JP5709456B2 - Processing apparatus, processing method, medical support system, and program - Google Patents

Description

The present invention includes a processing unit, the processing method, the medical support system, and relates to a program for executing the processing method on a computer.

  In recent years, computerization has progressed in medical institutions such as hospitals, and an increasing number of institutions have introduced electronic medical records. The introduction of an electronic medical record eliminates the need for storing paper media, eliminates the need for physical space, and has an advantage that data can be easily shared and reused. On the other hand, doctors who are not proficient with computers are difficult to operate, have restrictions on input, and have difficulty in putting a little memo or figure.

  In order to solve these problems, conventionally, a handwritten electronic medical record system that detects handwriting data representing temporal changes in the coordinates of the pen tip and creates an electronic medical record by character recognition based on the handwriting data has been proposed (for example, See Patent Document 1 below). However, in Patent Document 1, it is not possible to record a plurality of medical actions in a hospital for a single patient or a medical action by a plurality of medical institutions according to a time series of original medical actions.

  In order to solve such a problem, in Patent Document 2 and Patent Document 3 below, a medical chart in which minute dots are printed on the entire surface of a sheet in advance using an electronic pen capable of tracking handwriting in real time is used. Fill out. This makes it possible to record electronic medical records along the timeline of medical practice.

Japanese Patent Laid-Open No. 9-171528 JP 2001-320571 A JP 2004-25607 A JP 2004-178002 A JP-A-7-93483

  However, the conventional method described above has a problem that a dedicated digital pen and a dedicated sheet are required, and initial investment is required.

  The present invention has been made in view of such problems, and provides a mechanism for correctly restoring the time series of medical practices from a chart of handwritten input to paper without the need for a dedicated digital pen or paper. With the goal.

The processing apparatus according to the present invention includes an extraction unit that extracts a plurality of additional writing portions corresponding to a plurality of medical documents in which medical document data of a patient is printed on a print medium, and temporally before and after the extracted plurality of additional writing portions. An estimation unit configured to estimate a relationship; and an update unit configured to update the medical document data by adding the extracted plurality of additional portions to the medical document data based on the estimated context.
Another aspect of the processing apparatus according to the present invention includes an extraction unit that extracts a plurality of additional portions in a medical document in which patient medical document data is printed on a print medium, and a plurality of medical treatments included in a standardized medical treatment process chart. The medical document data is added to the medical document data by adding the plurality of extracted additional writing parts to the medical document data based on the order of the plurality of medical care items corresponding to the extracted plurality of additional writing parts. Updating means for updating.
In another aspect of the processing apparatus of the present invention, the medical document data of the patient is included in the history of the order of medical treatment of the patient and the extraction means for extracting a plurality of additional portions in the medical document printed on the print medium. A plurality of additional items to be added to the medical document data based on the order of the plurality of additional items corresponding to the plurality of additional items to be extracted. Updating means for updating the document data .
In another aspect of the processing apparatus of the present invention, there are extraction means for extracting a plurality of additional portions in a medical document in which medical document data of a patient is printed on a print medium, and a plurality of medical items included in the clinical path. And updating the medical document data by adding the extracted plurality of additional writing portions to the medical document data based on the order of the plurality of medical treatment items corresponding to the extracted plurality of additional writing portions. Means.
According to another aspect of the processing apparatus of the present invention, there are provided extraction means for extracting a plurality of additional portions in a medical document in which patient medical document data is printed on a print medium, and detection means for detecting a time stamp from the medical document. A plurality of time representations included in the detected time stamp, wherein the extracted plurality of additional write portions are based on the plurality of time representations corresponding to the extracted plurality of additional write portions. Updating means for updating the medical document data by adding to the document data .
The medical support system of the present invention is a medical support system for performing medical support by reflecting information added to a paper medical record printed out from an original electronic medical record in the original electronic medical record, An output unit that outputs a paper chart in which identification information indicating that the original has been printed is embedded; an input unit that reads and inputs the paper chart in which the identification information is embedded; and a paper chart that is input from the input unit And extraction means for extracting the difference between the original of the electronic medical record and extracting the postscript portion added to the paper medical record, the clinical path that is a medical treatment / treatment process table for a certain patient, and medical history information Using the estimation means for estimating the order of the temporal context of the plurality of additional writing portions, and the additional writing portions in the order estimated by the estimating means With the updating means for updating to reflect the original text to.
The present invention also includes a processing method by the above-described processing apparatus and a program for causing a computer to execute the processing method.

