JP5361683B2 - Medical information processing apparatus and program - Google Patents

Description

  The present invention relates to a medical information processing apparatus and a program.

  In a medical institution such as a hospital, it is possible to provide a prompt and homogeneous medical service by standardizing a medical procedure and a schedule at the time of admission according to injury or illness. The content of the “standard medical care plan” for a certain injury or illness may be recognized as personal knowledge by a doctor or nurse working at a medical institution. Alternatively, a general medical care plan (called a clinical path) may be provided in a medical book or the like.

  As an example of a technique for supporting the creation of a standard medical care plan, Patent Document 1 discloses that a set of medical procedures (a set of medical treatment items and days elapsed from the date of hospitalization) that have a common disease name is averaged. A technique for obtaining a standard medical procedure is disclosed.

  In Patent Document 2, a medical process is represented by a two-dimensional matrix composed of a time axis representing the number of days elapsed from the date of hospitalization and medical practice items, and an average of medical processes (two-dimensional matrix) for a set of similar medical processes. A technique for creating a standard medical care plan by calculating the above is disclosed.

JP-A-2001-1118014 JP 2008-47154 A

  By the way, the “standard medical treatment plan” is determined by intricately intertwining the sickness and the state of the patient, the equipment of the medical institution, the medical compensation system, the medical scientific basis, and the like. For this reason, the “standard medical care plan” suitable for each medical institution is different.

  In addition, in the conventional technique for calculating the average of similar medical procedures or medical processes, “medical items that can be standardized” and “when clinical items that can be standardized” are implemented from the displayed average value or medical plan table. Need to judge and decide. For this reason, it takes a load to create a standard medical care plan, which is not efficient.

  An object of the present invention is to provide a medical information processing apparatus and a program that support efficient creation of a “standard medical care plan” suitable for each medical institution.

  The medical information processing apparatus according to one aspect of the present invention stores medical data acquired from medical performance information in units from one hospitalization to discharge from a patient at a medical institution and associated with at least medical items and their implementation time. And a medical information processing unit that extracts standard medical treatment candidates based on the medical data and displays them on a display unit, wherein the medical information processing unit standardizes the medical data stored in the storage unit Appearance rate calculating means for calculating the appearance rate for each medical care item with respect to the total number of medical care data related to the wound and the like, and the elapsed time calculation for calculating the time interval from the time of admission to the time of execution of each medical care item for each medical care data Means, standard deviation calculating means for calculating the standard deviation of the time interval for each medical care item, and the appearance rate calculated by the appearance rate calculating means may be standardized. A value that is greater than or equal to a preset threshold value and the standard deviation calculated by the standard deviation calculating means is less than or equal to a threshold value that is preset as a value that can be estimated to be standard medical treatment execution timing A medical information processing apparatus comprising: a standard medical treatment candidate extracting unit that extracts an item as a standard medical treatment candidate; and a display control unit that displays the standard medical treatment candidate on the display unit.

  The standard deviation calculating unit further calculates an average time of the time interval for each medical item, and the display control unit uses the average time of the medical item extracted as the standard medical candidate at the time of admission. The standard medical treatment candidates may be displayed on the display unit in such a manner that the order of execution of the standard medical treatment candidates from the time of discharge to the time of discharge can be identified.

  In addition, the display control means sets a time axis that represents a lapse of time from hospitalization to discharge, and displays the standard medical treatment candidate arranged at the position of the average time of the standard medical treatment candidate on the time axis. May be.

  1 aspect of this invention WHEREIN: The said medical information processing part calculates the relative elapsed time calculation means which calculates the relative time interval from the implementation time of each said standard medical treatment candidate to the implementation time of each other medical treatment item for every said medical data. Second standard deviation calculation means for calculating a standard deviation of the relative time interval and an average time of the relative time interval for each combination of the standard medical treatment candidate and other medical items, and the standard medical treatment candidate and the other The second appearance rate calculating means for calculating the appearance rate of the combination with respect to the total number, and the appearance rate calculated by the second appearance rate calculating means may be standardized for each combination with the medical item It is possible to estimate that the standard deviation calculated by the second standard deviation calculating means is a standard medical treatment execution timing that is equal to or greater than a preset threshold value. A relative standard medical candidate extraction unit that extracts the other medical items in a combination that is equal to or less than a preset threshold value as a relative standard medical candidate, and the display control unit includes the standard medical candidate and Using the average time calculated by the second standard deviation calculation means for the combination with the relative standard medical treatment candidate, in an aspect capable of identifying the order of execution of the relative standard medical treatment candidate from the time of hospitalization to the time of discharge, The relative standard medical treatment candidate may be displayed on the display unit in association with the standard medical treatment candidate.

  Further, the display control means uses a position representing the time of execution of the standard medical treatment candidate corresponding to the relative standard medical treatment candidate as a reference, and a position corresponding to the average time of the combination of the standard medical treatment candidate and the relative standard medical treatment candidate The relative standard medical treatment candidate may be arranged and displayed.

  The program according to one aspect of the present invention stores, in a computer, medical data acquired from medical performance information in units from hospitalization to discharge from a patient at a medical institution and associated with at least medical items and their implementation time. An appearance rate calculating step for calculating an appearance rate for each of the medical items with respect to the total number of medical data related to wounds and diseases to be standardized among the medical data stored in the storage unit, and for each of the medical data, An elapsed time calculating step for calculating a time interval from the time of admission to the time of performing each medical item, a standard deviation calculating step for calculating a standard deviation of the time interval for each medical item, and an appearance rate calculating step The calculated appearance rate is equal to or greater than a threshold set in advance as a value that may be standardized, and the standard deviation calculating step A standard medical treatment candidate extraction step for extracting a medical treatment item whose standard deviation is less than or equal to a threshold set in advance as a value that can be estimated as a standard medical treatment execution timing, and the standard medical treatment candidate is displayed. And a display control step to be displayed on the unit.

