JP5157111B2 - Cancer chemotherapy management system - Google Patents

Description

  The present invention relates to a cancer chemotherapy management system. In particular, apart from a cancer chemotherapy protocol set for each patient, a general cancer chemotherapy (hereinafter simply referred to as a therapy) corresponding to a drug such as an anticancer drug is a database. As a result, it is possible to share such cancer chemotherapy, enable the advancement and development of the therapy, and quickly create a cancer chemotherapy protocol and a cancer chemotherapy protocol. The present invention relates to a cancer chemotherapy management system that can increase the degree of freedom of creation, or even doctors who are unskilled in therapy can easily come into contact with the therapy, and can promote the advancement of cancer medical treatment.

In general, cancer chemotherapy is a treatment that administers an anticancer drug (anticancer drug), which is a chemical substance, to cancer patients to suppress the growth of cancer cells and destroy cancer cells. , Gastric cancer, colorectal cancer, esophageal cancer), a plurality of cancer chemotherapy (for example, MTX-5-FU alternation therapy, levofolinate-fluorouracil therapy, 5-FU-Landa therapy) are being performed.
Although research on cancer treatment using such anticancer drugs is gradually progressing, humanity has not yet obtained perfect anticancer drugs. Therefore, various anticancer drugs are in the middle of trials, and the development method of anticancer drugs is to apply the anticancer drugs under trial to the treatment of actual cancer, and to develop anticancer drugs that are in symptom while accumulating experience with the applied anticancer drugs. The technique of discovering is taken.
What is important in the actual situation of treatment combined with research and development of such anticancer drugs is that when the anticancer drug under trial is applied to symptoms as described above, the conditions of application and the anticancer drug applied to the conditions are A technique for clearly extracting the causal relationship with the effect must be taken. In particular, the development of an anticancer drug is not advanced until it is combined with an actual treatment as described above. However, since the actual treatment must be adapted to the health condition of a living patient from time to time, In fact, it is extremely difficult to clearly extract the causal relationship between the application conditions and the effects.
Therefore, the actual situation is that the anticancer agent itself and a suitable therapy applied to the developed anticancer agent have been developed at the same time. In other words, in the treatment using anticancer drugs, there are problems of developing anticancer drugs such as what kind of anticancer drugs are available, and problems of developing therapies using anticancer drugs such as how to use the selected anticancer drugs. It is common knowledge in the field of current anticancer drug development and cancer treatment that these two combined to achieve an effective anticancer action.

On the other hand, in principle, drug development is a problem for the development company, and the problem of therapy is considered as a problem for the medical institution that uses the drug, from the standpoint of separating the medical site from the drug development site, or This is desirable because each development is promoted both at the site and at the drug development site.
However, unlike general drugs, in the field of anticancer drugs, as described above, since the method of drug development by feeding back the results of trial and error at the actual treatment site to drug development has become established, For general therapies for anti-cancer drugs that have left the hospital, the drug developer has developed, and the practice of communicating the information to medical institutions in the form of specifications, for example, has been established. Each time a chemotherapy protocol is created, a procedure is performed in which a doctor creates data for application to a specific patient, that is, a cancer chemotherapy protocol, with reference to the description of such specifications.
For example, Patent Document 1 discloses a prescription support system for an anticancer drug having a database on the cancer chemotherapy protocol.
In this conventionally known system, a doctor or the like uses this system to perform cancer chemotherapy for each cancer patient, an anticancer drug to be applied in the cancer chemotherapy, a plurality of application days for applying the anticancer drug, A cancer chemotherapy protocol including the number of times of application on the day of application can be created, and the cancer chemotherapy protocol created for each cancer patient by using this system by a pharmacist, etc., and the cancer chemotherapy It is said that prescription information based on the protocol can be checked reliably and quickly.
In Patent Document 1, cancer chemotherapy protocol data includes patient ID, registration date, category, patient's name and sex, date of birth and age, and patient's ward and ward if the category is hospitalization, clinical department , Doctor in charge, type, patient's height and weight, body surface area and CCR, disease name and cancer chemotherapy name, etc., anticancer drug to be applied, date of application of each anticancer drug, each time of each anticancer drug It is said that the information on the dosage, the combination date to be applied, the date of application of the combination drug, and the dose of each time of the combination drug is provided when the combination drug is used together.
Moreover, in this patent document 1, although the dosage at each application is calculated and determined using the master coefficient of each anticancer drug memorize | stored in the chemotherapy data file regarding the said chemotherapy protocol, each cancer chemotherapy Regarding the master coefficient of information, the default value or the read value can be changed (corrected) to an appropriate numerical value (see paragraph 45).
Specifically, after the cancer chemotherapy protocol is created, the application date, the number of applications, the dose, the master coefficient, etc. can be changed. When this change is made (S13; Yes), the process proceeds to S10 and the application is performed. The date, number of applications, and dose are re-determined. The disease name and cancer chemotherapy can also be changed (see paragraph 73). In addition, “By using this system, doctors, etc. can apply cancer chemotherapy to each cancer patient, anticancer drugs to be applied in the cancer chemotherapy, and multiple application days to apply anticancer drugs. Therefore, it is possible to make a cancer chemotherapy protocol by determining the number of times of application on each application day reliably and promptly, and to support the prescription of anticancer drugs. When preparing, it is possible to appropriately change the application pattern of the anticancer drug and the master coefficient to create an optimal cancer chemotherapy protocol for each cancer patient (see paragraph 84).
Thus, in the case of treatment using a conventionally known anticancer agent, the above-mentioned cancer chemotherapy protocol data is obtained by changing the data of application of an anticancer agent to a specific patient, that is, the cancer chemotherapy protocol according to a specific case. In addition to promoting the accumulation of information, it encourages the accumulation of information and aims to enrich feedback information to drug developers.

By the way, the specific condition of application to the symptoms of each patient is separated, that is, apart from the cancer chemotherapy protocol in Patent Document 1, "therapy" that is considered as a general application method of the developed anticancer agent, Conventionally, only the specifications provided by the developer of the anticancer drug as described above are available on the medical institution side, and in order to create a cancer chemotherapy protocol, it is necessary to refer to the above specifications etc. Met. Also, when inputting without looking at the specifications, etc., it also depends on the memory of the doctor, and there is a high possibility of errors due to memory differences.
As described above, “therapies” are to be developed and improved by medical institutions such as doctors. However, as mentioned above, there is no system for accumulating “therapies” databases on the medical institutions side as described above. There was a limit to the development and improvement of “therapy”.
However, the therapy that can be regarded as a general application method of the above-mentioned anti-cancer drugs can naturally have various preferable “therapies” based on the experience of the doctors who apply them. In addition, it is possible to promote the enrichment and optimization of cancer chemotherapy protocol, which is an application example of “therapy”, at once.
In addition, by having the “therapy database” as described above, young doctors who are unfamiliar with therapy can actively touch the excellent therapy created by veteran doctors, and the rapid advancement of cancer medical technology can be achieved quickly. It seems that it can be aimed at.
JP 2004-287946 A

  Therefore, an object of the present invention is to independently enrich and optimize the “therapy” itself by having a database of “therapy” defined as a general usage of the anticancer drug as described above. In addition, the cancer chemotherapy protocol that is an application example of such “therapy” is promoted at once, and a cancer chemotherapy management system that does not require skill in using the therapy is provided. That is.

In order to solve the above problems, the cancer chemotherapy management system of the present invention comprises:
A therapy input means for inputting a plurality of therapies corresponding to general usage of a plurality of drugs for cancer treatment,
Therapy storage means for storing a plurality of therapies input by the therapy input means,
A cancer chemotherapy protocol creation means for creating a prescription and administration plan of a drug adapted to a specific patient's condition with reference to the therapy stored in the therapy storage means;
Cancer chemotherapy protocol storage means for storing the prescription and administration plan of the drug prepared by the cancer chemotherapy protocol preparation means,
A dose limit value storage means for storing a dose limit value for each unit of patient vital data for a drug group including the above drugs stored in the drug master in association with a drug having the same efficacy;
Drug history storage means for storing data including a dose history of the drug reflecting the prescription and administration plan of the drug stored in the cancer chemotherapy protocol storage means;
In addition to the drug dose history stored in the drug history storage means, an off-history drug dose input means for inputting past drug doses for each drug group displayed on the screen of the drug group list ;
A vital data input means for inputting vital data including the current height and weight of the patient;
Vital data recording and updating means for recording and updating the vital data input by the vital data input means;
Limit dose calculation means for calculating a limit dose based on the latest patient vital data recorded in the vital data record update means and the dose limit value;
For the drug group, the dose of the drug stored in the drug history storage means and the dose of the drug input by the out-of-history drug dose input means are added together, and the total value and the dose limit value storage means and drug dosage display means for displaying together the limit dose calculated by the limit dose calculation means based on the dosage limits stored in,
A cancer chemotherapy management system characterized by comprising:
The cancer chemotherapy management system may be configured such that the total value is close to a limit dose calculated by the limit dose calculation means based on the dose limit value stored in the dose limit value storage means, or It is conceivable to further comprise a medicine dose limit warning display means for displaying a warning when it exceeds that.
Further, the drug dose display means displays the combined value, the dose limit value stored in the dose limit value storage means, and the limit dose calculated by the limit dose calculation means together. It is thought that it is what to do.
Although the therapy stored in the therapy storage means cannot be modified, the therapy can be copied and the copied therapy can be modified and stored as a new therapy.
However, only a person with a predetermined qualification can perform new creation, copying, and modification of therapy and storage (registration) in the therapy storage means.
Furthermore, the therapy storage means stores the therapy name, disease name, number of days in one course, standard number of cools, maximum number of cools, name of drug used, prescription amount of drug used, and administration schedule for each stored therapy. It is desirable that
The therapy storage means may further be one that stores the maximum amount of drug to be used, the administration method, and the usage for each stored therapy.

