JP5798336B2 - Medical information system and interpretation report system - Google Patents

Description

  The present invention relates to a medical information system and an interpretation report system that can easily grasp whether or not conditions necessary for obtaining medical fees are satisfied.

  The compensation for medical practice is determined as a score in the medical fee table. Consideration for image diagnosis is also determined in the medical remuneration score table, and points for imaging medical images by medical imaging apparatuses such as X-ray CT apparatuses and MRI apparatuses are determined.

  In the medical fee score table, in addition to the medical fee that can be obtained by taking a medical image, a score that is added by satisfying a predetermined condition is determined. For example, “image diagnosis management addition 2” is defined as the addition score. The facility criteria for this “Image Diagnosis Management Addition 2” are the hospital advocating the radiology department, the appointment of a full-time doctor in charge of image diagnosis within the insurance medical institution, nuclear medicine Interpretation results of at least 80% of diagnoses and computed tomography diagnoses must be reported to the attending physician by the full-day medical examination at the latest by the full-time doctor who is in charge of diagnostic imaging. is there.

  In recent years, an increasing number of medical institutions have built systems for handling medical information such as medical images and interpretation reports. Examples of such a system include a system in which a medical image server that stores a medical image captured by a medical image capturing apparatus and a radiology report server that stores an interpretation report are connected via a network (for example, Patent Document 1). In such a medical institution, when the attending physician requests imaging by the medical imaging apparatus at a terminal on the system, imaging request information is stored in the medical image server or the interpretation report server via the network. When a technician who is in charge of photographing of a photographing request item photographs a medical image, medical image data is stored in the medical image server. Then, the interpretation doctor displays the medical image stored in the medical image server at the interpretation terminal connected to the network, and creates an interpretation report. The created interpretation report is stored in the interpretation report server, and the attending doctor determines a treatment policy based on the interpretation report stored in the interpretation report server.

Japanese Patent No. 4095655

  Of the above-mentioned conditions defined in “Image diagnosis management addition 2”, the interpretation results of at least 80% or more of nuclear medicine diagnosis and computed tomography diagnosis are not confirmed at the latest by a full-time doctor in charge of image diagnosis. Regarding the condition that it is reported to the attending physician by the next medical treatment day after the photographing date, it is required to pay attention in daily hospital work (in this case, medical image diagnosis work). Therefore, it is hoped that the system that handles medical information can easily grasp whether or not the conditions that require attention in daily hospital operations among the conditions for obtaining medical fees are satisfied. It is rare.

  The invention made in order to solve the above-mentioned problem is information about a medical image photographing request item, and stores a storage unit that stores information related to conditions necessary for obtaining a medical fee, and is stored in the storage unit. Based on the received information, a determination unit for determining whether or not the condition is satisfied for the photographing request case, a monitor on which the determination result of the determination unit is displayed, and a display for displaying the determination result of the determination unit on the monitor A medical information system comprising a control unit.

  Another aspect of the invention includes an image interpretation report server and an image interpretation terminal connected to the image interpretation report server via a network. The image interpretation report server is information on a medical image photographing request item. A storage unit for storing information related to conditions necessary for obtaining a medical fee related to an interpretation report for the medical image, and whether or not the condition is satisfied for the imaging request item based on the information stored in the storage unit The interpretation terminal includes a monitor on which the determination result of the determination unit is displayed, and a display control unit that displays the determination result of the determination unit on the monitor. Is an interpretation report system characterized by

  According to the above aspect of the invention, since the determination result of whether or not the condition necessary for obtaining the medical fee is satisfied is displayed, it is easy to determine whether or not the condition necessary for obtaining the medical fee is satisfied. I can grasp it.

It is a block diagram of the medical information system of an embodiment. It is a block diagram of the interpretation terminal in the medical information system shown in FIG. FIG. 2 is a block diagram of an interpretation report server in the medical information system shown in FIG. 1. It is a flowchart which shows the effect | action in the medical information system shown in FIG. It is a flowchart of preparation of the interpretation report in the flowchart of FIG. It is a figure which shows an example of the list | wrist of the imaging | photography request item displayed on the monitor. It is a figure which shows the monitor with which the creation screen of the interpretation report was displayed. It is a flowchart which shows the process for displaying whether the conditions required in order to obtain medical treatment fee are satisfied in the list of imaging request cases. It is a figure which shows an example of the list | wrist of the photography request | requirement item by which the color display was displayed. It is a figure which shows the monitor on which the other example of the creation screen of an interpretation report was displayed.