  According to the present invention, when the medical information is added to the paper medical record printed out from only the original medical chart data held as electronic data and reflected in the original data again, the added medical information is correct. Can be reflected in the series. That is, it is possible to correctly restore the time series of medical practices from the handwritten input chart for paper without the need for a dedicated digital pen or paper.

It is a block diagram which shows an example of schematic structure of the medical assistance system which concerns on the 1st Embodiment of this invention. It is a block diagram which shows the flow of a process of the medical assistance system which concerns on the 1st Embodiment of this invention. It is a flowchart which shows an example of the flow of a process of the medical assistance system which concerns on the 1st Embodiment of this invention. It is a flowchart which shows the detail of the writer estimation process in step S305 of FIG. It is a schematic diagram which shows the 1st Embodiment of this invention and shows an example of the input paper chart. It is a flowchart which shows the detail of the entry time detection process in FIG.3 S306. It is a schematic diagram which shows the 1st Embodiment of this invention and shows an example of the time stamp detected by step S601 of FIG. FIG. 4 is a schematic diagram illustrating a part of a clinical path that is associated with a character string region in step S308 of FIG. It is a flowchart which shows the detail of the character string area | region and clinical path matching process in step S308 of FIG. It is a flowchart which shows the detail of the process which estimates the context of the character string area | region in step S311 of FIG. FIG. 11 is a schematic diagram for illustrating a medical procedure probability flow obtained in step S1001 of FIG. 10 according to the first embodiment of this invention. It is a schematic diagram of an example which shows the 1st Embodiment of this invention and shows the difference with the original of the paper chart input by this process. It is a schematic diagram which shows the 1st Embodiment of this invention and shows an example of the description content of the electronic medical chart original. It is a schematic diagram which shows the 2nd Embodiment of this invention and shows an example of the description content of a paper chart.

  Hereinafter, embodiments (embodiments) for carrying out the present invention will be described with reference to the drawings.

(First embodiment)
FIG. 1 is a block diagram illustrating an example of a schematic configuration of a medical support system according to the first embodiment of the present invention.
As shown in FIG. 1, the medical support system according to the present embodiment includes a CPU 101, a ROM 102, a RAM 103, a storage device 104, a document input device 105, and a document output device 106.

  The CPU 101 controls the entire medical support system by executing a control program stored in the ROM 102.

  The ROM 102 stores a control program executed by the CPU 101 and various parameters. The control program is executed by the CPU 101 to cause the medical support system to function as various means for executing each process shown in the flowchart described below.

  The RAM 103 stores various images and various data. In addition, the control program stored in the ROM 102 is expanded and executed by the CPU 101.

  The storage device 104 is a device that stores image data and an output electronic file that are processing targets of the present invention.

  The document input device 105 is a device such as a scanner that reads a paper chart document to be processed in the present invention and converts it into electronic data.

  The document output device 106 is an output device for outputting the original electronic medical record of the present invention as a paper medical record.

  Here, the chart electronic information input from the document input device 105 such as a scanner is temporarily stored in the storage device 104 such as a hard disk. Further, the chart electronic information is subjected to an additional information order estimation process by a processing program developed in the RAM 103, and the processing result is stored again in the storage device 104 such as a hard disk.

  In this embodiment, processing corresponding to each step of the flowchart described later is realized by software using a computer (CPU 101), but part or all of the processing is realized by hardware such as an electronic circuit. Anyway.

