JP5573283B2 - Inspection execution support program, inspection execution support device, inspection execution support system, and inspection execution support method - Google Patents

Description

  This case relates to an inspection execution support program, an inspection execution support device, an inspection execution support system, and an inspection execution support method.

  In recent years, in many hospitals, electronic medical record systems that are mainly used by medical staff such as doctors and nurses of medical departments and manage patient medical record data have been introduced. Also used by medical radiologists in radiology departments that mainly perform radiation handling and imaging, such as CR (Computed Radiography) inspection, CT (Computed Tomography) inspection, MRI (Magnetic Resonance Imaging) inspection, and X-ray inspection. Introduction of radiation information systems (RIS) and image information systems (PACS: Picture Archiving and Communication System) used by interpretation specialists (interpretation physicians) are also increasing. In many cases, an electronic medical record system, a radiation information system, and an image information system are communicably connected via a network to construct an information system in a hospital.

  In a hospital, when a patient is inspected, a doctor in a medical department issues an inspection order to an inspection department such as a radiology department, and the inspection itself is often performed by the inspection department. When the electronic medical record system, the radiation information system, and the image information system are introduced, when a doctor in the medical department issues an inspection order for the radiology department with the electronic medical record system, the inspection order is placed in the radiation information system and the image information system. Sent. The medical radiographer performs an examination such as imaging based on the examination order displayed on the terminal of the radiation information system. The captured image is transmitted from the radiation information system to the image information system. The interpreting doctor diagnoses the image taken using the terminal of the image information system. The interpreting doctor creates a diagnosis result as a report and sends it to the electronic medical record system. A doctor in the medical department can perform a treatment diagnosis while referring to the captured image and a report (for example, Patent Document 1).

JP 2000-166908 A

  By the way, when there is a shortage of information in the examination order or when there is a possibility that the contents of the examination order are incorrect, the medical radiographer may ask the interpretation doctor for an instruction. For example, if a patient has asthma, kidney damage, or heart disease, contrasting the image or administering a contrast agent to enhance certain tissues will cause allergic symptoms and Shock symptoms can cause serious symptoms in patients. Therefore, when receiving such an examination order, the medical radiologist needs to ask the interpretation doctor for instructions.

  In a conventional radiation information system, when an examination order is received from an electronic medical chart system, a medical radiographer can view the contents of the examination order from a terminal of the radiation information system and perform an examination. Therefore, if the medical radiographer does not notice an error in the inspection order, the inspection according to the inspection order is performed, and a medical error may occur.

  This case has been made in view of the above circumstances, and an object thereof is to provide an inspection execution support program, an inspection execution support apparatus, an inspection execution support system, and an inspection execution support method that can support appropriate inspection execution. And

In order to solve the above-described problem, the examination execution support program disclosed in the specification is configured to provide an examination order including patient information of a patient to be examined and examination information of the examination to be performed on the patient. An acquisition step acquired from a first terminal operated by a doctor of the patient, an examination condition specifying the examination information, and a confirmation of the patient requiring confirmation by a second doctor before performing an examination corresponding to the examination condition Based on the check condition specifying the patient information and the influence on the patient when the test specified by the test condition is performed on a patient having the patient information specified by the check condition an inspection check master associated with items, the set Te, based on said examination order obtained by the obtaining step, whether confirmation of the examination order by said second doctor must A determination step of constant for the determination result in the determination step, a display step of displaying on the second terminal of the second doctor to operate, carried authorization of the examination order from the second terminal to said examination order With respect to the acceptance step for accepting the examination and the examination order that needs to be confirmed by the second doctor, an engineer who carries out the examination cannot view at least a part of the examination order until the acceptance permission is accepted in the acceptance step. The browsing control step to be performed by the computer, and in the determination step, when the value of the item set based on the influence on the patient is a predetermined value, the examination by the second doctor It is determined that order confirmation is necessary .

In order to solve the above-described problem, the examination execution support device disclosed in the specification is configured to provide an examination order including patient information of a patient to be examined and examination information of the examination to be performed on the patient. An acquisition unit that is acquired from a first terminal operated by a doctor of the patient, an examination condition that specifies the examination information, and a confirmation of the patient that needs to be confirmed by a second doctor before an examination corresponding to the examination condition is performed. Based on the check condition specifying the patient information and the influence on the patient when the test specified by the test condition is performed on a patient having the patient information specified by the check condition a storage unit for storing inspection check master associated with items, the set Te, and the inspection check master stored in the storage unit, on the basis of said examination order obtained by the obtaining unit, before A determination unit for determining whether or not the examination order needs to be confirmed by a second doctor, and a display unit for displaying a determination result by the determination unit for the examination order on a second terminal operated by the second doctor And an acceptance unit that accepts execution permission of the examination order from the second terminal, and the examination order that requires confirmation of the second doctor until the acceptance permission is accepted by the acceptance unit. A browsing control unit that prevents at least a part of the inspection order from being viewed by an engineer who performs the inspection, and the determination unit has a predetermined value of an item set based on an influence on the patient In some cases, it is determined that confirmation of the examination order by the second doctor is necessary .