On the other hand, there are generally dose limits for drugs. In particular, those used in cancer chemotherapy such as anticancer drugs are highly effective, and there are many cases in which the limit of the dose that can be used throughout life is strictly determined. This is called the total dose limit and lifetime dose limit. Naturally, the total dose is not a specific value for each individual drug, but a drug as a superordinate concept that has the same effect as each drug. In the present invention, this is called a drug group.
Since the total drug dose as described above is the sum of the amount of each drug used in the cancer chemotherapy protocol storage means in the present invention, it is very easy to manage in the present invention using the cancer chemotherapy protocol storage means. .
However, this is only true for drugs managed by this system. For example, if a patient managed by another system at another hospital is accepted from the middle, there is no data compatibility. Therefore, the total dose cannot be managed as it is.

Therefore, in the present invention, the dose limit value for the drug group as described above is stored in advance in the dose limit value storage means.
Further, data including a drug dosage history reflecting the prescription and administration plan of the drug stored in the cancer chemotherapy protocol storage means is stored in a drug history storage means such as a drug history master.

Data relating to past dosages such as data at other hospitals as described above is input to this system separately from the drug dosage history stored in the drug history storage means. This procedure is performed by an off-history drug dose input means.
As a result, for the drug group, the drug dose stored in the drug history storage means and the drug dose input by the out-of-history drug dose input means are summed, and this drug in this patient The group's previous usage is calculated. As a physician, care should be taken that this does not exceed the total dosage limit for this group of drugs. For this reason, in the present invention, the combined value and the dose limit value stored in the dose limit value storage means are displayed in accordance with the display unit to alert the doctor.

In addition, if this combined value is likely to exceed the total dosage limit, a warning should be issued to alert the physician.
The drug dose limit warning display means in the present invention is for displaying such a warning.

As described above, the present invention provides a therapy input means for inputting a plurality of therapies corresponding to general usage of a plurality of drugs for cancer treatment, and a plurality of therapies input by the therapy input means, respectively. A memorizing therapy memorizing means, a cancer chemotherapy protocol creating means for creating a prescription and administration plan of a drug adapted to a specific patient condition with reference to the therapy memorized in the therapy memorizing means, and the cancer chemotherapy protocol Patient vitals for cancer chemotherapy protocol storage means for memorizing the prescription and administration plan of the drug created by the creation means, and for a drug group that includes the above drugs stored in the drug master in association with drugs with the same efficacy a dose limit value storing means for storing the dosage limit for each one unit of the data, stored in the cancer chemotherapy protocols storage means And Kusurireki storage means for storing data including the dosage history of drug formulation and dosage regimen of the drug is reflected, separately from the dosage history of drug stored in the drug history storage means, the screen of the agent group list An unhistoric drug dose input means for inputting past drug doses for each of the drug groups displayed on the screen, vital data input means for inputting vital data including the current height and weight of the patient, and the vital data Vital data recording / updating means for recording and updating vital data input by the input means, and calculating the limit dose based on the latest patient vital data recorded in the vital data recording / updating means and the dose limit value. and limits the dose calculation means for, for the agent group, the dose of the drug stored in the drug history storing means and the history out drug administration Summing the dose of the drug that has been input by the input means, sum and limits the dose calculated by the limit dose calculation means based on the dosage limits stored in the dose limit value storage unit and drug dosage display means for displaying together the door, is a cancer chemotherapeutic management system characterized in that it comprises a (claim 1).
In this way, a therapy for each drug that is specified separately from a specific patient or its symptoms is databased separately from the cancer chemotherapy protocol that creates drug prescriptions and dosing plans that adapt to the specific patient's symptoms. Therefore, when creating a cancer chemotherapy protocol, it is not necessary to check the drug specifications, and a cancer chemotherapy protocol can be created quickly.

Moreover, since the therapy is databased in advance as described above, any doctor who is authorized to access this database can refer to the therapy of the drug. Therefore, even an inexperienced doctor who is unfamiliar with therapy can quickly use the therapy, and the level of cancer medical care can be improved at once.
In addition, when an improved drug is obtained for a drug and it becomes necessary to reconstruct the therapy for that drug, a part of the therapy for the previous drug may be modified to make a new therapy. In such a case, it is possible to copy the therapy stored in the therapy storage means and to modify the copied therapy and store it as a new therapy (Claim 3). , Physicians can easily build new therapies and reduce the time and effort of busy doctors.

Of course, even if a new drug is developed rather than an improved drug, if a therapy close to the existing therapy is suitable, a part of the existing therapy can be modified. By making it possible to modify this, the labor of the doctor is remarkably reduced.
In addition, since therapy is information that is fundamental to cancer science treatment, it is desirable that only a doctor with a predetermined qualification should be able to create, copy, modify, and store (register) therapy in the therapy storage means. By restricting access to the therapy in this way, mistakes in the construction or modification of the therapy can be prevented. In particular, the authority of therapy registration relating to the new creation or copying and modification of the therapy by the therapy input means, and the authority of master registration to register the therapy created by the therapy input means in the therapy storage means, Are set individually, and the therapy created by the therapy input means after the login of the person who has the authority to register the therapy is stored in the therapy storage means by the permission after the login of the person who has the authority to register the master. It may be registered.

  However, it is basically desirable to prevent alteration of the therapy so that the therapy itself stored in the therapy storage means cannot be changed at all (claim 2).

Subsequently, an embodiment of the present invention will be described with reference to the drawings for understanding of the present invention.
Here, FIG. 1 is a conceptual diagram of the entire computer system used in the cancer chemotherapy management system according to one embodiment of the present invention, and FIG. 2 is an entrance to the cancer chemotherapy management system according to one embodiment of the present invention. FIG. 3 is a diagram showing a menu screen of a cancer chemotherapy management system according to an embodiment of the present invention, FIG. 4 is a diagram showing a therapy list screen, and FIG. Fig. 6 is a diagram showing a chemotherapy name input screen, Fig. 6 is a diagram showing a disease name input screen, Fig. 7 is a diagram showing a department name input screen, and Fig. 8 is an input screen for doctor names, registrant names, etc. FIG. 9 is a diagram showing a prescription input screen, FIG. 10 is a diagram showing a recipe details input screen, FIG. 11 is a diagram showing a medicine classification selection screen, FIG. 12 is a diagram showing a medicine selection screen, FIG. Is a diagram showing an input screen for a medicine administration method, and FIG. FIG. 15 is a diagram showing an administration route input screen, FIG. 15 is a diagram showing a medicine usage input screen, FIG. 16 is a diagram showing a prescription date assignment screen, FIG. 17 is a diagram showing a prescription date assignment procedure, and FIG. FIG. 19 is a diagram illustrating an assignment procedure, FIG. 19 is a diagram illustrating an assignment cool list screen, FIG. 20 is a diagram illustrating a therapy selection screen in a new assignment cool addition procedure, and FIG. 21 is a therapy assignment screen in a new assignment cool addition procedure. FIG. 22 is a diagram showing a part of the therapy assignment procedure in the new assignment procedure of the assignment cool, FIG. 23 is a diagram showing a part of the therapy assignment procedure in the new addition procedure of the assignment cool, and FIG. The figure which shows a part of therapy assignment procedure in the new addition procedure of assignment cool, FIG. 25 is the figure which shows the assignment cool list screen in the change procedure of assignment cool, 26 is a view showing a prescription screen in allocation cool change procedure. FIG. 27 is a diagram showing a prescription amount change screen in the assignment cool change procedure, FIG. 28 is a diagram showing an example of a prescription date change screen in the assignment cool change procedure, and FIG. 29 is a prescription date change in the assignment cool change procedure. FIG. 30 is a diagram showing an example of a calendar screen in the assignment cool change procedure, FIG. 31 is a diagram showing another example of the prescription date change screen in the assignment cool change procedure, and FIG. 32 is a diagram showing screens before and after the prescription date shift in the assignment course changing procedure, FIG. 33 is a diagram showing the contents of the user master table, FIG. 34 is a diagram showing the contents of the therapy master table, and FIG. FIG. 36 is a diagram showing the contents of the patient therapy master prescription details table, and FIG. 37 is a diagram showing the check process of the medication request. FIG. 38 is a flowchart showing the procedure for updating the administration plan accompanying the addition of the pretreatment drug, FIG. 39 is a diagram showing the therapy registration screen, and FIG. 40 is a diagram showing the therapy registration screen. 41 is a diagram showing a pretreatment drug input screen, FIG. 42 is a diagram showing a pretreatment drug input screen, FIG. 43 is a diagram showing a pretreatment drug input screen, and FIG. 44 is a therapy registration screen. FIG. 45 is a flowchart showing a procedure for displaying the past entry and limit amount of a drug group, FIG. 46 is a diagram showing a drug group master, and FIG. 47 is a drug. FIG. 48 is a diagram showing a master, FIG. 48 is a diagram showing a dosage plan screen for inputting past amounts of drugs, FIG. 49 is a diagram showing a screen for selecting and inputting drug group names in cumulative dose, and FIG. Figure 51 of the administration plan screen showing that the past was entered, Figure 51, The figure which shows the screen of the therapy registration in which the added past part was reflected, FIG. 52 is a figure which shows the warning about a total dose and its limit amount.
53 is a flowchart showing a login procedure to the cancer chemotherapy management system, FIG. 54 is a flowchart showing an input procedure such as a disease name and therapy, and FIG. 55 is a flowchart showing a therapy input procedure. 56 is a flowchart showing an input procedure such as prescription method and procedure, FIG. 57 is a flowchart showing an input procedure such as usage, FIG. 58 is a flowchart showing an input procedure to the calendar of the cool plan, and FIG. FIG. 60 is a flowchart showing a procedure for assigning a cancer chemotherapy protocol, and FIG. 61 is a flowchart showing a prescription correction procedure.
An outline of a computer device that executes the cancer chemotherapy management system of the present invention is shown in FIG.
The system shown in Fig. 1 is responsible for managing cancer chemotherapy in one hospital. Naturally, multiple hospitals are connected via a wide-area or regional network such as the Internet. An independent server may be provided to handle management data intensively.
The system shown in FIG. 1 handles a system completed in a hospital and is connected to the data server 1 storing a therapy master, a patient master, a hospital equipment master, a hospital personnel master, and the like described below. A management server 3 is provided. The above-mentioned therapy master, hospital equipment master, hospital personnel master, etc. are generic names thereof. Actually, the therapy master is a clinical department master, unit master, therapy master attribute (FIG. 34), therapy master prescription attribute, therapy master prescription. Includes details, therapy master prescription drug supplement, therapy master prescription usage, therapy master prescription comments, etc.
The hospital equipment master includes a ward / room master and others.
The hospital personnel master includes a user master (FIG. 33), an approval master, and the like.