FIG. 2 is a block diagram showing a processing flow of the medical support system according to the first embodiment of the present invention.
The medical support system first outputs a plurality of paper charts that can be input by handwriting using a manuscript output unit 202 such as a printer with respect to a single original electronic chart. Next, a doctor adds medical information to each paper chart, and the paper medical chart with the medical information added is read again by the document input unit 207 such as a scanner, and the updated contents are reflected in the original electronic data. That is, this medical support system performs medical support by reflecting information added to a paper medical record printed out from the original electronic medical record in the original electronic medical record.

  Specifically, in FIG. 2, an electronic medical record original 201 is printed out from a document output unit 202 such as a printer. In this example, a paper chart a 203 and a paper chart b 205 are printed out. An editable period is set for the paper chart a203 and the paper chart b205 that are output. For example, if the input is not re-input from the document input unit 207 within one hour after the output, the electronic medical chart is displayed even if re-input. It is assumed that the original 201 is not reflected. The output paper chart a203 and paper chart b205 are output by digital watermarking, etc., as version information of the original electronic medical chart 201 of the printing source, identification numbers (identification information) of the paper chart a203 and paper chart b205, editable period, output operation A user ID is embedded.

Next, the doctor's diagnosis information and examination information are added to the paper chart a203 and the paper chart b205, respectively, so that the paper chart a'204 and the paper chart b'206 are obtained.
When the paper chart a ′ 204 and the paper chart b ′ 206 to which medical information is added are read as electronic data by the document input section 207 such as a scanner within the editable period, they are input to the original update section 208. Then, the original update unit 208 estimates the time series of the medical information (additional part) and updates the additional part to the electronic medical record original 201 so that the order is correct.

2, the document output unit 202 includes, for example, the CPU 101 in FIG. 1, a control program stored in the ROM 102, and the document output device 106.
The document input unit 207 includes, for example, the CPU 101 in FIG. 1, a control program stored in the ROM 102, and the document input device 105.
Further, the original update unit 208 is constituted by, for example, a control program stored in the CPU 101 and the ROM 102 of FIG.

FIG. 3 is a flowchart illustrating an example of a process flow of the medical support system according to the first embodiment of the present invention.
Specifically, it is a flowchart showing processing performed when the output paper chart is taken in as electronic data by the document input unit 207 and the changed part is reflected in the original electronic chart. That is, the flowchart of FIG. 3 is processing mainly performed by the original update unit 208 (CPU 101) of FIG.

  In step S301, the CPU 101 determines whether or not the editable period of the re-input paper chart has expired. As described in FIG. 2, an editable period is embedded in the paper chart and set in advance. If the editable period has not ended (if it is within the editable period), a step is performed. The process proceeds to S302. On the other hand, if the editable period has ended, the process proceeds to step S314, and an input error is displayed and the process ends.

  In step S302, the CPU 101 creates a difference image from the original electronic medical record for the optically read paper medical record document image, and extracts a part to be added (additional writing part).

  Subsequently, in step S303, the CPU 101 extracts a plurality of character string areas existing in the difference image obtained in step S302 by area division. Here, with respect to the difference image generation method and the region division method, for example, existing techniques such as “the retouching extraction device, the retouching extraction method, the same program, and the recording medium” of Patent Document 4 can be used.

  Subsequently, in step S304, the CPU 101 sets one of the character string areas acquired by the area division in step S303.

  Subsequently, in step S305, the CPU 101 estimates the entry person of the character string area set in step S304 using stamp recognition, handwriting collation, and the like. Details of this processing will be described later with reference to FIG.

  Subsequently, in step S306, the CPU 101 detects that a time expression is included in the character string area. Details of this processing will be described later with reference to FIG.

  Subsequently, in step S307, the CPU 101 determines whether or not the entry time is detected in step S306. If the entry time is detected as a result of this determination, the process proceeds to step S309, and the entry time is stored in association with the character string area. On the other hand, if the entry time is not detected, the process proceeds to step S308, and the clinical path corresponding to the character string area is linked. Here, the clinical path is a process chart of medical treatment / treatment in a hospital for a certain patient. An example of a clinical path will be described later with reference to FIG. Details of step S308 will be described later with reference to FIG.