In order to solve the above-described problem, the examination execution support system disclosed in the specification is configured to provide an examination order including patient information of a patient to be examined and examination information of the examination to be performed on the patient. An acquisition unit that is acquired from a first terminal operated by a doctor of the patient, an examination condition that specifies the examination information, and a confirmation of the patient that needs to be confirmed by a second doctor before an examination corresponding to the examination condition is performed. Based on the check condition specifying the patient information and the influence on the patient when the test specified by the test condition is performed on a patient having the patient information specified by the check condition a storage unit for storing inspection check master associated with items, the set Te, and the inspection check master stored in the storage unit, on the basis of said examination order obtained by the obtaining unit And a confirmation is necessary for determining whether the determination of the examination order by the second doctor, the determination unit, the value of items that are set on the basis of the impact on the patient is at a predetermined value In this case, the first information processing apparatus that determines that the second doctor needs to confirm the examination order, and the second doctor who operates the determination result by the determination unit for the examination order. A second information processing apparatus comprising: a display unit that displays on a second terminal; and a reception unit that accepts the execution permission of the examination order from the second terminal; and the examination that requires confirmation from the second doctor For the order, a third information processing apparatus including a browsing control unit that prevents an engineer who performs the inspection from browsing at least a part of the inspection order until the acceptance permission is received by the reception unit. Prepare

In order to solve the above-mentioned problem, the examination execution support method disclosed in the specification has an examination order that includes patient information of a patient to be examined and examination information of the examination to be performed on the patient. The acquisition step acquired from the first terminal operated by the first doctor, the examination condition specifying the examination information, and confirmation by the second doctor are required before the examination corresponding to the examination condition is performed. When a check condition specifying the patient information of the patient and the inspection specified by the inspection condition are performed on a patient having the patient information specified by the check condition, it is given to the patient and items that are set based on the effects, the test checks the master which associates, on the basis of said examination order obtained by the obtaining step, a confirmation of the examination order by said second doctor A determination step whether necessity or not, a display step the determination result in the determination step for said examination order is displayed on the second terminal of the second doctor to operate, the inspection from the second terminal With respect to the reception step of accepting the execution permission of the order and the inspection order that needs to be confirmed by the second doctor, an engineer who performs the inspection will receive at least one of the inspection orders until the execution permission is received in the reception step. A browsing control step that prevents browsing of the part, and in the determination step, when the value of the item set based on the influence on the patient is a predetermined value, the second doctor It is determined that confirmation of the inspection order is necessary .

  According to the inspection execution support program, the inspection execution support device, the inspection execution support system, and the inspection execution support method disclosed in the specification, it is possible to support the execution of an appropriate inspection.

It is a figure which shows an example of the information system in a hospital containing the examination implementation assistance apparatus of this case. It is a figure which shows an example of the hardware constitutions of a RIS * PACS compound system. It is a functional block diagram which shows an example of the function with which a RIS / PACS composite system is provided. It is an example of the inspection order table stored in the storage unit and the inspection check master. It is a figure which shows an example of the examination order detail screen displayed on the user terminal which a medical radiographer operates. It is a figure for demonstrating an example of the additional display of an imaging | photography instruction | indication. It is an example of the examination order displayed on the user terminal operated by the interpretation doctor. It is a figure explaining registration of the photography directions to an inspection check master. It is an example of the examination order list displayed on the user terminal operated by the medical radiographer when the browsing control unit performs browsing control. It is a flowchart showing an example of the process which determines whether confirmation of the examination order by an image interpretation doctor is required. 10 is a flowchart illustrating an example of processing executed by the RIS / PACS combined system 30 when an inspection order browsing request is received. It is a figure which shows an example of a structure of a test implementation assistance system.

  Hereinafter, embodiments of the present invention will be described with reference to the accompanying drawings.

  First, with reference to FIG. 1, an example of an information system in a hospital including the examination execution support apparatus of the present case will be described. As shown in FIG. 1, user terminals 10 a to 10 c, an electronic medical record system 20, and a combined RIS / PACS system (examination execution support device) 30 are provided.

  The user terminals 10a to 10c are client terminals, and are connected to the electronic medical record system 20 and the RIS / PACS combined system 30 via a network 40 built in a hospital such as a LAN (Local Area Network). The user terminals 10a to 10c are, for example, personal computers, and may be wireless communication terminals, PDAs (Personal Digital Assistants), or the like. The user terminals 10a to 10c are installed in a treatment room for performing a procedure such as surgery, an imaging room for performing X-ray imaging, an examination room for performing various examinations, an examination room for doctors, and the like. In the present embodiment, it is assumed that the user terminal 10a is installed in an examination room and operated by a doctor in the medical department. The user terminal 10b is installed in a radiographing room that performs X-ray imaging or the like, and is operated by a radiology technician in the radiology department. The user terminal 10c is installed in a radiology interpretation room and is operated by a radiology interpreter.

  The doctor (first doctor) in the medical department calls the patient's electronic medical record information from the electronic medical record system 20 using the user terminal 10a (first terminal), and inputs (creates) or browses the electronic medical record. In addition, the doctor in the medical department creates an examination order for requesting the radiology department to perform an examination using the user terminal 10a. The inspection order input to the user terminal 10a is transmitted to the electronic medical record system 20.

  The radiology technician (engineer performing the examination) of the radiology department accesses the RIS / PACS combined system 30 and browses the examination order using the user terminal 10b. The medical radiographer can check the examination content by viewing the examination order. The medical radiographer performs an examination (imaging) according to the examination information of the examination order. When the examination is completed, the medical radiographer inputs an implementation result including details of the captured image and the examination conditions at the time of the examination to the examination order displayed on the user terminal 10b. The implementation result is transmitted from the user terminal 10 b to the RIS / PACS composite system 30.

  The interpreting doctor (second doctor) operates the user terminal 10c (second terminal), acquires an image taken by the medical radiographer from the RIS / PACS combined system 30, and displays it on the user terminal 10c. The interpretation doctor interprets the image displayed on the user terminal 10c and creates an interpretation report. The created interpretation report is transmitted from the user terminal 10 c to the RIS / PACS combined system 30.