  Hereinafter, embodiments of the present invention will be described with reference to FIGS. A medical information system 100 shown in FIG. 1 is an example of an embodiment of a medical information system according to the present invention, and includes an interpretation report system according to the present invention.

  In the medical information system 100, an HIS (Hospital Information System) 1 and an RIS (Radiology Information System) server (Server) 2 are connected via a gateway device 3. The RIS server 2 is connected to an interpretation terminal 4, an interpretation report server 5, a medical image server 6, and a modality 7 via a network 8.

  The HIS 1 has a HIS terminal (not shown). The HIS terminal allows the attending physician to input information on an item (imaging request item) to be requested (examination request) for taking a medical image, that is, imaging request information. . For example, the imaging request information includes information such as the patient's name and ID, the name of the requesting doctor, and the imaging modality. Further, at the HIS terminal, the attending physician can make an imaging request and can view an interpretation report created for the medical image.

  The RIS server 2 stores imaging request information input from the HIS 1 via the gateway device 3.

  The imaging request information stored in the RIS server 2 is stored in the interpretation report server 5 and the medical image server 6 via the network 8. The medical image server 6 stores medical image data captured by the modality 7 in association with the imaging request information.

  Incidentally, the RIS server 2, the interpretation report server 5, and the medical image server 6 have a known configuration as a server, and only the interpretation report server 5 will be described later.

  As the modality 7, for example, a nuclear medicine diagnostic apparatus, an X-ray CT (Computed Tomography) apparatus, an MRI (Magnetic Resonance Imaging) apparatus, a general X-ray imaging apparatus, and the like are connected to the network 8.

  The image interpretation terminal 4 is a general-purpose personal computer, and includes an input unit 41, a CPU (Central Processing Unit) 42, a monitor 43, and a communication interface 44, as shown in FIG. Yes. However, in FIG. 2, only main components in the present embodiment are shown, and description of components known as computers is omitted.

  The input unit 41 includes a keyboard and a mouse. The CPU 42 reads out a program stored in a storage unit (not shown) and executes various functions in the interpretation terminal 4. The CPU 42 includes a display control unit 421 as shown in FIG. The display control unit 421 executes a function of displaying an image on the monitor 43 as an example of a function executed by the CPU 42 (display control function). Examples of the display control function by the display control unit 421 include a function of displaying a determination result (color display CG in FIG. 9) by the determination unit 521 described later on the monitor 43. The display control unit 421 is an example of an embodiment of a display control unit in the present invention. The display control function is an example of an embodiment of a display control unit in the present invention.

  For example, when creating an interpretation report, the monitor 43 displays a list L of imaging request items (see FIG. 6), an interpretation report creation screen (see FIG. 7), and the like as will be described later. The monitor 43 is an example of an embodiment of the monitor according to the present invention.

  The image interpretation report server 5 includes a storage unit 51, a CPU 52, and a communication interface (Interface) 53, as shown in FIG. The storage unit 51 is an example of an embodiment of a storage unit in the present invention, and is configured by an HDD (Hard Disk Drive), a semiconductor memory, or the like.

  The storage unit 51 stores information about medical image shooting request cases. The information about the imaging request item includes information related to the interpretation report such as status information of the interpretation report and imaging date information of the medical image, in addition to the imaging request information. The status information of the interpretation report and the date of photographing of the medical image are information related to conditions necessary for obtaining the medical fee, and specifically, the above-mentioned “image” which is the medical fee related to the interpretation report for the medical image. This is information on the facility standard condition of “diagnosis management addition 2”.

  Incidentally, the status information of the interpretation report is, for example, information such as the interpretation report being created, waiting for the interpretation report approval, and the interpretation report being approved (finally confirmed).