When the process of step S308 or S309 ends, the process proceeds to step S310.
In step S310, the CPU 101 determines whether or not processing has been performed on all character string areas acquired by area division in step S303. If it is determined that all character string areas have been processed, the process proceeds to step S311. On the other hand, if there is an unprocessed character string area, the process returns to step S304 to perform processing for the next unprocessed character string area.

  In step S311, the CPU 101 uses the clinical path and the medical record (medical history information) to estimate the order of the temporal context in which each character string area is written. Specifically, the CPU 101 obtains the transition probability between the medical items for each treatment item (each medical item) indicated by the clinical path from the history information of the medical items actually performed in the specified range, and determines the transition probability. Based on this, the order of the temporal context of the postscript portion related to the character string area is estimated. Details of this processing will be described later with reference to FIG.

  Subsequently, in step S312, the CPU 101 rearranges the character string areas based on the order estimated in step S311 and notifies the writer by e-mail for prompting approval.

  Subsequently, in step S313, the CPU 101 determines whether or not approval of all the writers notified in step S312 has been obtained. As a result of this determination, if the approval of all the writers is not obtained, the process returns to step S312. On the other hand, if the approval of all the writers is obtained, the process of this flowchart is terminated.

  FIG. 4 is a flowchart showing details of the writer estimation process in step S305 of FIG.

  When the process of step S305 in FIG. 3 is started, first, in step S401, the CPU 101 performs a process of detecting a stamp indicating the writer. An example of the writer stamp is shown in FIG.

  Subsequently, in step S402, the CPU 101 determines whether or not a writer stamp is detected in step S401. As a result of this determination, if the writer stamp is detected, the process proceeds to step S404, and the CPU 101 performs stamp recognition to extract the writer. Here, the method of extracting the entrant is performed by registering the seal of the entrant stamp of the doctor who may be entered in the paper chart in advance and matching with the entrant stamp on the paper chart. When the writer is extracted, the process proceeds to step S406, and the CPU 101 associates the character string area with the writer name and stores them in the storage device 104 (or RAM 103).

  On the other hand, if the writer stamp is not detected in step S402, the process proceeds to step S403, and the CPU 101 compares the handwriting of the doctor's name registered in advance with the name in the character string area and extracts the writer. . Here, as a handwriting collation method, for example, an existing technique such as “handwritten character recognition method and handwritten character recognition device” of Patent Document 5 can be used.

  Subsequently, in step S405, the CPU 101 determines whether or not the entry person has been detected in step S403. As a result of this determination, if the writer can be detected, the process advances to step S406, and the CPU 101 associates the character string area with the writer name and stores them in the storage device 104 (or RAM 103). On the other hand, if the writer cannot be detected, the process proceeds to step S407 to notify the user who entered the paper chart that the writer is unknown.

  When the process of step S406 is completed or when the process of step S407 is completed, the CPU 101 ends the process of this flowchart.

FIG. 5 is a schematic diagram illustrating an example of an input paper chart according to the first embodiment of this invention.
In the paper chart 500, the character string area 501 is one of the character string areas divided in step S303 in FIG. In addition, the contents to be added to the paper chart 500 include a doctor name to be entered and an entry date, such as an entrant stamp 502, a medical treatment stamp 503 indicating main treatment and medical treatment, and findings and diagnosis. , A handwritten area 504 in which a drug name is entered.

  FIG. 6 is a flowchart showing details of the entry time detection process in step S306 of FIG.

  When the process of step S306 in FIG. 3 is started, in step S601, the CPU 101 performs a process of detecting a time stamp. Here, the time stamp is a stamp including a time expression. An example of this time stamp is shown in FIG.

  Subsequently, in step S602, the CPU 101 determines whether a time stamp has been detected. If a time stamp is detected as a result of the determination, the process advances to step S603, and the CPU 101 recognizes the stamp and extracts a time expression from the stamp.