  A plurality of terminals 5 provided in each doctor or hospital room are connected to the management server 3, and each terminal 5 includes a control unit 7 such as a CPU. These control units 7 communicate with the management server 3 on the basis of the procedure described later, perform various displays while referring to each master stored in the data server 1, and input / Operates according to the writing program.

Next, a processing procedure of the control unit 7 according to a program for a doctor to register a new therapy by accessing the management server 3 from one of the terminals 5 will be described with reference to the control unit 7 shown in FIG. This will be described together with the operation of the operator with reference to a flow chart showing the processing procedure. Hereinafter, S1, S2, and the numbers of processing procedures (steps) are shown.
A. Therapy registration procedure <Login>
First, when the cancer chemotherapy management system is started up in the terminal 5, the control unit 7 displays the login screen 1a shown in FIG. 2 on the monitor (S1).
On the login screen 1a, user code and user password input windows 1b and 1c are displayed. When the user inputs the user code and password and presses the OK button 1d, the control unit 7 uses the input user code and password as the user code of the user master stored in the data server 1. The user code and password stored in the field and password field are collated (S3).
In this way, the control unit 7 refers to various master tables in the data server 1 and writes to them. In the following explanation, particularly important user master table (FIG. 33), therapy master attribute table (FIG. 34), only the patient therapy master attribute table (FIG. 35) and the patient therapy master prescription details table (FIG. 36) are shown, and the other illustrations are omitted.

If it is determined that the user code and password entered here match the user code and password in the referenced user master, the control unit subsequently monitors the menu screen 2a in FIG. (S5).
If they do not match, the control unit 7 redisplays the login screen 1a shown in FIG. 2 together with a comment such as “input data is incorrect. Enter correct data”.
On the left side of the menu screen 2a shown in FIG. 3, a prescription / administration plan button 2b for proceeding to the prescription / administration plan procedure is displayed. On the right side, a therapy registration button 2c for proceeding to a procedure for therapy registration is displayed.

<Register therapy name, etc.>
When the therapy registration button 2c is pressed (YES in S7), the control unit 7 displays the therapy list screen 3a shown in FIG. 4 on the monitor (S9).
At the top of the therapy list screen 3a, there are provided input windows 3b, 3c, 3d, and 3z for the therapy name, the disease name, the department name, and the number of days for which one unit of therapy is performed (1 cool day). ing.
In the lower part, a new button 3e, a usable button 3f, an unconfirmed button 3g, a confirmed button 3h, an unusable button 3i, an all display button 3j, and a return button 3k are displayed.

Further, in the center of the therapy list screen 3a, a medical department tab for switching between a medical department display unit 3m showing a list of medical department names in a tree form and a disease name display unit 3m showing a disease name in a tree form is displayed. 3p and disease name tab 3r are displayed.
Here, since it is a scene to input a procedure for registering a new therapy, the operator presses the new button 3e (YES in S11).
A signal indicating that the new button 3e has been pressed is transmitted to the control unit 7, and the control unit 7 receiving the signal displays the therapy registration screen 4a shown in FIG. 5 (S13).
At this time, the therapy name input window 3b, disease name input window 3c, clinical department name input window 3d, 1 cool day input window 3z, standard cool number input window 3s, and maximum cool number input window 3t on the upper stage of the therapy registration screen 4a. , And the application doctor input window 3u, the approved doctor input window 3v, the registrant input window 3w, and the registration confirmer input window 3x are displayed, and the control unit 7 activates the therapy use start date input window 3y.
In addition, the control unit 7 activates the lower registration button 4b, recipe addition button 4c, use stop button 4d, and end button 4c.
Further, in the middle stage, any one of the prescription display part 4j, the examination display part 4k, and the side effect display part 4m that can be switched and displayed by the prescription tab 4g, the examination tab 4h, and the side effect tab 4i can be displayed.

First, the operator clicks on the therapy name input window 3b and inputs the text of the name of how to use the target anticancer drug, that is, the chemotherapy name (S15). Since such input is always performed by a doctor, the ID and password input on the login screen 1a shown in FIG. 2 must be the doctor ID and password in the case of therapy registration.
When the chemotherapy name is input by the doctor in this manner, the operator (doctor) then places the pointer in the disease name input window 3c and right-clicks (S17).
Upon receiving the right click signal in the disease name input window 3c, the control unit 7 refers to the disease name code, disease name, and disease group fields of the disease name master, and displays a tree-like disease name list displayed in FIG. 4-2a is displayed over the therapy registration screen (S19).

The disease name list 4-2a as described above is compiled for each clinical department, and a disease name as a subordinate concept is displayed at the end of the branch of the clinical department name.
Therefore, the operator selects and selects one disease name from among the disease names included in the branches of each medical department name (for example, internal medicine, respiratory department,...) In the disease name list 4-2a. Double-click the disease name or press the OK button 4-2b (S21).
Upon receiving the double click signal or the OK button press signal for each disease name, the control unit 7 displays the selected disease name in the disease name input window 3c (S23).

Next, the operator places a pointer on the clinical department name input window 3d and performs a right click operation in order to input the clinical department name (YES in S25).
Upon receiving this right-click operation signal, the control unit 7 displays the department name list screen 4-3a shown in FIG. 7 with reference to the department code field and department name field of the department master (S27). ).

<Enter doctor name>
Here, when the operator again selects the name of the applicable department in the department list screen 4-3a and right-clicks on the spot (YES in S29), the controller 7 selects the selected department. The belonging doctor name list screen 4-4a is displayed as shown in FIG. 8 (S31).
At this time, the control unit 7 refers to the user code field and the job type field of the user master shown in FIG. 33, and based on the user code and password entered on the logon screen of FIG. The job type is narrowed down, and the narrowed doctor is displayed as described above.
As mentioned above, the doctor with the application authority registered in the user master is referred to together with the user code and password on the login screen, so that only the doctor with the application authority for therapy can register the therapy. Therefore, the accuracy of therapy input is maintained.

When the selection of the doctor is completed, the operator (applicant doctor himself) presses an OK button 4-4b displayed at the bottom of the doctor name list screen 4-4a in FIG.
Upon receipt of this OK button 4-4b pressing signal (YES in S33), the control unit 7 displays the selected medical department name on the clinical department name input window 3d and displays the selected doctor name on the application doctor input window. 3u is displayed (S35).
The registrant in the therapy registration screen 4a is a person who inputs to the registration screen 4a as described above, and in many cases is the applicant doctor. Accordingly, when the input of the applying doctor is completed, the name of the applying doctor is also displayed in the registrant input window 3w.

<Application / registration / confirmation authority>
Here, the authority regarding the application (creation) of therapy and registration to the master will be described.
The therapy and its specific application, the cancer chemotherapeutic protocol, are basic information on treatment, so input or incorrect modifications can cause medical errors and are extremely problematic.
Therefore, in this cancer chemotherapy management system, a double confirmation or approval procedure is provided for the entered therapy.

Details of such confirmation will be described here.
First, in this system, the preparation of the therapy, that is, the application, and the procedure for registering it in the therapy master are separated. In other words, a check procedure at the stage of creating a therapy and a check procedure at the stage of finally registering the created therapy in the therapy master are provided.
I have already mentioned that therapies can only be created by doctors.
In addition to doctors, pharmacists and nurses also intervene in medical institutions, but therapy is particularly important, so it is limited to doctors, and application rights are set for doctors as well. You can't go into the procedure. Such authority of the applicant is set in five levels in the user master of FIG.
Three of these are essential authorities,
○ Therapy registration authority ○ Assignment registration authority ○ Master registration authority.

