician. Contrast is mainly a function that reveals the same and different points of disease name and treatment.

  After the step 351, the response request server 110 executes second opinion response time limit management, which is a predefined step 352. This second opinion response deadline management is a function that prompts the corresponding second opinion doctor to answer the deadline when the number of days until the answer deadline reaches a predetermined period, and when the second opinion doctor logs in, a message prompting an answer to the second opinion answer request is issued. Send. If the second opinion doctor has not logged in for a while, use the other communication means (email, fax, etc.) to the second opinion doctor or the person related to the second opinion (supervisor, subordinate, colleagues, system administrator, etc.) Notice. Second opinion reply deadline management stops after the reply information is recorded in step 381 (step 382).

After the response information in step 383 is transmitted to the corresponding patient, the cost required for the second opinion is updated in the medical database 140 (step 384). When a doctor who works in a hospital where a patient is hospitalized becomes a second opinion doctor, the expenses required for the second opinion are recorded. If a doctor at another hospital becomes a second opinion doctor, the expense required for outsourcing the second opinion will be recorded. If a patient pays directly to another hospital, no costs are recorded. These differ depending on the hospital's accounting.
The case where the answer type is “electronic text” has been described, but when the second opinion doctor answers to the corresponding patient with another answer type, the “answer not yet completed” button on the request reception screen is pressed, so that step 391 is performed. Migrate to

[4. Other Configurations of Embodiment]
[4.1 Response request and reply by e-mail to second opinion doctor]
If the user terminal used by the second opinion doctor or the external user terminal does not have the client program of the answer request system installed and the answer request system cannot be used with ASP, the normal dedicated screen cannot be used. .

In this case, the response request server 110 may be configured such that the request information is an e-mail text, the patient information is an attached file, and the response request server 110 transmits to a pre-registered e-mail address of the second opinion doctor. FIG. 16 shows a screen on which this mail is displayed by the mailer. It is desirable to encrypt the attached file from the viewpoint of security. In some cases, only the patient information in the attached file may be separately received from the data server.
In addition to mail, transmission by FAX is also possible. The response request server 110 has a FAX function, converts the request information and patient information into a FAX data format, and transmits it to the FAX number registered in advance by the second opinion doctor.

[4.2 Selection of respondents]
In the present embodiment, the selection of the second opinion doctor has been explained. Explain the selection of respondents other than second opinion doctors.
Similar to the selection of the second opinion doctor, the history of the person in charge, the number of responses, the number of responses to the in-hospital patient, and the average response period can be displayed as selection criteria.

  The person in charge of answering can be limited to the hospital. Furthermore, the medical staff currently in charge can be automatically selected, and if necessary, the medical staff can be selected other than the medical staff in charge. Scheduled medical staff for scheduled items, medical staff receiving instructions, implementation of medical staff for scheduled items, medical workers who directed scheduled items, healthcare workers who manage scheduled items, or healthcare workers who have created clinical paths Items that are not recorded in association with items need to be recorded in association. Since patients can meet doctors and nurses directly, they can also ask questions at any time. However, there are generally fewer opportunities to meet pharmacists, dietitians, etc., even if they meet, compared to doctors and nurses. In some cases, the patient may not know the pharmacist or nutritionist in charge. By providing such a medical staff with a mechanism that allows the patient to ask for answers when necessary, the convenience of the patient is greatly improved, and anxiety during hospitalization is also eliminated.

(Other embodiments)
[Details of diagnostic treatment of the attending physician and the second opinion comparison function]
FIG. 17 is a diagnostic treatment comparison screen which is one of the answer screens according to the present embodiment.
The diagnosis / treatment comparison screen displays items of disease name, treatment, and remarks so that the diagnosis of the name of the primary doctor and the second opinion doctor can be compared with the treatment. In FIG. 17, “◯” indicating the same is displayed on the dotted line connecting both text boxes with the same disease name diagnosis. On the other hand, the treatment is different, and “x” indicating a difference is displayed on a dotted line connecting both text boxes. This FIG. 17 is an example, and it is only necessary to show on the screen information that can easily identify whether the diagnosis and treatment are the same.