  According to the present invention, efficient creation of a “standard medical care plan” suitable for each medical institution can be supported.

It is a block diagram which shows the example of schematic structure of a medical information processing apparatus. It is a figure which shows the example of the content of the medical data memorize | stored in a memory | storage part. It is a figure which shows the example of the time interval from the time of admission calculated for every medical treatment item. It is a figure which shows the example of an appearance rate, a standard deviation, and an average time calculated for every medical treatment item. It is a figure which shows the example of the relative time interval calculated for every combination of a standard medical treatment candidate and another medical treatment item. It is a figure which shows the example of an appearance rate, a standard deviation, and average time calculated for every combination of a standard medical treatment candidate and another medical treatment item. It is a figure which shows the example of the standard medical treatment candidate displayed on a display part. It is a figure which shows the example of the standard medical treatment candidate displayed on a display part, and a relative standard medical treatment candidate. It is a flowchart which shows the example of the procedure of the process which a medical information processing apparatus performs. It is a flowchart which shows the example of the procedure of a standard medical treatment candidate extraction process. It is a flowchart which shows the example of the procedure of a relative standard medical treatment candidate extraction process.

  In FIG. 1, the example of schematic structure of the medical information processing apparatus by one Embodiment of this invention is shown. The medical information processing apparatus 1 in FIG. 1 includes a medical information processing unit 10, a storage unit 12, an input unit 14, and a display unit 16.

  The medical information processing unit 10 performs processing using the medical data stored in the storage unit 12. Details of the medical information processing unit 10 will be described later.

  The storage unit 12 stores medical data acquired from medical performance information recorded in a medical information system or the like (not shown) of a medical institution. The storage unit 12 is realized by, for example, a computer hard disk or a portable nonvolatile recording medium (for example, CD, DVD, flash memory) of various standards. The medical data is information associating at least the medical items performed during the hospitalization period and the time of implementation, with the unit from hospitalization to discharge from each patient as a unit.

  FIG. 2 shows an example of the contents of medical data stored in the storage unit 12. One row in the table of FIG. 2 represents an implementation history of one medical practice. The table in FIG. 2 includes items of a facility code, a data identification number, a hospitalization date, a discharge date, a DPC code, an implementation date, a medical treatment item, and the number of times after hospitalization. The facility code is identification information of a facility of a medical institution that records medical performance information that is the basis of medical data. The data identification number is a number for identifying a unit of medical data. In the table of FIG. 2, a row including the same data identification number represents information on a medical practice performed between a single hospitalization and discharge from the same patient. Patient identification information may be used as the data identification number. The date of hospitalization and the date of discharge represent the date when the corresponding patient was hospitalized and the date of discharge, respectively. For this reason, the line containing the same data identification number contains the same hospitalization date and discharge date.

  The DPC code is a number representing the diagnosis procedure combination (Diagnosis Procedure Combination, DPC), and is a 14-digit number that is determined based on the name of the injured disease, the age of the patient, the presence or absence of surgery, the severity of injury, etc. Is the number. DPC is used for classification of injury and illness in a comprehensive payment system for hospitalized medical expenses. In the comprehensive payment system for medical expenses, a comprehensive medical fee is determined according to the diagnosis group classification represented by the DPC code, regardless of the number of tests or medications actually performed. In a medical institution that complies with a comprehensive payment system for medical expenses by DPC, the results of medical treatment for patients are managed using DPC codes. Therefore, the DPC code can be acquired as one item of the medical data from the medical performance information from one hospitalization to the discharge from one patient.

  In DPC, about 2450 diagnostic group classifications are defined, and a DPC code is assigned to each diagnostic group classification. Each 14-digit digit of the DPC code represents the following contents in order from the left.

-1st and 2nd digits MDC (Major Diagnostic Category) 2 digit code. MDC is a code that classifies DPCs into 16 groups (eg, “01” for MDC is a nervous system disease, “02” is “ophthalmic disease”, etc.).
・ 3rd to 6th digits The 4-digit classification code of the name of the sickness that has invested the most medical resources.
・ 7th digit Purpose of hospitalization. Not used since April 2006 revision.
・ 8th digit Indicates a specific condition. For example, age condition, birth weight condition, JCS (Japan Coma Scale) condition (index of consciousness disorder level), Burn Index condition (index to judge burn severity), GAF (Global Assessment of Functioning) condition (psychological, Overall assessment and scale of social and professional functions).
・ 9th-10th digits Surgery information.
・ 11th digit Surgery / treatment, etc. 1 or not.
・ 12th digit Existence of 2 such as operation, treatment.
・ 13th digit Existence of minor injury.
・ 14th digit Presence or absence of severity.

  If there is no corresponding information in each digit, “x” representing “not applicable” is set instead of a number. For example, the seventh digit is “x” because it is unused.

  The DPC code has been described above. The analysis of the later-described embodiment is performed on the medical data group having the same DPC code, so that creation of a standard medical care plan in the same case can be supported.

  The implementation date in the table of FIG. 2 represents the date on which the medical practice of the corresponding medical treatment item was implemented. The medical treatment item represents a medical practice performed. The number of times after hospitalization represents the corresponding implementation date and the number of times the practice of the medical treatment item is implemented after hospitalization.

  Note that the items of medical data may include not only the items illustrated in FIG. 2 but also items representing various types of information necessary for calculating medical fees.

  Referring again to FIG. 1, the medical information processing unit 10 includes an appearance rate calculation unit 100, an elapsed time calculation unit 102, a standard deviation calculation unit 104, a standard medical treatment candidate extraction unit 106, a second appearance rate calculation unit 108, and a relative progress. A time calculation unit 110, a second standard deviation calculation unit 112, a relative standard medical treatment candidate extraction unit 114, and a display control unit 116 are provided. The medical information processing unit 10 is realized by a CPU (Central Processing Unit) of a computer or the like. For example, a program that describes the procedure of processing by each unit described later is stored in a storage device (not shown), and the CPU is read from the storage device and executed by the CPU, thereby causing the CPU to function as the medical information processing unit 10. be able to.

