JP5435882B2 - Business cooperation support apparatus and method, department system, and medical network system - Google Patents

Description

  The present invention relates to a business support apparatus and method for supporting business cooperation between departments in a medical facility, a department system, and a medical network system.

  In a relatively large hospital, there are multiple departments such as internal medicine and surgery to which doctors who mainly handle patients belong, wards that are the center of clinical activities for outpatients and inpatients, and doctors in each department. On the basis of a request from, a department (referred to as a central medical department or the like) that specially supports the medical activity is arranged independently in the organization. The department includes examination departments such as a radiology department, an endoscopy department, and a pathology department. The Department of Radiology performs inspections that mainly handle radiation, such as CR (Computed Radiography) inspection, CT (Computed Tomography) inspection, and MRI (Magnetic Resonance Imaging) inspection. The endoscopy department uses the endoscope to perform digestive and respiratory examinations, and the pathology department observes the tissues and cells collected from the patient with the naked eye and a microscope to check for lesions. Conduct pathological examinations to make pathological diagnoses such as benign and malignant.

  A doctor in the medical department determines a medical policy for systematically performing medical examinations such as examination, examination, and treatment according to the patient, and requests work from each department according to the medical policy. The plan that defines the medical policy is called a clinical path. In the clinical path, the contents of medical treatment and the order in which the examinations and treatments are performed, in what order, when and in what order, are recorded.

  For example, if a diagnosis of gastric cancer is found by medical examination, first, an image diagnosis based on a simple abdominal image is performed by CR examination, and the endoscopic examination and pathological examination are performed as necessary after receiving the examination result. In addition, a clinical path is determined. Endoscopic examination and pathological examination are judged based on the results of the CR examination. If the endoscopy is started before the CR examination is completed, the endoscopy itself May be wasted. Therefore, the execution order is recorded in the clinical path in the form of, for example, a time schedule so that a plurality of related examinations are executed in an appropriate order.

  The information system constructed in such hospitals is mainly used by clinical department staff such as doctors and nurses in the clinical department, and manages the medical record data (electronic data) of the patient, and through the medical record system and network It is communicably connected, and is composed of department-specific department systems mainly used by examination department staff such as specialists (radiologists, endoscopists, pathologists) of each examination department and examination technicians.

  The staff of the medical department issues an order for an inspection request in the medical chart system, and the issued order is transmitted to the department system online. In the order, examination request information such as patient ID, patient name, examination type, scheduled examination date, and examination purpose is recorded. Each department system has an order receiving function for receiving and receiving orders issued from the chart system. The staff of the inspection department confirms the order received by the department system, and performs the inspection according to the contents specified in the order.

  As described above, when a plurality of related examinations are required for one patient, the department staff must issue a procedure for issuing each order to each department system. In addition, if you change the schedule of one of the related tests, it will affect the schedule of other tests, so the department staff will contact the affected department and adjust the schedule. Must.

In the medical record system of Patent Document 1, the order of a plurality of related examinations is transmitted to each department system by selecting a clinical path in which the schedules of the related examinations are recorded. In addition, in this medical record system, when the schedule of one examination is changed, the schedule of the related examination is automatically changed in conjunction with the change of the schedule of one examination, and this is notified to each department system. doing. According to this, procedures for issuing orders for multiple examinations are simplified, and work such as contact and adjustment of clinical department staff to each examination department that occurs due to changes in the order contents such as changes in the examination schedule The complexity is eliminated.
JP 2005-157560 A

  The technique of the above-mentioned patent document 1 can eliminate the complexity of work associated with the issue or change of orders performed by the staff of the requesting department when performing a plurality of related examinations. However, in order to perform multiple related examinations in the order of execution, the cooperation of the requested examination departments is indispensable. The result was an increase in the complexity of the work.

  This is because each examination department conducts examinations based on orders from clinical departments, but in order to conduct multiple examinations in the order determined by the clinical path, the order of execution is the same when starting examinations. Confirmation work must be done on the progress of previous inspections (whether they have been completed, etc.). This confirmation work can be confirmed by the staff of the examination department by contacting the requesting department by telephone or email, or by examining the examination department that conducts the previous examination in the order of execution, and the staff of the examination department It is done by the method of contacting and confirming by telephone or e-mail.

  In the technique of the above-mentioned Patent Document 1, such a problem is not taken into consideration and a problem remains. Of course, the inspection schedule is specified in the order transmitted from the medical chart system to the department system. Therefore, if the execution order is delayed in the previous examination, the doctor in the department will change the examination schedule of the order on the chart system without delay, so that the actual examination progress will be accurately ordered. As long as it is reflected, each examination department only needs to carry out the inspection as specified by the order, and it is not necessary to perform the above confirmation work. However, in reality, there are not a few divergences between the order on the computer system and the actual situation, and the actual situation is that these divergences are manually compensated.

  As a solution for eliminating the complexity of the work of the staff of the examination department, it is conceivable to introduce a terminal for a medical chart system into each examination department. The medical record system is notified of the contact from each requested examination department, so the order issued to each examination department and the progress of examination in each examination department are recorded. Therefore, if a chart system terminal is installed in the examination department, the staff of the examination department can directly view the chart and check the progress of the examination in other examination departments. The confirmation work by telephone and e-mail with the department becomes unnecessary.

  However, in the examination department, since the main work is performed at the terminal of the department system, it is wasteful in terms of installation space and introduction cost to introduce a chart terminal that is less frequently used only for the confirmation work. Since the number of medical chart terminals to be introduced increases according to the number of examination departments, waste of space and cost becomes significant. Moreover, even if a medical record terminal is introduced, the work itself of using a plurality of terminals is complicated.