[Presentation to the patient of the reason for the appointment that is out of the clinical path]
FIG. 9 shows a screen on which a medical worker inputs the reason for occurrence of variance when variance occurs. It can also be configured to show the patient the reason for the variance entered on this screen. The reason of variance that is input in the hospital business management may be shown to the patient as it is, but in addition to the reason input box in FIG. 9, an input box for the reason for the patient can be arranged, and the information input there May be configured to be presented to the patient. As a timing of presenting the patient's variance reason for the patient, characters, icons, etc. on the clinical path revealed by the method of revealing the scheduled items of variance are displayed at the timing when the patient presses. The response request screen is displayed after presenting the reason for variance for the patient. For example, a button for an answer request screen is arranged on a screen presenting a reason for variance for a patient, and the answer request screen is displayed when the button is pressed by the patient.
By comprising in this way, the medical worker can reply only to the important reply request which needs a reply request, even if it tells a patient the reason of variance while suppressing the frequent reply request from a patient.

The following additional notes will be made regarding the above embodiments.
(Appendix)
(Supplementary Note 1) The patient terminal used by the patient includes means for requesting acquisition of a clinical path specifying the patient, and the response request server detects a schedule out of schedule among the schedules constituting the clinical path as variance. And a means for transmitting the clinical path of the patient whose variance has been identified to the patient terminal that requested the acquisition of the clinical path in response to the request of the clinical path from the patient terminal, the patient terminal receiving the clinical path A means for displaying and displaying the variance, a means for accepting an answer request consisting of input or selection of the person in charge of answering and the contents of the answer request in the case of showing the variance, and answering the person in charge of answering and the contents of the answer request And a response request received by the response request server and the content of the response request. And a means for sending the response request content to the response officer terminal used by the received answer officer, and the answer officer terminal displays the received answer request content. Including a means for displaying, a means for receiving an answer to the content of the received answer request, and a means for transmitting the received answer to the answer request server and information for specifying the answer request, wherein the answer request server records the received answer An answer request system further comprising: a means for recording in association with an answer request being received; a means for transmitting the recorded answer to a patient terminal used by the patient who requested the answer; and a means for displaying the answer received by the patient terminal .

    (Additional remark 2) The patient terminal newly includes a means for accepting selection of the variance causing the answer request and a means for transmitting the variance causing the selected answer request to the answer request server. A new means to identify the responder who is associated with the schedule related to the variance from the staff storage means in which the server records the schedule and the medical staff in association, and to send to the patient terminal as the default answerer The answer request system according to appendix 1, wherein the default answerer received by the patient terminal is the answerer of the answer request.

    (Supplementary Note 3) The patient terminal newly includes means for accepting an input or selection regarding a time limit of a reply person to reply to the reply request at the time of the reply request. The response deadline of the person in charge of the response to the response request that has been input or selected in the “transmission means” is also sent to the response request server, and the received response person and the contents of the response request are recorded in association with the patient who requested the answer. Record the time limit for responding to the response request received in "How to do", and when the response request server has passed the response time limit or when the response time limit for the response request is within the specified period The reply request system according to the above supplementary note 1, further including means for prompting the reply staff terminal of the reply staff of the reply request that has not been answered to the request.

    (Supplementary note 4) Means that the responder terminal accepts at least the minimum required response period, which is the response period required until the response request of the responder, information for identifying the responder and the minimum required response of the responder Means for transmitting the period to the response request server, and the response request server transmits the minimum required response period of the response person in association with the responder and the minimum required response period to the patient terminal. A response deadline that satisfies the conditions of the minimum required response period of the corresponding answerer in the above-mentioned "means of accepting input or selection of answer deadline of answerer to answer request at the time of answer request" or 4. The reply request system according to appendix 3, which accepts a selection.

    (Additional remark 5) The response request using the patient terminal from the patient is a second opinion, and the record of the corresponding patient is recorded by the “means for transmitting the response request content to the response officer terminal used by the received answer officer”. The reply request system according to the above supplementary note 1, wherein a diagnosis result of the attending physician and / or a test result recorded by the corresponding patient is also transmitted to the reply staff terminal.

    (Supplementary note 6) A second opinion doctor who newly includes a means for transmitting the diagnosis of the attending physician to the patient terminal used by the patient who requested the answer by the answer request server, and who is in charge of answering the diagnosis and answer request of the attending physician received by the patient terminal 6. The reply request system according to appendix 5, which further includes means for displaying the diagnosis by contrasting.