  Further, the storage unit 51 stores a list L of photographing request items and an interpretation report. The list L of imaging request items and the interpretation report are stored in association with each other.

  Further, the storage unit 51 stores a program for executing various functions in the interpretation report server 5.

  The CPU 52 reads a program stored in the storage unit 51 and executes various functions in the interpretation report server 5. The CPU 52 has a determination unit 521 as shown in FIG. As an example of the function executed by the CPU 52, the determination unit 521 determines whether or not a condition necessary for obtaining a medical fee for the imaging request item is satisfied based on information stored in the storage unit 51. (Judgment function). The determination unit 521 is an example of an embodiment of the determination unit in the present invention, and the determination function is an example of an embodiment of the determination function in the present invention.

  The condition determined by the determination unit 521 is a condition related to a medical image diagnosis job in the medical fee. In this example, it is a condition necessary for obtaining the addition of the medical fee, and is the condition of the facility standard of “image diagnosis management addition 2” described above. Details will be described later.

  Next, the operation of the medical information system 100 will be described with reference to FIG. First, in step S <b> 1 shown in FIG. 4, imaging request information is output from the HIS 1 to the RIS server 2 via the gateway device 3. The imaging request information is output when the attending physician performs an imaging request operation at the HIS terminal. In step S2, the imaging request information stored in the RIS server 2 is stored in the interpretation report server 5 and the medical image server 6. More specifically, the imaging request information is first stored in the storage unit 51 of the interpretation report server 5 via the network 8. Then, in the interpretation report server 5, a list L of imaging request items is created based on the imaging request information and stored in the storage unit 51.

  Further, the imaging request information stored in the storage unit 51 is output from the communication interface 53 to the medical image server 6 via the network 8 and stored in a storage unit (not shown) of the medical image server 6. Is done. However, the imaging request information may be stored directly from the RIS server 2 to the medical image server 6.

  Next, in step S3, a medical image is taken in the modality 7 for the imaging request case. The obtained medical image data is stored in the medical image server 6 via the network 8. In the medical image server 6, the medical image data is stored in association with the imaging request information. The medical image server 6 also stores information on the shooting date in association with the medical image data. The shooting date information is also stored in the storage unit 51 of the interpretation report server 5.

  Next, in step S4, an interpretation report is created by the interpretation doctor at the interpretation terminal 4. The process of step S4 will be described based on the flowchart of FIG. In step S41 of FIG. 5, when an interpretation report generation start operation is performed by the interpretation doctor at the input unit 41 of the interpretation terminal 4, the display control unit 421 of the interpretation terminal 4 as shown in FIG. A list L of photographing request items is displayed on the monitor 43. The list L is input from the storage unit 51 of the interpretation report server 5 to the interpretation terminal 4 via the communication interface 53 and the network 8.

  In the list L, the information of one photographing request item is displayed per line. As information on the imaging request item, information such as a report status indicating the creation status of the interpretation report, imaging date and time, patient ID, patient name, imaging modality, and the like are displayed.

  As the list L of the shooting request items displayed in step S41, for example, a list narrowed down by shooting dates can be displayed. Therefore, when an imaging date or the like to be displayed is input by the interpretation doctor, a list L of imaging request items on the input imaging date is displayed. In this list L, a display that shows whether or not a condition necessary for obtaining a medical fee is satisfied is displayed. Details will be described later.

  Next, in step S42, the interpretation doctor selects an interpretation report creation target from the list L of the imaging request cases. Specifically, an interpretation doctor creates an interpretation report by moving a cursor (not shown) displayed on the monitor 43 using the mouse of the input unit 41 and instructing a desired imaging request item. Is selected.

  When an interpretation report creation target is selected in step S42, in step S43, as shown in FIG. 7, the display control unit 421 displays an interpretation report creation screen G1 for the selected imaging request item on the monitor. 43.

  In the interpretation report creation screen G1, X11 is a column for displaying patient information such as patient name and ID, and information such as imaging modality and imaging date, X12 is a finding column for entering findings, and X13 is for entering diagnostic details. This is a diagnostic column. X14 is an image field to which an image that is a key in diagnosis is attached, X15 is patient information such as a patient's name, height, weight, blood type, imaging information such as an imaging region, and a past interpretation report. This is the field where the screen is displayed.