  The present invention has been made in view of the above background, and the purpose of the present invention is to perform each business operation without waste of space and cost when performing a plurality of business operations in a plurality of departments. This is to reduce the complexity of the work of the staff at the request destination.

  In order to solve the above-described problem, the business cooperation support device of the present invention is connected to a plurality of department systems that receive orders for business requests provided for each department in a medical facility through a network. In the business cooperation support apparatus that supports business cooperation when performing each business, storage means for storing the execution order designated by the requester for each business corresponding to a plurality of orders, and an end notification notifying the end of the business Based on the execution order read from the storage means and the end notification receiving means received from each department system, determine the next work corresponding to the end notice received by the end notice receiving means, A transmission means for transmitting a start permission notice that gives permission to start a job to a department system of a department that performs the next job. That.

  It is preferable that the transmission unit transmits an order corresponding to the job unconditionally to each department for the job having the first execution order.

  The start permission notification is preferably transmitted separately from the order after transmitting orders corresponding to the plurality of tasks to the respective departments.

  The business is, for example, a medical examination. Test result receiving means for receiving the test result of the medical test from each department system, and determination means for determining whether or not the next medical test is necessary based on the test result received by the test result receiving means. And when the determination means determines that the next medical examination is necessary, the transmission means transmits the start permission notice to the transmitted examination order and determines that the next medical examination is unnecessary. If it is, it is preferable to transmit a cancellation notification for canceling the transmitted inspection order.

  Address information transfer means for receiving address information for referring to the examination data of the completed medical examination from the department system and sending the received address information to the department system to which the start permission notification is sent It is preferable to provide.

  The transmission means may replace the start permission notification by transmitting the order. In this case, when it is determined that a task corresponding to the next order is unnecessary, it is preferable to discard an order not yet transmitted to the department system.

  The department system of the present invention is communicably connected via a network with a business cooperation support device that supports business cooperation when performing a plurality of work whose execution order is predetermined in a plurality of departments in a medical facility, Transmitting means for transmitting an end notification notifying the end of the work to the work support apparatus in the department system that is provided for each department and receives the order for requesting the work sent from the work cooperation support apparatus And receiving means for receiving a start permission notice for giving permission to start the work from the work cooperation support apparatus.

  A console control unit configured to control a console configured by a display that outputs a GUI and an input device for inputting an operation instruction through the GUI. The console control unit receives the start permission notification from the business cooperation support device. Based on this, it is preferable to control at least one of the input and output of the console.

  Preferably, the GUI includes a list screen that displays a list of the plurality of received orders, and the console control unit controls the list screen based on the start permission notification.

  As the output control of the console control means, the presence or absence of the start permission notification for each order is displayed on the list screen, or the order for which the start permission notification has not been received is not displayed on the list screen. Is preferred. Further, as input control of the console control means, it is preferable to prohibit selection by the input device for orders not received by the start permission notification among orders displayed on the list screen. Specifically, for example, even when an order in the list screen is selected with a mouse or the like, display of detailed information on the order is prohibited, or input and change operations of information on the order are prohibited.

  The business cooperation support method of the present invention is provided for each department in a medical facility, communicates via a network with a plurality of department systems that accept orders for business requests, and performs business cooperation at the time of performing each business. In the business cooperation support method for supporting a job, a storage step for storing an execution order specified by a requester for each business corresponding to a plurality of orders, and a termination notification for receiving a termination notification informing the termination of the job from each department system Based on the receiving step and the execution order read from the storage means, the next work of the work corresponding to the end notice received by the end notice receiving means is determined, and the department of the department that performs the next work And a transmission step of transmitting a start permission notice that gives permission to start the business to the system.

  The medical network system of the present invention is provided for each of a plurality of departments in a medical facility, and is connected to a plurality of department systems that accept orders for business requests, and each department system is communicably connected via a network. In a medical network system comprising a business cooperation support apparatus that supports business cooperation when performing business, the business cooperation support apparatus stores storage order specified by a requester for each business corresponding to a plurality of orders Corresponding to the end notice received by the end notice receiving means based on the execution order read from the storage means, and an end notice receiving means for receiving an end notice notifying the end of the work from the department system Judge the next task to be performed, and start the task for the department system of the department that performs the next task Characterized by comprising a transmitting means for transmitting a start permission notice giving variable.

  According to the present invention, since an end notification related to an operation is received from the department system, and based on the end notification, an operation start permission is transmitted to the department system of the department that performs the next operation, the execution order is determined. When performing a plurality of tasks performed in a plurality of departments, it is possible to reduce the complexity of the work of the staff who is the request destination of each task without causing waste of space and cost.

The medical network system shown in FIG. 1 is constructed in a medical facility such as a hospital, for example.
The medical network system includes a medical record system 11 disposed in the ward 10, department systems 16 to 18 disposed in the respective examination departments of the radiology department 12, the endoscopy department 13, and the pathology department 14, and each examination. It consists of a business cooperation support server (hereinafter referred to as a support server) 19 for supporting business cooperation of departments, and is communicably connected through a network 20. The network 20 is, for example, a LAN laid in the hospital.

  The medical chart system 11 includes a medical record server 21 and medical department terminals 23 arranged in the respective medical departments 22 such as internal medicine and surgery. In the medical record server 21, a medical record DB (Data Base) 24 is constructed in which medical record data for each patient is stored so as to be searchable. The clinical department terminal 23 is operated by staff of the clinical department 22 such as doctors and nurses of the clinical department 22, and in addition to browsing and inputting medical records, orders for requesting examinations to the respective examination departments 12 to 14 are provided. Used for issuing.

