JP5595758B2 - Medical information system - Google Patents

Description

  The present invention relates to a medical information system that provides information related to an interpretation report.

  A system including a medical image photographing device, a medical image storage device, and a report creation device is used. In this system, a technique for creating and storing an interpretation report is known (for example, Patent Document 1). For example, a doctor creates an interpretation report by referring to information such as medical images and past interpretation reports. In the above system, a list of created interpretation reports is displayed.

JP 2005-301453 A

  Conventionally, after a doctor interprets a medical image and before creating an interpretation report, even if a new medical image is added or the incidental information of a medical image is changed, it is added to the list of interpretation reports Not notified of changes. Further, even if the information used to create the interpretation report is changed after the interpretation report is created, the change is not notified to the operator, and thus there is a possibility that interpretation may be missed. That is, since the operator cannot recognize the change, the created report may not reflect accurate information. For example, after an interpretation report is created for a certain examination, a new medical image may be added to the examination. In this case, since the interpretation report has been created, the added image may not be interpreted. As a result, the added image information is not reflected in the interpretation report.

  Conventionally, a list of examinations performed on patients is displayed. When a new medical image is added to a certain examination, the date and time of the examination to be processed is updated. However, in order to confirm whether or not a new medical image has been added after the interpretation report is created, the operator compares the creation date and time of the interpretation report with the update date and time of the examination, and the examination is performed after the creation date and time. It is necessary to check whether it has been updated. That is, the operator needs to compare the update date and time shown in the inspection list with the creation date and time shown in the report list. Further, in order to specify the added image, the operator needs to compare the registration date / time of each image with the creation date / time of the report. Such work is very time consuming and inefficient.

  In addition, after the interpretation report is created, for example, a past interpretation report, a similar case interpretation report, or a medical image may be changed. Even if there is a change in the information used to create the interpretation report, there is no mechanism for notifying the operator of the change, so it is difficult to reflect the change in the interpretation report.

  In addition, since the change is not notified to the operator, it is difficult to detect even if an interpretation report is created based on old information.

  The present invention solves the above problems, and an object of the present invention is to provide a medical information system capable of providing information for preventing image interpretation omission and interpretation with incorrect information.

The invention of claim 1 includes a report management unit for managing assigned the report identification information by referring to the reference information by receiving an input of the interpretation report created, identifying the device for generating or changing the reference information The reference information with the information is received and managed, and if the received reference information is attached with the same identification information as the already received reference information, it is determined that there has been a change. A reference information management unit that associates and manages change information indicating that there is a change to the received reference information, report identification information of the interpretation report, and identification of the reference information that is referred to when the interpretation report is created A request for an interpretation report, and a related information management unit that associates and manages the change information based on the association by the reference information management unit. When Tsu, the based on the association by related information management unit, and an output unit for confirming the presence or absence of changes of the reference information for the interpretation report is requested, the change if there is a change in the reference information A medical information system comprising: an informing means for informing the user.
According to a fourth aspect of the present invention, there is provided storage means for receiving the input of an interpretation report and storing the interpretation report in association with reference information referred to when the interpretation report is created, and the interpretation report. The management means for confirming whether or not the reference information associated with the information has been changed, and the mode for notifying the change of the reference information is changed according to the state of creation of the interpretation report stored in the storage means. And a notifying means for notifying the change of the reference information.
The invention according to claim 5 is a storage means for receiving the input of the interpretation report and storing the interpretation report in association with the reference information referred to when the interpretation report is created, and the interpretation report. The management means for confirming whether or not the reference information associated with the information has been changed, and according to the type of the reference information stored in the storage means, the manner of notifying the change of the reference information is changed and the reference information is changed. A medical information system including a notification unit configured to notify a change in reference information.
The invention according to claim 6 is a storage means for receiving the input of the interpretation report and storing the interpretation report in association with the reference information referred to when the interpretation report is created, and the interpretation report. Management means for confirming whether or not the reference information associated with the information has been changed, a state of creation of the interpretation report stored in the storage means, a type of the reference information, and a change in the reference information Based on two or three of the above, there is provided a medical information system that has a notification means for notifying the change of the reference information by changing the mode for notifying the change of the reference information.

  According to this invention, the interpretation report and the reference information are stored in association with each other, and when there is a change in the reference information associated with the interpretation report, the change is notified. Therefore, the operator can recognize the change of the reference information used for creating the interpretation report. As described above, according to the present invention, it is possible to provide information for preventing image interpretation omission and image interpretation with incorrect information.

It is a block diagram which shows the medical information system which concerns on embodiment of this invention. It is a figure which shows a report management table. It is a figure which shows a reference information management table. It is a figure which shows an image management table. It is a figure which shows a patient information management table. It is a figure which shows a test | inspection information management table. It is a figure which shows a related information management table. It is a figure which shows a related information management table and a reference information management table. It is a figure for demonstrating the method to display the change of reference information. It is a figure for demonstrating the method to display the change of reference information. It is a schematic diagram which shows the relationship between a some test | inspection and an interpretation report. It is a figure which shows the display mode of the change of reference information. It is a figure which shows the example of a display in an image viewer. It is a figure which shows the example of a setting of the alerting | reporting aspect of a change of reference information.

  A medical information system according to an embodiment of the present invention will be described with reference to FIG. In the medical information system, the medical image storage device 1, the medical image photographing device 40, the medical image observation device 50, the medical image processing device 60, the imaging device 70, and the hospital information system (via the network N) HIS) 80 and radiation information system (RIS) 90 are connected.

  The medical image storage apparatus 1 includes a computer having a communication function and can perform data communication via the network N. The medical image storage apparatus 1 has a management function for registering medical image data and notifying the storage destination of medical image data, and manages medical image data by storing medical image data in a plurality of image storage devices. ing. For example, the medical image storage device 1 receives medical image data transmitted from the medical image photographing device 40, the medical image processing device 60, or the image inspection device 70, and stores the medical image data.

  As an example, the medical image storage device 1 includes a report creation device (report creation unit 4 and report storage unit 5). The report creation device may be connected to the network N independently of the medical image storage device 1 or may be included in another device.