  In step S44, the interpretation doctor creates an interpretation report in the interpretation terminal 4. Specifically, first, the display control unit 421 displays the medical image stored in the medical image server 6 on the monitor 43. Next, the interpreting doctor uses the input unit 41 to enter the contents of the observation column X12 and the diagnosis column X13 on the interpretation report creation screen G1, or attach an image that is a key in the diagnosis to the image column X14. Or create an interpretation report. The created interpretation report is stored in the storage unit 51 of the interpretation report server 5.

  Incidentally, the storage unit 51 also appropriately stores status information of the interpretation report.

  Next, in step S45, an operation for finalizing the interpretation report is performed. For example, the interpretation report is finally finalized by performing an approval operation on another interpretation terminal 4 by an interpretation doctor different from the interpretation doctor in charge of creating the interpretation report. When the final confirmation operation of the interpretation report is performed, the status information of the interpretation report is updated to the final confirmation status in the storage unit 51 of the interpretation report server 5.

  Next, in step S46, the final confirmation of the interpretation report is notified to the attending physician. Specifically, when the final confirmation operation is performed in the interpretation terminal 4 (step S45), the final confirmation information of the interpretation report is transmitted from the interpretation report server 5 via the RIS server 2 and the gateway device 3. Are input to the HIS1. Thereby, using the terminal in the HIS 1, the attending physician can access the interpretation report server 5 and view the interpretation report stored in the storage unit 51.

  When the final confirmation of the interpretation report is notified to the attending physician in step S46, the process in step S4 ends, and the process proceeds to step S5. In step S5, the attending physician displays an interpretation report on the HIS1 terminal and confirms the contents. Then, the attending physician decides the treatment policy.

  Next, a process for displaying in step S42 whether or not a condition necessary for obtaining medical fees in the list L is satisfied will be described with reference to FIG. Here, the condition necessary for obtaining medical treatment fee is “the diagnostic criteria for“ addition of diagnostic imaging management 2 ””. Must be reported to the attending physician at the latest by the next medical care day by the full-time doctor who is in charge of "." As a display for determining whether or not this condition is satisfied, a color display CG is displayed in the list L as shown in FIG. This color display CG is a display in which a row of a shooting request item for which an interpretation report is not finalized is colored. Hereinafter, specific processing will be described in detail.

  First, in step S411, the determination unit 521 of the interpretation report server 5 performs the medical treatment one day before the date on which the imaging report is created from the imaging request cases stored in the storage unit 51. An imaging request item that is a day (previous medical day) and whose imaging modality is nuclear medicine diagnosis or computer tomography diagnosis is extracted. The determination unit 521 performs extraction in step S411 with reference to the shooting date information and the shooting modality information stored in the storage unit 51. Let A be the number of shooting request cases extracted in step S411.

  Next, in step S412, the determination unit 521 extracts an image interpretation report whose final interpretation report has not been finalized (one in which the processing in step S45 has not been completed) from the imaging request cases extracted in step S411. To do. The determination unit 521 refers to the status information of the interpretation report stored in the storage unit 51 and performs the extraction in step S412. It is assumed that the number of photographing request cases extracted in step S412 is B.

  Next, in step S413, the determination unit 521 determines the ratio C of the number B of shooting request cases extracted in step S412 to the number A of shooting request cases extracted in step S411, that is, C = B / A. (By the way, C ≦ 1.0) is calculated. In step S414, the determination unit 521 determines whether the ratio C exceeds 0.2, and outputs the determination result to the interpretation terminal via the network 8.

  When the ratio C exceeds 0.2 in step S414 (C> 0.2), the process proceeds to step S415. When the ratio C exceeds 0.2, the condition of “image diagnosis management addition 2” is not satisfied.

  On the other hand, when the ratio C is 0.2 or less in step S414 (C ≦ 0.2), the process proceeds to step S416. When the ratio C is 0.2 or less, the condition of “image diagnosis management addition 2” is satisfied.