The authority to register a therapy is the authority to create a new therapy or to make a duplicate of a therapy and modify it. Only set.
The authority to register for assignment is the authority to create or modify a prescription / administration plan to be described later, and is set only for doctors who are allowed to create a prescription / administration plan. Is done.
However, since there is no problem with prescribing and administration plans, it is not subject to double check, but only authorized doctors can register. Of course, the above prescription / administration plan can also be subject to double check. The method may be the same as the check for therapy.
Further, the master registration authority is an authority to finally register the therapy created as described above in the therapy attribute master.
The procedure for master registration is not particularly new, so the explanation is omitted. However, when you right-click on the created therapy in the registration confirmer input window 3x, a list of doctors with authority to register the master is displayed. If the doctor's ID and password selected from the displayed list match the ID and password entered on the login screen, registration to the master is permitted.
In addition, the therapy registration screen 4a shown in FIG. 5 has an input window 3v for an approved doctor. Since this is an input window for an approver of registration for an applied therapy, the registration checker is substantially the same. Will be entered by the same person.

<Treatment prescription input>
Subsequently, the procedure proceeds to the prescription input procedure of FIG.

Here, the operator first inputs text into the 1-cool day input window 3z, the standard cool-number input window 3s, and the maximum cool-number 3t, respectively.
These values are then displayed in the respective input windows (S37).

<Enter therapy recipe details>
Thereafter, the operator places a pointer in one column of the prescription display section 4j in the middle row and double-clicks here.
The double click operation signal is transmitted to the control unit 7.
The control unit 7 that has received the double-click operation signal (YES in S39) displays the recipe detail input screen 5a shown in FIG. 10 on the therapy registration screen 4a (S41).
In the above recipe details input screen 5a, the recipe No. An input window 5b is provided, and a drug type selection unit 5c for selecting whether the corresponding drug is an internal medicine, an injection, or an external medicine is displayed on the right side thereof.
Here, the operator checks the corresponding drug type, puts the pointer on the drug input field 5d provided at the lower stage, and performs a right click operation.

<Therapeutic drug input>
Upon receipt of the right click operation signal (YES in S45), the control unit 7 further displays the medicine list screen 5-2a shown in FIG. 11 on the recipe detail input screen 5a (S45).
At this time, the control unit 7 refers to the medicine classification code field, the medicine classification name field of the medicine classification master, the medicine code field, the medicine name field, and the medicine classification code field of the medicine master, and displays the medicine list screen 5-2a. indicate.
The drug list displayed on the above drug list screen 5-2a is the type of drug (digestive system drug, hormone drug, fluid replacement, anticancer drug, quasi-anticancer drug (for protocol), quasi-anticancer drug (for protocol), dissolution / dilution. (For protocol)) is a tree structure in which specific medicines are arranged in the subordinate concept with the classification such as) as a superordinate concept.
Here, since it is a scene which registers the therapy about a new anticancer agent, an operator selects the anticancer agent (for protocol) as a chemical | medical agent classification, and presses OK button 5-2b of the screen lower part.
In response to the button press signal, the control unit 7 displays an anticancer agent list screen 5-3a displaying a list of anticancer agents belonging to the subordinate concept of the anticancer agent (for protocol) as shown in FIG. 12 (S47, 49).

Here, the operator selects the corresponding medicine and presses the OK button 5-3b displayed at the bottom.
Upon receiving this OK button press signal (YES in S51), the control unit 7 displays the selected anticancer drug name in the drug name input field 5d of the recipe input detail screen 5a as shown in FIG.
When the medicine name is input in this way, the operator next inputs the DOSE, the maximum amount, and their units displayed on the right side of the middle stage of FIG.
DOSE is the prescription amount of the drug. For these prescription amounts, the standard prescription amount provided by the drug developer can be entered, but doctors have their own experience and knowledge about the drug. It is also possible to enter another value based on.
In addition, doctors can input appropriate units based on their knowledge.
However, the above-mentioned DOSE, the maximum amount that is the prescription limit amount, and their units are extremely important information. It is set appropriately by referring to each field of the 3 unit code and the AUC target section and referring to the unit code field and the unit name field in the unit master.

As described above, the prescription amount, maximum amount and unit of the corresponding medicine can be arbitrarily set or changed based on the doctor's own knowledge. It will be appreciated that this can significantly increase the degree of freedom in setting the therapy. It can also reflect changes in medical technology that make rapid progress every day. For example, advanced therapies can be quickly introduced into this system in response to presentations at academic conferences, changes in ministerial ordinances, and changes in on-site empirical rules.
Furthermore, based on such applicability and flexibility, even inexperienced doctors can quickly incorporate superior therapies set by experienced doctors, which can contribute to the significant development of therapy technology.

<Therapeutic drug (administration method) input>
Next, the doctor places a pointer in the administration method input window 5-5a formed at the bottom of the medicine / DOSE column and right-clicks. Upon receipt of the right click operation signal (YES in S57), the control unit 7 refers to the administration method field / route division field, code field, and name field in the administration method / route master, as shown in FIG. The procedure list screen 5-5b is displayed so as to overlap the detail input screen 5a (S59).
The procedure list displayed here displays a list of drug administration methods including, for example, intravenous injection, intravenous infusion, intravenous infusion (precision machine), subcutaneous injection, intramuscular injection, intraarterial injection (internal organs), etc. The operator selects an appropriate administration method from the technique list and presses the registration button 5-5j displayed at the bottom of the screen.

<Therapeutic drug (administration route) input>
The control unit 7 that has received the pressing signal of the registration button 5-5j (YES in S61) further displays a route list screen 5-5c that embodies the route of the selected procedure. Referring to the route field, code field, and name field, as shown in FIG. 14, the recipe detail input screen 5a is overlaid and displayed (S63).
The route is displayed in, for example, main 1, main 2, sub 1, sub 2, etc.
Here, when the operator selects an appropriate route and double-clicks there or presses the registration button 5-5h at the bottom of the screen (YES in S65), the administration method and the administration route are as shown in FIG. The information is displayed by the control unit 7 on the method input window 5-5a and the administration route input window 5-5d (S67).
When the administration route is input by the above procedure, the usage input is subsequently performed in the usage input window 5-5e displayed on the right side of the administration route.

<Therapeutic medicine (usage) input>
Here, the operator places a pointer in the usage column 5-5f of the usage input window 5-5e and right-clicks.
Upon receipt of this right-click operation signal (YES in S69), the control unit 7 can be applied with reference to the usage division field, the administration division field, the usage code field, and the usage name field of the usage master as shown in FIG. The usage is displayed on the usage list screen 5-5g (S71).
Here, since the administration method is injection, “once” is displayed, but if it is an internal medicine, usage such as minutes 1, minutes 2, minutes 3 (after morning, noon, dinner) is displayed. When there are multiple usages as described above, they are expanded into a tree structure.

Subsequently, when the operator moves the pointer to the usage displayed on the usage list screen 5-5g and double-clicks or presses the OK button 5-5i at the bottom of the screen (YES in S73), the control unit 7 displays the selected usage in the usage input field 5-5f (S75).
When the administration method, administration route, and usage for the medicine are thus entered, the operator presses a registration button 5e provided at the lower part of the recipe detail input screen 5a.
Thus, when the push signal of the registration button 5e is transmitted to the control unit 7 (YES in S77), the control unit 7 returns the screen to the therapy registration screen 4a shown in FIG. At this time, the control unit 7 displays the prescription date allocation field 6a on the lower right side of the therapy registration screen 4a (S79).

<Treatment prescription assignment input>
The input regarding therapy, the input regarding the medicine to be used, and the input regarding the applicant are completed by the above input processing, and the procedure proceeds to the procedure for inputting the prescription date and the cycle of this drug.
The prescription date assignment as described above is performed using the prescription day assignment column 6a in the right half of the prescription column 4j shown in the lower part of FIG.
This prescription date allocation column 6a basically represents the administration schedule of the selected drug during one day that can be determined by the number of one cool day.
Therefore, in principle, this is achieved by the operator using the prescription assignment field 6a in the right half to mark the medicinal box corresponding to the day on which the drug should be administered and memorize it. Here, in order to simplify input, an improved calendar display input method described below is adopted.

That is, when the appropriate frame (medication date) in the therapy assignment field 6a displayed on the right half of the therapy registration screen 4a shown in FIG. 16 is right-clicked (YES in S81), the control unit 7 displays a 1-cool days input window. A calendar input screen 6-1a obtained by dividing the number of days input to 3z into an appropriate number of cycle days is displayed superimposed on the therapy registration screen 4a as shown in FIG. 16 (S83).
The calendar input screen 6-1a is an integer that can be appropriately divided by “28”, for example, when the number of cool days is 28 as shown in the figure, for example, “7 days” as shown in FIG. It is divided and displayed.
The first function of this calendar input screen 6-1a is to select a date in a vertical column indicated by a frame 6-1p as shown in FIG. 17, for example, and press a registration button 6-1b provided at the bottom thereof ( When YES in S85, the medication date mark 6-1c displayed by the downward arrow is displayed on the selected day as shown in FIG. 18 (S87).
That is, when the doctor wants to administer a drug every 7 days for this drug, as shown in FIG. 17, a calendar input screen 6-1a having a period of 7 days in the horizontal direction is created. From the desired start date of administration from 1 to 7, select a date in a vertical line from there downward, and press the registration button 6-1b, so that the administration date is 7 days apart from any start date Can be entered and displayed all at once on the prescription assignment screen.