    (Supplementary note 7) Newly includes means for accepting designation that the patient terminal transmits an answer request to the attending physician and / or family doctor, and transmitting it to the answer request server. 6. The reply request system according to appendix 5, further including means for transmitting to a terminal used by the attending physician and / or a terminal used by a family doctor of the designated corresponding patient.

    (Supplementary Note 8) Means for the answer request server to count the answer request and / or answer for each person in charge of the answer, the number of answer requests from the patient terminal and / or the number of answer requests counted according to the request for the answer count and / or Alternatively, the answer request system according to appendix 5, further including means for transmitting to the patient terminal that requested the number of answers.

    (Supplementary Note 9) Means for the response request server to count the response requests and / or responses for the response requests made from the hospital where the corresponding patient is provided for each response person, and the number of response requests and / or the number of responses from the patient terminal 6. The response request system according to appendix 5, which newly includes a response request count and / or a means for transmitting the response count to the patient terminal that has requested the response count for a response request made from a hospital where the corresponding patient is counted.

    (Additional remark 10) The step which the patient terminal which a patient uses requests | requires acquisition of the clinical path which specified the patient, The response request server detects the plan which became out of schedule among the schedules which comprise a clinical path, and In response to a clinical path request from the patient terminal, a step of transmitting the clinical path of the corresponding patient whose variance has been identified to the patient terminal that has requested acquisition of the clinical path, and the patient terminal reveals the variance of the received clinical path. A response request consisting of inputting and selecting the person in charge of answering and the contents of the answer request when the variance is revealed, and sending the person in charge of answering and the contents of the answer request to the answer request server The response request server received by the response request server And a step of recording the response request content in association with the patient who requested the response, and a step of transmitting the response request content to the response officer terminal used by the received response officer. The response request server includes a means for displaying the response request content, a step for receiving an answer to the received response request content, and a step for transmitting the received response to the response request server. A step of recording the response in association with the response request recording the response, and a step of transmitting the recorded response to the patient terminal used by the patient who requested the response, and means for displaying the response received by the patient terminal. An answer request method that also includes.

  Although the present invention has been described with the above embodiments, the technical scope of the present invention is not limited to the scope described in the embodiments, and various modifications or improvements can be added to these embodiments. . And embodiment which added such a change or improvement is also contained in the technical scope of the present invention. This is apparent from the claims and the means for solving the problems.

It is a system block diagram constructed | assembled inside and outside the hospital containing the reply request system which concerns on the 1st Embodiment of this invention. It is a hardware block diagram of the computer which concerns on the 1st Embodiment of this invention. It is a flowchart of a clinical path creation process according to the first embodiment of the present invention. It is an initial screen of the clinical path which concerns on the 1st Embodiment of this invention. It is a standard clinical path selection screen according to the first embodiment of the present invention. It is a clinical path edit screen which concerns on the 1st Embodiment of this invention. It is a flowchart of the input process to the clinical path which concerns on the 1st Embodiment of this invention. It is the implementation input screen to the clinical path which concerns on the 1st Embodiment of this invention. It is a variance input screen of a clinical path concerning the 1st embodiment of the present invention. It is a display of the icon of the variance which concerns on the 1st Embodiment of this invention. It is a clinical path evaluation screen according to the first embodiment of the present invention. It is an operation | movement flowchart of the reply request system which concerns on the 1st Embodiment of this invention. It is a second opinion request screen which is one of the response requests according to the first embodiment of the present invention. It is an operation | movement flowchart of the reply request system which concerns on the 1st Embodiment of this invention. It is a second opinion request receiving screen which is one of the answer request receiving screens according to the first embodiment of the present invention. It is a second opinion request acceptance screen <mail> which is one of the answer request acceptance screens according to the first embodiment of the present invention. It is a diagnostic treatment contrast screen which is one of the reply screens according to another embodiment.