  Subsequently, in step S604, the CPU 101 associates the detected entry time with the character string area and stores it in the storage device 104 (or RAM 103).

  If it is determined in step S602 that a time stamp has not been detected, or if the process of step S604 is completed, the CPU 101 ends the process of this flowchart.

FIG. 7 is a schematic diagram illustrating an example of the time stamp detected in step S601 in FIG. 6 according to the first embodiment of this invention.
A region 701 in FIG. 7 is obtained by extracting a part of the paper chart 500, and the stamp 702 is an example of a time stamp integrated with the writer stamp. The numerical part of “10:30” in the time stamp can be freely changed by the user. An area 703 is another example in which a part of the paper chart 500 is taken out. A stamp 704 indicating time is present in the vicinity of the stamp 705 indicating medical treatment / treatment.

  FIG. 8 is a schematic diagram showing a first embodiment of the present invention and showing an example of a part of a clinical path associated with a character string area in step S308 of FIG. Here, as described above, the clinical path is a process chart of treatment and examination standardized in the hospital for a patient with a certain symptom.

  The clinical path 800 is created for each patient as in the area 801 and used as a treatment process table. A region 802 indicates a treatment process on July 1, 2010, and a treatment item (medical treatment item) 803 is described. The patient is treated along this clinical path 800.

  FIG. 9 is a flowchart showing details of the character string region and clinical path association process in step S308 of FIG.

  When step S308 in FIG. 3 is started, first, in step S901, the CPU 101 performs processing for detecting a stamp indicating the treatment item 803 in FIG. Further, the medical treatment content stamp 503 of FIG. 5 shows an example of a treatment item stamp indicating “infusion”.

  Subsequently, in step S902, the CPU 101 determines whether or not a treatment item stamp is detected in step S901. If a treatment item stamp is detected as a result of this determination, the process advances to step S904, and the CPU 101 performs stamp recognition to extract a treatment item. Here, as a method for extracting treatment items, an imprint of a treatment item stamp that may be entered in a paper chart is registered in advance, and matching with the treatment item stamp on the paper chart is performed. Subsequently, if a treatment item is extracted, the process advances to step S906, and the CPU 101 associates the treatment item of the clinical path corresponding to the character string area and stores it in the storage device 104 (or RAM 103).

  On the other hand, when the treatment item stamp is not detected in step S902, the process proceeds to step S903, and the CPU 101 collates the handwritten character of the treatment item registered in advance with the character string in the character string area, and treats the treatment item. To extract. Here, as a handwriting collation method, for example, an existing technique such as “handwritten character recognition method and handwritten character recognition device” of Patent Document 5 can be used.

  Subsequently, in step S905, the CPU 101 determines whether or not a treatment item has been detected in step S903. If the treatment item is detected as a result of this determination, the process advances to step S906, and the CPU 101 associates the character string area with the treatment item and stores it in the storage device 104 (or RAM 103).

  When the treatment item cannot be detected in step S905, or when the process of step S906 ends, the CPU 101 ends the process of this flowchart.

  FIG. 10 is a flowchart showing details of the process for estimating the front-rear relationship of the character string region in step S311 of FIG.

  When the process of step S311 in FIG. 3 is started, in step S1001, the CPU 101 performs a process of acquiring a medical treatment order probability flow. Here, the medical treatment order probability flow is a record of the order in which each treatment item of the clinical path is actually performed as a history, and the transition probability from the treatment item to the next treatment item is preserved. . This medical treatment order probability flow will be described later with reference to FIG.

  Subsequently, in step S1002, the CPU 101 sorts the treatment items along the medical treatment order probability flow acquired in step S1001. In the example of FIG. 11 to be described later, the images are sorted in the order of X-ray, electrocardiogram, drip, blood pressure, urinalysis, and blood collection.

  Subsequently, in step S1003, the CPU 101 rearranges the character string regions associated with the treatment items in the order determined in step S1002, and stores this in the storage device 104 (or RAM 103).