  In step S415, the display control unit 421 of the image interpretation terminal 4 to which the determination result of the determination unit 521 has been input is displayed in the list L in the row of the imaging request case for which the image interpretation report has not been finalized. CG is displayed. The color display CG is a display indicating that the condition of the “image diagnosis management addition 2” is not satisfied, and is an example of a display of a determination result by the determination unit 521. The interpretation doctor selects an imaging request item on which the color display CG is displayed and creates an interpretation report.

  When the color display CG is displayed in step S415, the process returns to step S414. Then, after the determination process of step S414 is performed at a predetermined timing, the process proceeds to the process of step S415 or step S416. The predetermined timing may be, for example, every predetermined time set in advance, or may be the timing at which the final interpretation of the interpretation report is performed in step S45 described above.

  On the other hand, in step S416, the display control unit 421 does not display the color display CG, but displays the list L as it is.

  According to the above-described example, when less than 80% of the imaging request cases taken on the previous medical examination day have not been finalized in the interpretation report, the color is displayed on the monitor 43 of the interpretation terminal 4. A display CG is displayed (step S415). Therefore, the number of reports of interpretation results up to the next medical care day is more than 80%, which is a condition that the interpreting physician is required to pay attention to in the daily work out of the facility criteria of “image diagnosis management addition 2”. It is possible to easily grasp whether or not it is satisfied. In addition, the color display CG allows the interpretation doctor to intuitively grasp the imaging request case for which an interpretation report should be created.

  As mentioned above, although this invention was demonstrated by the said embodiment, of course, this invention can be variously implemented in the range which does not change the main point. For example, the display control unit 421 may change the color of the color display CG when a predetermined time before the medical treatment end time comes. For example, the display control unit 421 may display the color display CG in yellow and display it in red when it is two hours before the end of medical examination. Thereby, the image interpretation doctor can recognize that the facility standard of the “image diagnosis management addition 2” is not satisfied even though the medical treatment end time is approaching.

  Incidentally, the timing for changing the color of the color display CG may be set by being input at the interpretation terminal 4 or the like.

  In addition, the display control unit 421 may display a message on the monitor 43 for recognizing that the medical treatment end time is approaching when a predetermined time has passed before the medical treatment end time.

  Further, the determination unit 521 has a ratio E (E) of the number D (D = A−B) of the number of imaging request cases for which the interpretation report is finally finalized with respect to the number A of the imaging request cases taken on the previous medical treatment day. = D / A) may be calculated. Then, the display control unit 421 may display the percentage (%) of the ratio E in the ratio display column X16 of the monitor 43 as shown in FIG.

  The ratio E may be displayed on a screen on which a list L of photographing request items is displayed.

4 Interpretation Terminal 5 Interpretation Report Server 8 Network 43 Monitor 51 Storage Unit 100 Medical Information System 421 Display Control Unit 521 Judgment Unit CG Color Display

Claims (5)

An interpretation report server, and an interpretation terminal connected to the interpretation report server via a network,
The image interpretation report server is a storage unit that stores information related to a medical image photographing request item, and stores information related to conditions necessary for obtaining a medical fee related to an image interpretation report for the medical image, and the storage unit stores the information. And a determination unit that determines whether or not the above-described condition is satisfied for the photographing request case based on the information that has been made,
The image interpretation report system, comprising: a monitor on which the determination result of the determination unit is displayed; and a display control unit that displays the determination result of the determination unit on the monitor. The interpretation report system according to claim 1, wherein the condition necessary for obtaining the medical fee is a condition necessary for obtaining an addition of the medical fee. The interpretation report system according to claim 1, wherein the medical fee is an image diagnosis management addition. The interpretation report system according to any one of claims 1 to 3, wherein the information stored in the storage unit is status information of an interpretation report of a medical image and information on a photographing date of the medical image. An interpretation report system control program comprising an interpretation report server and an interpretation terminal connected to the interpretation report server via a network,
Based on the information about the imaging request item for the medical image, the information about the imaging request item for the medical image, which is necessary for obtaining the medical fee related to the interpretation report for the medical image. To execute a determination function to determine whether or not
A control program for an interpretation report system, wherein the interpretation terminal is caused to execute a display control function for displaying a determination result by the determination function on a monitor.

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