  The appearance rate calculating means 100 calculates the appearance rate for each medical item with respect to the total number of medical data related to wounds and diseases to be standardized among the medical data stored in the storage unit 12. Or you may calculate the appearance rate for every medical treatment item with respect to the total number of medical treatment data selected as analysis object among the medical data memorize | stored in the memory | storage part 12. FIG. For example, when the medical data with the DPC code “010060x097 × 3xx” is selected as the analysis target and the total number of the medical data to be analyzed is 100, there are 90 clinical data including the medical item “injection 01”. The appearance rate of the medical treatment item “injection 01” is 90%. In addition, regarding the same medical care item, the appearance rate may be obtained by distinguishing items having different numbers of times after hospitalization. For example, when the total number of medical data to be analyzed is 100, there are 92 medical data whose number of post-hospitalizations is “1” and the number of post-hospitalizations is “2” for a medical item “examination 01”. Consider the case where 89 medical data exist. At this time, the appearance rate of the first medical item “examination 01 (first time)” after hospitalization is calculated as 92%, and the second medical item “examination 01 (second time)” after hospitalization is 89%. % Is calculated. In the following description, it is assumed that the appearance rate calculation unit 100 calculates the appearance rate by distinguishing items having the same number of times of hospitalization even if they are the same medical care item. In addition, for each same facility code, an appearance rate for each medical item may be calculated with respect to the total number of medical data regarding wounds and diseases to be standardized. The calculated appearance rate is registered in the storage unit 12 in association with the corresponding medical treatment item (and the number of times after hospitalization).

  The elapsed time calculation means 102 calculates the time interval from the time of admission to the time of the execution of each medical item for each medical data. This time interval can be calculated by obtaining the elapsed time from the date of hospitalization of each medical data to the date of implementation of each medical item included in the medical data. The calculated time interval is registered in the storage unit 12 in association with the corresponding medical treatment item. The elapsed time calculation means 102 calculates the time interval from the time of admission for each row in the table of FIG.

  FIG. 3 shows an example of a table of time intervals registered in the storage unit 12. The table of FIG. 3 includes items of data identification number, DPC code, reference medical item, target medical item, and time interval. Among these, the “target medical treatment item” is a medical treatment item to be processed by the elapsed time calculation unit 102 and corresponds to each medical treatment item in the medical treatment data. In FIG. 3, the value of “target medical treatment item” includes information indicating the medical treatment item in the medical treatment data and the number of times after hospitalization. The “time interval” is a time interval calculated by the elapsed time calculation means 102 for the “target medical treatment item”. The “data identification number” and the “DPC code” are the same data as the medical data used as the basis of each record already described above. The “reference medical item” represents a medical item as a reference point when the elapsed time calculation unit 102 calculates the “time interval” until the “target medical item” is executed. Since the “time interval” calculated by the elapsed time calculation means 102 is the time interval from the time of admission to the time when the “target medical treatment item” is performed, the “reference medical treatment item” is “hospitalization” in each row of the table of FIG. "Is set.

  Referring again to FIG. 1, the standard deviation calculation unit 104 uses the time interval calculated by the elapsed time calculation unit 102 for the medical data stored in the storage unit 12, for each medical item, the time interval described above. Calculate the standard deviation. In addition, the standard deviation calculation unit 104 calculates an average time for each medical treatment item using the time interval calculated by the elapsed time calculation unit 102. The calculated standard deviation and average time are registered in the storage unit 12 in association with the medical treatment item.

  FIG. 4 shows an example of a table of standard deviation of time intervals and average time registered in the storage unit 12. In the table of FIG. 4, the average of the time intervals calculated by the standard deviation calculation unit 104 for the target medical item in association with the combination of the DPC code, the standard medical item, and the target medical item similar to the table of FIG. 3. Time and standard deviation are shown. The average time and the standard deviation are the average and standard deviation of values of a plurality of time intervals associated with the same target medical treatment item in the table of FIG. FIG. 4 also shows the appearance rate calculated by the appearance rate calculation means 100 for each target medical treatment item.

  Returning to the description of FIG. 1, the standard medical treatment candidate extracting unit 106 determines that the appearance rate calculated by the appearance rate calculating unit 100 is equal to or higher than a threshold value set in advance as a value that may be standardized (for example, 90% or higher). And the standard deviation calculated by the standard deviation calculating means 104 is a threshold value that is less than or equal to a preset threshold value (for example, 0.6 or less) as a value that can be estimated to be the standard medical practice timing. Are extracted as standard medical treatment candidates. Here, the “standard medical treatment candidate” means a medical treatment item candidate to be included in the standard medical treatment plan. For example, in the case of the table of FIG. 4, the target medical treatment items “examination 01 (first time)” and “medication 01 (first time)” having an appearance rate of 90% or more and a standard deviation of 0.6 or less as standard medical treatment candidates. , And “medication 01 (second time)” are extracted (within the broken line frame). Each threshold value is not limited to this. Further, a threshold value may be arbitrarily set on the user side.

  The second appearance rate calculating unit 108 is configured to calculate the combination of each of the standard medical candidates extracted by the standard medical candidate extraction unit 106 and each of the other medical items with respect to the total number of medical data to be analyzed. An appearance rate of medical data including the combination is calculated. For example, in the case of the above-described example with reference to FIG. 4, each of the standard examination candidates “examination 01 (first time)”, “medication 01 (first time)”, and “medication 01 (second time)” Target medical treatment items ("MRI imaging (1st time)", "Injection 01 (1st time)", "Surgery 01 (1st time)", "Examination 03 (1st time)", "Examination 02 (1st time)") The appearance rate of each combination is calculated.