  The electronic medical record system 20 is a server computer, for example, and centrally manages various types of information related to the electronic medical record. The electronic medical chart system 20 transmits electronic medical chart information to the user terminal 10a in response to a request from the user terminal 10a. Also, the inspection order transmitted from the user terminal 10 a is received, information on the inspection order managed by the electronic medical record system 20 is updated, and the inspection order is transmitted to the RIS / PACS combined system 30.

  The RIS / PACS combined system 30 is a server computer, for example, and is a system for supporting examinations and interpretation performed in the radiology department. The combined RIS / PACS system 30 receives the inspection order from the electronic medical chart system 20. The RIS / PACS combined system 30 transmits information on examination orders to the user terminal 10b in response to a request from the user terminal 10b operated by the medical radiographer. Further, the combined RIS / PACS system 30 receives the inspection execution record transmitted from the user terminal 10b.

  Further, the RIS / PACS combined system 30 transmits an image captured by the medical radiographer to the user terminal 10c in response to a request from the user terminal 10c operated by the radiogram interpreting doctor. Further, the RIS / PACS combined system 30 receives the interpretation report transmitted from the user terminal 10c. The combined RIS / PACS system 30 transmits the received interpretation report information to the electronic medical record system 20. Thereby, the doctor of the medical department can confirm the test result of the test requested in the test order from the electronic medical record system 20.

  Next, an example of the hardware configuration of the RIS / PACS composite system 30 will be described. FIG. 2 is a diagram illustrating an example of a hardware configuration of the combined RIS / PACS system 30.

  The RIS / PACS composite system 30 includes an input / output unit 301, a ROM (Read Only Memory) 302, a central processing unit (CPU: Central Processing Unit) 303, a RAM (Random Access Memory) 304, and a hard disk (HDD: Hard Disk Drive) 305. Is provided.

  The input / output unit 301 transmits and receives data to and from the user terminals 10 a to 10 c and the electronic medical record system 20. The ROM 302 stores a program (details will be described later) and the like for determining whether or not an examination order needs to be confirmed by an interpretation doctor. The CPU 303 reads and executes a program stored in the ROM 302. Further, the functions of the acquisition unit 312, the determination unit 313, the display unit 314, the reception unit 315, the registration unit 316, and the browsing control unit 317 illustrated in FIG. 3 are executed by calculation by the CPU 303 of the program stored in the ROM 302. The RAM 304 stores temporary data used when executing the program. The HDD 305 stores the examination order received from the electronic medical record system 20, the image taken by the medical radiographer, the interpretation report created by the interpretation doctor, and the like, and corresponds to the storage unit 311 in FIG.

  Next, an example of functions provided in the combined RIS / PACS system 30 will be described. FIG. 3 is a functional block diagram illustrating an example of functions provided in the combined RIS / PACS system 30.

  The RIS / PACS combined system 30 includes a storage unit 311, an acquisition unit 312, a determination unit 313, a display unit 314, a reception unit 315, a registration unit 316, and a browsing control unit 317.

  The storage unit 311 stores an examination order table that stores examination orders received from the electronic medical record system 20. The storage unit 311 stores an examination check master used for determining whether or not the examination order needs to be confirmed by an interpretation doctor. Here, the inspection order table and the inspection check master stored in the storage unit 311 will be described.

  FIG. 4 is an example of an inspection order table and an inspection check master stored in the storage unit 311. First, the inspection order table will be described. 4A, the examination order table includes items of examination request ID, patient information, examination information, permission flag, imaging instruction, and confirmation flag. The inspection request ID is an identification number for uniquely identifying the inspection order.

  Registered in the patient information is information related to the patient on whom the examination identified by the examination request ID is performed. The patient information includes items of “patient ID” for uniquely identifying the patient, “patient name”, “history”, “allergy”, and “infection” of the patient. For example, in FIG. 4A, the examination based on the examination order with the examination request ID “0002” is performed on the patient with the patient ID “A0378” who has the history of “asthma, heart disease” with the disease name “renal disorder”. It is shown that it will be implemented.

  In the inspection information, information related to the inspection content of the inspection identified by the inspection request ID is registered. The inspection information is used for the “inspection date” that specifies the date of the inspection, “inspection type” that indicates the type of inspection, “part” that specifies the part to be imaged, “method” that specifies the imaging method, and imaging The item of “medicine” that specifies the medicine to be included is included. For example, in FIG. 4A, the examination order with the examination request ID “0002” requests that the CT examination of the chest be performed by contrast imaging using the contrast agent A.

  The permission flag is a flag indicating whether or not to permit the execution of the inspection based on the inspection order, and “permitted” or “not permitted” is set. How the permission flag is set will be described later.

  The imaging instruction stores instruction information input by the image interpretation doctor for the examination identified by the examination request ID. The contents input in the imaging instruction can be confirmed in the examination order displayed on the user terminal 10b operated by the medical radiographer. For example, in the example of the examination order detail screen displayed on the user terminal 10b operated by the medical radiologist shown in FIG. 5, the medical radiologist can view the details of the examination and the imaging instruction input by the interpretation doctor.

  The confirmation flag is a flag indicating whether or not the examination information and the imaging instruction are confirmed when the medical radiographer performs the examination based on the examination order, and “confirmed” or “unconfirmed” is set. For example, in FIG. 5, the medical radiologist can confirm the examination content and the imaging instruction and press the confirmation button B <b> 10 to input the examination. When the confirmation button B10 is pressed, the confirmation flag item in the examination order table changes from “unconfirmed” to “confirmed”.