  The department systems 16 to 18 are respectively a department system (hereinafter referred to as RAD system) 16 of the radiology department 12, a department system (hereinafter referred to as ES system) 17 of the endoscopy department 13, and a department system of pathology department 14. 18 (hereinafter referred to as PATH system). Each department system 16-18 receives and accepts the order issued by the medical department terminal 23 via the network 20. The staff of each examination department 12-14 uses each department system 16-18, and communicates with a request source, such as confirmation of an order, report of completion of an inspection, and report of an inspection result. The RAD system 16 is also called RIS (Radiology Information System).

  The RAD system 16 includes a RAD server 26 and a RAD terminal 27. In the RAD server 26, a RAD-DB 28 in which an order addressed to the radiology department 12 is stored is constructed. The ES system 17 includes an ES server 31 and an ES terminal 32. In the ES server 31, an ES-DB 33 in which an order addressed to the endoscopy department 13 is stored is constructed. The PATH system 18 includes a PATH server 36 and a PATH terminal 37. In the PATH server 36, a PATH-DB 38 in which an order addressed to the pathology department 14 is stored is constructed.

  The support server 19 relays the order issued by the medical department terminal 23 and transmits it to each department system 16-18. In the support server 19, a support DB 39 in which orders to be relayed are stored is constructed. In addition, the support server 19 relays notifications transmitted from the department systems 16 to 18 to the medical department terminal 23 and transmits them to the medical department terminal 23. Based on the received notification, the support server 19 notifies the department systems 16 to 18 as necessary to support the business cooperation between the clinical departments 22 and the examination departments 12, 13, and 14.

  Each of these servers 21, 26, 31, 36 and each terminal 23, 27, 32, 37 is based on a computer such as a personal computer or a workstation, and a control program such as an operating system, a client program, or a server program It is configured by installing the application program.

  As shown in FIG. 2, the computers constituting the server and the terminal have substantially the same basic configuration, and include a CPU 41, a memory 42, a storage device 43, a LAN port 44, and a console 46, respectively. These are connected via a data bus 47. The console 46 includes a display 48 and an input device 49 such as a keyboard and a mouse.

  The storage device 43 is an HDD (Hard Disk Drive), for example, and stores a control program and an application program (AP) 50. In addition to the HDD that stores the program, for example, a disk array in which a plurality of HDDs are connected is provided in the server in which the DB is constructed, as the DB storage device 43. The disk array may be built in the server main body, or may be provided separately from the server main body and connected to the server main body through a cable or a network.

  The memory 42 is a work memory for the CPU 41 to execute processing. The CPU 41 loads the control program stored in the storage device 43 into the memory 42 and executes processing according to the program, thereby comprehensively controlling each part of the computer. The LAN port 44 is a network interface that performs transmission control with the network 20.

  In the medical department terminal 23, a client program for medical charts for browsing and editing medical charts is installed as AP50. When the chart client program is started, an operation screen for charts using a GUI (Graphical User Interface) is displayed on the display of the medical department terminal 23. On the operation screen, the patient chart data selected by the input device and read from the chart DB 24 is displayed. The medical department terminal 23 receives operation instructions such as a chart input / edit instruction and an examination order input / issue instruction through a console including a display and an input device. The input chart and order data are stored in the chart DB 24.

  As a chart client program, a chart-dedicated program may be used, or a general-purpose Web browser compatible with HTTP (Hyper Text Transfer Protocol) may be used. When using a chart-dedicated program, the operation screen is generated based on screen data defined by the chart-dedicated program. When a general-purpose web browser is used, an operation screen is generated by downloading a web page including screen data from the chart server 21.

  The client program for medical records communicates with the medical record server 21 in accordance with an operation instruction from the console of the medical department terminal 23, and issues a request for processing such as data reading, update, and search to the medical record server 21. In the medical record server 21, a server program is installed as an AP 50 that executes processing in response to a request from the medical department terminal 23 and responds to the processing result.

  In the RAD terminal 27, ES terminal 32, and PATH terminal 37, as the AP 50, an order management client program for managing the received order is installed. When the client program for order management is activated, each terminal 27, 32, and 37 displays a GUI operation screen on each display. The operation screen includes work lists 67, 68, and 69 (see FIG. 5) that are list screens that display a list of a plurality of received orders.

  An operation instruction is input to each terminal 27, 32, and 37 through a console including a display and an input device. The staff of each examination department 12-14 inputs an operation instruction through the console of each terminal 27, 32, and 37, and contacts the request source such as confirmation of the order, completion of the examination corresponding to the order, and reporting of the result. .

  As with the clinical department terminal 23, the operation screens of the terminals 27, 32, and 37 may be generated by a dedicated client program for order reception, or each server 26 using a general-purpose Web browser. , 31 and 36, a web page for generating an operation screen may be downloaded.

  The client program for order management of each terminal 27, 32, 37 communicates with each server 26, 31, 36 according to an operation instruction input from the console, and requests processing such as data reading, updating, and searching. Is issued to each server 26, 31, 36.

  In the RAD server 26, the ES server 31, and the PATH server 36, as the AP 50, a server program that executes processing in response to requests from the terminals 27, 32, and 37 and responds to the processing result is installed. Further, the server program receives the order issued from the medical department terminal 23 and stores the received order in each DB 28, 33, 38.