(Medical image capturing device 40)
The medical image photographing apparatus 40 generates medical image data related to the subject by photographing the subject. As the medical imaging apparatus 40, an ultrasonic diagnostic apparatus, an X-ray diagnostic apparatus, an X-ray CT apparatus, an MRI apparatus, a nuclear medicine imaging apparatus, or the like is used. The medical image photographing apparatus 40 includes a computer having a communication function and can perform data communication via the network N.

  As an example, the medical image data generated by the medical image capturing apparatus 40 is classified for each patient according to the DICOM standard, and the classification for each patient is further classified for each examination. The examination is composed of a series of medical image data, and the series includes a plurality of medical image data. When a plurality of medical image data are classified in such a structure, the patient is at the top and an examination on the patient is performed. The examination consists of a series of medical image data, and the series includes a plurality of medical image data. Become.

  The medical image photographing device 40 attaches image supplementary information to medical image data and outputs medical image data. For example, according to the DICOM standard, the image supplementary information includes examination date information, patient identification information (name, date of birth, sex, age, patient ID, etc.), examination identification information (examination ID), series identification information (series ID), and medical information. It includes an image ID, which is image-specific identification information, shooting condition information, and image generation condition information.

  Information such as patient identification information, examination ID, series ID, image ID, imaging condition information, and image generation condition information is standardized according to the DICOM standard. For example, the patient ID is information that identifies a photographed patient. The inspection ID is information for specifying the inspection content. The series ID is information used for classification according to the imaged site, image generation time, slice thickness, presence or absence of a contrast agent, and the like.

  When a plurality of examinations are performed on a patient, an examination ID indicating each examination is attached to the medical image data acquired in each examination, and is classified for each examination. In addition, when a plurality of series are included in the examination, such as by imaging multiple parts, the series ID indicating each series is attached to the medical image data acquired for each series, and each series are categorized. That is, a plurality of medical image data attached with a certain patient ID is classified for each examination by examination ID, and further, for each examination, it is classified for each series by series ID.

  The medical image photographing device 40 transmits medical image data to the medical image storage device 1. Further, the medical image photographing apparatus 40 may transmit medical image data to the medical image processing apparatus 60 or may transmit medical image data to the image inspection apparatus 70.

(Medical image observation apparatus 50)
The medical image observation apparatus 50 includes a computer having a communication function and can perform data communication via the network N. The medical image observation device 50 receives medical image data from the medical image storage device 1 and displays the medical image on the display device.

(Medical image processing apparatus 60)
The medical image processing apparatus 60 is configured by a 2D workstation, a 3D workstation, or the like. The medical image processing apparatus 60 includes a computer having a communication function and can perform data communication via the network N. The medical image processing device 60 receives the medical image data from the medical image photographing device 40 or the medical image storage device 1 and performs image processing such as rendering on the medical image data, whereby three-dimensional image data or MPR image data ( Medical image data such as image data in an arbitrary cross section) is generated. The medical image processing device 60 transmits medical image data to the medical image storage device 1.

(Image detector 70)
The imaging device 70 includes a computer having a communication function, and data communication is possible via the network N. The image inspection device 70 receives medical image data from the medical image photographing device 40 and causes the display device to display the medical image. The operator refers to the medical image displayed on the display device or the image supplementary information of the medical image, and confirms or corrects the image supplementary information. For example, the operator confirms the patient information, and if the name of the patient is different from the information stored in the database, the name is corrected using the input device. The image inspection apparatus 70 may perform image processing. Image processing includes processing for changing the order of a plurality of medical image data that are taken continuously, processing for reversing the left and right or top and bottom of a medical image, processing for changing black and white gray scale for black and white medical image data, etc. Is included. Processing including confirmation, correction, or image processing of a medical image is referred to as “image inspection”. After the image inspection is performed, the image inspection device 70 transmits medical image data to the medical image storage device 1.

  The image inspection apparatus 70 may perform image inspection on medical image data stored in the medical image storage apparatus 1. In this case, the image inspection device 70 reads the medical image data from the medical image storage device 1 and performs image inspection. After the image inspection is performed, the image inspection device 70 transmits medical image data to the medical image storage device 1.

(HIS80)
The hospital information system (HIS) 80 accepts patients, processes the reception to the department in charge of internal medicine and surgery, patient identification information (patient ID, name, gender, age, address, visit history, treatment information, etc.) ) Management and accounting for medical expenses.

(RIS90)
The radiation information system (RIS) 90 manages various types of information in the radiology department. The RIS 90 performs, for example, management of reception of examinations and reservations in the radiology department, management of examination execution time, examination contents and imaging time for each medical image photographing apparatus 40, management of imaging time, and the like.

  The HIS 80 and the RIS 90 attach general-purpose identification information to general-purpose data (data including character strings or image data) such as a letter of introduction, and transmit the general-purpose data to the medical image storage device 1. In addition, when information such as patient identification information is changed, the HIS 80 and the RIS 90 transmit the changed information to the medical image storage device 1.

(Medical image storage device 1)
The medical image storage apparatus 1 includes a transmission / reception unit 2, an image storage unit 3, a report creation unit 4, a report storage unit 5, a display control unit 6, a management unit 10, and a user interface (UI) 20. ing.

(Transceiver 2)
The transmission / reception unit 2 includes a network adapter, and transmits data to devices connected to the network N and receives data from these devices. The transmission / reception unit 2 receives the medical image data transmitted via the network N and outputs the medical image data to the image storage unit 3. For example, the transmission / reception unit 2 receives the medical image data after imaging transmitted from the imaging device 70, outputs the medical image data to the image storage unit 3, and manages the image supplementary information attached to the medical image data. To the unit 10. The transmission / reception unit 2 receives the medical image data transmitted from the medical image capturing device 40 or the medical image processing device 60, outputs the medical image data to the image storage unit 3, and outputs the image supplementary information to the management unit 10. To do. Further, the transmission / reception unit 2 receives information such as patient identification information and general-purpose data transmitted from the HIS 80 or RIS 90, and outputs information such as general-purpose data to the image storage unit 3 and the management unit 10.