  Next, the inspection check master will be described. As shown in FIG. 4B, the inspection check master includes items of check ID, inspection condition, check condition, importance, and imaging instruction.

  The check ID is an identification number for uniquely identifying a record registered in the inspection check master.

  The examination conditions are for designating examinations for which the necessity of examination order by the interpretation doctor is specified, and include items of “examination type”, “part”, “method”, and “medicine”. Check conditions are used to specify patient information to be checked when the test specified in the test conditions is performed. Items of "Disease name", "Past history", "Allergy", and "Infectious disease" including. For example, in FIG. 4B, with check ID “0001”, when performing a CT examination of the chest by contrast imaging using contrast agent A, the disease name of the patient to be examined is renal disorder, and Specify whether to have a history of asthma and heart disease.

  The importance indicates the importance of the examination order including the examination condition and the check condition in the examination information and patient information. When the importance is “high”, the examination order is obeyed without the permission of the interpretation doctor. Means that the inspection cannot be carried out. In the examination check master, the importance is set based on the influence given to the patient when the examination designated by the examination condition is performed on the patient corresponding to the patient information designated by the check condition. Note that the inspection order including the inspection condition and the check condition in the inspection information and the patient information is hereinafter referred to as an inspection order corresponding to the inspection condition and the check condition. The importance “high” is set for the check ID “0001” described above. This is because, when a CT scan of the chest is performed by contrast imaging using contrast agent A, if the name of the patient to be examined is renal disorder and there is a history of asthma and heart disease, This means that the examination according to the examination order cannot be performed without the permission of the doctor.

  Further, when the importance is “medium”, it means that the examination according to the examination order cannot be performed unless the radiological technologist confirms the imaging instruction input by the interpreting doctor. For example, the head MR examination is usually performed under the conditions of T2WI (T2-weighted image), T1WI (T1-weighted image), and FLAIR (flare image). However, if the patient has a history of subarachnoid hemorrhage, the interpretation doctor is more likely to perform interpretation by performing MRA (MR angiography). In this way, the addition of the examinations and instruction items necessary for the image interpretation doctor to correctly perform the interpretation are set to the importance “medium” although there is no danger to the patient. When the importance is “medium”, the examination execution support apparatus prevents the examination from being carried out until it is detected that the radiological technologist has confirmed the radiographer's imaging instruction.

  In the imaging instruction item, instruction contents previously given by the interpreting doctor for the examination order corresponding to the examination condition and the check condition are stored. The content stored in the “imaging instruction” of the inspection check master is that when the inspection order corresponding to the inspection condition and the check condition is displayed on the user terminal 10b or the inspection order is displayed on the user terminal 10c, In addition to the instruction information input in the “instruction” item, it is displayed on the screen of the inspection order. For example, in the check ID “0003”, “MRA addition” is registered in the shooting instruction item. In the inspection order table of FIG. 4A, the inspection order with the inspection request ID “0004” corresponds to the inspection condition and the check condition with the check ID “0003”. Accordingly, when the inspection order with the inspection request ID “0004” is displayed on the user terminal 10b or the user terminal 10c, “shooting at 0.5 mm” input in the item of “imaging instruction” in the inspection order table. In addition, “MRA addition” input in the “imaging instruction” item of the inspection check master is also displayed as an imaging instruction.

  For example, it is assumed that “shooting at 0.5 mm” is input in the “shooting instruction” item of the inspection order table, and nothing is input in the “shooting instruction” item of the inspection check master. In this case, on the inspection order detail screen displayed on the user terminal 10c, as shown in FIG. 6A, as an imaging instruction, “imaging at 0.5 mm” input in the item “imaging instruction” of the inspection order table. "Is displayed. On the other hand, when “Add MRA” is entered in the “Shooting instruction” item of the inspection check master, as shown in FIG. 6B, the shooting instruction is “Shoot at 0.5 mm” and “Add MRA”. Is displayed.

  Returning to FIG. 3, the description will be continued. The acquisition unit 312 acquires the examination order input by the doctor in the medical department from the user terminal 10a. In the present embodiment, the examination order input from the user terminal 10 a by the doctor in the medical department is stored in the examination order table of the storage unit 311 of the combined RIS / PACS system 30 via the electronic medical record system 20. Therefore, the acquisition unit 312 acquires from the examination order table stored in the storage unit 311 an examination order for which it has not been determined whether confirmation by an interpreting doctor is necessary. Specifically, the acquisition unit 312 acquires an inspection order for which no value is input in the “permission flag”. The acquisition unit 312 outputs the acquired inspection order to the determination unit 313.

  The determination unit 313 receives the inspection order from the acquisition unit 312. The determination unit 313 uses the examination information and patient information included in the examination order received from the acquisition unit 312 to extract, from the examination check master, records in which the examination order satisfies the examination condition and the check condition. In the extracted record, when “high” is set in the importance item, the determination unit 313 determines that the examination order needs to be confirmed by the interpreting doctor, and sets the permission flag of the examination order table to “ Set to "Unauthorized". When anything other than “high” is set in the item of importance, the determination unit 313 determines that confirmation of the examination order by the interpretation doctor is not particularly necessary, and sets the permission flag of the examination order table to “permitted”.

  The display unit 314 displays the examination order on the user terminal 10c operated by the interpretation doctor based on the contents of the examination order table in the storage unit 311. FIG. 7A is an example of a list of examination orders displayed on the user terminal 10c. In the example of FIG. 7A, a list of examinations whose examination date is January 15 is displayed. On the list display screen, for example, items of necessity of confirmation are displayed together with patient information and examination information. The item of necessity of confirmation is an item for requesting the interpretation doctor to confirm the examination order and determine whether or not to permit the examination based on the examination order. When displaying the inspection order, the display unit 314 displays, for example, “necessary” in the confirmation necessity item when “not permitted” is set in the permission flag of the inspection order table. Thereby, the image interpretation doctor can easily find out the examination order that needs to be confirmed.