  As shown in FIG. 3, the medical record DB 24 stores data of a clinical path 61 determined by a doctor of the medical department 22 and defining a patient medical policy. When a doctor in the medical department 22 suspects gastric cancer, as described in the exemplary clinical path 61, a CR test is first performed to perform a simple abdominal image diagnosis, and the test result Accordingly, a medical treatment policy is determined such that an endoscopic examination (ES examination) is performed to make a diagnosis with an endoscope, and a third pathological examination (PATH examination) is performed. In the clinical path 61, a time schedule representing the schedule of each examination is recorded. In the figure, the first CR inspection will be performed on February 22, the second ES inspection on February 25, and the third PATH inspection on February 26, scheduled for inspection The day is set.

  When a doctor of the medical department 22 requests a plurality of related examinations, the medical department terminal 23 is operated to read the clinical path 61 from the medical record DB 24. The medical department terminal 23 receives the contents of the CR order 62, the ES order 63, and the PATH order 64 and the execution order according to the clinical path 61, and then inputs an association instruction. When the association instruction is input, the medical department terminal 23 performs association processing on each of the orders 62 to 64 and stores each data in the medical record DB 24.

  Each order 62, 63, 64 includes a patient ID, a patient name, an order number, a request date, request source information ("Suzuki of internal medicine"), request destination information ("Radiology department"), and examination type ( Information such as “CR inspection” and scheduled inspection date (“February 22”) is recorded.

  The order number is identification information for identifying each order issued by the request source. The order number includes, for example, an ID for identifying each clinical department 22 such as “I” for internal medicine and “E” for surgery, and a request date (for example, “218” for February 18). The serial number of the day (“1” represents the first case of the day).

  A branch number separated by a hyphen appended after the serial number is given when the execution order is input and the association is made. A plurality of related orders are common up to the serial number before the hyphen, and the common order identifies the related order, and the execution order is identified by the branch number after the hyphen.

  In the figure, a branch number “1” is assigned to the CR order 62, indicating that the CR order execution order is first. Similarly, the branch number indicating that the execution order is second is included in the order number of the ES order 63, and the branch number indicating that the execution order is third is included in the order number of the PATH order 64, respectively. (See FIG. 5).

  When an order issuance instruction is made after the association process is performed in the medical department terminal 23, the medical department terminal 23 issues the respective orders 62, 63, 64 and transmits them to the support server 19.

  As for the method of inputting and associating the execution order, as described in Patent Document 1, a plurality of clinical paths in which a combination of a plurality of examinations and their execution order are recorded in advance are prepared, and those clinical paths are prepared. By selecting one from the paths, the order of execution may be associated with the order.

  As shown in FIG. 4, a support server program is installed in the support server 19 as the AP 50, and by starting this server program, the CPU of the support server 19 performs the order transmission / reception unit 19 a, execution order. It functions as the control unit 19b.

  The order transmitting / receiving unit 19a receives the order issued by each clinical department terminal 23 and stores it in the support DB 39. In each order, an order number is recorded. If the order is associated, the order number includes the execution order. Therefore, the order is stored in the support DB 39 to store the execution order. . Then, the order transmitting / receiving unit 19a reads the received order from the support DB 39, determines the destination from the request destination information of each order, and transmits it to each of the systems 16-18.

  The execution order control unit 19b receives the examination completion notification transmitted from each of the systems 16 to 18 and transmits it to the requesting medical department terminal 23. Further, the execution order control unit 19b controls based on the end notification and the execution order stored in the support DB 39 so that inspections corresponding to a plurality of related orders are executed in the order specified by the request source. To do.

  When the order transmitting / receiving unit 19a receives the order, the execution order control unit 19b reads the order number from the received order and checks whether there is another related order. Specifically, the commonality of the order number up to the hyphen is checked, and if there is a common order, it is determined that the order is related. If there is no related order, do nothing.

  If there is an associated order, the execution order of the orders to be transmitted is checked based on the branch number after the hyphen of the order number. When the execution order is first, a start permission notice for the order is transmitted unconditionally to the destination of the order. The start permission notification is a notification that gives permission that the examination corresponding to the order may be started as scheduled according to the order. When the execution order is the second or later, the start permission notice is transmitted after waiting for the notice of completion of the previous examination to be sent from the systems 16 to 18.

  For example, when the execution order control unit 19b receives the CR order 62, based on the commonality (“I2181”) of the order number before the hyphen (“I2181”), the related order (ES order 63 or PATH) The order 64) is determined to exist, and the branch number is checked to check the execution order. Since the CR order 62 has the first execution order, the execution order control unit 19b unconditionally transmits a start permission notification to the RAD system 16.

  In the case of the ES order 63, since the execution order of the ES order 63 is the second, the execution order control unit 19b starts the ES order 63 until the end notification of the CR order 62 with the previous execution order is received. Do not send permission notifications. When the execution order control unit 19b receives an end notification for the CR order 62 from the RAD system 16, the execution order control unit 19b relates to the next order based on the order number (branch number “1”) of the CR order 62 corresponding to the end notification. The ES order 63 in the execution order (branch number “2”) is searched from the support DB 39, and a start permission notice for the ES order 63 is transmitted. In addition, an end notification from the RAD system 16 is transmitted to the requesting department terminal 23.

  As shown in FIG. 4, an order table 66 is provided in the support DB 39. The order table 66 stores the order data received from the medical department terminal 23. In the order table 66, for each order, in addition to the fields in which the items entered in the medical department terminal 23 such as patient ID, patient name, request date, order number, examination type, and scheduled examination date are recorded, A field for recording a status indicating the progress is provided.

  As the progress status, for example, three states such as “incomplete”, “end”, and “stop” are displayed. “Unfinished” is displayed until an end notification is received from each department system such as the RAD system 16, ES system 17, and PATH system 18 after receiving the order. When the end notification is received, “end” indicating that the inspection is ended is displayed. “Cancel” means that the order has been canceled.