(Image storage unit 3)
The image storage unit 3 includes a storage device including a plurality of HDDs, NAS (Network Attached Storage), and the like, and stores medical image data.

(Report creation unit 4, report storage unit 5)
The report creation unit 4 supports creation of an interpretation report by an operator such as a doctor. The interpretation report is document format data, and includes a character string indicating the report contents such as findings. Corresponding to the input of findings using the input unit 22, the report creation unit 4 arranges character strings and generates interpretation report data. The report creation unit 4 attaches report identification information and patient identification information to the interpretation report data, and outputs the interpretation report data to the report storage unit 5 and the management unit 10. The report identification information is information for specifying the interpretation report. The report storage unit 5 stores interpretation report data.

  The operator creates an interpretation report with reference to the reference information. The reference information includes at least one of medical image data belonging to the examination, interpretation reports created in the past, patient identification information that is information from the HIS 80 or RIS 90, examination information data indicating the type of medicine, and general-purpose data. Contains data. The operator creates an interpretation report with reference to at least one of medical images, interpretation reports created in the past, patient identification information, examination information data, and general-purpose data.

  When an operator creates an interpretation report with reference to a medical image, the operator inputs an examination ID to be interpreted by the input unit 22. The display control unit 6 reads the medical image data attached with the examination ID input from the input unit 22 from the image storage unit 3 and causes the display unit 21 to display the medical image.

  When an interpretation report is created by an operator referring to an interpretation report created in the past, the operator inputs report identification information through the input unit 22. The display control unit 6 reads the data of the interpretation report (past interpretation report) attached with the report identification information input from the input unit 22 from the report storage unit 5 and causes the display unit 21 to display the past interpretation report. .

  When an operator creates an interpretation report by referring to information indicated by the general-purpose data, the operator inputs the general-purpose identification information through the input unit 22. The display control unit 6 reads the general-purpose data attached with the general-purpose identification information input from the input unit 22 from the image storage unit 3 and causes the display unit 21 to display information indicated by the general-purpose data.

  The operator refers to reference information such as medical images, past interpretation reports, or general-purpose data displayed on the display unit 21 and inputs findings using the input unit 22. The report creation unit 4 generates interpretation report data in response to the input by the input unit 22. The report creation unit 4 appends report identification information and patient identification information to the interpretation report data, and outputs the interpretation report data to the report storage unit 5 and the management unit 10. The report storage unit 5 stores interpretation report data.

  The report creation unit 4 outputs the identification information of the reference information referred in creating the interpretation report to the management unit 10. When the interpretation report is created with reference to the medical image, the report creation unit 4 outputs the examination ID to the management unit 10. For example, the report creation unit 4 outputs the examination ID of the examination to which the medical image displayed on the display unit 21 belongs to the management unit 10. Alternatively, the operator may specify the referenced medical image using the input unit 22. In this case, the report creation unit 4 outputs the examination ID of the examination to which the medical image specified by the input unit 22 belongs to the management unit 10. When an interpretation report is created by referring to a past interpretation report, the report creation unit 4 outputs report identification information of the past interpretation report to the management unit 10. For example, the report creation unit 4 outputs report identification information of a past interpretation report displayed on the display unit 21 to the management unit 10. Alternatively, the operator may specify the past interpretation report referred to by using the input unit 22. In this case, the report creation unit 4 outputs the report identification information of the interpretation report designated by the input unit 22 to the management unit 10. When the interpretation report is created by referring to the general-purpose data, the report creation unit 4 outputs the general-purpose identification information to the management unit 10. For example, the report creation unit 4 outputs the general-purpose identification information of the general-purpose data displayed on the display unit 21 to the management unit 10. Alternatively, the operator may specify the general-purpose identification information of the referenced general-purpose data using the input unit 22. In this case, the report creation unit 4 outputs the general-purpose identification information of the general-purpose data designated by the input unit 22 to the management unit 10.

(Management unit 10)
The management unit 10 includes a report management unit 11, a reference information management unit 12, a related information management unit 13, an output unit 14, and a notification mode determination unit 15.

(Report Manager 11)
The report management unit 11 receives the data of the interpretation report created by the report creation unit 4 and associates the date and time (creation date and time) when the interpretation report was created with the report identification information. For example, as shown in FIG. 2, when the interpretation report 100 is created, the report management unit 11 creates a report management table 110 in which report identification information is associated with creation date and time. In the report management table 110, a report R1, a report R2, a report R3, and a report R4 are report identification information. The report management table 110 is a table in which report identification information such as the report R1 is associated with the creation date (for example, 2009/10/08 11:12:00). In addition, the report management unit 11 may include the interpretation report change history, patient ID, report information A, and report information B in the report management table 110. The change history indicates the number of changes in the interpretation report. If the change history is “0”, it means that there is no change. If the change history is “1”, it means the first change. Each time there is a change in the interpretation report, the report management unit 11 increments the change history related to the changed interpretation report. The report storage unit 5 stores data of the report management table. The report storage unit 5 corresponds to an example of the “storage unit” of the present invention.

(Reference information management unit 12)
The reference information management unit 12 manages a history of changes in reference information used for creating an interpretation report. That is, the reference information management unit 12 manages the history of changes in information (reference information) that is the basis for creating an interpretation report. The reference information management unit 12 receives the image supplementary information and general-purpose data attached to the medical image data from the transmission / reception unit 2, and manages the change history of the reference information using the image supplementary information and general-purpose identification information. For example, as illustrated in FIG. 3, the reference information management unit 12 includes reference information identification information (for example, inspection T1, inspection T2, inspection T3, general purpose G1, general purpose G2, general purpose G3), change history, and reference information. The reference information management table 120 in which the updated date and time (update date and time) is associated with the change content (for example, image addition) is created. The change history indicates the number of changes. For example, if the change history is “0”, it means that there is no change. If the change history is “1”, it means the first change. Whenever there is a change in the reference information, the reference information management unit 12 increments the change history related to the changed reference information. The report storage unit 5 stores data of the reference information management table.