  Further, when displaying the inspection order on the user terminal 10c, the display unit 314 determines whether the inspection order corresponds to the inspection condition and the check condition for which a value is input in the “imaging instruction” of the inspection check master. To do. When the inspection order corresponds to the inspection condition and the check condition for which a value is input in the “imaging instruction” of the inspection check master, the display unit 314 displays “ The contents input in the “imaging instruction” item are displayed in addition to the contents input in the “imaging instruction” item of the inspection order table.

  The accepting unit 315 accepts an input of examination order execution permission and an imaging instruction input from the user terminal 10c operated by the image interpretation doctor. FIG. 7B is an example of a detailed screen of an examination order that is displayed when an interpretation doctor selects one of the examination orders displayed in the examination order list of FIG. The interpretation doctor selects an examination order in which “necessary” is displayed in the item of necessity of confirmation in FIG. 7A, and browses the details of the examination information on the details screen of FIG. 7B. The interpretation doctor determines whether or not an examination based on the examination order may be performed. For example, the image interpretation doctor can permit the examination to be performed by pressing an execution permission button B20 arranged on the examination order detail screen in FIG. 7B. In addition, the interpretation doctor can input an imaging instruction to the examination order when permitting the examination to be performed under a specific condition, or when giving a detailed instruction to the examination. Note that even for examination orders in which “unnecessary” is displayed in the item of necessity of confirmation, the interpretation doctor can browse and input imaging instructions.

  When the acceptance unit 315 accepts the execution permission for the inspection order from the user terminal 10c, the reception unit 315 sets “permission” in the item of the permission flag of the inspection order table. In addition, the reception unit 315 inputs the imaging instruction received from the user terminal 10c to the item “imaging instruction” in the examination order table. In addition, the reception unit 315 outputs the shooting instruction received from the user terminal 10 c to the registration unit 316.

  The registration unit 316 associates the examination information and patient information of the examination order in which the imaging instruction is input with the imaging instruction input by the interpretation doctor, and registers them in the examination check master. For example, it is assumed that the radiographing doctor inputs “shoot at 0.5 mm” as an imaging instruction to the examination order shown in FIG. 8A as an imaging instruction. In this case, as shown in FIG. 8B, when there is a record in which the examination condition and the check condition match the examination information and patient information of the examination order, the registration unit 316 displays the “imaging instruction” of the record. In the item, the photographing instruction “photograph at 0.5 mm” input in the inspection order is registered. In addition, when there is no record in which the examination condition and the check condition match the examination information and patient information of the examination order, a new record is registered and entered in the “imaging instruction” item of the new record by the examination order. Register the shooting instruction “shoot at 0.5 mm”. At that time, the registration unit 316 sets the importance item to, for example, “medium” as shown in FIG.

  The browsing control unit 317 controls whether or not the medical radiation technician can view the examination order by controlling the display method of the examination order displayed on the user terminal 10b operated by the medical radiation technician. For the inspection order for which “not permitted” is set in the permission flag of the inspection order table, the browsing control unit 317 receives at least inspection information from the user terminal 10b so that the medical radiographer cannot perform the inspection based on the inspection order. Prevent viewing some of them.

  FIG. 9 is an example of a list of examination orders displayed on the user terminal 10b operated by the medical radiographer when the browsing control unit 317 performs browsing control. In the example screen of the examination order list shown in FIG. 9, when one of the imaging rooms displayed on the left side of the screen is selected, the examination order list of examinations scheduled in the selected imaging room is displayed on the right side of the screen. It is like that. Here, for example, in the CT imaging room 1, a CT examination for patient A and a CT examination for patient B are scheduled, but “not permitted” is set in the permission flag of the examination order for CT examination for patient B. Suppose that In this case, for example, as shown in FIG. 9A, the browsing control unit 317 prevents the medical radiographer from browsing the examination order by not displaying the examination order of the CT examination for the patient B on the screen. Alternatively, as shown in FIG. 9B, the browsing control unit 317 displays the patient name and the examination type so that the medical radiographer can confirm that the CT examination for the patient B is scheduled. Prevent radiological technologists from viewing information necessary for the implementation of tests, such as methods, drugs, etc. In addition, as shown in FIG. 9C, the browsing control unit 317 displays the permission flag information on the screen so that the medical radiographer can confirm why the information necessary for the examination is not displayed. Good.

  Further, when the browsing control unit 317 enables browsing of the inspection order from the user terminal 10b, the inspection order corresponds to the inspection condition and the check condition in which a value is input in the “imaging instruction” of the inspection check master. It is determined whether or not. When the inspection order corresponds to the inspection condition and the check condition for which the value is input in the “imaging instruction” of the inspection check master, the browsing control unit 317, as described with reference to FIG. The contents input in the “imaging instruction” item are displayed in addition to the contents input in the “imaging instruction” item of the inspection order table.

  Next, an example of processing executed by the RIS / PACS combined system 30 will be described. First, an example of a process for determining whether or not an examination order needs to be confirmed by an interpretation doctor will be described with reference to FIG.

  First, the acquisition unit 312 determines whether or not there is an examination order (examination target to be judged) in the examination order table that has not been checked for confirmation by the interpretation doctor (step S11). If the determination in step S11 is NO, the acquisition unit 312 ends this process.

