JP5809015B2 - System for medical imaging work capable of registering re-shooting instruction information and re-shooting instruction registration method - Google Patents

Description

  The present invention relates to a radiation information system capable of registering re-shooting instruction information that can cope with a case where re-shooting (re-shooting) occurs due to failed shooting in medical image shooting work in a hospital or clinic.

  With the digitization and filmless of image diagnosis, in medical facilities such as hospitals and clinics, examinations are performed by photographing digital images using a medical image photographing device (modality).

  Usually, in such examination, for example, the modality generates a medical image based on an operation by a medical radiographer, and the generated medical image is subjected to image check (image inspection). The check contents of the generated medical image are, for example, if the medical image is inconvenient to the medical image, and if the medical image is inconvenient by confirming whether the image matches the inspection purpose and can withstand medical treatment Will be corrected or re-taken as appropriate.

Then, the medical image that has been imaged by the technician is transferred to an image data server (PACS, Picture Archiving and Communication System) that stores and manages the medical image. Medical images stored in the PACS are appropriately referred to by medical personnel such as doctors. If necessary, an interpretation report is created by the doctor.
A specific procedure of such a process will be described below based on a system related to medical image photographing work.

  FIG. 1 is a diagram showing an example of the configuration of a conventional inspection information management system S1. As shown in FIG. 1, the examination information management system S1 includes a hospital information system (HIS) 20, a radiation information system (RIS) 30, which are connected to each other via a communication network 10 such as a LAN line so that data communication is possible. A modality 40, an imaging system 50, an image data server (PACS) 60, a reporting system 70, an arbitrary data server (not shown), and an optional other department system (not shown) are configured. Yes.

  Further, of the systems connected to the communication network 10, a system that needs to check an examination image when using the system, for example, a hospital information system 20, a radiation information system 30, an imaging system 50, a PACS 60, a reporting system. A display device 80 for image confirmation is connected to 70 and the like as necessary, and an inspection image can be confirmed.

  Usually, when there is a patient that needs to be examined, the doctor informs the person performing the examination, for example, the information regarding the examination to be performed (order information 100), for example, a medical radiologist, Based on the transmitted information, the patient to be examined and the examination to be performed are identified, and the identified examination is performed using the modality 40 for the identified patient.

  The hospital information system (HIS) 20 is a system for integrated management of hospital information including an order entry system, an electronic medical record system, a medical accounting system, and the like. The hospital information system 20 receives the input of the doctor in charge of the patient, generates the order information 100 including the request contents of the image diagnosis photographing, the patient information, and the like, and transmits the order information 100 via the communication network 10 in the hospital. The information system 30 is notified.

  The radiation information system (RIS) 30 is a system that performs overall management of information in the radiology department by performing medical appointment reservations, management of examination result information related to imaging photography inspection, management of material inventory information, etc. in the radiology department. is there. The radiation information system 30 receives the order information 100 transmitted from the hospital information system 20 and records it in the recording means 31 provided in the radiation information system 30.

  The order information 100 may be transmitted using a paper medium such as an inspection request form, or may be transmitted using a portable storage medium such as an IC card. When the order information 100 is transmitted using a paper medium, the transmitted medical radiographer or the like may record the transmitted order information 100 in the recording unit 31 provided in the radiation information system 30. Further, when the order information 100 is transmitted using a storage medium, the radiation information system 30 or a terminal connected to the radiation information system 30 includes means for reading the contents stored in the storage medium, and the read information is converted into the radiation information. The recording means 31 provided in the system 30 may be recorded. By doing so, the order information 100 is recorded in the radiation information system 30 even when the order information 100 is transmitted using a paper medium or a storage medium.

  The order information 100 includes patient basic information 110 and examination information 120. The former is information about a patient such as a patient name, patient ID, sex, and date of birth, and is a subset of patient information registered in the hospital information system (HIS) 20. The latter examination information 120 is information relating to the contents of the examination registered by the examination requesting doctor in the hospital information system 20. The inspection information 120 further includes basic inspection information 130 indicating inspection reservation date and time, inspection type, and the like, and shot information 140 indicating inspection items, articles used for the items, inspection conditions, and the like.

  On the basis of the recorded order information 100, the medical radiographer performs an image diagnostic imaging work. The radiation information system 30 manages the progress of the inspection by appropriately changing the order status 101 and the shot status 141 according to the progress of the inspection. For example, information such as “not implemented”, “accepted”, “inspection”, “executed”, “actual correction”, “cancel”, and the like are registered in the order status 101, and “not implemented”, “executed”, “ Information such as “miss shot” and “cancel” is registered. When the examination status is changed, the radiation information system 30 notifies the hospital information system 20 of the examination status as appropriate and indicates the status of the examination.

  The order status 101 and the shot status 141 are used not only for representing the progress of the inspection in the normal business flow but also for data consistency between systems. For example, when the examination progresses after the order status 101 is “accepted”, the hospital information system 20 cannot cancel or change the order after that, or the examination “in examination” is performed in a plurality of examination rooms (terminals). Therefore, the hospital information system 20 and the radiation information system 30 are prohibited means (not shown) for prohibiting information changes so that the examination start process cannot be performed or the examination of “result correction” cannot be corrected simultaneously from other terminals. )have.