  For example, when new medical image data is added for a certain examination, medical image data belonging to the examination is modified, or image identification information is modified, the reference information management unit 12 changes the examination. Manage your change history. In addition, when certain general-purpose data is changed, the reference information management unit 12 manages the history of changes in the general-purpose data.

  For example, the transmission / reception unit 2 receives medical image data belonging to the examination T1, and the reference information management unit 12 receives image supplementary information including the examination ID of the examination T1 from the transmission / reception unit 2. As shown in FIG. 3, the reference information management unit 12 includes the inspection ID of the inspection T1 included in the image supplementary information, the update date and time (for example, 2010/01/19 20:39:00) when the inspection T1 was executed. Associate and manage. At this time, since the information belonging to the examination T1 is not changed, the reference information management unit 12 sets the change history to “0”. For example, the image inspection apparatus 70 transmits the medical image data after the image belonging to the examination T1 to the medical image storage apparatus 1. When the transmission / reception unit 2 receives post-examination medical image data belonging to the examination T1, the reference information management unit 12 manages the examination ID of the examination T1 and the update date and time in association with each other.

  As an example, a case where a new medical image is added to the examination T1 will be described. For example, when the medical image capturing apparatus 40 performs new imaging for the examination T1, the medical image capturing apparatus 40 transmits new medical image data belonging to the examination T1 to the medical image storage apparatus 1. The transmission / reception unit 2 receives new medical image data belonging to the examination T1, and the reference information management unit 12 receives image supplementary information including the examination ID of the examination T1 from the transmission / reception unit 2. The reference information management unit 12 determines whether or not the inspection T1 has been changed based on the update date and time of the inspection T1.

  For example, the reference information management unit 12 creates an image management table 120A shown in FIG. Specifically, the reference information management unit 12 performs image management in which the examination ID, series ID, image ID, registration date / time when the examination is registered, and update date / time when the examination is updated are associated with the transmitted medical image data. A table 120A is created. The report storage unit 5 stores data of the image management table. When the examination ID of the transmitted medical image data exists in the image management table 120A, the reference information management unit 12 updates the examination ID of the transmitted medical image data and determines that the examination T1 has been updated.

  As illustrated in FIG. 3, the reference information management unit 12 includes the inspection ID of the inspection T1, the update date and time (2010/01/19 21:20:00) when the inspection T1 is updated, the change content (image addition), Associate. Further, the reference information management unit 12 increments the reference information change history in the reference information management table 120. If it is the first change, the reference information management unit 12 increments the change history to “1”.

  The medical image processing apparatus 60 may generate new medical image data belonging to the examination T1 by reading the medical image data belonging to the examination T1 from the medical image storage apparatus 1 and performing image processing. The medical image processing apparatus 60 transmits new medical image data belonging to the examination T1 to the medical image storage apparatus 1. Also in this case, the reference information management unit 12 associates the examination ID of the examination T1, the update date and time when the medical image data belonging to the examination T1 is added, and the change content (image addition).

  The image inspection apparatus 70 may read medical image data belonging to the examination T1 from the medical image storage apparatus 1 and newly perform image inspection (correction or image processing). In this case, the image inspection device 70 transmits the medical image data after the image belonging to the examination T1 to the medical image storage device 1. Also in this case, the reference information management unit 12 associates the examination ID of the examination T1, the update date and time when the medical image data belonging to the examination T1 is newly examined, and the change content (such as image correction).

  When patient identification information or general-purpose data is corrected by the HIS 80 or RIS 90, the HIS 80 or RIS 90 may transmit the corrected patient identification information or general-purpose data to the medical image storage apparatus 1. The reference information management unit 12 associates the update date and time when the patient identification information and the general-purpose data are corrected with the changed content.

  As another example, the case where the patient identification information is changed will be described. For example, when the patient identification information is changed by the HIS 80 or the RIS 90, the HIS 80 or RIS 90 transmits the patient identification information to the medical image storage device 1. The transmission / reception unit 2 receives the patient identification information, and the reference information management unit 12 receives the patient identification information from the transmission / reception unit 2. The reference information management unit 12 determines whether or not the patient identification information has been changed based on the update date and time of the patient identification information.

  For example, the reference information management unit 12 creates a patient information management table 120B shown in FIG. Specifically, the reference information management unit 12 stores the patient information management table 120B in which the patient ID, change history, registration date, name, date of birth, and past history included in the transmitted patient identification information are associated. create. The report storage unit 5 stores data of a patient information management table. The reference information management unit 12 determines a change in the patient identification information based on the difference in the history of the patient identification information. The reference information management unit 12 associates the patient ID included in the patient identification information, the change date and time when the patient identification information is changed, and the change content.

  As another example, the case where the inspection as an order is changed will be described. The inspection as an order corresponds to the interpretation report. For example, the reference information management unit 12 creates an examination information management table 120C shown in FIG. Specifically, the reference information management unit 12 includes an examination information management table 120C in which report identification information of an interpretation report corresponding to an examination as an order, change history, registration date and time, examination name, medicine, and part are associated. Create The report storage unit 5 stores an examination information management table 120C. The reference information management unit 12 determines a test change corresponding to the order based on the history difference. The reference information management unit 12 associates the inspection identification information (report identification information), the change date and time when the inspection corresponding to the order is changed, and the change content.

  Note that the image management table 120A, the patient information management table 120B, and the examination information management table 120C may be created and managed by an apparatus other than the management unit 10.

(Related Information Management Unit 13)
The related information management unit 13 receives the identification information of the reference information from the report creation unit 4 and associates the report identification information with the reference information. For example, as shown in FIG. 7, when an interpretation report (report R4) is created by referring to medical images belonging to examination T1, past interpretation reports (report R3), and general-purpose data (general-purpose G1, G2). The related information management unit 13 creates a related information management table 130 in which report identification information and reference information are associated with each other. The related information management table 130 is a table in which report identification information indicating the report R4 is associated with reference information (examination T1, report R3, general purpose G1, general purpose G2). The report storage unit 5 stores the data of the related information management table.