Further, the second function of the prescription date assignment field 6a is to display only the prescription date by pressing the “display only medication date” button 6-1d displayed at the top of the prescription day assignment field 6a (YES in S89). The point is that it can be displayed in a packed manner (S91).
That is, when the “display only medication date” button 6-1d is pressed, the control unit 7 shows only the date with the medication date mark 6-1c on the right side of FIG. 18, as shown in FIG. Displayed in stuff.
This allows doctors and the like to check the state of drug administration at a glance.
When the “display only medication date” button 6-1d is pressed, the screen changes as shown on the right side of FIG. 18, but the “display all” button 6-1e is displayed on the screen, and the operator When the “all display button” 6-1e is pressed (YES in S93), the control unit 7 that has received the button pressing signal changes the screen to a screen that displays the total number of cool days on the left side of FIG. 18 (S95). .

Further, the third function of the prescription date assignment screen is that the cycle of the calendar input screen 6-1a shown in FIG. 17 can be arbitrarily changed.
There are various methods. For example, when the pointer is aligned with either the left or right vertical side 6-1n or 6-1m of the calendar input screen 6-1a (YES in S97), the pointer is directed in the horizontal direction. In this state, the pointer is moved with the right mouse button being clicked (S101), thereby changing the horizontal and vertical lengths of the calendar input screen 6-1a (S103). This is the point.
As a result, for example, the calendar input screen 6-1a that was initially set to one cycle on the 7th is a cycle that is longer than that, 8th, 9th, 10th,... Or 6th, 5th, 4th,. It can be changed like a calendar.
The change of the period as described above is such that when the pointer is placed on the upper end 6-1x or the lower end 6-1y of the calendar input screen 6-1a, the pointer is changed to an up and down arrow, and the pointer is moved up or down in that state. By moving it downward, the vertical width of the calendar input screen 6-1a may be changed so that the cycle itself can be changed.

As described above, by using this prescription date allocation field 6a, it is possible to quickly enter a medication schedule of an arbitrary period, and only a medication date (indicated by a downward arrow), or a medication date and a no medication day. Either of the states in which both are displayed can be easily switched, and the labor for assigning the doctor's prescription date can be greatly simplified.
When the assignment is thus completed, the operator presses the registration button 4b at the bottom of the therapy registration screen 4a. When the registration button 4b is pressed (YES in S105), the control unit 7 makes all the elements related to the therapy set in FIGS. 4 to 18 such as the number of cool days, the standard cool number, the maximum cool number (set in FIG. 5), Drugs such as anticancer agents to be used (set in FIG. 13), prescription amounts of the drugs, maximum prescription amounts and units (set in FIG. 12), administration methods of the drugs (set in FIG. 13), administration routes (FIG. 14) ), Usage (set in FIG. 15), and assigned prescription date (set in FIGS. 16 to 17) are stored in each field of the therapy master attribute table (FIG. 34) and stored (S107).

This stored content should be locked and stored so that even a doctor cannot change it. This is because if the therapy is changed suddenly, it will be a big problem for another doctor who doesn't know it and other medical personnel who use the therapy.
However, it is possible to copy the stored contents and modify the copied contents. By saving the copied therapy in another name, it is possible to modify it later, and by using it as a basis for developing a new therapy, the therapy itself can be improved. As a result, it is possible to quickly create new therapies based on new information at any time, and to create new chemotherapy protocols using them easily and quickly. You can stay in touch with therapy at any time and make a significant contribution to medical progress.

  With the above procedure, the doctor can arbitrarily set the therapy for each developed drug based on his / her own knowledge, separately from the method of medication for the specific patient, that is, the cancer chemotherapy protocol. This greatly expands the degree of freedom for physicians to choose information and accordingly increases the degree of freedom in setting specific cancer chemotherapy protocols.

B. Prescription / Administration Plan Next, a procedure for applying the therapy registered as described above to a specific patient treatment plan, that is, a procedure for creating a cancer chemotherapy protocol will be described with reference to FIG. 19 and subsequent drawings.

<Login>
To enter this prescription / administration plan, enter the user code and password on the login screen 1a of FIG. 2 and press the OK button to enter the menu screen 2a of FIG. The process starts by pressing the prescription / administration plan button 2b arranged on the left side.
Therefore, only a doctor who has been granted a pre-set application as described above, or a doctor who has been approved for approval can enter this procedure.
The following is a procedure for creating a new prescription / administration plan.

<Patient selection>
When the prescription / administration plan procedure is started, the assigned cool list screen 13a of FIG. 19 is displayed by the control unit 7 (S121).
In the assignment cool list screen 13a, a patient number input window 13b and a patient name field 13c are formed in the upper stage, and the operator inputs a patient number at the first stage of creating a prescription / administration plan (YES in S123). .
When the patient number is input, the control unit 7 determines whether the prescription / plan is already registered (124). The determination is made with reference to the description of the patient therapy master attribute table shown in FIG. In this case, since it is newly created, the determination is NO, and in next S125, the patient number is referred to by the control unit as the patient number field and patient name field of the patient master, the patient name is extracted, and the patient name field It is displayed on 13c (S125).
In FIG. 19, the patient number 700 is input and the patient name “Kazuo Yuyama” is displayed.
When the patient number and the patient name are determined in this way, the control unit 7 activates the new addition button 13d provided at the lower part of the assignment cool list screen 13a.

<Select therapy>
When the operator presses the new addition button 13d (YES in S127), the control unit 7 displays the therapy selection screen 14a of FIG. 20 (S129).
The therapy list screen 14a includes a medical department display unit 14b and a disease name display unit 14c. When the medical department tab 14d is pressed, the medical department display unit 14b presses, and when the disease name tab 14e is pressed, the disease name display unit 14c is displayed. , And are switched and displayed by the control unit 7, respectively.
At this time, the control unit 7 refers to the clinical department code field and the clinical department name field in the therapy master attribute table shown in FIG. 34, displays the clinical department name, refers to the disease name code field and the disease name field, Each disease name is displayed.

In FIG. 20, the clinical department tab 14d is pressed, and the registered therapies belonging to the clinical departments (internal medicine, respiratory department,...) And the lower classifications are displayed.
On this page, the operator selects an appropriate medical department, expands and displays the lower-level therapy, and selects an arbitrary therapy from the expanded therapy.
Further, the disease name tab 14e is pressed to display the disease name display unit 14c, and an arbitrary disease name is selected.
The selected therapy name and disease name are displayed at the top of the therapy list screen 14a (S13).
After completing the selection of therapy and disease name in this way, the operator presses a selection button 14f provided at the bottom of the therapy list display screen 14a. The pressing signal of the selection button 14f is transmitted to the control unit 7 (YES in S133), and the control unit 7 switches the screen to the therapy assignment screen 14-2a of FIG. 21 (S135).

<Therapeutic assignment>
When the therapy name, disease name, and medical department are determined in this way, all elements related to the therapy set in FIGS. 4 to 18 defined in the therapy name, disease name, and medical department are available.
Examples of these elements include the number of cool days, the standard number of cools, the maximum number of cools (set in FIG. 5), the drug used such as an anticancer drug (set in FIG. 19), the prescription amount of the drug, the maximum prescription amount and their units. (Set in FIG. 12), administration method of the drug (set in FIG. 19), administration route (set in FIG. 14), usage (set in FIG. 15), assigned prescription date (set in FIGS. 16 to 17) Etc.

When the chemotherapy to be applied to a specific patient is selected as described above, the procedure proceeds to the assignment of the therapy, that is, the administration plan.
FIG. 21 shows a schedule for therapy allocation displayed on the calendar 14-2b. In order to assign the therapy to the calendar 14-2b, the operator first inputs the assignment start date and the number of times of assignment to the start date input window 14-2c and the number input window 14-2d in FIG. .
The start date input window 14-2c is input by selection input, and the frequency input window 14-2d is input by text input.
When the pull-down button 14-2e for the start date in FIG. 21 is pressed (YES in S137), the control unit 7 displays the date input calendar 14-3a shown in FIG. 22 (S139). When the operator selects an arbitrary date in the calendar 14-3a and presses the execution button 14-3b (YES in S141), the control unit 7 displays the selected date in the start date input window 14-2c. Along with (S143), the calendar 14-2b is displayed with reference to the number of days in one cool period (here, 21 days), as shown in FIG. ).
The calendar 14-4a can be displayed by shifting the contents of the calendar in the right or left direction by clicking the right or left arrow button 14-4b or 14-4c shown at the right end of FIG.

When the assignment of cancer chemotherapy for each patient (cancer chemotherapy protocol) is completed in this way, the operator presses the registration button 14-4d at the bottom of the screen (YES in S147). As a result, the registration completion display 14-5a is displayed as shown in FIG. 24, and the registration is completed.
The registered contents are written and stored in the patient therapy master attribute table shown in FIG. 35 (S149).
In order to display the calendar 14-4a as described above, the control unit 7 controls the patient therapy master prescription administration table, the patient therapy master prescription specification table (see FIG. 36), the patient therapy master prescription usage table, and the patient therapy master prescription comment. Browse the table.
Of course, the operator can arbitrarily change the number of cools 14-2d (four times in FIG. 24).

The above description is about the procedure for registering a new prescription / administration plan, or the prescription / administration plan is already registered by the above procedure, and the system is entered from the login screen 1a (FIG. 2). The patient number is input to the patient number input window 13b of the assignment cool list screen 13a shown in FIG. And YES), the assignment cool list screen 15a shown in FIG. 25 is displayed (S150).
In this assigned cool list screen 15a, “situation”, “cool period”, “therapy name”, and “cool eyes” are displayed in order from the left.