  For example, when an attempt is made to access the “result modification” inspection from another terminal, the prohibition means allows only the reference of the contents and prevents the modification of the contents of the results. Further, when there is an inspection in which at least one shot status 141 is “not executed”, the order status 101 cannot be changed to “executed”, or if all the shot statuses 141 become “stopped”, the order status 101 For example, “Cancel” is set, and a restriction is also provided between the order status 101 and the shot status 141 as appropriate.

  An example of the order information 100, the patient basic information 110, and the examination basic information 130 is shown in FIG. FIG. 2 shows that the patient basic information 110 is “patient name is patent Taro, patient ID is 1234567, gender is male, date of birth is May 17, 1979”, and examination basic information 130 is “request department: chest surgery, request Doctor name: Hanako Suzuki, scheduled examination date: January 31, 2011, 10:00 am, examination type: X-ray examination, and the shot information 130 indicates that the examination includes the front and side of the chest. It is assumed that the radiation information system 30 is in a state where the order information 100 is notified from the hospital information system 20, that is, a state in which an examination is not performed. At this time, “not implemented” is set in the order status 101. (Fig. 2 (1))

  When the patient comes to the examination room, for example, the receptionist operates the radiation information system 30 to perform reception registration. By this operation, the order status 101 is changed to “accepted”.

When the order of examinations comes, examinations are started, for example, by operating a radiation information system 30 by a medical radiographer. When the inspection is started, the order status 101 is changed to “under inspection”.
Further, the radiation information system 30 transmits the order information 100 to the modality 40 based on the order information 100, and further notifies the hospital information system 20 of the examination execution information of the corresponding examination. For communication between the modality 40 and the radiation information system 30, communication defined in DICOM may be used. DICOM calls a process to be executed as a service class, and information to be transmitted / received by communication is also determined for each service class. In DICOM, the above-described modality 40 obtains examination patient information from the radiation information system 30 in a service class called MWM (Modality Worklist Management). In this MWM, examination number, patient ID, patient name, gender, The date of birth, reserved inspection date and time, etc. are defined as information to be transmitted and received. Therefore, as the contents of the examination patient information acquired from the radiation information system 30 by the modality 40 described above, the contents of information to be transmitted / received in this MWM may be used.

  The modality 40 is given as a medical image photographing device such as an X-ray photographing device, a CT device, an MRI device, or an ultrasonic photographing device. The modality 40 images the affected area of the patient and generates image data (actual image data) of the imaged part. Further, the modality 40 generates incidental information related to the image data based on the order information 100 received from the radiation information system 30 through the MWM connection, and adds the incidental information to the image data.

  Using the monitor connected to the modality console 41 connected to the modality 40, the generated image is visually checked to see if an image that matches the purpose of the inspection is taken. The medical radiographer transmits the image to the imaging system 50 when it is confirmed that there is no problem with the image. In addition, when it is discovered that there is a problem with the image, the medical radiographer performs appropriate redoing and correction of incidental information as appropriate. (Image confirmation 1)

  After performing the examination, the medical radiographer uses the radiation information system 30 to input the contents of the examination performed as examination result information. Further, in response to the operation of a medical radiographer, the radiation information system 30 records the input information in the recording unit 31 and further sets the order status 101 to “completed” to perform the examination completion process. (FIG. 2 (2)) Thereby, examination result information can be managed by the radiation information system 30.

  Examples of information input as inspection result information include the contents of an irradiation record created when an inspection using radiation, which is a part of the shot information 140, and information on an article used for the inspection. The law stipulates that when a medical radiographer irradiates a human body, an irradiation record must be created that includes information such as the name of the person who received the irradiation, the date of irradiation, and the method of irradiation. (Article 28 of the Medical Radiologist Law, Article 16 of the Regulations on Medical Radiologist Law). Information on the article used for the inspection is notified to the hospital information system 20 so that it can be used to calculate the inspection cost charged to the patient. The state of the order information 100 after the inspection is completed is shown in FIG.

  Further, the examination result information may be transmitted from the modality 40 to the radiation information system 30. When the examination end process is performed in the modality 40, information such as the contents of the examination performed by the modality 40 and the date and time of the examination may be transmitted to the radiation information system 30. For the transmission of inspection result information from the modality 40 to the radiation information system 30, a service class called MPPS (Modality Performed Procedure Step) defined in DICOM is often used. In this MPPS, at the end of the inspection, An imaging end time, imaging conditions, and the like are transmitted from the modality 40 to the radiation information system 30. Therefore, as the content of the examination result information transmitted from the above-described modality 40 to the radiation information system 30, the content of information to be transmitted / received in this MPPS may be used.

  In the image inspection system 50, the inspection image (medical photographed image) transmitted from the modality 40 is received and the image inspection is executed. “Image inspection” is to determine whether the photographed inspection image matches the inspection information or whether the inspection image has an image quality suitable for diagnosis. The image inspection is executed by an engineer viewing the display device 80 connected to the image detection system 50. (Image Confirmation 2) Further, the image inspection system 50 transmits the image subjected to the image inspection to the image data server 60.