  In addition, the related information management unit 13 refers to the related information management table 130 and the reference information management table 120 to determine whether or not the related information management table 130 includes an interpretation report associated with the changed reference information. To check. The reference information management table 120 is a table for managing the history of changes in reference information, and shows the history of changes in reference information. The related information management unit 13 refers to the reference information management table 120 and confirms whether there is changed reference information. When the changed reference information is included in the reference information management table 120, the related information management unit 13 refers to the related information management table 130 to determine whether there is an interpretation report associated with the changed reference information. To check. The related information management unit 13 provides a column indicating whether or not the reference information is changed in the related information management table 130, and adds information indicating whether or not there is a change to the column indicating whether or not there is a change. When the interpretation report associated with the changed reference information is included in the related information management table 130, the related information management unit 13 changes the information (change information) indicating the change to the related information management table 130. Add to the presence / absence column. The report storage unit 5 stores a related information management table 130 to which change information is added.

  The reference information management table 120 and the related information management table 130 are shown in FIG. In the example illustrated in FIG. 8, the reference information management table 120 indicates that the examination T1 (reference information) has been changed (added image). The related information management unit 13 refers to the related information management table 130 and specifies an interpretation report associated with the changed examination T1 (reference information). That is, the related information management unit 13 specifies an interpretation report associated with the changed examination T1 (reference information) from the related information management table 130 using the changed examination T1 (reference information) as a search key. In this embodiment, an interpretation report whose report identification information is report R4 is associated with the changed examination T1 (reference information). Therefore, the related information management unit 13 adds information (changed) indicating that the change has been made to the column (change presence / absence) corresponding to the changed examination T1 in the related information management table 130.

  In addition, the related information management unit 13 may add information (no change) indicating that it has not been changed to the column corresponding to the reference information that has not been changed in the related information management table 130. As shown in the related information management table 130, the interpretation report of the report R3, the general-purpose data of the general-purpose G1, and the general-purpose data of the general-purpose G2 are used as reference information for the interpretation report of the report R4. Further, the interpretation report of the report R3, the general-purpose data of the general-purpose G1, and the general-purpose data of the general-purpose G2 are not changed. In this case, in the related information management table 130, the related information management unit 13 includes information indicating that no change has been made in the columns (changed / not changed) corresponding to the report R3, the general purpose G1, and the general purpose G2, respectively (no change). Add

  As described above, the related information management unit 13 provides a flag indicating whether or not the reference information has been changed in the related information management table 130.

(Output unit 14)
The output unit 14 confirms whether or not the reference information has been changed for the interpretation report requested to be displayed, and creates a list of interpretation reports including information indicating whether or not the reference information has been changed. For example, the operator inputs a patient ID, a patient name, and the like through the input unit 22. Information such as a patient ID is output from the user interface (UI) 20 to the management unit 10. The output unit 14 searches the report storage unit 5 using information such as a patient ID as a search key, and specifies data of an interpretation report attached with patient identification information including the patient ID. An interpretation report accompanied by patient identification information including the input patient ID corresponds to an interpretation report requested to be displayed. The output unit 14 refers to the related information management table and confirms whether there is a change in the reference information associated with the interpretation report based on the report identification information of the interpretation report that has been requested to be displayed. Since the related information management table is provided with a flag indicating whether or not the reference information has been changed, the output unit 14 checks whether or not the reference information has been changed based on the flag.

  A specific example will be described with reference to FIG. FIG. 9 shows a list of interpretation reports and a related information management table. For example, a case where there is a display request for the report R1, the report R2, the report R3, and the report R4 will be described. The output unit 14 refers to the related information management table 130 and determines whether there is a change in the reference information associated with the interpretation report based on the report identification information (report R1, report R2, report R3, report R4). Check. In the related information management table 130 shown in FIG. 9, the reference information (examination T1) is changed for the report R4. Therefore, the output unit 14 determines that the reference information has been changed for the report R4.

  The output unit 14 creates a report list 140 shown in FIG. 9 as an example. Specifically, the output unit 14 creates a report list 140 including information change, patient ID, patient name, examination date, examination name, and report identification information. The output unit 14 adds whether or not the reference information has been changed to the information change column. Since the reference information has been changed for the report R4, the output unit 14 adds information (for example, “changed”) indicating that the reference information has been changed to the column corresponding to the report R4 in the report list 140. . The output unit 14 outputs the report list data to the display control unit 6.

(Display control unit 6)
The display control unit 6 receives the report list data from the output unit 14 and causes the display unit 21 to display the report list table. For example, as shown in FIG. 9, the display control unit 6 displays a report list 140 on the display unit 21. As a result, a message indicating whether or not the reference information has been changed is displayed on the report list table 140. The display control unit 6 and the display unit 21 constitute an example of the “notification unit” of the present invention.

(User interface (UI) 20)
The user interface (UI) 20 includes a display unit 21 and an input unit 22. The display unit 21 is a monitor such as a liquid crystal display or a CRT. The input unit 22 is an input device such as a keyboard or a mouse.

  According to the medical information system having the above configuration, the history of changes in the reference information used for creating the interpretation report is managed, and when the reference information is changed, the change is displayed (notified). For example, when displaying a report list, a message indicating a change in reference information is displayed on the report list. As a result, the operator can recognize the change in the reference information used to create the interpretation report. As a result, it is possible to prevent image interpretation omission and image interpretation with incorrect information. Even after the interpretation report is created, if there is a change in the reference information used to create the interpretation report, the change is notified (displayed). Therefore, it is possible to easily identify an interpretation report that leads to a misdiagnosis.

  In the prior art, whether or not the reference information has been changed is not displayed in the report list, so that the operator cannot recognize the change in the reference information. In the prior art, the operator cannot specify an interpretation report (interpretation report in which the reference information is changed) that leads to misdiagnosis only by referring to the report list. In order to identify an interpretation report that leads to a misdiagnosis, it is necessary for the operator to check the update date and time of the reference information and compare the creation date and time of the interpretation report with the update date and time of the reference information. As described above, in the prior art, it has been very troublesome to specify an interpretation report that leads to a misdiagnosis.

  According to the medical information system according to this embodiment, since the change of the reference information used to create the interpretation report is displayed, it is possible to efficiently identify the interpretation report that leads to a misdiagnosis without trouble as in the conventional technique. It becomes possible.