  When the determination in step S11 is YES, the acquisition unit 312 acquires the inspection order to be determined from the inspection order table (step S12).

  Next, the determination unit 313 determines whether or not the inspection condition included in the inspection information of the inspection order acquired in Step S12 exists in the inspection check master (Step S13).

  When the determination in step S13 is YES, the determination unit 313 determines whether the check condition associated with the examination condition is included in the patient information acquired in step S12 (step S14). When the determination in step S14 is YES, the determination unit 313 determines whether or not “high” is set in the importance item (step S15).

  When “high” is set in the item of importance (step S15 / YES), the determination unit 313 sets “not permitted” in the item of the permission flag of the inspection order (step S16).

  If the determination in step S13 is NO, if the determination in step S14 is NO, or if the determination in step S15 is NO, the determination unit 313 sets “permitted” in the item of the permission flag of the inspection order (step S17). ).

  When the process of step S16 or step S17 is completed, the determination unit 313 ends this process.

  Next, an example of processing executed by the combined RIS / PACS system 30 when an inspection order browsing request is received will be described with reference to FIG.

  The display unit 314 and the browsing control unit 317 determine whether an inspection order browsing request has been received (step S21). When determination of step S21 is NO, the display part 314 and the browsing control part 317 continue the process of step S21.

  If the determination in step S21 is YES, the display unit 314 and the browsing control unit 317 determine whether the request source requesting the browsing of the examination order is the user terminal 10b operated by the interpreting doctor, or the user terminal operated by the medical radiographer It is determined whether it is 10c (step S22). When the request source of the inspection order browsing request is the user terminal 10b operated by the interpreting doctor (step S22 / interpreting doctor), the display unit 314 asks the user terminal 10c whether the inspection order needs to be confirmed for each inspection order. It is displayed (step S23). Next, the accepting unit 315 accepts an input of inspection order execution permission from the user terminal 10c (step S24). The accepting unit 315 finishes this process when accepting the input of the execution permission is finished.

  When the request source of the inspection order viewing request is the user terminal 10c operated by the medical radiation technician (step S22 / medical radiation technician), the viewing control unit 317 sets “permitted” in the item of the permission flag of the inspection order. It is determined whether it has been performed (step S25).

  When the determination in step S25 is YES, the browsing control unit 317 enables browsing of the inspection order from the user terminal 10b (step S26) and ends the process. When the determination in step S25 is NO, the browsing control unit 317 disables browsing of at least a part of the inspection order (step S27), and ends this process.

  As is clear from the above description, according to the above-described embodiment, the acquiring unit 312 acquires patient information and test information of the patient to be tested from the test order, and the determining unit 313 acquires the test check master and the test check master. Based on the examination information and patient information acquired by the unit 312, it is determined whether confirmation by the interpretation doctor of the examination order is necessary, and the display unit 314 is a user who operates the interpretation result of the determination unit 313 by the interpretation doctor It is displayed on the terminal 10c. For examination orders that need to be confirmed by the interpreting physician, the browsing control unit 317 examines from the user terminal 10b operated by the medical radiographer until the receiving unit 315 receives an execution permission from the user terminal 10c operated by the interpreting physician. Make it impossible to view at least a part of. Thereby, it is possible to reduce the possibility that a medical radiographer performs an examination based on an examination order that is highly likely to be registered with incorrect contents. Also, for examinations for which “high” is set as the importance level, it is necessary to permit the interpretation doctor to perform, so the possibility that an appropriate examination based on correct examination information will be carried out increases. In addition, the possibility of a medical error occurring by performing an examination based on an examination order that is highly likely to be registered with incorrect contents can be reduced.

  Here, in order to prevent a medical error due to an examination based on an examination order that is highly likely to be registered with incorrect contents, for example, an interpretation doctor confirms all examination orders and interprets the interpretation. It is conceivable that after a doctor's confirmation, a medical radiographer performs an operation based on an inspection order. However, in this case, the interpretation doctor may take a lot of time for the confirmation work of the examination order other than the interpretation. As a result, there is a possibility that the examination is delayed, or the examination result (interpretation report) is difficult to reach the doctor in the medical department. In the above-described embodiment, the importance of the inspection check master is set based on the influence on the patient when the inspection specified by the inspection condition is performed on the patient having the patient information specified by the check condition. ing. As a result, examination orders that need to be confirmed by the interpretation doctor are selected, so that delays in examinations and examination result reports can be suppressed and examinations according to inappropriate examination order contents are performed. Medical malpractice can be suppressed.

  Further, the browsing control unit 317 can browse the examination type until the receiving unit 315 receives permission to perform the examination when the interpretation doctor needs to confirm the examination order. Thereby, the medical radiographer can estimate the number of examinations scheduled to be performed, the degree of congestion, and the like.

  The accepting unit 315 receives input of instruction information for the examination order from the user terminal 10c operated by the interpretation doctor, and the registration unit 316 includes examination information and patient information of the examination order in which the instruction information is inputted, and instruction information. Are registered in the inspection check master. When the examination information and patient information of the examination order matches the examination conditions and check conditions associated with the instruction information, when the execution permission is accepted, the instruction information registered in the examination check master is added and the examination order is added. Allow browsing. As a result, the instruction content input when the image interpretation doctor has performed a similar examination in the past is reflected in the examination order, so that omissions in instructions can be reduced. In addition, the medical radiographer can perform an appropriate examination based on the examination order reflecting the instruction content.

  Note that the examination order entered by the doctor in the clinical department includes examination information such as examination type, imaging method, and medicines to be used. In some cases, the radiology technician is instructed about the site, imaging method, chemicals used, imaging conditions, and the like. The interpreting physician has more knowledge than the attending physician about the imaging method for conducting a more appropriate examination that matches the purpose of the examination, the drug used, and the method for controlling the radiation exposure dose of the patient. It is because it is doing.