  When the process of step S1003 ends, the CPU 101 ends the process of this flowchart.

  FIG. 11 is a schematic diagram for explaining the medical procedure probability flow acquired in step S1001 of FIG. 10 according to the first embodiment of this invention. Here, one medical procedure order probability flow is generated for one treatment process of the clinical path. When a treatment based on a certain clinical path is performed in a hospital, the order in which the treatment items included in the clinical path are actually performed is stored as a history, and the treatment items are determined based on the history. Total transition probabilities are stored and stored throughout the hospital.

The medical treatment order probability flow 1100 has a one-to-one correspondence with the clinical path treatment process described in the treatment item 803 of FIG.
The electrocardiogram (1101) is a treatment item existing in the clinical path of FIG. 8, and the probability 1102 indicates the probability of transition to the corresponding treatment item. In FIG. 11, the probability of first performing an electrocardiogram (1101) measurement is 40% (1102), and the probability of first performing an X-ray (1103) measurement is 60% (1104). Unlike the clinical path of FIG. 1103) It can be seen that there is a high possibility that the measurement has been performed first. Further, the order of the electrocardiogram (1101) measurement and the X-ray (1103) measurement is not so important, and it is understood that the infusion is performed after the electrocardiogram (1101) measurement and the X-ray (1103) measurement are always performed. Similarly, in the transition of probabilities 1105 and 1106, there is a slight possibility that urinalysis was performed after blood pressure measurement.

FIG. 12 is a schematic diagram of an example illustrating the first embodiment of the present invention and showing a difference from the original paper chart input in this processing.
In FIG. 2, the paper chart a ′ 1201 is an example of the paper chart a ′ in which the medical records are added to the paper chart a 203 with respect to the paper chart a 203 and the paper chart b 205 output from the same electronic medical record original 201. The paper chart b ′ 1202 is an example of the paper chart b ′ in which the medical record is added to the paper chart b205.

The paper chart a ′ 1201 and the paper chart b ′ 1202 are reflected in the original electronic medical chart as shown in FIG. 13 by this processing.
FIG. 13 is a schematic diagram illustrating an example of the description content of the original electronic medical record according to the first embodiment of this invention.

  In the electronic medical record original 1300 in FIG. 13, a column 1301 is a column indicating an entry person. A column 1302 is a column indicating the entry time estimated from the temporal order of the output time, the input time, and the character string area of the paper chart. A column 1303 is a column for describing medical information, findings, and the like. In a column 1303, images of a medical treatment item (treatment item) stamp 1304 and handwritten medical treatment information 1305 are pasted.

  In FIG. 2, the output time of the paper chart a203 is 15:15, and the input time of the paper chart a′204 is 15:35. Further, it is presumed that the medical record a′204 is added with the medical information before the paper medical record b′206 according to the medical procedure order probability flow of FIG. Accordingly, the estimated input time of the paper chart a′204 is estimated to be after the output time 15:15 of the paper chart a203 and before the input time 15:30 of the paper chart b′206.

  In FIG. 13, according to the medical procedure order probability flow of FIG. 11, the paper chart a ′ of “entryer = Yamada” and “medical treatment item (treatment item) = infusion” becomes “entryer = Suzuki”, “treatment item (treatment item). ) = Blood Collection ”is written in the original electronic medical chart before the paper chart b ′.

  Here, a difference image from the original paper chart input is pasted, but the recognized text information may be described if character recognition is possible. In addition, each item of the electronic medical record original may be linked to a corresponding paper medical chart image so that it can be browsed.

  In this way, even when different medical information is added to a plurality of paper medical records output from the same electronic medical record original, it can be reflected in the electronic medical original in the correct medical order.

(Second Embodiment)
Next, a second embodiment of the present invention will be described with reference to the drawings.
The first embodiment is an example in which a plurality of paper charts are output from the same original as shown in FIG. 2 and additionally recorded. However, as shown in FIG. 14, a plurality of pieces of medical information are added to one sheet medical chart. This method can be applied even if it is done.