(Comparison of interpretation report creation date and time when reference information was changed)
The output unit 14 may compare the creation date and time when the interpretation report is created with the update date and time when the reference information is changed, and specify the change contents of the reference information that is changed after the interpretation report is created. . In this case, the display control unit 6 causes the display unit 21 to display the changed content.

  With reference to FIG. 10, the process of comparing the creation date and the update date will be described. For example, a case where there is a display request for the report R1, the report R2, the report R3, and the report R4 will be described. The output unit 14 refers to the related information management table 130 and determines whether or not there is a change in the reference information associated with the interpretation report based on the report identification information (report R1, report R2, report R3, report R4). Confirm. In the related information management table 130 shown in FIG. 10, the reference information (examination T1) is changed for the report R4. Therefore, the output unit 14 determines that the reference information has been changed for the report R4.

  Further, the output unit 14 refers to the reference information management table 120 to check the change history of the changed reference information (examination T1), and acquires the update date and time when the reference information is changed. In the example shown in FIG. 10, the inspection T1 is changed, and there are a change history “0” and a change history “1”. The output unit 14 updates the update date and time when the change history is “0” (2010/01/19 20:33:00) and the update date and time when the change history is “1” (2010/01/19 21:20). : 00).

  Further, the output unit 14 refers to the report management table 110 and acquires the creation date and time of the interpretation report whose reference information has been changed. In the example illustrated in FIG. 10, the output unit 14 acquires the creation date and time (2010/01/19 21: 09: 0) of the report R4.

  Then, the output unit 14 compares the creation date and time when the interpretation report was created with the update date and time when the reference information was changed, and specifies the change contents of the reference information that was changed after the interpretation report was created. In the example illustrated in FIG. 10, the output unit 14 compares the creation date and time of the report R4 with the update date and time when the change history of the examination T1 is “0”. Further, the output unit 14 compares the creation date / time of the report R4 with the update date / time when the change history of the examination T1 is “1”. Since the update date and time when the change history is “1” is later than the creation date and time of the report R4, the output unit 14 specifies the change content (image addition) corresponding to the change history “1”.

  Then, the output unit 14 adds the change content (for example, “examination: image addition”) to the “information change” column corresponding to the report R4 in the report list 140. The output unit 14 outputs the report list data to the display control unit 6.

  The display control unit 6 causes the display unit 21 to display the report list table 140 including the change contents of the reference information.

  As described above, the creation date of the interpretation report is compared with the update date and time of the reference information, and the reference information change contents made after the creation date and time are displayed. As a result, the operator can confirm the change contents of the reference information after the interpretation report is created.

(Multiple order inspection)
The operator may create one interpretation report with reference to examinations corresponding to a plurality of orders. When there is a change in the inspection of each of the multiple orders, the change is notified. For example, as shown in FIG. 11, the operator creates one interpretation report 100 with reference to the examination T corresponding to the plurality of orders 200. In this case, the related information management unit 13 associates the identification information of each examination of the plurality of orders with the report identification information. As described above, the output unit 14 confirms whether or not each inspection (reference information) is changed, and creates a report list including information indicating whether or not each inspection (reference information) is changed. The display control unit 6 causes the display unit 21 to display a report list including whether or not each examination is changed. Thus, even when a plurality of examinations are associated with one interpretation report, it is possible to notify whether or not each examination has been changed.

(Modification of display mode)
Whether the reference information is changed may be displayed in a display mode other than the report list. For example, as shown in FIG. 12, the output unit 14 creates a matrix-like table based on the examination name and the examination date / time. Furthermore, the output unit 14 includes a mark 151 such as an icon representing an interpretation report corresponding to the examination and the examination date and time, and change information 152 (for example, “changed”) indicating that the reference information is changed in a matrix table. And add. The output unit 14 outputs matrix table data to the display control unit 6. The display control unit 6 causes the display unit 21 to display a matrix table. As a result, a message indicating that the reference information has been changed is displayed in a matrix-like table. Thus, even if the presence / absence of the interpretation report is displayed by a mark such as an icon and the presence / absence of the change of the reference information is displayed in the vicinity of the mark, the same effect as the above-described embodiment can be obtained.

  As shown in FIG. 12, the display control unit 6 may display an interpretation report 160 on the display unit 21, and may display information indicating whether or not reference information has been changed on the display unit 21 together with the interpretation report 160. When the reference information has been changed, the display control unit 6 causes the display unit 21 to display the interpretation report 160 and the change information 161 (for example, “changed”).

  Specifically, the operator inputs report identification information through the input unit 22. The display control unit 6 reads the interpretation report data attached with the input report identification information from the report storage unit 5 and causes the display unit 21 to display the interpretation report data. As described above, the output unit 14 confirms whether or not the reference information associated with the interpretation report has been changed. The output unit 14 outputs information indicating whether the reference information has been changed to the display control unit 6. The display control unit 6 causes the display unit 21 to display an interpretation report and information indicating whether the reference information has been changed. Thus, even if it displays the presence or absence of a change of reference information with an image interpretation report, there can exist the same effect as embodiment mentioned above.

  Further, whether or not the reference information is changed may be displayed on the image viewer. For example, the operator inputs an examination ID using the input unit 22. The entered examination ID is output from the user interface (UI) 20 to the display control unit 6 and the management unit 10. The display control unit 6 reads medical image data in which the input examination ID is attached as image supplementary information from the image storage unit 3 and causes the display unit 21 to display a medical image. For example, as shown in FIG. 13, the display control unit 6 displays the medical image 300 on the display unit 21. If there is an interpretation report in which the reference information is changed among the interpretation reports associated with the examination indicated by the examination ID as reference information, the output unit 14 displays the changed information (for example, “changed”) as a display control unit. 6 is output. The display control unit 6 causes the display unit 21 to display the change information 310 together with the medical image 300.