  However, in the conventional image information system, the inspection order can be confirmed, but information such as an imaging instruction cannot be input to the inspection order, so the instruction must be given using a telephone or a memo. It was. For this reason, there is a possibility that the instruction content is not correctly transmitted to the medical radiographer, and the instruction content is not reflected in the examination. In addition, since there is no record of the transmitted instruction content, it is difficult to confirm whether or not an inspection based on the instruction content has actually been performed.

  On the other hand, according to the above-described embodiment, since the imaging instruction input by the interpretation doctor is recorded in the examination order table, it is possible to leave a record of the transmitted instruction content. In addition, as described with reference to FIG. 6, when the medical radiographer confirms an imaging instruction from the interpretation doctor and presses the confirmation button B <b> 10, “confirmation” is set in the confirmation flag of the examination order table. Therefore, by confirming the confirmation flag in the examination order table, it is possible to determine whether or not the instruction content has been transmitted to the clinical radiographer. Further, in the above-described embodiment, the medical radiographer cannot input the execution of the examination unless the confirmation button B10 is pressed. Thereby, it is possible to urge the medical radiographer to perform an examination based on the instruction content.

  Note that the functions of the RIS / PACS combined system 30 include the server 50 (first information processing apparatus), the image information system (PACS) 60 (second information processing apparatus), and the radiation information system (RIS) 70 (first). The information processing apparatus 3) may be distributed and provided to form an inspection implementation support system. For example, as illustrated in FIG. 12, the server 50 includes a storage unit, an acquisition unit, and a determination unit, the PACS 60 includes a reception unit, a display unit, and a registration unit, the RIS 70 includes a browsing control unit, and each unit via a network 40. By transmitting and receiving data, it is possible to obtain the same effect as the above-described RIS / PACS combined system 30. Since the processing executed by each unit is the same as the processing of each unit described above, description thereof is omitted.

  The embodiment of the present invention has been described in detail above. However, the present invention is not limited to the specific embodiment, and various modifications and changes can be made within the scope of the gist of the present invention described in the claims. Is possible.

  In the above-described embodiment, for the sake of simplicity, the examination type, the site, the method, and the medicine are designated as the examination conditions. However, the examination conditions and the examination information are not limited thereto. As the inspection conditions, an inspection name, body posture direction, inspection purpose, special instructions, standard comments, and the like may be used. Here, the special instruction is, for example, a free text item, and an instruction regarding inspection is input. The standard comment is a comment that is selected by a doctor from comments that are listed and registered in advance (for example, “use of wheelchair”, “use of stretcher”, etc.).

  Further, in the above-described embodiment, for simplification of description, the disease name, past history, allergy, and infectious disease are specified as the check conditions, but the check conditions are not limited to this. For example, check conditions include body weight, BMI, body surface area, body fatness, body fat percentage, blood group, TPHA, PPR, HBs antigen, HVS antibody, Tsuwa, Mr. Wa, HIV, HRS, Ab, HBsAb, MRSA, FTA -ABS, HBS, E antibody, pregnancy information, head circumference, chest circumference, sitting height, height, etc. may be used.

  Further, in the above-described embodiment, when the examination check master includes the importance item and the importance is “high”, the determination unit 313 determines that the examination order needs to be confirmed by the interpretation doctor. However, the inspection check master does not necessarily have an importance item. For example, if only the inspection condition and the check condition are registered in the inspection check master and the inspection order corresponds to the inspection condition and the check condition registered in the inspection check master, the determination unit 313 needs to confirm the inspection order by the interpretation doctor. It may be determined that

  Further, in the above-described embodiment, the doctor in the medical department, the radiological technologist, and the interpretation doctor individually operate the user terminals 10a to 10c, but the three may use the same user terminal 10a. . In this case, an access system (for example, the electronic medical record system 20 for a doctor in the medical department) can be controlled by an ID number for identifying each person. In this case, the user terminal 10a corresponds to a first terminal and a second terminal.

  Note that the functions of the inspection execution support apparatus (RIS / PACS combined system 30) can be realized by a computer including a CPU, a ROM, a RAM, and the like. In that case, a program describing the processing contents of the functions that the examination support apparatus should have is provided. By executing the program on a computer, the above processing functions are realized on the computer. The program describing the processing contents can be recorded on a computer-readable recording medium.

  When the program is distributed, for example, it is sold in the form of a portable recording medium such as a DVD (Digital Versatile Disc) or a CD-ROM (Compact Disc Read Only Memory) on which the program is recorded. It is also possible to store the program in a storage device of a server computer and transfer the program from the server computer to another computer via a network.

  The computer that executes the program stores, for example, the program recorded on the portable recording medium or the program transferred from the server computer in its own storage device. Then, the computer reads the program from its own storage device and executes processing according to the program. The computer can also read the program directly from the portable recording medium and execute processing according to the program. Further, each time the program is transferred from the server computer, the computer can sequentially execute processing according to the received program.