FIG. 14 is a schematic diagram showing an example of the contents of a paper chart, showing the second embodiment of the present invention.
In FIG. 14, medical information is added to a paper chart 1400. The medical record 1400 describes medical information 1401 that has been reflected in the original electronic medical record and newly added medical information 1402, 1403, 1404, and 1405. Here, in particular, the order of medical information 1403, 1404, and 1405 cannot be determined from the layout information.

  Even in such input information, the medical information 1403, 1404, and 1405 are divided by region division in step S303 in FIG. 3 and the context is estimated in step S311 for each of them, so that the medical information follows the correct time series. And reflected in the original electronic medical record.

(Other embodiments)
The present invention can also be realized by executing the following processing. That is, software (program) that realizes the functions of the above-described embodiments is supplied to a system or apparatus via a network or various storage media, and a computer (or CPU, MPU, or the like) of the system or apparatus reads the program. It is a process to be executed.
This program and a computer-readable recording medium storing the program are included in the present invention.

201 Electronic chart original, 202 Document output section, 203 Paper chart a, 204 Paper chart a ', 205 Paper chart b, 206 Paper chart b', 207 Document input section, 208 Original update section

Claims (22)

Extraction means for extracting a plurality of additional portions corresponding to a plurality of medical documents in which medical document data of a patient is printed on a print medium;
Estimating means for estimating the temporal context of the plurality of extracted additional writing parts;
Updating means for updating the medical document data by adding the extracted plurality of additional write portions to the medical document data based on the estimated context;
A processing apparatus comprising:   The processing apparatus according to claim 1, wherein the estimation unit estimates the context based on a standardized medical procedure table.   The processing apparatus according to claim 1, wherein the estimation unit estimates the front-rear relationship based on a history of a medical treatment order of the patient.   The processing apparatus according to claim 1, wherein the estimation unit estimates the front-rear relationship based on a clinical path. Detection means for detecting a time stamp from the plurality of medical documents;
5. The processing apparatus according to claim 1, wherein the estimation unit estimates the context based on the detected time stamp. 6. Determining means for determining whether or not the editable period set in the plurality of medical documents has ended;
Display control means for displaying an error display on the display means when it is determined that the editable period has ended; and
The processing apparatus according to claim 1, further comprising:   The processing apparatus according to claim 1, further comprising notification means for notifying an entrant corresponding to the plurality of medical documents when the context is estimated.   8. The extraction unit according to claim 1, wherein the extraction unit extracts a difference between the electronic data obtained by reading the plurality of medical documents by the manuscript input device and the medical document data as the additional writing part. The processing apparatus according to item 1. Extracting means for extracting a plurality of additional write portions in a medical document in which patient medical document data is printed on a print medium;
A plurality of medical treatment items included in the standardized medical treatment process chart, wherein the plurality of extracted additional writing portions are based on the order of the plurality of medical treatment items corresponding to the extracted plurality of additional writing portions. Updating means for updating the medical document data by adding to the medical document data ;
A processing apparatus comprising: Extracting means for extracting a plurality of additional write portions in a medical document in which patient medical document data is printed on a print medium;
A plurality of medical care items included in the history of the medical care order of the patient, wherein the plurality of extracted additional writing portions are based on the order of the plurality of medical treatment items corresponding to the extracted plurality of additional writing portions. Updating means for updating the medical document data by adding to the medical document data ;
A processing apparatus comprising: Extracting means for extracting a plurality of additional write portions in a medical document in which patient medical document data is printed on a print medium;
A plurality of medical items contained in the clinical pathway, based on the order of the plurality of medical items corresponding to the extracted plurality of additional entry portion, adding the extracted plurality of additional entry portion to the medical document data Updating means for updating the medical document data by
A processing apparatus comprising: Extracting means for extracting a plurality of additional write portions in a medical document in which patient medical document data is printed on a print medium;
Detecting means for detecting a time stamp from the medical document;
A plurality of time expressions included in the detected time stamp, wherein the extracted plurality of additional write portions are represented as the medical document data based on the plurality of time expressions corresponding to the extracted plurality of additional write portions. Updating means for updating the medical document data by adding to