  The relative elapsed time calculation unit 110 calculates a relative time interval from the time of execution of the standard medical treatment candidate to the time of execution of each of other medical care items for each standard medical care candidate extracted by the standard medical treatment candidate extraction unit 106. This relative time interval is obtained by calculating the elapsed time from the implementation date of the standard practice candidate to the implementation date of each other medical care item for each clinical data including the standard practice candidate. It can be calculated. For other medical items performed before the standard medical treatment candidate is executed, the relative time interval may be calculated as a negative value. The calculated relative time interval is registered in the storage unit 12 in association with the combination of the standard medical treatment candidate and the medical treatment item.

  FIG. 5 shows an example of a relative time interval table registered in the storage unit 12. The items included in the table of FIG. 5 are the same as the table of FIG. 3 described above (the table of time intervals from the time of admission). However, in the table of FIG. 5, the corresponding standard medical treatment candidate is registered as “reference medical treatment item” instead of “hospitalization”. The row a in the table of FIG. 5 shows that in a certain medical data, the time interval from the implementation of the standard medical treatment candidate “examination 01 (first)” to the implementation of the target medical treatment item “examination 02 (first)” is 2 days. It represents that. Similarly, in the rows b and c, the time interval between the time when the “examination 01 (first time)” is performed and the time when the “examination 02 (first time)” is performed is 2 days in each of the two corresponding medical data. And 3 days. Lines d and e indicate the time from the implementation of the standard medical treatment candidate “medicine 01 (first time)” to the implementation of the target medical treatment item “medicine 01 (second time)” in each of the two corresponding medical data. Each interval represents one day.

  Returning to the description of FIG. 1, the second standard deviation calculating unit 112 calculates the relative time interval calculated by the relative elapsed time calculating unit 110 for each combination of each standard medical candidate and other medical items in the medical data. Calculate the standard deviation. In addition, the second standard deviation calculation unit 112 calculates the average time for each combination described above using the relative time interval calculated by the relative elapsed time calculation unit 110. The calculated standard deviation and average time are registered in the storage unit 12 in association with combinations of standard medical treatment candidates and other medical treatment items.

  FIG. 6 shows an example of a standard deviation and average time table registered in the storage unit 12. The table in FIG. 6 includes the same items as the table in FIG. 4 (table of standard deviation and average time of time interval from admission). However, in the table of FIG. 6, instead of “hospitalization”, standard medical treatment candidates are registered as “reference medical treatment items”. A set of “reference medical treatment item” and “target medical treatment item” represents a combination of a standard medical treatment candidate and another medical treatment item. The average time and standard deviation corresponding to each combination are the average and standard deviation of values of a plurality of relative time intervals associated with the combination in the table of FIG. FIG. 6 also shows the appearance rate calculated by the second appearance rate calculation means 108 for each combination.

  The tables in FIGS. 3 to 6 referred to in the above description do not limit specific modes of information registered in the storage unit 12 by each unit of the medical information processing unit 10. For example, the time interval table may include a data identification number in addition to the items shown in FIGS. Further, for example, the table of time intervals calculated by the elapsed time calculation unit 102 and the relative elapsed time calculation unit 110 and registered in the storage unit 12 has been described above with reference to FIG. 3 and FIG. May be registered in the storage unit 12 together. Similarly, the average time, standard deviation, and appearance rate tables shown in FIGS. 4 and 6 may be combined into one table and registered in the storage unit 12.

  Referring again to FIG. 1, the relative standard medical treatment candidate extraction unit 114 determines that the appearance rate calculated by the second appearance rate calculation unit 108 is equal to or greater than a threshold set in advance as a value that may be standardized (for example, 90% or more), and the standard deviation calculated by the second standard deviation calculating means 112 is equal to or less than a threshold value set in advance as a value that can be estimated to be a standard medical practice timing (for example, 0. 0%). 6 or less) is extracted as a relative standard medical treatment candidate. Here, the “relative standard medical treatment candidate” represents a medical practice that is considered to be performed as standard when the above-mentioned standard medical treatment candidate is used as a reference. In the case of the example of FIG. 6, since the appearance rate of both the row f and the row g is 90% or more and the standard deviation is 0.6 or less, the target medical treatment item “test 02 (first time) of the rows f and g” "," Medication 01 (second time) "is extracted. Each threshold value is not limited to this. Moreover, the structure which enables a user to set a threshold value arbitrarily may be sufficient. Furthermore, each threshold value may be a value different from the threshold value of the appearance rate and the standard deviation in the standard medical treatment candidate extraction unit 106.

  The display control unit 116 performs processing for causing the display unit 16 to display the processing result in the medical information processing unit 10. For example, the standard medical treatment candidate extracted by the standard medical treatment candidate extracting unit 106 is output and displayed on the display unit 16. The display mode is not particularly limited, and only the item names of standard medical treatment candidates may be displayed, or the execution order of standard medical treatment candidates may be displayed based on the average time calculated by the standard deviation calculating unit 104. Good. Alternatively, standard medical treatment candidates may be arranged in the order of execution and displayed in association with the average time. Alternatively, the display mode illustrated in FIG. 7 may be used. FIG. 7 shows the number of days from admission when standard treatment candidates are implemented in a standard treatment plan. The “target medical treatment item” in each row of the table of FIG. 7 represents the item name of the standard medical treatment candidate extracted by the standard medical treatment candidate extraction unit 106 (see the broken line in FIG. 4). “Days” in each column of the table in FIG. 7 represents the number of days since admission. The number of days in the column corresponding to the hatched cell in each target medical treatment item row corresponds to the average time calculated for the standard medical treatment candidate in that row. When the average time is calculated including a value after the decimal point, for example, the number of days expressed by an integer may be displayed by rounding off the decimal point. From the above, in the table of FIG. 7, in the standard medical care plan, “medicine 01 (first time)” is performed on the third day after hospitalization, and “medicine 01 (second time)” is performed on the fourth day after hospitalization. In other words, “examination 01 (first time)” is performed on the eighth day after hospitalization. Further, in the table of FIG. 7, it is only necessary to display the medical treatment items having different post-hospital times such as “medication 01 (first time)” and “medication 01 (second time)” so that the order of execution can be understood. You may display on one line.