<Prescription change>
If these allocation plans have not yet been applied, i.e. are not currently in the cool period, the status item is displayed as "planned".
In the list of cools displayed as described above, when the schedule is to be confirmed or changed, the operator first selects the assignment cool to be changed or confirmed, and the assignment cool change screen of FIG. Press any button displayed at the bottom of 15a.
The user presses the change button 15b to correct the prescription content (prescription amount), and presses the calendar button 15c to check the schedule plan. In addition, after confirming the schedule plan, the calendar button 15c is pushed (S151) when it is desired to further modify the schedule plan itself.
When the change button 15b is pressed, the control unit 7 changes the screen to a prescription screen 16a shown in FIG.
When the calendar button 15c is pressed, the control unit 7 changes the screen to the calendar screen 17a of FIG. 30 (S152).

<Prescription change>
A processing procedure of the control unit 7 when the change button 15b is pressed, that is, when the prescription amount is corrected will be described.
In this case, the prescription screen 16a shown in FIG. At this time, an administration mark 16c is displayed on the administration date of the medicine on the administration schedule display portion 16b of FIG. The administration mark 16c expresses a relative change in the dose of the drug by a symbol mark, and is shown by a horizontal arrow as an example here. There are three types of arrows. That is, any one of a horizontal arrow →, a downward arrow ↓, and an upward arrow ↑ is displayed. The date without the indication of the administration mark 16c indicates that the medicine is not administered.
Here, → means that there is no change in the daily dose compared to the previous dose.
↑ means that the daily dose is increased compared to the previous dose.
↓ means that the daily dose has decreased compared to the previous dose.
However, dose changes are not absolute changes, but relative changes corrected by body surface area and other factors.

For example, for a drug whose dosage changes according to body surface area, if the body surface area decreases by 10% on the current administration date compared to the previous administration date, the current dosage is automatically adjusted according to the change in body surface area. This is a 10% reduction. Therefore, if the criterion for the administration mark is an absolute amount, a downward arrow ↓ must be attached due to a 10% decrease in the dose. The criterion here is a relative change according to the body surface area, etc. The administration mark remains as →.
Conversely, for a drug prescribed for a dose according to the body surface area, the doctor should ensure that the dose is the same as the previous dose in order to ensure the dose at the doctor, even though the body surface area has decreased by 10%. When changed, ↑ is displayed as the administration mark.
In displaying this screen, the control unit 7 sets the patient therapy master attribute (see FIG. 35), the patient therapy master prescription patient, the patient therapy master prescription administration, the patient therapy master prescription details (see FIG. 36), the patient as the master related to the patient. Refer to each table of therapy master prescription usage and patient therapy master prescription comments.

Also, the changes (such as arrows) described above are written in the patient therapy master prescription patient, patient therapy master prescription administration, patient therapy master prescription details, patient therapy master prescription usage, and patient therapy master prescription comments. Done.
When the prescription screen 16a is displayed by the control unit 7 and the operator selects a specific administration date in the drug administration date column (YES in S153), the control unit 7 receives the selection signal. Then, the prescription amount change button 16d and the prescription date change button 16e at the bottom of the screen are activated (S154).

When it is desired to change the prescription amount, the operator presses the prescription amount change button 16d (YES in S155). In response to the pressing signal of the prescription amount change button 16d, the control unit 7 displays a prescription amount change screen 16-1a as shown in FIG. 27 so as to overlap the prescription screen 16a (S156).
In this example, the dose related to endoxane administered on July 22 is displayed. The amount displayed here is a value of a ratio in which the initially set amount is 100%. When changing the dose, the numerical value in the ratio display window 16-1b displaying the 100% number is displayed. Is achieved by changing to any number.
The dose (prescription amount) changed in this way is written in the patient therapy master prescription specification table of FIG. 36 by pressing the registration button 16-1e (YES in S157), and the dose ratio is changed there. (S158).
As described above, when the prescription amount changes as a relative value compared to the previous dose, if the change is increased, ↑ is changed, and if the change is decreased, ↓ is changed. Is displayed.

Examples of the above-mentioned administration marks are →, ↓, ↑, and the like. In short, as long as the relative change in dosage can be clearly understood, the above-mentioned arrow is not particular.
In this way, changes in drug dosage can be displayed with symbols such as arrows, so that substantial changes in drug dosage can be visually and intuitively evaluated, and changes in dosage can be seen in busy medical fields. It is possible to achieve an excellent effect that errors are extremely reduced.
In FIG. 27, the height and weight of the patient are displayed, and the body surface area calculated from these is also displayed. As described above, prescribed medication is, when it is calculated by weight per body surface area, the dose of medication is automatically changed in response to changes in the surface area of the patient.

  When the change of the dose is achieved by changing the dose ratio in this way, the operator presses the registration button 16f on the prescription screen 16a to determine the dose. In this case, the dose set for each patient and for each therapy for each patient is changed, but the dose data for each basic therapy set in the procedure of therapy registration is not changed.

<Change in prescription date>
Next, the procedure for changing the prescription date by the control unit 7 will be described.
When the prescription date change button 16e on the prescription screen shown in FIG. 26 is pressed (YES in S159), the control unit 7 displays a prescription date change screen 16-2a as shown in FIG. 28 (S160).
Here, the part for setting whether the prescription date is changed only for this time or after this time, the previous display, the current display 16-2b, and the next display are displayed side by side. The display can be changed. When the date in the current display 16-2b is changed, the previous time and the next time are automatically changed.
Further, in order to change the prescription date, the number of days to be shifted may be input in addition to the method of changing individual dates (displayed on the current display 16-2b) as described above. The prescription date change screen 16-2a displays a shift day input column 16-2c for inputting the shift days.
Furthermore, with regard to medication, it is possible to select whether this is the only time for discontinuing administration or the plan for the future.
To change only the current administration date on the prescription date change screen 16-2a, check "Only this time" and change the current date arbitrarily or enter the number of shift days To do.
In addition, regarding discontinuation of medication, enter whether to discontinue only this time or whether to discontinue next time.

When these inputs are completed, the operator presses an OK button 16-2d provided at the bottom of the prescription date change screen 16-2a in FIG. 28 (YES in S161).
At this time, based on the change data described in the prescription date change screen 16-2a, the control unit 7 performs a patient therapy master attribute table (see FIG. 35), a patient therapy master prescription patient table, a patient therapy master prescription administration table, The contents related to the prescription date in the patient therapy master prescription detail table (see FIG. 36) and the patient therapy master prescription comment table are updated (S163).
The prescription date can also be changed by right-clicking the administration date column of the drug to be changed.

FIG. 29 shows a prescription date change screen 16-3a displayed by the control unit 7 by right-clicking.
The administration date can be changed on the calendar screen 14-4a shown in FIG.
For example, when one of the administration dates (the day marked with an asterisk) is selected on the therapy assignment calendar screen 14-4a shown in FIG. 30 similar to FIG. 23, the control unit 7 receiving this selection signal , Activates the prescription date change button 16e.
When the operator presses the prescription date change button 16e in this state, the control unit 7 receives the button press signal and displays the prescription date change screen 17-1a in FIG.
Here, the same screen as the prescription date change screen 16-2a in FIG. 28 is displayed.
Therefore, the prescription date can be changed here.

If the prescription date is changed on the calendar screen 14-4a in FIG. 31, the shift state of the administration date can be understood at a glance by visual observation. For example, in the calendar screen 14-4a of FIG. 32, as shown in FIG. 30, the therapy assignment with July 22 as the start date is performed. When the control is performed, the control unit 7 receiving the shift shifts the start date to the 29th. As a result, all subsequent scheduled dates are shifted by 7 days and changed to a calendar screen 17-2a as shown in FIG.
When the change of the prescription amount, the change of the prescription date, etc. is completed by the procedure described above, the operator presses the registration button 16f displayed at the bottom of the therapy assignment screen 17a (YES in S165).
. Thus, the contents of the patient therapy master attribute table of FIG. 35 are updated with the changed contents (S167).

As described above, a medication administration plan for a patient is created, and when the administration date arrives, the doctor must issue a request for preparation for actual administration.
Generally, this assortment request is also accumulated in the storage means of the management server 3. The doctor in contact with the patient thinks about the administration plan for the patient, but the considered administration plan may not match the medication administration plan stored in the cancer chemotherapy protocol storage means for the patient. Therefore, the doctor should respond appropriately by comparing the request for medicines with the doctor and the administration plan of the medicine stored in the cancer chemotherapy protocol storage means for the patient and displaying the comparison result. Is desirable. For this reason, the assortment requirement-plan comparison means of the present invention is employed.

  However, for example, if the patient's condition changes suddenly, there may not be a dosage plan to be compared yet. In such a case, it is desirable to take a new procedure to compare the dose schedule. The new administration plan creation means in the present invention is for executing a procedure for promptly creating an administration plan when there is no such administration plan to be compared.

A specific procedure will be described with reference to the drawings.
FIG. 37 shows a processing procedure by the control unit 7.
The doctor receives, from the management server 3, a medication order prepared in advance when trying to administer a drug, that is, a drug assortment request, using his terminal 5 (S 301).
Such an assortment request is input by the doctor in advance, and the data includes the amount, form, procedure, etc. of the drug as in the medication plan shown in FIG. The information stored in the storage area is acquired by downloading the patient name.
When the assortment request is received, the control unit 7 of the doctor-side terminal 5 determines for each medicine whether or not there is a need for audit (S302). The necessity for the inspection is predetermined for each medicine, and is stored in the medicine master in association with the medicine.
In cases such as anticancer drugs, most of them are necessary, but judgment is made just in case.
Next, the control unit 7 searches the cancer chemotherapy protocol storage means in the storage area in the management server 3 by the patient name as to whether or not the administration plan corresponding to the assortment request is registered.
If it is determined that there is a corresponding administration plan (YES in S303), then the drug preparation request for the patient and the administration plan of the drug stored in the cancer chemotherapy protocol storage means for the patient Are compared (S304).