  The three orders with the patient ID “1234” correspond to the CR order 62, the ES order 63, and the PATH order 64, respectively. The orders 62, 63, and 64 are transmitted to the RAD system 16, the ES system 17, and the PATH system 18, respectively, and stored in the DBs 28, 33, and 38, respectively. The RAD work list 67, the ES work list 68, and the PATH work list 69 are examples of list screens displayed on the consoles of the terminals 27, 32, and 37 of the systems 16 to 17, respectively.

  Each work list 67-69 displays a list of orders received by the respective department systems 16-18. Each work list 67 to 69 is provided with fields for displaying information such as reception ID, reception date, patient ID, patient name, scheduled examination date, and start permission for each order. The reception ID is an ID issued when each department system 16-18 receives an order, and is order identification information for uniquely identifying the order within each department system 16-18. The reception ID includes, for example, a combination of a code (“CR” or “ES”) for identifying the inspection type, a reception date (“218”), and a serial number. The reception date is the date of reception. The patient ID, patient name, and scheduled examination date are items that are input at the clinical department terminal 23 and included in each order.

  In the start permission field, presence / absence of a start permission notification transmitted from the support server 19 is displayed. If the start permission notification is received, “◯” is displayed. If not received, “×” is displayed. In the figure, the related CR order 62, ES order 63, and PATH order 64 are transmitted to the RAD system 16, ES system 17, and PATH system 18 respectively, and only for the first CR order 62 in the execution order, Indicates a state in which a start permission notification is being transmitted. In addition, for a single examination with no related order, a hatched line is displayed in the start permission field, and “O” and “X” are not displayed.

  The staff of each examination department 12-14 can confirm whether or not the examination corresponding to the order may be carried out according to the schedule specified by the order by confirming the display of the start permission. it can.

  The operation of the above configuration will be described below with reference to the flowchart shown in FIG. The doctor of the medical department 22 inputs an order at the medical department terminal 23 when making an inspection request to each of the inspection departments 12 to 14. When there are a plurality of related inspections, the execution order of the CR inspection, the ES inspection, and the PATH inspection is input based on the clinical path 61, and the respective association instructions are given. The medical department terminal 23 associates the CR order 62, the ES order 63, and the PATH order 64, and issues the CR order 62, the ES order 63, and the PATH order 64 in response to the input of the issuing instructions, and the support server 19 to send.

  The support server 19 receives the orders 62, 63 and 64 by the order transmitting / receiving unit 19a, and stores the received data in the order table 66 of the support DB 39. Since the execution order of the related orders 62, 63, 64 is recorded in the order number, the execution order is stored by storing the data in the order table 66. In addition, since each of the orders 62, 63, and 64 has not been inspected, “incomplete” is recorded in the status of the order table 66.

  The order transmitting / receiving unit 19a transmits the received orders 62, 63, 64 to the respective systems 16-18. Each system 16-18 receives each order, performs reception processing, and stores it in each DB 28, 33, 38.

  The execution order control unit 19b reads the order number from the CR order 62 stored in the support DB 39, and checks the order number. A branch number is attached to the order number of the CR order 62, and it can be seen that a related order exists. If there is a related order, the execution order is examined. The execution order control unit 19b determines that the execution order is first because the branch number of the CR order 62 is “1”. In the case where the execution order is the first, there is no inspection that is performed before that in the related inspections, and therefore, a start permission notification is immediately transmitted to the RAD system 16 that is the destination of the CR order 62.

  The execution order control unit 19b also checks the order numbers of the ES order 63 and the PATH order 64 in the same manner as the CR order 62, and checks the existence of other related orders and the execution order. The ES order 63 and the PATH order 64 have related orders, respectively, but since the status of the CR order 62 in the previous execution order is “incomplete”, the ES order 63 and the PATH order 64 are notified of the start permission. Is not issued.

  When the RAD system 16 receives the start permission notification of the CR order 62, the display of the start permission field of the RAD work list 67 for the CR order 62 is set to “◯”. The staff of the radiology department 12 confirms that the start permission of the RAD work list 67 displayed on the console of the RAD terminal 27 is “◯”, and performs the CR inspection according to the schedule specified in the CR order 62. . When the CR examination is completed, the staff of the radiology department 12 selects the CR order 62 for which the examination is completed from the RAD work list 67, and inputs an instruction to issue an end notice through the console. When the issue instruction is input, the RAD system 16 transmits an end notification to the support server 19.

  On the other hand, since the ES system 17 and the PATH system 18 have received the ES order 63 and the PATH order 64, respectively, but have not received the start permission notification, the start permission display of the ES work list 68 and the PATH work list 69 is displayed. Is “×”. The staff of the endoscopy department 13 and the pathology department 14 confirm that the examination should not be started with respect to the ES order 63 and the PATH order 64 while this display does not change to “◯”. For this reason, the subsequent inspection is not performed before the previous CR inspection is completed. Thereby, the related inspection is performed according to the execution order specified by the requester.

  When receiving the end notification, the support server 19 transmits the end notification to the requesting medical department terminal 23. Also, the CR order 62 corresponding to the end notification is read from the order table 66, and the presence / absence of the related order and the execution order of the next order are checked based on the order number. Based on the commonality of the first half of the order number (“I2181”) and the branch number (“1”), the execution order control unit 19b includes the ES order 63 and the PATH order 64 in the CR order 62, and the CR order. The next order 62 is determined to be the ES order 63 whose branch number is “2”. The execution order control unit 19 b updates the status of the CR order 62 in the order table 66 from “incomplete” to “finished”, and transmits a start permission notification of the ES order 63 to the ES system 17.