A processing apparatus comprising: A processing method by a processing device,
An extraction step in which the processing device extracts a plurality of additional portions corresponding to a plurality of medical documents in which patient medical document data is printed on a print medium;
An estimation step in which the processing device estimates a temporal context of the extracted plurality of additional write portions; and
An update step in which the processing device updates the medical document data by adding the extracted plurality of additional write portions to the medical document data based on the estimated context.
A processing method characterized by comprising: A processing method by a processing device,
An extraction step in which the processing device extracts a plurality of additional write portions in a medical document in which patient medical document data is printed on a print medium;
The processing device includes a plurality of extracted medical items based on an order of the plurality of medical items that are a plurality of medical items included in the standardized medical treatment process table and correspond to the plurality of extracted additional write portions. An update step of updating the medical document data by adding a postscript portion of the medical document data;
A processing method characterized by comprising: A processing method by a processing device,
An extraction step in which the processing device extracts a plurality of additional write portions in a medical document in which patient medical document data is printed on a print medium;
The processing device is a plurality of medical care items included in a history of the order of medical treatment of the patient, and is extracted based on the order of the plurality of medical care items corresponding to the plurality of extracted additional write portions. An update step of updating the medical document data by adding a plurality of additional write portions to the medical document data;
A processing method characterized by comprising: A processing method by a processing device,
An extraction step in which the processing device extracts a plurality of additional write portions in a medical document in which patient medical document data is printed on a print medium;
The processing device is a plurality of medical items included in a clinical path, and the plurality of extracted additional write portions are based on an order of the plurality of medical items corresponding to the extracted plurality of additional write portions. An update step of updating the medical document data by adding to the medical document data ;
A processing method characterized by comprising: A processing method by a processing device,
An extraction step in which the processing device extracts a plurality of additional write portions in a medical document in which patient medical document data is printed on a print medium;
A detecting step in which the processing device detects a time stamp from the medical document;
The processing device is a plurality of time representations included in the detected time stamp, and the plurality of extracted additional write portions based on the plurality of time representations corresponding to the extracted plurality of additional write portions Updating the medical document data by adding to the medical document data ;
A processing method characterized by comprising:   The program for making a computer perform each step of the processing method of any one of Claim 13 thru | or 17. A medical support system for providing medical support by reflecting information added to a paper medical record printed out from an original electronic medical record on the original electronic medical record,
Output means for outputting a paper medical record in which identification information indicating that the electronic medical record is printed is embedded;
Input means for reading and inputting a paper chart in which the identification information is embedded;
An extraction means for extracting a difference between the paper chart input from the input means and the original electronic chart and extracting a postscript portion added to the paper chart;
Estimating means for estimating the order of temporal context of the plurality of additional writing parts using a clinical path, which is a medical treatment / treatment process table for a patient, and medical history information;
Updating means for updating the postscript portion to reflect the original electronic medical record in the order estimated by the estimating means;
A medical support system characterized by comprising: Notification means for notifying the writer of the order of the temporal context of the postscript part estimated by the estimation means;
An approval means for obtaining approval;
Further comprising
The medical support system according to claim 19, wherein the update unit terminates the update of the original electronic medical record when the approval of the writer is obtained. A setting means for setting an editable period of the paper chart;
The output means outputs a paper chart in which the editable period is embedded,
21. The medical support system according to claim 19 or 20, wherein the updating unit updates only the paper chart input by the input unit within the editable period by reflecting the original electronic chart.   The estimation means obtains a transition probability between medical items for each medical item indicated by the clinical path from a history of the medical items actually performed in a specified range, and the time of the additional portion is based on the transition probability. The medical support system according to any one of claims 19 to 21, wherein the order of the target context is estimated.

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