10a to 10c ... user terminal 30 ... RIS / PACS combined system 50 ... server 60 ... image information system 70 ... radiation information system 311 ... storage unit 312 ... acquisition unit 313 ... determination unit 314 ... display unit 315 ... reception unit 316 ... registration unit 317 ... Browsing control unit

Claims (8)

An acquisition step of acquiring from a first terminal operated by a first doctor an examination order including patient information of a patient to be examined and examination information of the examination to be performed on the patient;
Specified by the inspection conditions specifying the inspection information, the check conditions specifying the patient information of the patient that needs to be confirmed by a second doctor before performing the inspection corresponding to the inspection conditions, and the inspection conditions When the examination is performed on a patient having the patient information specified by the check condition, an examination check master that associates items set based on the influence on the patient , A determination step for determining whether confirmation of the examination order by the second doctor is necessary based on the examination order obtained in the obtaining step;
A display step of displaying a determination result in the determination step for the examination order on a second terminal operated by the second doctor;
An accepting step of accepting the execution permission of the inspection order from the second terminal;
For the inspection order that needs to be confirmed by the second doctor, a viewing control step for preventing an engineer who performs the inspection from browsing at least a part of the inspection order until receiving the permission for execution in the receiving step. When,
To the computer ,
In the determination step, when the value of an item set based on the influence on the patient is a predetermined value, it is determined that the examination order needs to be confirmed by the second doctor. An inspection implementation support program.   In the inspection control step, for the examination order that needs to be confirmed by the second doctor, the examination type is selected from the examination information included in the examination order until the acceptance permission is accepted in the acceptance step. The inspection execution support program according to claim 1, wherein the inspection type to be displayed can be browsed by the engineer. An instruction receiving step for receiving input of instruction information for the examination information included in the examination order from the second terminal operated by the second doctor;
When receiving the instruction information in the instruction receiving step, the examination information and the patient information included in the examination order in which the instruction information is input are set as the examination condition and the check condition, respectively. A registration step of associating and registering in the inspection check master;
When the acceptance permission for another inspection order is accepted in the reception step, the inspection control step and the check condition associated with the instruction information and another inspection included in the other inspection order are received in the browsing control step. The examination execution support program according to claim 1 or 2, wherein the instruction information is added and the other examination order can be browsed based on information and other patient information.   The inspection check master is created based on an influence on the patient when the inspection specified by the inspection condition is performed on the patient having the patient information specified by the check condition. The inspection execution support program according to any one of claims 1 to 3, wherein The inspection execution support program according to claim 1, wherein at least a part of the inspection order is information viewed by an engineer who performs the inspection when the inspection is performed. An acquisition unit for acquiring from a first terminal operated by a first doctor an examination order including patient information of a patient to be examined and examination information of the examination to be performed on the patient;
Specified by the inspection conditions specifying the inspection information, the check conditions specifying the patient information of the patient that needs to be confirmed by a second doctor before performing the inspection corresponding to the inspection conditions, and the inspection conditions When the examination is performed on a patient having the patient information specified by the check condition, an examination check master that associates items set based on the influence on the patient is stored. A storage unit;
A determination unit for determining whether or not the second doctor needs to confirm the examination order based on the examination check master stored in the storage unit and the examination order obtained by the obtaining unit;
A display unit for displaying a determination result by the determination unit for the examination order on a second terminal operated by the second doctor;
An accepting unit for accepting the execution permission of the inspection order from the second terminal;
Browsing control for the inspection order that needs to be confirmed by the second doctor so that an engineer who performs the inspection cannot view at least a part of the inspection order until the acceptance permission is received by the reception unit. And
Equipped with a,
The determination unit determines that confirmation of the examination order by the second doctor is necessary when a value of an item set based on an influence on the patient is a predetermined value. An inspection implementation support device. An acquisition unit that acquires from a first terminal operated by a first doctor an examination order including patient information of a patient to be examined and examination information of the examination to be performed on the patient; and the examination An examination condition that designates information, a check condition that designates the patient information of the patient that needs to be confirmed by a second doctor before the examination corresponding to the examination condition, and the examination condition designated by the examination condition A storage unit that stores an examination check master that associates items set based on an influence on a patient when the examination is performed on a patient having the patient information specified by the check condition. And determining whether or not the second doctor needs to confirm the test order based on the test check master stored in the storage unit and the test order acquired by the acquiring unit. Comprising a part, wherein the determination unit, when the value of the item set based on the impact on the patient is a predetermined value, and the second is required to check the examination order by a doctor of A first information processing device for determining ;
A display unit for displaying a determination result by the determination unit for the examination order on a second terminal operated by the second doctor; and a reception unit for accepting the execution permission of the examination order from the second terminal; A second information processing apparatus comprising:
Browsing control for the inspection order that needs to be confirmed by the second doctor so that an engineer who performs the inspection cannot view at least a part of the inspection order until the acceptance permission is received by the reception unit. A third information processing apparatus comprising a unit;
An inspection implementation support system comprising: Computer
An acquisition step of acquiring from a first terminal operated by a first doctor an examination order including patient information of a patient to be examined and examination information of the examination to be performed on the patient;
Specified by the inspection conditions specifying the inspection information, the check conditions specifying the patient information of the patient that needs to be confirmed by a second doctor before performing the inspection corresponding to the inspection conditions, and the inspection conditions When the examination is performed on a patient having the patient information specified by the check condition, an examination check master that associates items set based on the influence on the patient , A determination step for determining whether confirmation of the examination order by the second doctor is necessary based on the examination order obtained in the obtaining step;
A display step of displaying a determination result in the determination step for the examination order on a second terminal operated by the second doctor;
An accepting step of accepting the execution permission of the inspection order from the second terminal;
For the inspection order that needs to be confirmed by the second doctor, a viewing control step for preventing an engineer who performs the inspection from browsing at least a part of the inspection order until receiving the permission for execution in the receiving step. When,
The execution,
In the determination step, when the value of an item set based on the influence on the patient is a predetermined value, it is determined that the examination order needs to be confirmed by the second doctor. inspection implementation support how to.

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