  The display control unit 116 may further output the relative standard medical treatment candidate extracted by the relative standard medical treatment candidate extraction unit 114 to the display unit 16. The display mode may be a mode that allows the user to understand the relationship with the standard medical treatment candidate and the order of execution of the relative standard medical treatment candidates. For example, as shown in FIG. 8, both the standard medical treatment candidate and the relative standard medical treatment candidate may be displayed in the same manner as the table of FIG. Referring to FIG. 8, “medication 01 (first time)”, “medication 01 (second time)”, and “examination 01 (first time)” are standard medical treatment candidates similar to those in FIG. “Examination 02 (first time)” is the item name (see FIG. 6) of the relative standard medical care candidate extracted by the relative standard medical care candidate extraction means 114. For the display at the time of execution of the relative standard medical treatment candidate, the average time of the relative time interval from the time of execution of the standard medical treatment candidate used as the reference in the extraction process is used. For example, referring to the table of FIG. 6, for the target medical treatment item “Examination 02 (first time)”, the reference medical treatment item is “Examination 01 (first time)”, and the average time is “2.1”. . For this reason, in the table of FIG. 8, the time when “Examination 02 (first time)” is performed corresponds to the time when 2.1 days have passed since the 8th day when “Inspection 01 (first time)” is performed. Shown as day. In this example, “medicine 01 (first time)” is extracted as a standard medical treatment candidate and a relative medical treatment candidate (see FIGS. 4 and 6). The average time calculated for the standard medical care candidate or the average time calculated for the relative standard medical care candidate may be used for displaying such medical items at the time of implementation.

  Further, when the display is performed in the manner as shown in FIGS. 7 and 8, the color of the cell representing the time of implementation of each target medical treatment item or the manner of painting may be different from each other. As an example, a different color may be considered according to the standard deviation of the time interval calculated for the target medical treatment item. For example, when the corresponding standard deviation is smaller, the color of the cell is darker, so that it is possible to visually express that the number of days corresponding to the cell is more likely to be standard when the target medical treatment item is performed. Further, for example, at the cell corresponding to the time of implementation, at least one of the average time and the standard deviation calculated for the target medical treatment item may be displayed. When displaying numerical values, the numerical values may be displayed so as to be superimposed on the filled cells, or only the numerical values may be displayed without filling the cells. Alternatively, a numerical value corresponding to the cell may be displayed only when the user uses the input unit 14 to instruct a specific cell, such as when instructed by a mouse pointer on the display screen. Moreover, it is good also as a different color according to the kind of medical treatment item. For example, in FIG. 7, the cells representing the first and second “medicine 01” are displayed in the same color, and the cells representing the “test 01” are displayed in a different color from “medicine 01”. May be. Moreover, you may display with a different icon image according to the kind of medical treatment item. In addition, when a plurality of target medical treatment items are implemented on the same day in a certain medical data, a plurality of different tone or pattern areas are provided in the corresponding number of days in the table, and the implementation is performed on the same day. It is also possible to display the plurality of medical treatment items that can be distinguished from each other.

  Referring again to FIG. 1, the input unit 14 receives a user input and passes it to the medical information processing unit 10. The user inputs various instructions to the medical information processing apparatus 1 using the input unit 14. The input unit 14 is realized by an input device such as a keyboard, a mouse, or a touch panel.

  The display unit 16 is controlled by the display control unit 116 and displays the processing result of the medical information processing unit. The display unit 16 is realized by a display device such as a CRT (Cathode Ray Tube) display or a liquid crystal display, for example.

  Hereinafter, an example of a processing procedure in the medical information processing apparatus 1 will be described. FIG. 9 is a flowchart illustrating an example of a procedure of processing performed by the medical information processing apparatus 1. For example, when the medical information processing apparatus 1 receives an instruction to start processing from the user via the input unit 14, the medical information processing apparatus 1 starts processing of the procedure in the example of FIG. 9.

  First, the medical information processing unit 10 reads medical performance information output from a medical information system (not shown) of a medical institution (step S1). For example, the medical record information may be acquired from a database provided in a medical information system or the like via a network such as the Internet or a LAN (Local Area Network). Alternatively, for example, medical record information recorded on a portable storage medium such as a CD or a DVD may be read by a reading device corresponding to the storage medium.

  The medical information processing unit 10 extracts information necessary for processing in each unit of the medical information processing unit 10 from the medical treatment result information acquired in step S1, and stores the information as medical data in the storage unit 12 (step S2). The table of medical data stored in the storage unit 12 may be a table as described with reference to FIG. In step S2, the medical information processing unit 10 not only extracts the value itself registered as the item in the medical data from the medical performance information, but also in the medical data based on various types of information included in the medical performance information. The value of the item may be obtained. For example, in the medical treatment record information recorded in the medical institution, it is assumed that the value of “number of times after hospitalization” among the items illustrated in FIG. 2 is not included and the values of other items are included. In this example, the medical information processing unit 10 performs each year of implementation if information corresponding to one unit of medical data (information from one hospitalization to one discharge) includes a plurality of identical medical care items. Check the month and day, and set the number of post-hospitalizations by 1 in order from “1” in order of early implementation date. Further, if only one medical item is included in the information corresponding to one unit of medical data, the post-hospital number of the medical item is set to “1”.

  When the medical data is stored in the storage unit 12, the medical information processing unit 10 refers to the medical data in the storage unit 12 and performs standard medical candidate extraction processing (step S3). Step S3 is executed by the appearance rate calculating means 100, the elapsed time calculating means 102, the standard deviation calculating means 104, and the standard medical care candidate extracting means 106. The detailed procedure of step S3 will be described later.

  When the standard medical treatment candidate is extracted in step S3, the medical information processing unit 10 performs a relative standard medical treatment candidate extraction process (step S4). Step S4 is executed by the second appearance rate calculating means 108, the relative elapsed time calculating means 110, the second standard deviation calculating means 112, and the relative standard medical care candidate extracting means 114. The detailed procedure of step S4 will be described later.