In the above comparison, the patient name is described in the information (medicine name, procedure, administration method, prescription amount, usage, etc.) described in the drug assembling request. This is done by checking whether or not they match.
The comparison result is displayed (S305). A perfect match is usually adopted as the match (S5).
The display when they do not match is important.

A specific example will be described with reference to FIG.
In this case, it is planned to administer kiloside 500 mg on the second and third days. Therefore, it is planned to administer a total of 1000 mg, but if there are three 500 mg in the assortment request, it will be more than planned.
However, the dosage of the drug kiloside is expressed in terms of the patient's body surface area, so if the patient's body surface area is greater than the time when this plan was made, it is currently greater than the planned amount. You can give more. Therefore, the doctor can give an instruction to change the plan to administer more than the plan. In this way, there is a possibility that the plan and the request are shifted.
Therefore, as described above, there is a case where the comparison does not match in the comparison in S304, and if the doctor does not need to match, it is sufficient, and if the button indicating approval is pressed, the assortment request value is adopted as the plan. That is, the administration plan side is rewritten. If the request is incorrect, the doctor presses the cancel button. This corrects the assortment request.

On the other hand, even if the management server 3 is searched in S303, there may be no administration plan itself depending on the case.
For example, in the case of an emergency such as a sudden change in condition, there may be no time for planning. In other words, it is sometimes called prescription (administration) immediately after diagnosis by a doctor.
In such a case, a display indicating no registration plan (no protocol) is issued (S306).
Therefore, the doctor can input the administration plan again (S307).
The plan inputted there and the currently received stock request are compared and checked in S304.
Of course, the assortment request and the administration plan should be the same here, but in order to avoid typing errors etc., it is checked once.
In this way, it is possible to check whether or not an appropriate administration is being performed for an anticancer drug administration plan that requires strict administration.

In cancer chemotherapy, multiple drugs are used. These drugs are roughly divided into main drugs and pretreatment drugs. Pretreatment drugs are premised on pre-administration of certain active drugs such as anticancer drugs. For example, if there is something that causes intense nausea as a function of anticancer agent A, it is effective to administer physiological saline into the body several days before the protocol (administration plan) is executed There are cases.
This supplements the function of the main drug A and has no effect on cancer chemotherapy as such but is administered before the main drug is administered. Examples of the type include the above-mentioned physiological saline and glucose.
Since the administration of physiological saline and glucose is not directly related to the anticancer drug, which is the main drug, it is generally inserted by the doctor into the administration plan as needed regardless of the main drug. It is treated.
Therefore, in the conventional cancer chemotherapy planning system, even if the administration plan is changed, for example, when the cool period is shifted, such pretreatment drugs are not shifted following.
However, if a pretreatment drug is administered on a day that is not related to the main drug administration, there is no point in pretreatment drug administration. Therefore, it is desirable to associate these pretreatment drugs with the main drug and reflect them in the drug administration plan.
Therefore, in this invention, pretreatment drug additional input means for inputting a pretreatment drug and the administration plan of the pretreatment drug in relation to the main drug used in the drug administration plan stored in the cancer chemotherapy protocol storage means. Is adopted. Then, the pretreatment drug administration plan input by the pretreatment drug additional input unit is reflected in the prescription and administration plan of the drug stored in the cancer chemotherapy protocol storage unit, and is stored in the cancer chemotherapy protocol storage unit. Update stored drug prescriptions and dosing schedules. This update process is performed by the cancer chemotherapy protocol update means.
As a result, even if there is a change in the drug administration plan, the pretreatment drug administration plan is shifted along with it, so that the pretreatment drug works properly and the pretreatment drug can be used to relieve pain. The effect is definitely demonstrated.

Specific association processing will be described with reference to the flowchart shown in FIG. 38 and FIGS.
This process is also performed by the control unit 7 of the doctor's terminal 5.
The doctor selects a protocol (administration plan) including the main drug in question (S400).
In response to the selection, a screen (FIG. 39) showing the administration plan describing the protocol is opened (S402).
When the screen of FIG. 39 is opened, the doctor presses the pretreatment drug button 39a in the screen (S404).
In response to this, the screen of FIG. 40 is opened (S406).

Here, the doctor selects the main drug corresponding to the pretreatment drug. As the method of selection, the No. of the prescription (Rp) containing the main drug is instructed on the Rp instruction screen 40a. Click (40b) (S408). In the example in the figure, since the pretreatment drug for the main drug endoxane is registered, Rp. No. Click [4].
When the click is detected, the control unit 7 subsequently shifts the screen to the screen shown in FIG. 41 (S410). A pretreatment drug processing screen is displayed in the upper part 41a of the screen.
When right-clicking in the prescription area 41b in this screen (S412), a department name list is displayed as in FIG. 11, and after selecting a department name there, a pretreatment drug displayed further as shown in FIG. 12 is selected. When the OK button is pressed, the pretreatment drug is confirmed and input (S414), and the screen returns to FIG.
Here, the doctor inputs the number of days of the pretreatment drug prescription period on the screen in the pretreatment drug prescription period input field 41c (S416). In other words, enter the number of days before this drug is administered before the main drug is administered. FIG. 42 shows a state in which the number of days has been input. Here, “3 days” is entered. By this input, the period display unit 42a in FIG. 42 is displayed up to 3 days before the medication date.
When the OK button 42b is pressed here (S418), the screen shifts to the screen shown in FIG. 43, and the selected pretreatment drug, here glucose, is scheduled to be administered together with the RpNo. 7 is written in the prescription column 7 (S420). In addition, necessary information can be written manually.
If the OK button 43a is further pressed here, the control unit 7 displays the screen of FIG. In this way, glucose is additionally displayed in Rp, and the drug prescription and administration plan stored in the cancer chemotherapy protocol storage means are updated (S422).
In the prescription column, the main drug is RpNo. It is described by. Of course, it is understood from the drawing that the administration plan is changed to reflect the number of days of pretreatment drug prescription period (3 days).
Further, by selecting Rp of the pretreatment drug, the corresponding main drug may be displayed with high brightness.
If there is no problem with this, the doctor presses the save button 44a. This will reflect this data in the dosing schedule.
If there are multiple pretreatment drugs, multiple entries are made.

On the other hand, there are generally dose limits for drugs. In particular, those used in cancer chemotherapy such as anticancer drugs are highly effective, and there are many cases in which the limit of the dose that can be used throughout life is strictly determined. This is called the total dose limit and lifetime dose limit. The total dose is, of course, not a specific value for each individual drug, but a drug as a superordinate concept that has the same efficacy as the drug here. In the present invention, this is called a drug group.
In the present invention, the dose limit value for the drug group as described above is stored in advance in the dose limit value storage means.
Further, data including a drug dosage history reflecting the prescription and administration plan of the drug stored in the cancer chemotherapy protocol storage means is stored in a drug history storage means such as a drug history master.
Since the total drug dose as described above is the sum of the amount of each drug used in the cancer chemotherapy protocol storage means in the present invention, it is very easy to manage in the present invention using the cancer chemotherapy protocol storage means. .
However, this is only true for drugs managed by this system. For example, if a patient managed by another system at another hospital is accepted from the middle, there is no data compatibility. Therefore, the total dose cannot be managed as it is.
Therefore, data related to past dosages such as data at other hospitals as described above is input to this system separately from the drug dosage history stored in the drug history storage means. This procedure is performed by an off-history drug dose input means.
As a result, for the drug group, the drug dose stored in the drug history storage means and the drug dose input by the out-of-history drug dose input means are summed, and this drug in this patient The group's previous usage is calculated. As a physician, care should be taken that this does not exceed the total dosage limit for this group of drugs. For this reason, in the present invention, the combined value and the dose limit value stored in the dose limit value storage means are displayed in accordance with the display unit to alert the doctor.
In addition, if this combined value is likely to exceed the total dosage limit, a warning is issued to alert the physician.
The drug dose limit warning display means in the present invention is for displaying such a warning. The medicine master maintenance screen is opened (S500), and a medicine group is selected by placing a pointer on the cumulative administration group input window 47a in the screen shown in FIG. The selection method is the same as that shown in FIG.

Specifically, the processing proceeds according to the flowchart of FIG.
First, the doctor opens the therapy allocation screen shown in FIG. 47 (S506), and presses the past input button 48a in FIG. When the past input button 48a is pressed (S508), the screen is switched to FIG. 49 (S510).
This control is a process in which the control unit 7 opens the medicine group list screen (FIG. 49) with reference to the medicine group master shown in FIG. 46 and the medicine master shown in FIG. The drug group master shown in FIG. 46 is simply a list of drug groups, and the drug master shown in FIG. 47 associates the contents of units, conversion values, etc. of individual drugs included in the drug group with the groups. It is a master to let memorize.
Here, the doctor manually inputs the past dose of, for example, doxorubicin hydrochloride from the past chart (S512). In the case of patients coming from other hospitals as described above, past medical chart data is data written in the charts of other hospitals mentioned above, or given to patients before this system is launched. For example, data on the amount of drug obtained can be considered. Therefore, if the past data is electronic data, the data may be transferred therefrom.
The dose entered is not the actual body weight / body surface area, but the actual dose.
Subsequently, when the doctor presses the registration button 49a (S514), it is reflected in the dose in the medicine history master for each patient. That is, the upper limit value and the administered dose are displayed in the total dose check column 50a of FIG. 50 (S516).
As a result, as shown in the protocol screen of FIG. 51, the specific drug “Meyron” included in the drug group “Doxorubicin hydrochloride” is added to the past, and the control unit 7 determines whether the limit is exceeded. If it is over the limit (S518), a warning screen as shown in FIG. 52 is displayed (S520).