  When receiving the start permission notification, the ES system 17 updates the display of the start permission corresponding to the ES order 63 in the ES work list 68 to “◯”. The staff of the endoscopy department 13 confirms from this display that the previous examination in the execution order has ended and that the ES examination may be started as scheduled according to the ES order 63.

  When the ES examination is completed, the staff of the endoscopy department 13 selects the ES order 63 for which the examination is completed from the ES work list 68, and inputs an instruction to issue an end notification through the console. The ES system 17 transmits an end notification to the support server 19.

  When receiving the end notification, the support server 19 transmits the end notification to the requesting medical department terminal 23. Similarly to the processing of the CR order 62, the ES order 63 corresponding to the end notification is read from the order table 66, and the presence / absence of the related order and the execution order of the next order are checked based on the order number. Based on the commonality of the first half of the order number (“I2181”) and the branch number (“2”), the execution order control unit 19b determines the PATH order 64 (the branch number is “3”) next to the ES order 63. Identify. The execution order control unit 19 b updates the status of the ES order 63 in the order table 66 from “incomplete” to “finished”, and transmits a start permission notification of the PATH order 64 to the PATH system 18.

  Upon receiving the start permission notification, the PATH system 18 updates the display of the start permission corresponding to the PATH order 64 in the PATH work list 69 to “◯”. The staff of the pathological examination department 14 may start the PATH examination designated by the PATH order 64 by the display, like the staff of the endoscopic examination department 13, that the examination in the previous execution order has been completed. Make sure. When the PATH inspection is completed, an end notification is transmitted to the support server 19 through the PATH terminal 37. The support server 19 transmits an end notification to the medical department terminal 23 and updates the status corresponding to the PATH order 64 in the order table 66 from “incomplete” to “end”.

  As described above, when there are a plurality of related examinations, the support server 19 transmits the next examination start permission notice based on the notice of completion of each examination from each department system 16 to 18. , The execution order of each inspection can be controlled.

  Since each work list 67-69 of each examination department 12-14 displays the presence or absence of start permission based on the start permission notification from the support server 19, the staff of each examination department 12-14 requests It is not necessary to confirm the progress of the inspection by e-mail or telephone to the original or other inspection departments. Further, since the work lists 67 to 69 are displayed on the consoles of the terminals 27, 32, and 37 of the department systems 16 to 18, it is not necessary to introduce a terminal for browsing the medical chart. Therefore, it is possible to reduce the work of the staff of the examination department without causing waste of space and cost as compared with the conventional case.

  In addition, since the start permission notification is transmitted separately from the order, the staff of each examination department can confirm the contents of the order even when the start permission is not received. For this reason, it is possible to secure a sufficient working time for preparation for the inspection.

  Further, the support server 19 transmits a start permission notification using an end notification transmitted from the department system to the request source. The end notification transmission function to the requester is a function possessed by many department systems, so that the modification of the existing department system can be reduced. For this reason, the modification cost of the department system can be suppressed.

  Further, as shown in FIG. 7, for example, in the ES work list 68, when the staff of the endoscopy department 13 selects an order for which the start permission notification is not received through the console of the ES terminal 32, a warning is given to the console. The message 71 may be displayed. Reference numeral 72 indicates a mouse pointer for selecting an order. As the warning message 71, for example, a message that the previous inspection in the execution order has not ended and therefore the main inspection cannot be started is used. The message may further display the examination type (for example, CR examination) of the examination having the previous execution order and the examination department (for example, radiological examination department) corresponding thereto. In this case, the ES system 17 acquires related examination information from the support server 19 and displays examination types and examination departments based on the obtained information.

  By displaying the warning message 71, the staff of the examination department can more clearly grasp that the start of the examination of the order is stopped, and the execution order is more thoroughly controlled. Further, in addition to the message for stopping the start of the inspection, the reason that the start of the inspection is stopped can be grasped by including in the message that the previous inspection is not completed in the execution order.

  In this example, a work permission field is provided in the work list and a warning message is displayed. However, the warning message may be displayed without the start permission field. In addition, for orders that have not received a start permission notification, display on the worklist is allowed, but detailed contents of the order cannot be displayed, and furthermore, display on the worklist itself is prohibited (not displayed) ) Input / output control of the console, such as display and selection of orders in these work lists, is performed by the CPUs of the terminals and servers constituting the department system.

  Also, as shown in FIG. 8, the support server uses the reference URL for referring to the examination data transmitted from the department system of the department where the examination is completed to the medical department terminal 23 to the department system of the next order destination. You may make it forward to. In the case of CR inspection, the inspection data is data such as a CR image taken in the CR inspection and a report that summarizes the diagnostic results of the image diagnosis made based on the CR image. The inspection data is stored in an image server (not shown) or a report server (not shown) connected to be communicable via the network 20. The reference URL is, for example, storage address information in which inspection data in the image server or report server is stored.

  For example, the RAD system 16 includes the reference URL in the end notification and transmits it to the execution order control unit 19 b of the support server 19. The execution sequence control unit 19b includes the reference URL in the start permission notification and transmits it to the ES system 17. Thereby, the staff of the endoscopic examination department 13 can access the image server and the report server from the ES terminal 32 and refer to the examination data of the CR examination having the previous execution order.

  In the inspection practice, when there are a plurality of related inspections, the contents of the inspection performed earlier may be used as a reference for determining the method of the subsequent inspection. For example, if the location of the lesion can be roughly identified in the previous examination, the points important for imaging can be grasped in advance in the later examination, and the examination parameters (imaging conditions, etc.) In response, the inspection parameters for the subsequent inspection can be determined. By notifying the examination department that conducts the subsequent examination of the URL for referring to the examination data of the previous examination, the staff of the examination department that carries out the later examination can carry out the examination based on the previous examination result. You can enjoy the benefits.