  After step S4, the medical information processing unit 10 creates a standard medical care plan in accordance with an instruction from the user via the input unit 14 (step S5). The user refers to the standard medical treatment candidate and the relative standard medical treatment candidate displayed on the display unit 16, and uses the input unit 14 to instruct the medical treatment items to be included in the standard medical treatment plan and the time of implementation. Receiving this instruction, the medical information processing unit 10 causes the storage unit 12 to store information including the instructed medical care item and the time of execution of each medical care item as a standard medical care plan.

  After step S5, the process of the procedure in the example of FIG. 9 ends.

  FIG. 10 is a flowchart illustrating an example of a detailed procedure of step S3 of FIG. When step S3 is started, the medical information processing unit 10 starts processing of the procedure in the example of FIG.

  First, the medical information processing unit 10 receives selection of a medical data group to be analyzed (step S301). For example, the input of the user who designates the medical data group is accepted via the input unit 14. In the present embodiment, the designation of the medical data group is performed by 14 digits of the DPC code.

  The medical information processing unit 10 reads the medical data group selected in step S301 from the storage unit 12, and performs the processing of steps S302 to S308 described below for each of all the medical items included in the read medical data group. I do. Hereinafter, the processing of steps S302 to S308 will be described by taking as an example a case where medical data of the DPC code “010060x097x3xx” illustrated in FIG. 2 is read from the storage unit 12 as an analysis target.

  First, the appearance rate of the medical item to be processed is calculated by the appearance rate calculating unit 100 using the medical item in one row of the table in FIG. 2 as a processing target (step S302). In this example, the appearance rate is calculated by distinguishing the number of times after hospitalization. Thus, for example, in the case of the row of the medical treatment item “MRI imaging” in FIG. 2, first, of the medical data to be analyzed, the medical treatment item is “MRI imaging” and the number of times after hospitalization is “1” is included. Find the number of medical data. Then, the appearance rate is calculated by dividing the obtained number of medical data by the total number of medical data to be analyzed.

  If the appearance rate calculated in step S302 is smaller than a preset threshold value (predetermined appearance rate) (NO in step S303), the medical information processing unit 10 performs step S304 and subsequent steps on the current medical treatment item. Without performing the processing, the processing of step S302 and subsequent steps is performed on a set of untreated medical treatment items and the number of post-hospitalizations (included in the other one row of the table in FIG. 2) as a processing target.

  If the appearance rate calculated in step S302 is equal to or higher than the predetermined appearance rate (YES in step S303), the elapsed time calculation means 102 calculates the time interval from the time of admission to the time when the medical treatment item to be processed is executed (step). S304). In step S304, all the treatment items to be processed and the implementation history of the number of times after admission (corresponding to the information on one line in the table of FIG. 2) are extracted from the analysis data to be analyzed, Calculate the time interval from time to time. In the case of the example in FIG. 2, the elapsed time from the date of hospitalization to the date of implementation is calculated for each extracted row. The time interval calculated in step S304 is registered in the storage unit 12 as a table like the example of FIG.

  Next, the standard deviation of the time interval calculated in step S304 is calculated by the standard deviation calculation means 104 (step S305). The calculated standard deviation is registered in the storage unit 12 in association with the current medical treatment item to be processed and the number of hospitalizations (see FIG. 4).

  If the standard deviation calculated in step S305 exceeds a preset threshold (predetermined standard deviation) (NO in step S306), the medical information processing unit 10 performs step S307 for the current medical treatment item to be processed. Without performing the subsequent processing, the processing in step S302 and subsequent steps is performed on a set of unprocessed medical treatment items and the number of times after hospitalization as a processing target.

  If the standard deviation calculated in step S305 is equal to or smaller than the predetermined standard deviation (YES in step S306), the standard deviation calculation means 104 calculates the average time of the time interval calculated in step S304 (step S307). The calculated average time is registered in the storage unit 12 in association with the current medical treatment item to be processed and the number of times after hospitalization (see FIG. 4).

  After step S307, the current medical treatment item to be processed is registered in the storage unit 12 as a standard medical treatment candidate by the standard medical treatment candidate extraction unit 106 (step S308). If the appearance rate of the medical treatment item to be processed is equal to or higher than the predetermined appearance rate (YES in step S303) and the standard deviation of the time interval from hospitalization is equal to or smaller than the predetermined standard deviation (YES in step S306), step Since the processing of S308 is executed, the medical treatment item is set as a standard medical treatment candidate in this step.

  After step S308, if there is a set of unprocessed medical items and the number of times after hospitalization, the processing after step S302 is repeated for the unprocessed group, and if all the sets of medical items and the number of times after hospitalization have been processed. The process proceeds to step S309.

  In step S309, the display control means 116 displays the standard medical treatment candidate on the display unit 16. An example of the display mode is as described with reference to FIG.

  After step S309, the standard medical treatment candidate extraction process ends, and the process proceeds to step S4 in FIG.

  FIG. 11 is a flowchart illustrating an example of a detailed procedure of step S4 of FIG. When step S4 is started, the medical information processing unit 10 starts processing of the procedure in the example of FIG.

  Referring to FIG. 11, for all combinations in the medical data of all the extracted standard medical candidates and each of the other medical items included in the medical data group to be analyzed, steps S401 to S407 are performed. Processing is performed.

  First, a combination of one of the standard medical treatment candidates and one of the other medical treatment items is set as a processing target, and the appearance rate of the combination in the medical data group to be analyzed by the second appearance rate calculating unit 108 Is calculated (step S401). For example, if the combination of the standard medical treatment candidate “Examination 01 (first time)” and one of the other medical treatment items “MRI imaging (first time)” is a processing target, By dividing the number of medical data including both “examination 01 (first time)” and “MRI imaging (first time)” by the total number of medical data to be analyzed, the appearance rate of the combination of processing targets is calculated.