  For example, the output unit 14 refers to the reference information management table 120 and the related information management table 130 illustrated in FIG. 8 and confirms whether there is a change in the reference information indicated by the examination ID. When there is a change in the reference information, the output unit 14 outputs the change information to the display control unit 6. Further, the output unit 14 refers to the related information management table 130 shown in FIG. 8, identifies an interpretation report in which the reference information has been changed, and displays the report identification information of the interpretation report and the changed contents of the reference information. 6 may be output. For example, as shown in FIG. 13, the display control unit 6 causes the display unit 21 to display a table 320 including report identification information and information change (change contents). Thus, even if the presence or absence of a change in reference information is displayed together with a medical image, the operator can confirm the presence or absence of an interpretation report in which the reference information has been changed.

  Further, information indicating whether or not the reference information is changed may be displayed in a pop-up. For example, the display control unit 6 receives information indicating whether or not the reference information has been changed from the management unit 10, and indicates whether or not the reference information has been changed when displaying a report list or a matrix table on the display unit 21. Information is displayed on the display unit 21 in a pop-up. In this way, the presence or absence of a change may be displayed so as to stand out by the pop-up. In addition, when the medical image storage device 1 is activated, the display control unit 6 may display information indicating whether or not the reference information has been changed on the display unit 21. Further, a speaker may be provided in the medical image storage device 1 so that the speaker emits a sound indicating whether or not the reference information has been changed.

(Notification mode determination unit 15)
Depending on the status of the interpretation report creation (interpretation status), the type of reference information that has been changed, or the content of the change, the notification mode of information (change information) indicating that the reference information has been changed may be changed. Good. The notification mode determination unit 15 determines a notification mode of information (change information) indicating that the reference information has been changed, based on the interpretation report generation status (interpretation status). Further, the notification mode determination unit 15 may determine the notification mode of the change information based on the type of reference information that has been changed. Moreover, the alerting | reporting mode determination part 15 may determine the alerting | reporting mode of change information based on the change content. The notification mode determination unit 15 may determine a notification mode based on all the conditions of the interpretation report creation status, the type of reference information, and the change content. Or the alerting | reporting mode determination part 15 may determine the alerting | reporting mode based on one or two conditions of the condition of preparation of an interpretation report, the kind of reference information, and a change content.

  When the notification mode is determined by the notification mode determination unit 15, the display control unit 6 displays the change information on the display unit 21 in accordance with the determined notification mode. For example, the display control unit 6 displays the reference information on the display unit 21 by including it in the report list or displays the reference information on the display unit 21 in a pop-up according to the state of creating the interpretation report.

  The interpretation report creation status includes a confirmed status and a check status. An interpretation report in a confirmed state is an interpretation report in a state in which the contents of the created interpretation report are confirmed. For example, an interpretation report that has been confirmed by an authorized doctor corresponds to an interpretation report in a confirmed state. An interpretation report in a checked state is an interpretation report that needs to be confirmed by a person other than the creator. For example, an interpretation report created by a resident or the like corresponds to an interpretation report in a check status.

  For example, the report management unit 11 manages the status of the interpretation report creation (interpretation status). That is, the report management unit 11 creates a report management table in which the interpretation report creation date and time, report identification information, and the interpretation report creation status are associated with each other.

  For example, an authorized doctor uses the input unit 22 to give confirmation to a certain interpretation report. Information indicating the confirmed status input from the input unit 22 is output to the management unit 10. The report management unit 11 creates a report management table that associates information indicating the confirmation status (creation status), the interpretation report creation date and time, and the report identification information.

  In addition, a trainee or the like uses the input unit 22 to input information indicating a check status for a certain interpretation report. Information indicating the check status input from the input unit 22 is output to the management unit 10. The report management unit 11 creates a report management table in which information indicating the check status (creation status), the interpretation report creation date and time, and the report identification information are associated with each other.

  As an example, the notification mode determination unit 15 determines the notification mode based on the interpretation report creation status (interpretation status), the type of reference information that has been changed, and the content of the change. FIG. 14 shows a setting example of the notification mode. The setting table 400 is a table in which the interpretation status, the type of reference information that has been changed, the content of the change, and the notification mode are associated with each other. The interpretation status includes a confirmed status and a check status. The types of reference information include inspections and general-purpose files. Changes include image addition and change. As a notification mode, there are a mode in which change information is included in a report list (list) and displayed, and a mode in which change information is displayed in a pop-up.

  As described above, the output unit 14 refers to the reference information management table 120 and the related information management table 130 illustrated in FIG. 8 and determines whether or not there is a change in the reference information associated with the interpretation report that has been requested to be displayed. To check. The output unit 14 outputs the changed reference information and the changed content to the notification mode determination unit 15. The notification mode determination unit 15 refers to the report management table associated with the status of the interpretation report creation (interpretation status), and based on the report identification information of the interpretation report requested for display, the interpretation report requested for display. Identify the status of creation. Then, the notification mode determination unit 15 refers to the setting table 400 illustrated in FIG. 14 and determines the notification mode based on the state of creating the interpretation report, the type of reference information that has been changed, and the content of the change. .

  For example, when the interpretation status of a certain interpretation report is “check”, the notification mode determination unit 15 determines the notification mode as “list display”. When the interpretation status of a certain interpretation report is “determined”, the notification mode determination unit 15 determines the notification mode as “pop-up display”. The confirmed interpretation report is confirmed by an authorized doctor. Therefore, when the reference information associated with the confirmed interpretation report is changed, it is preferable to display the change of the reference information in a conspicuous manner. That is, since the confirmed interpretation report has high importance, the reference information change is displayed in a conspicuous manner. Therefore, when the reference information associated with the confirmed interpretation report is changed, the notification mode determination unit 15 determines the notification mode as “pop-up display”.

  When the change content of the reference information is “image addition”, the notification mode determination unit 15 determines the notification mode as “pop-up display”. Further, when the change content of the reference information is “change of general-purpose file”, the notification mode determination unit 15 determines the notification mode as “list display”. Since the doctor creates an interpretation report with reference to the medical image, it is preferable to display the change of the reference information in a conspicuous manner when the medical image is added. That is, since the addition of an image is highly important, the reference information change is displayed in a conspicuous manner. Therefore, when the change content of the reference information is “image addition”, the notification mode determination unit 15 determines the notification mode as “pop-up display”.