  Further, as shown in the flowchart of FIG. 9, the support server 19 determines the necessity of the next inspection based on the inspection result of the previous inspection, and the next inspection based on the determination result. You may cancel the order. The test result is, for example, information indicating that there is no abnormality and that there is an abnormality, and is notified from the department system to the requesting medical department terminal together with an end notification. For example, the execution order control unit 19b of the support server 19 receives the test result of the CR test notified from the RAD system 16 to the medical department terminal 23, and transmits the received test result to the medical department terminal 23.

  Furthermore, the execution order control unit 19b determines the necessity of the next ES inspection based on the inspection result of the CR inspection. When the inspection result of the CR inspection is abnormal, it is determined that the ES inspection is necessary, and a start permission notification is transmitted to the ES system 17. When the inspection result of the CR inspection is normal, the execution order control unit 19b determines that the ES inspection is not necessary, and cancels the corresponding ES order 63 that has already been transmitted to the ES system 17. Send notifications. When receiving the cancellation notification, the ES system 17 deletes the corresponding ES order 63. In addition, the execution order control unit 19b transmits to the requesting medical department terminal 23 that a cancellation notification has been transmitted to the ES system 17.

  Note that the final authority for determining the necessity of the next examination belongs to the doctor of the requesting department 22 in principle. Therefore, before the execution order control unit 19b transmits the cancellation notification to the ES system 17, the execution order control unit 19b transmits a message for inquiring transmission permission of the cancellation notification to the requesting medical department terminal 23, and the doctor of the medical department 22 makes a judgment. It is preferable to prompt. In this case, the execution order control unit 19b transmits a cancellation notification to the ES system 17 when the transmission permission of the cancellation notification is acquired from the medical department terminal 23, and sends a cancellation notification while the transmission permission cannot be acquired. Do not send.

  In the above-described embodiment, an example in which the start permission notification is transmitted separately from the order has been described. However, the order and the start permission notification may be combined. In this case, even if the support server 19 receives the order issued from the medical department terminal 23, the department server that is the destination of the order until the end notification of the previous examination is received, Do not send orders.

  For example, when receiving the CR order 62, the ES order 63, and the PATH order 64 from the medical department terminal 23, the execution order control unit 19b transmits the CR order 62 having the first execution order to the RAD system 16, and the RAD system 16 The ES order 63 is not transmitted until an end notification from the system 16 is received. When the end notification from the RAD system 16 is received, the ES order 63 is transmitted to the ES system 17, and when the end notification from the ES system 17 is received, the next PATH order 64 is set to the PATH system. 18 to send.

  Since the order itself is not transmitted to the ES system 17 and the PATH system 18 until the previous examination is completed, the staff of the endoscopy department 13 and the pathology department 14 mistakenly perform the examination. The inspection will not begin before the previous inspection has been completed.

  In the case of using both the order and the start permission notification, when performing the determination of the necessity of the next inspection based on the inspection result described above, the execution order control unit 19b, when there is a need for the next inspection, The next inspection order is transmitted to the corresponding department system. If there is no necessity, the order is discarded without being transmitted.

  In the above embodiment, the start permission notification is transmitted to the department system corresponding to the next inspection based on the end notification received from the department system that has completed the inspection, but the received end notification is used as the start permission notification. You may send it. For example, the execution order control unit 19b transfers an end notification received from the RAD system 16 to the ES system 17 as a start permission notification.

  In the said embodiment, it demonstrated by the example which provided the assistance server separately from the medical chart system. By providing a support server separately from the chart system, the cost of introducing the support server can be reduced because it is possible to reduce the modification of the already installed chart system. Of course, the function realized by the support server may be incorporated in the chart system, and the chart system and the support server may be configured integrally.

  In the above embodiment, an example of using a clinical path when issuing orders for a plurality of related examinations has been described. However, it is not necessary to use a clinical path, and a plurality of related tests may be used when issuing an order. It suffices if the inspection execution order is determined. In addition, it is not necessary to issue a plurality of related orders at the same time, and as long as the execution order of each order is determined, the timing of issuing and transmitting each order may be shifted.

  In the above embodiment, the execution order is recorded in the order number in each order, and this is used for controlling the execution order. However, the data in which the execution order is recorded separately from each order, It may be used to control the execution order.

  In the above embodiment, the medical record system, the support server, and the DBs of each department system have been described as being constructed on separate servers. However, the support DB and the medical record DB can be constructed on a single server, Each DB used in a plurality of systems may be integrated into one server, such as constructing a DB on one server. Further, although the example has been described in which the medical record system and each department system are configured by a client server type computer system including a client terminal and a server, the medical record system and each department system may be configured by a single computer in which a DB is built in an internal storage. Thus, the physical configuration of the computer system can be changed as appropriate.

  In the above embodiment, the LAN is described as an example of the network. However, in the case where the ward and the examination department are distributed at a plurality of bases, a WAN may be used as the network.

  In the above embodiment, CR inspection, ES (endoscope) inspection, and PATH (pathology) inspection are described as examples. However, the inspection type is not limited to the above example, and other inspection types such as MRI inspection and physiological inspection may be used. Absent. In addition, although examination images and reports have been described as examination data as examples, there are various kinds of examination data depending on the examination type, for example, an electrocardiogram or numerical data in the case of a physiological examination. Either of these may be used.

  Moreover, although the examination has been described as an example of the work, the present invention may be applied to work related to diagnosis and treatment other than the examination. In addition to the examination department, there are departments that carry out work other than examinations, such as a pharmacy department that prepares and dispenses drugs according to prescriptions, and a rehabilitation department that guides patient rehabilitation according to physical therapy. The present invention may be applied to work performed by these departments. Of course, a plurality of related tasks may be a combination of these different tasks.