  If the appearance rate calculated in step S401 is smaller than a preset threshold value (predetermined appearance rate) (NO in step S402), the medical information processing unit 10 performs the processing from step S403 on for the current combination of processing targets. Without performing step S401 and subsequent steps with the unprocessed combination as a processing target.

  If the appearance rate calculated in step S401 is equal to or greater than the predetermined appearance rate (YES in step S402), the relative elapsed time calculation unit 110 causes other medical items in the combination to be processed from the time of execution of the standard medical treatment candidate in the processing target combination. The time interval until the implementation is calculated as a relative time interval (step S403). In step S403, all the medical data including the combination of the processing target is extracted from the medical data to be analyzed, and for each of the extracted medical data, the other medical items in the combination from the implementation of the standard medical candidate in the combination. The time interval until the implementation of is calculated. The relative time interval calculated in step S403 is registered in the storage unit 12 as a table like the example of FIG.

  Next, the standard deviation of the relative time interval calculated in step S403 is calculated by the second standard deviation calculation unit 112 (step S404). The calculated standard deviation is registered in the storage unit 12 in association with the current combination of processing targets (see FIG. 6).

  If the standard deviation calculated in step S404 exceeds a preset threshold (relative predetermined standard deviation) (NO in step S405), the medical information processing unit 10 performs step S406 for the current combination of processing targets. Without performing the subsequent processing, the processing from step S401 is performed on the unprocessed combination as the processing target.

  If the standard deviation calculated in step S404 is less than or equal to the relative predetermined standard deviation (YES in step S405), the second standard deviation calculating unit 112 calculates the average time of the relative time intervals calculated in step S403 ( Step S406). The calculated average time is registered in the storage unit 12 in association with the current combination of processing targets (see FIG. 6).

  After step S406, the other medical treatment items of the standard medical treatment candidate in the current combination of processing targets are registered in the storage unit 12 as relative standard medical treatment candidates by the relative standard medical treatment candidate extracting unit 114 (step S407). Step S407 is executed when the appearance rate is equal to or higher than the predetermined appearance rate for the combination to be processed (YES in Step S402) and the standard deviation of the relative time interval is equal to or less than the relative predetermined standard deviation (YES in Step S405). Therefore, in this step, other medical treatment items in the combination are set as relative standard medical treatment candidates.

  After step S407, if there is an unprocessed combination, the process from step S401 onward is repeated for the unprocessed combination, and if all the combinations have been processed, the process proceeds to step S408.

  In step S408, the display control means 116 displays the relative standard medical treatment candidate on the display unit 16. An example of this display mode is as described above with reference to FIG.

  After step S408, the relative standard medical care candidate extraction process ends, and the process proceeds to step S5 in FIG.

  According to the embodiment described above, the medical treatment data obtained from the medical treatment record information recorded in a specific medical institution is stored in the storage unit 12 as an analysis target, so that a standard medical treatment candidate suitable for the medical institution can be obtained. Can be extracted. In addition, according to the standard medical treatment candidate extraction process (see FIG. 10), standard medical treatment candidates that are considered to be standardized are automatically extracted and displayed, thereby improving the efficiency of creating a standard medical treatment plan. Can be achieved. Further, according to the relative standard medical treatment candidate extraction process (see FIG. 11), when the standard medical treatment candidate extracted in consideration of the elapsed time from admission to the execution time is used as a reference, It is possible to automatically extract and display relative standard medical treatment candidates that are medical practices that can be standardized. This makes it possible to more reliably extract medical items that have a strong correlation only when a specific medical item is performed, as compared with a technique that extracts only a standard medical practice considering only the elapsed time from hospitalization.

  The above-described embodiment is merely an example of the embodiment of the present invention, and there may be various modifications. For example, in the above-described embodiment, the DPC code 14 digits are used to classify the medical data, but different codes are used as long as each medical data can identify what kind of injury or illness data. May be. For example, it is possible to specify a medical data group to be analyzed using only the first six digits of the DPC code and perform the same processing as in the above-described embodiment. Alternatively, a DRG (Diagnosis Related Group) code, which is a diagnosis group classification code developed in the United States, may be used instead of the DPC code.

  Moreover, in the above-mentioned embodiment, the date is recorded at the time of hospitalization and the implementation of each medical treatment item, and the time interval from the time of hospitalization and the relative time interval from the implementation of the standard medical treatment candidate are obtained on a daily basis. In another example, not only the date of hospitalization and implementation but also the time may be recorded, and the time interval and the relative time interval may be obtained in consideration of the time.

  Further, in the overall processing procedure of the medical information processing apparatus 1 (FIG. 9), the execution of the relative standard medical treatment candidate extraction processing (step S4) may be omitted after the standard medical treatment candidate extraction processing (step S3). . Or you may receive a user's selection about the presence or absence of execution of a relative standard medical treatment candidate extraction process, for example.

  Further, the standard medical treatment candidate extraction processing and the relative standard medical treatment candidate extraction processing may be performed according to procedures different from those in FIGS.

  For example, in the above-described embodiment, in the standard medical treatment candidate extraction process (FIG. 10), the selection of medical data to be analyzed by the user is accepted (step S301), and the selected medical data is analyzed. In another example, when the total number of analysis data selected by the user is equal to or less than a preset threshold value that may not yield a significant result by analysis, the execution of the analysis process is stopped. Or a warning may be displayed to inquire the user whether processing can be continued. In yet another example, the process of accepting selection by the user may be omitted, and all of the medical data stored in the storage unit 12 may be the analysis target. Moreover, it is good also as an analysis object for every facility code | cord | chord of medical treatment data.

  Further, for example, in the procedures of FIGS. 10 and 11, the time interval is calculated only when the appearance rate of the medical items or the appearance rate of the combination is equal to or higher than a predetermined appearance rate (YES in steps S303 and S402), and the time The average time is calculated only when the standard deviation of the interval is equal to or less than the (relative) predetermined standard deviation (YES in steps S306 and S405). In the procedure of another example, first, the appearance rate, the time interval, the standard deviation, and the average time are calculated and stored in the storage unit 12 for all medical treatment items and combinations to be processed, and then the appearance rate. The standard medical treatment candidate and the relative standard medical treatment candidate may be extracted by comparing with a threshold value of the standard deviation.