Explanation of symbols

11 CPU
12 RAM
13 ROM
14 HD
15 LAN card 16 Mouse 17 Keyboard 18 Video card 18a Display 19 Sound card 19a Speaker 20 Drive 21 Bar code reader 110 Answer request server 120 Clinical path server 130 Electronic medical record database 140 Medical database 210, 220, 230, 240, 250, 260, 270, 280 User terminal 310, 410 External user terminal

Claims (5)

The patient terminal used by the patient includes a clinical path acquisition request means for requesting acquisition of a clinical path specifying the patient,
Answer request server, the variance detecting means for detecting an event that has become unscheduled among plan to configure the clinical pathway as variance, in response to a request of the clinical pathway from the patient terminal, the relevant patient identifying the variance and a clinical pathway transmitting means for transmitting a clinical pathway to the patient terminal that has requested the acquisition of clinical pathways,
The patient terminal, a clinical pathway display means for displaying the clinical pathway received by revealing the variance, displayed and variance selection means for accepting a selection of the variance, the selected variance information the reply request server And variance transmission means for transmitting to
The answer request server associates and records a schedule and a medical worker, and the medical worker is associated with the schedule related to the transmitted variance information based on the responsible person storage means. Answering person specifying means for specifying the answering person as an answering person, and answering person sending means for sending the specified answering person as a default answering person to the patient terminal,
The patient terminal is transmitted, and the answer request accepting means for accepting an input or answer request comprising the selection of the default answer personnel and answers requests what it receives, the respondents personnel and answers request contents received in the reply request server And an answer request transmitting means for
The reply request server, the reply request recording means for recording in association with patients who request reply the respondents personnel and answers request contents received, the reply request contents respondents representative terminal in which the respondents person who received using And a response request content transmitting means for transmitting
The respondents person terminal, a reply request content display means for displaying the answer request contents received, and the answer receiving means for receiving a reply to the reply request contents received, the answer is accepted and information identifying the reply request And a first response transmission means for transmitting to the response request server,
The reply request server, the reply received, recorded and responded recording means for recording in association with the answers request is a second reply to send recorded the answer to the patient terminal used by patients who request reply A transmission means,
The patient terminal, answer request system further comprising an answer display means for displaying the answers received. Answer request using the patient terminal from the patient is second opinion,
Answer request system according to claim 1 wherein the answer request content transmitting means, recorded and are test results of the diagnosis and / or appropriate patient's doctor that the relevant patient records may be sent to the respondents representative terminal. The answer request server, only contains the means for transmitting the diagnosis of the attending physician to the patient terminal patient who has requested the answer is to use,
The patient terminal, answer request system according to comparison display means for display by comparing the diagnosis by second opinion doctor is respondents representative of the reply request and diagnosis of the attending physicians who received including the claim 2. The reply request server, aggregator and answer request number and / or answer number from the patient terminal to aggregate the answer request has been made from the hospital there are appropriate patients the reply request and / or the answer to each answer representative Answer request system according the result of aggregation, and a totalization result transmitting means for transmitting to said patient terminal including claim 2 in response to the request. A clinical terminal acquisition request step in which a patient terminal used by the patient requests acquisition of a clinical path specifying the patient; and
Answer request server, the variance detection step of detecting an event that has become unscheduled among plan to configure the clinical pathway as variance, in response to a request of the clinical pathway from the patient terminal, the relevant patient identifying the variance a clinical pathway transmitting step of transmitting the clinical pathway on the patient terminal that has requested the acquisition of clinical pathways,
The patient terminal, a clinical pathway display step of displaying the clinical pathway received by revealing the variance, displayed and variance selection step of accepting a selection of the variance, the selected variance information the reply request server A variance transmission step to transmit to
The answer request server specifies, as an answerer, the healthcare worker associated with the transmitted schedule related to the variance information based on a person-in-charge storage unit that records the schedule and the healthcare worker in association with each other. An answerer specifying step; an answerer sending step of sending the identified answerer as a default answerer to the patient terminal;
Answer the patient terminal, of sending a reply request receiving step of receiving an input or answer request comprising the selection of the default answer personnel and answers requests what it receives, the response personnel and answers request contents received in the answer request server Send request step ;
The reply request server, the reply request recording step of recording the respondents personnel and answers request contents received in association with patients request reply, the reply request contents respondents representative terminal which received answer personnel uses An answer request content sending step to be sent ; and
The respondents person terminal, a reply request content display step of displaying the answer request contents of the received answers accepting step of accepting a reply to the reply request contents received, the answer is accepted and information identifying the reply request A first response transmission step for transmitting to the response request server ;
The reply request server, the reply received, recorded and responded recording step of recording in association with the answers request is a second reply to send recorded the answer to the patient terminal used by patients who request reply Sending step ;
The patient terminal, and respond display step and including Answer request method for displaying the answers received.

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