  As shown in the above embodiment, the present invention naturally extends to a program form and further to a storage medium for storing the program.

It is a block diagram of a medical network system. It is a block diagram which shows the outline of a computer. It is explanatory drawing of the order which a medical chart system issues. It is a functional block diagram of a support server. It is explanatory drawing of the work list of support DB and each department system. It is a flowchart which shows the execution order control procedure of a related some test | inspection. It is explanatory drawing of the example which displays a warning message. It is explanatory drawing of the example which notifies URL for reference. It is a flowchart which determines the necessity of the next test | inspection based on a test result.

Explanation of symbols

10 Wards 11 Medical Record System 12 Radiological Examination Department 13 Endoscopy Department 14 Pathological Examination Department 16 RAD System (Department System)
17 ES system (department system)
18 PATH system (department system)
19 Support Server 20 Network 21 Medical Record Server 22 Medical Department 23 Medical Department Terminal 24 Medical Record DB
26 RAD server 27 RAD terminal 28 RAD-DB
31 ES server 32 ES terminal 33 ES-DB
36 PATH server 37 PATH terminal 38 PATH-DB
39 Support DB
61 Clinical path 62 CR order 63 ES order 64 PATH order 66 Order table 67 RAD work list 68 ES work list 69 PATH work list 71 Warning message

Claims (12)

In a business cooperation support apparatus that is provided for each department in a medical facility and that is communicably connected via a network to a plurality of department systems that accept orders for business requests, and supports business cooperation when performing each business ,
Storage means for storing the execution order designated by the requester for each business corresponding to a plurality of orders;
An end notification receiving means for receiving an end notification notifying the end of the work from each department system;
Based on the execution order read from the storage means, the next work corresponding to the end notice received by the end notice receiving means is determined, and the department system of the department that performs the next work is determined. And a transmission means for transmitting a start permission notice for granting permission to start the business,
The business cooperation support apparatus, wherein the transmission unit transmits the start permission notification separately from the order after an order corresponding to the plurality of business operations is transmitted to each department system.   2. The business cooperation according to claim 1, wherein the transmission unit transmits the start permission notification for an order corresponding to the job unconditionally to the department system for the first job in the execution order. Support device.   The business cooperation support apparatus according to claim 1, wherein the business is a medical examination. A test result receiving means for receiving a test result of the medical test from each department system;
A determination means for determining whether or not the next medical examination is necessary based on the examination result received by the examination result receiving means;
The transmission unit transmits the start permission notification for the transmitted order when the determination unit determines that the next medical test is necessary, and when the next medical test is determined to be unnecessary. 4. The business cooperation support apparatus according to claim 3, wherein a cancel notification for canceling the transmitted order is transmitted. Address information transfer means for receiving address information for referring to the examination data of the completed medical examination from the department system and sending the received address information to the department system to which the start permission notification is sent claim 3 or 4 SL placing business linkage support apparatus characterized by comprising a. A plurality of departments in a medical facility are connected to a business cooperation support device that supports business cooperation when performing a plurality of work whose execution order is determined in advance through a network, and are provided for each department. In the department system that receives the order for the business request transmitted from the business cooperation support device,
A transmission means for transmitting an end notification to notify the end of the business to the business cooperation support device;
Receiving means for receiving the order and a start permission notice for giving permission to start the work from the work cooperation support device;
The department system characterized in that, after receiving the order, the receiving means receives the start permission notification separately from the order. Console control means for controlling a console comprising a display for outputting a GUI and an input device for inputting operation instructions through the GUI;
The department system according to claim 6, wherein the console control unit controls at least one of input and output of the console based on the start permission notification from the business cooperation support apparatus. The GUI includes a list screen that displays a list of the plurality of received orders.
The department system according to claim 7, wherein the console control unit controls the list screen based on the start permission notification.   The department system according to claim 8, wherein the console control unit displays the presence / absence of the start permission notification for each order on the list screen.   9. The department system according to claim 8, wherein the console control unit does not display the order on which the start permission notification has not been received on the list screen. Work that supports work cooperation when performing each work using a computer by communicating with multiple department systems that are provided for each department in the medical facility and accept orders for work requests via a network In the cooperation support method,
A storage step of storing in the storage means the execution order designated by the requester for each business corresponding to a plurality of orders;
An end notification receiving step of receiving an end notification notifying the end of the business from the department system by means of communication;
Based on the execution order read from the storage means, the next work of the work corresponding to the end notification received by the communication means is determined, and for the department system of the department that performs the next work, A transmission step of transmitting a start permission notification for giving permission to start a job by a communication means,
In the transmission step, after the orders corresponding to the plurality of tasks are transmitted to the department systems, the start permission notification is transmitted by the communication means separately from the order. . A plurality of department systems that are provided for each department in a medical facility and accept orders for work requests are connected to each department system via a network so that they can communicate with each other. In a medical network system consisting of a business cooperation support device to support,
The business cooperation support device is:
Storage means for storing the execution order designated by the requester for each business corresponding to a plurality of orders;
An end notification receiving means for receiving an end notification notifying the end of the work from each department system;
Based on the execution order read from the storage means, the next work corresponding to the end notice received by the end notice receiving means is determined, and the department system of the department that performs the next work is determined. And a transmission means for transmitting a start permission notice for granting permission to start the business,
The said transmission means transmits the said start permission notification separately from the said order, after the order according to the said some work is transmitted to each said department system, The medical network system characterized by the above-mentioned.

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