  When the interpretation status of a certain interpretation report is “check”, the type of reference information is “inspection”, and the change content is “add image”, the notification mode determination unit 15 selects the interpretation report. The notification mode may be determined as “list display”. When the interpretation status of a certain interpretation report is “confirmed”, the type of reference information is “inspection”, and the change content is “add image”, the notification mode determination unit 15 selects the interpretation report. The notification mode may be determined as “pop-up display”. Thus, the notification mode determination unit 15 may determine the notification mode based on a plurality of conditions.

  The notification mode determination unit 15 outputs information indicating the notification mode to the display control unit 6. The display control part 6 displays the presence or absence of the change of reference information on the display part 21 according to the alerting | reporting aspect.

  As described above, according to the interpretation status of the interpretation report, the type of the changed reference information, or the content of the change, the presence / absence of the reference information is changed by changing the notification mode. As a result, changes in important reference information are conspicuously displayed, so that the operator can easily recognize changes in important reference information.

  Note that the notification mode determination unit 15 may not be provided in the management unit 10 in the case where the notification mode is not changed according to the state of creation of the interpretation report, the type of reference information, or the content of change.

  Each of the report creation unit 4, the display control unit 6, and the management unit 10 may be configured by a processing device (not shown) such as a CPU, GPU, or ASIC, and a storage device (not shown) such as a ROM, RAM, or HDD. Good. The storage device stores a report creation program for executing the function of the report creation unit 4. The storage device stores a display control program for executing the functions of the display control unit 6. The storage device stores a management program for executing the functions of the management unit 10. The management program includes a report management program for executing the function of the report management unit 11, a reference information management program for executing the function of the reference information management unit 12, and a function of the related information management unit 13. Related information management program, and an output program for executing the function of the output unit 14. When the notification mode determination unit 15 is provided in the management unit 10, the management program includes a notification mode determination program for executing the function of the notification mode determination unit 15. A processing device such as a CPU executes the functions of each unit by executing each program stored in the storage device.

  The report creation unit 4, the report storage unit 5, and the management unit 10 may be included in a device other than the medical image storage device 1, and are connected to the network N independently of the medical image storage device 1. May be. Further, the medical information system according to this embodiment does not include all of the medical image photographing device 40, the medical image observation device 50, the medical image processing device 60, the image inspection device 70, the HIS 80, and the RIS 90. Only some devices may be included. For example, the medical information system may be configured only by the medical image storage device 1, the medical image photographing device 40, and the image inspection device 70.

DESCRIPTION OF SYMBOLS 1 Medical image storage apparatus 2 Transmission / reception part 3 Image storage part 4 Report preparation part 5 Report storage part 6 Display control part 10 Management part 11 Report management part 12 Reference information management part 13 Related information management part 14 Output part 15 Notification aspect determination part 20 User interface (UI)
DESCRIPTION OF SYMBOLS 21 Display part 22 Input part 40 Medical image imaging device 50 Medical image observation apparatus 60 Medical image processing apparatus 70 Imaging apparatus 80 Hospital information system (HIS)
90 Radiation Information System (RIS)

Claims (8)

A report management unit that receives an input of an interpretation report created by referring to the reference information and manages the report with identification information;
Received and managed the reference information with identification information from a device that generates or changes the reference information, and the received reference information was attached with the same identification information as already received reference information A reference information management unit that determines that there has been a change and manages the change information indicating that there has been a change in association with the received reference information;
Associating the report identification information of the interpretation report with the identification information of the reference information referred to when the interpretation report is created, and further associating the change information with them based on association by the reference information management unit Related information management department to manage
When there is a request for an interpretation report, based on the association by the related information management unit , an output unit for confirming whether or not the reference information has been changed for the requested interpretation report;
A medical information system comprising: notifying means for notifying the change when the reference information is changed. The report management unit manages the creation time when the input interpretation report is created,
The reference information management unit receives and manages the reference information with the identification information from a device that generates or changes the reference information, and the received reference information is the same as the reference information already received. Managing the update time when the reference information received or generated is changed when the identification information is attached;
2. The medical information system according to claim 1, wherein the output unit determines that there is a change when the update time is later than the time of creation of the interpretation report, and causes the notification unit to notify the change. . The reference information is a medical image in an examination on a subject,
The notification means receives a medical image display request in a specific examination, and based on the association by the related information management unit, the interpretation report in which the medical image requested to be displayed is associated as the reference information ; The medical information system according to claim 1 or 2, wherein the presence or absence of change information associated with the interpretation report is displayed on a display unit together with the medical image. Storage means for receiving the input of an interpretation report and storing the interpretation report and the reference information referred to when the interpretation report is created in association with each other;
Management means for confirming whether or not the reference information associated with the interpretation report has been changed;
Informing means for notifying the change of the reference information by changing the manner of notifying the change of the reference information according to the state of creation of the interpretation report stored in the storage means;
A medical information system. Storage means for receiving the input of an interpretation report and storing the interpretation report and the reference information referred to when the interpretation report is created in association with each other;
Management means for confirming whether or not the reference information associated with the interpretation report has been changed;
Informing means for notifying the change of the reference information by changing the manner of notifying the change of the reference information according to the type of the reference information stored in the storage means;
A medical information system. Storage means for receiving the input of an interpretation report and storing the interpretation report and the reference information referred to when the interpretation report is created in association with each other;
Management means for confirming whether or not the reference information associated with the interpretation report has been changed;
A mode of notifying the change of the reference information based on two or three of the state of creation of the interpretation report stored in the storage means, the type of the reference information, and the change of the reference information. Informing means for changing and informing the change of the reference information;
A medical information system. The notification means, a mode of the notification, the medical information system according to claim 6 claim 4, characterized in that to determine the selective list or a pop-up display.   The reference information indicates a medical image included in the examination on the subject, an interpretation report created in the past, patient identification information sent from the hospital information system, patient identification information sent from the radiation information system, and the type of medicine. The medical information system according to any one of claims 4 to 7, comprising at least one of examination information including at least information and general-purpose data including at least information indicating a letter of introduction.