  Further, in the display of the standard medical treatment candidate (step S309 in FIG. 10) and the relative standard medical treatment candidate (step S408 in FIG. 11), the user may select various display modes described above. For example, only item names of standard medical treatment candidates and relative standard medical treatment candidates are displayed as a list, or a matrix display as illustrated in FIGS. 7 and 8 is received, or a user's selection is accepted via the input unit 14 and selected. It is displayed on the display unit 16 in the manner described. Further, for example, when both the standard medical treatment candidate and the relative standard medical treatment candidate are displayed, it may be selected whether to display both of them separately or without displaying them. Alternatively, it may be possible to select to display only the relative standard medical treatment candidates without displaying the standard medical treatment candidates.

  The medical information processing apparatus 1 according to the embodiment and the modification described above may be realized by a single computer, or may be realized by distributing the functions of each unit or each means to a plurality of computers connected to each other. May be.

  DESCRIPTION OF SYMBOLS 1 Medical information processing apparatus, 10 Medical information processing part, 12 Storage part, 14 Input part, 16 Display part, 100 Appearance rate calculation means, 102 Elapsed time calculation means, 104 Standard deviation calculation means, 106 Standard medical treatment candidate extraction means, 108 Second appearance rate calculation means, 110 relative elapsed time calculation means, 112 second standard deviation calculation means, 114 relative standard medical treatment candidate extraction means, 116 display control means.

Claims (6)

A storage unit that stores medical data that is acquired from medical performance information in units from hospitalization to discharge from a single patient at a medical institution, and stores at least medical items and their implementation time;
A medical information processing unit that extracts standard medical treatment candidates based on the medical data and displays them on a display unit;
With
The medical information processing unit
Appearance rate calculating means for calculating an appearance rate for each medical care item with respect to the total number of medical care data related to wounds or diseases to be standardized among the medical data stored in the storage unit,
For each of the medical data, an elapsed time calculation means for calculating a time interval from the time of admission to the time of implementation of each medical item,
Standard deviation calculating means for calculating a standard deviation of the time interval for each medical item;
The appearance rate calculated by the appearance rate calculating means is equal to or greater than a threshold set in advance as a value that may be standardized, and the standard deviation calculated by the standard deviation calculating means is a standard practice. A standard medical treatment candidate extracting means for extracting a medical treatment item that is equal to or lower than a preset threshold as a value that can be estimated to be a timing as a standard medical treatment candidate;
Display control means for displaying the standard medical treatment candidate on the display unit,
Medical information processing device characterized by that. The standard deviation calculating means further calculates an average time of the time interval for each medical item,
The display control means uses the average time of the medical treatment items extracted as the standard medical treatment candidate to identify the standard medical treatment candidate in a manner capable of identifying the order of execution of the standard medical treatment candidate from hospitalization to discharge. The medical information processing apparatus according to claim 1, which is displayed on the display unit.   The display control means sets a time axis representing a lapse of time from admission to discharge, and arranges and displays the standard medical treatment candidate at the position of the average time of the standard medical treatment candidate on the time axis. Item 3. The medical information processing apparatus according to Item 2. The medical information processing unit
Relative elapsed time calculating means for calculating a relative time interval from the implementation of each of the standard medical treatment candidates to the implementation of each of the other medical treatment items for each of the medical data;
Second standard deviation calculating means for calculating a standard deviation of the relative time interval and an average time of the relative time interval for each combination of the standard medical treatment candidate and other medical items;
Second appearance rate calculating means for calculating the appearance rate of the combination with respect to the total number for each combination of the standard medical treatment candidate and other medical items;
The appearance rate calculated by the second appearance rate calculating means is equal to or greater than a threshold value set in advance as a value that may be standardized, and the standard deviation calculated by the second standard deviation calculating means is A relative standard medical treatment candidate extracting means for extracting the other medical care items in a combination that is equal to or lower than a threshold set in advance as a value that can be estimated to be standard medical treatment implementation timing as a relative standard medical treatment candidate; ,
The display control means uses the average time calculated by the second standard deviation calculation means for a combination of the standard medical treatment candidate and the relative standard medical treatment candidate, and uses the relative standard medical treatment candidate from hospitalization to discharge. The medical information processing apparatus according to claim 2, wherein the relative standard medical treatment candidate is displayed on the display unit in association with the standard medical treatment candidate in a manner in which the order of the implementations can be identified.   The display control means is based on a position representing the time of execution of the standard medical treatment candidate corresponding to the relative standard medical treatment candidate, and the position is equivalent to the average time of the combination of the standard medical treatment candidate and the relative standard medical treatment candidate. The medical information processing apparatus according to claim 4, wherein a relative standard medical treatment candidate is arranged and displayed. On the computer,
Refer to the storage unit that stores medical data that is acquired from medical treatment information in units of hospitalization and discharge from a patient at a medical institution and is associated with at least medical items and their implementation time,
An appearance rate calculating step for calculating an appearance rate for each of the medical items with respect to the total number of medical data regarding wounds and diseases to be standardized among the medical data stored in the storage unit;
For each of the medical data, an elapsed time calculating step for calculating a time interval from the time of admission to the time of implementation of each medical item,
A standard deviation calculating step for calculating a standard deviation of the time interval for each medical item;
The appearance rate calculated in the appearance rate calculating step is equal to or greater than a threshold set in advance as a value that may be standardized, and the standard deviation calculated in the standard deviation calculating step is a standard practice A standard medical candidate extraction step for extracting, as a standard medical candidate, a medical item that is equal to or less than a preset threshold value that can be estimated to be timing;
A display control step for displaying the standard medical treatment candidate on a display unit;
A program that executes

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