The final total dose is stored in a patient history master for each patient.
The warning screen shown in FIG. 52 displays the upper limit value of the total dose and the total dose so far or the total value of the total dose and the planned dose in the future. If these total values exceed the upper limit, a warning to the effect that they have been exceeded is displayed.
At that time, both the planned amount and the upper limit are displayed.
This allows physicians to take action, such as considering drug replacement, if the dose exceeds the total dose limit. If the body surface area has increased, the upper limit has also increased, so the upper limit may be calculated again.
Such an automatic check of the total dose makes it possible to prevent the occurrence of mistakes that cause the administered drug to exceed the upper limit and enter the dangerous area.
In addition, since the doses at other medical institutions can be added, the total dose can be strictly controlled.

The conceptual diagram of the whole computer system used for the cancer chemotherapy management system concerning one Embodiment of this invention. The figure which shows the login screen which controls an entrance at the entrance to the cancer chemotherapy management system concerning one Embodiment of this invention. The figure which shows the menu screen of the cancer chemotherapy management system concerning one Embodiment of this invention. The figure which shows a therapy list screen. The figure which shows a chemotherapy name input screen. The figure which shows a disease name input screen. The figure which shows a medical department name input screen. The figure which shows input screens, such as a doctor name and a registrant name. The figure which shows a prescription input screen. The figure which shows a recipe detailed input screen. The figure which shows a chemical | medical agent classification selection screen. The figure which shows a chemical | medical agent selection screen. The figure which shows the input screen of a chemical | medical agent administration method. The figure which shows a chemical | medical agent administration route input screen. The figure which shows a chemical usage input screen. The figure which shows a prescription day allocation screen. The figure which shows a prescription day allocation procedure. The figure which shows a prescription day allocation procedure. The figure which shows an allocation cool list screen. The figure which shows the therapy selection screen in the new addition procedure of allocation cool. The figure which shows the therapy assignment screen in the new addition procedure of assignment cool. The figure which shows a part of therapy assignment procedure in the new addition procedure of assignment cool. The figure which shows a part of therapy assignment procedure in the new addition procedure of assignment cool. The figure which shows a part of therapy assignment procedure in the new addition procedure of assignment cool. The figure which shows the allocation cool list screen in the change procedure of allocation cool. The figure which shows the prescription screen in the change procedure of allocation cool. The figure which shows the prescription amount change screen in the change procedure of allocation cool. The figure which shows an example of the prescription day change screen in the change procedure of allocation cool. The figure which shows the other example of the prescription date change screen in the change procedure of allocation cool. The figure which shows an example of the calendar screen in the change procedure of allocation cool. The figure which shows the other example of the prescription date change screen in the change procedure of allocation cool. The figure which shows the screen before and behind the shift of the prescription day in the change procedure of allocation cool. The figure which shows the content of a user master table. The figure which shows the content of the therapy master table. The figure which shows the content of the patient therapy master attribute table. The figure which shows the content of the patient therapy master prescription detailed table. The flowchart which shows the procedure of the check process of a medication request. The flowchart which shows the procedure of the administration plan update accompanying the addition of a pretreatment drug. The figure which shows the screen of therapy registration. The figure which shows the screen of therapy registration. The figure which shows a pretreatment medicine input screen. The figure which shows a pretreatment medicine input screen. The figure which shows a pretreatment medicine input screen. The figure which shows that the pretreatment medicine is input on the therapy registration screen. The flowchart which shows the procedure of displaying the past amount input and limit amount of a medicine group. The figure which shows the chemical | medical agent group master. The figure which shows the chemical | medical agent master. The figure which shows the administration plan screen for inputting the past part of a chemical | medical agent. The figure which shows the screen which selects and inputs the chemical | medical agent group name in a cumulative dose. The figure of the administration plan screen which shows that the past part of the chemical | medical agent was input. The figure which shows the screen of the therapy registration in which the past part added was reflected. The figure which shows the warning about the total dose and its limit. The flowchart which shows the login procedure to a cancer chemotherapy management system. The flowchart which shows input procedures, such as a disease name and therapy. The flowchart which shows a therapy input procedure. The flowchart which shows the input procedure, such as a prescription method and a technique. The flowchart which shows input procedures, such as usage. The flowchart which shows the input procedure to the calendar of a cool plan. The flowchart which shows a therapy selection procedure. The flowchart which shows the allocation procedure of a cancer chemotherapy protocol. The flowchart which shows the correction procedure of prescription.

DESCRIPTION OF SYMBOLS 1 ... Data server 3 ... Management server 5 ... Terminal 7 ... Control part 1a ... Login screen 2a ... Menu screen 3a ... Therapy list screen 4a ... Therapy registration screen 4-3a ... Medical department name list screen 4-4a ... Doctor name list screen 5a ... Recipe details input screen 5-2a ... Drug list screen 5-3a ... Anticancer agent list screen 5-5b ... Procedure list screen 5-5c ... Route list screen 5-5g ... Usage list and screen 6-1a ... Calendar input screen 13a ... cool assignment list screen 14a ... therapy list screen 14-2a ... therapy assignment screen 14-4a ... calendar 15a ... cool assignment list screen 39a ... pretreatment drug button 40a ... Rp instruction screen 40b ... prescription (Rp) No.
41a ... upper part 41b ... prescription area 41c ... pretreatment drug prescription period input field 42a ... disease name list 42b ... OK button 43a ... OK button 44a ... save button 47a ... cumulative administration group input window 47b ... drug name window 48a ... past Input button 49a ... Register button 50a ... Total dose check column S300, ...... Processing procedure number

Claims (9)

A therapy input means for inputting a plurality of therapies corresponding to general usage of a plurality of drugs for cancer treatment,
Therapy storage means for storing a plurality of therapies input by the therapy input means,
A cancer chemotherapy protocol creation means for creating a prescription and administration plan of a drug adapted to a specific patient's condition with reference to the therapy stored in the therapy storage means;
Cancer chemotherapy protocol storage means for storing the prescription and administration plan of the drug prepared by the cancer chemotherapy protocol preparation means,
A dose limit value storage means for storing a dose limit value for each unit of patient vital data for a drug group including the above drugs stored in the drug master in association with a drug having the same efficacy;
Drug history storage means for storing data including a dose history of the drug reflecting the prescription and administration plan of the drug stored in the cancer chemotherapy protocol storage means;
In addition to the drug dose history stored in the drug history storage means, an off-history drug dose input means for inputting past drug doses for each drug group displayed on the screen of the drug group list ;
A vital data input means for inputting vital data including the current height and weight of the patient;
Vital data recording and updating means for recording and updating the vital data input by the vital data input means;
Limit dose calculation means for calculating a limit dose based on the latest patient vital data recorded in the vital data record update means and the dose limit value;
For the drug group, the dose of the drug stored in the drug history storage means and the dose of the drug input by the out-of-history drug dose input means are added together, and the total value and the dose limit value storage means and drug dosage display means for displaying together the limit dose calculated by the limit dose calculation means based on the dosage limits stored in,
A cancer chemotherapy management system comprising: A warning is displayed when the combined value approaches or exceeds the limit dose calculated by the limit dose calculation means based on the dose limit value stored in the dose limit value storage means The cancer chemotherapy management system according to claim 1, further comprising a medicine dose limit warning display means.   The drug dose display means displays the total value, the dose limit value stored in the dose limit value storage means, and the limit dose calculated by the limit dose calculation means together. The cancer chemotherapy management system according to claim 1 or 2. The cancer chemotherapy management system according to any one of claims 1 to 3 , wherein the therapy stored in the therapy storage means is locked and stored so that it cannot be altered. Registered therapy copying means for copying the therapy stored in the therapy storage means, and modification for storing the modified therapy in the therapy storage means as a new therapy after modifying the therapy copied by the registered therapy copying means The cancer chemotherapy management system according to claim 4 , further comprising therapy storage means. The cancer chemotherapy management system according to any one of claims 1 to 5 , wherein only a person having a predetermined qualification can execute the new creation, copying, and modification of the therapy and storing the therapy in the therapy storage means. The authority of therapy registration relating to the new creation or copying and modification of the therapy by the therapy input means and the authority of master registration to register the therapy created by the therapy input means in the therapy storage means are individually provided. Is set to
The therapy the therapy created registration after logging of the person having the authority by the therapy input means, according to claim 6 which is registered in the therapy memory means by authorized after logging of the person having the authority of the master registration Cancer chemotherapy management system. The above-mentioned therapy storage means stores a therapy name, disease name, number of days for one course, standard number of cools, maximum number of cools, name of drug used, prescription amount of drug used and administration schedule for each stored therapy. Item 8. The cancer chemotherapy management system according to any one of Items 1 to 7 . The cancer therapy management system according to any one of claims 1 to 8 , wherein the therapy storage means further stores a maximum amount of a drug used, an administration method, and a usage for each stored therapy.

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