  The image data server (PACS) 60 is a database system that receives an examination image that has been photographed and examined, and stores and manages the examination image. When the examination image is stored in the PACS 60, the PACS 60 is accessed from a terminal (system) connected to the communication network 10 such as an in-hospital LAN line, and the examination is performed using the display device 80 connected to each system. The inspection image can be referred to.

The reporting system 70 is a system for storing and managing a report created by an interpretation doctor. The interpretation doctor uses the reporting system 70 to enter the interpretation report by referring to the examination image stored in the PACS 60 on the display device 80. At this time, if the interpretation doctor refers to the examination image and determines that the examination image is inconvenient, the medical radiologist re-takes the examination. (Image confirmation 3)
Interpretation reports are not necessarily written for all examinations, but are performed based on a request such as a report entry request that is made at the same time that a doctor who has requested examinations requests examinations.

  After completion of the examination, a medical staff such as a requesting doctor who requested the examination uses the display device 80 connected to the HIS 20 from a system such as the HIS 20 installed in the examination room or the like to report the examination image 70. It is possible to refer to the inspection result of the requested inspection by accessing and reading the interpretation report. At this time, if the requesting doctor refers to the examination image and determines that the examination image is inconvenient, the medical radiographer re-takes the examination. (Image confirmation 4)

  The above is the normal flow. In the image shooting work, shooting may fail and re-shooting (re-shooting) may occur. The timing for making the determination may be at each of the image confirmations 1 to 4 described above.

  Image confirmation 1, that is, a case where an inspection image is confirmed on the modality console 41 during photographing or immediately after photographing, and re-photographing is found. In this case, the examination completion processing is not performed by the modality 40 and the radiation information system 30 and the patient is often in the vicinity of the examination room, and it is easy to take a picture simply by performing a re-taking operation on the modality console 41. Repair can be done. When re-shooting is required at the stage of image confirmation 1, there is no difference from the normal workflow.

  During the image confirmation 2, that is, during the image inspection, the inspection image may be determined to be an inappropriate image. In this case, since both the radiation information system 30 and the modality 40 are in the state of performing the inspection completion process, it is impossible to continue the inspection.

  In order to create a report in the image confirmation 3, that is, the interpretation doctor in the interpretation room, it may be determined as an inappropriate image when referring to the examination image. At this time, as in the image confirmation 2, since the inspection completion processing is performed, it is impossible to continue the inspection.

  When the image confirmation 4, that is, when the attending physician refers to the examination result in the examination room, it may be determined that the examination image is not suitable for diagnosis. At this time, as in the image confirmation 2, since the inspection completion processing is performed, it is impossible to continue the inspection.

When re-photographing occurs at the stage of image confirmation 2 to 4, the following is currently handled as follows.
If a re-photograph is found, inform the medical radiographer about the reason for the re-capture, verbally or with a memo, and instruct it to re-shoot. If there is a defective image stored in the image inspection system 50 or PACS 60, the image is deleted. Further, the medical radiographer receives the contents of the re-imaging instruction, and the patient must enter the examination room for re-imaging and perform the re-examination using the radiation information system 30 immediately before starting the re-examination examination. The order information 100 of the inspection order is corrected, and re-imaging is performed.

  Of the orders including the shot information 140 of “chest front” and “chest side”, the case where the “chest front” photo is defective and retaken will be described as an example. The order status 101 of the examination that is “performed” stored in the radiation information system 30 that is in the state of examination completion is changed to “correct results” on the radiation information system 30 by an operation of the technician in charge of re-imaging. The shot status 141 of the “front of chest” of the existing “completed” is added to the “miss shot (indicating that imaging has failed)” and the shot information 140 of the front of the chest of “not performed” is added. Further, the added inspection (shot) is performed again. If necessary, the MWM connection with the modality 40 is performed, and the patient basic information 110 and the examination information 120 are notified from the radiation information system 30. From this state, an inspection (re-imaging) is further performed, and finally the order status 101 and the shot status 141 of the added “front of chest” are set to “performed”. However, information relating to miss shots remains without being deleted. (Fig. 2 (3))

  The reason why the failed chest front image is treated as a miss shot without deleting the shot information 140 at that time is because there is a request to manage the radiation irradiation condition according to the above-mentioned law.

  It is necessary to recall the patient for re-taking, but when the patient comes home, it may be reexamined at a later date. In this case, the above process is performed when the patient actually visits the hospital again, and the contents of the reason for re-taking are recorded until the re-taking is completed by taking notes or the like.

  That is, when the patient visits the examination room again and performs re-imaging with the existing system, the order status 101 is changed to the “corrected result” status immediately before the re-imaging examination is started, that is, after the patient comes to the examination room. The shot information 140 of the examination to be retaken is added manually with reference to the memos and the like. Furthermore, when shooting is completed, an operation is required in which the status of the added shot is set to “executed”, the used article / inspection condition is registered, and the order information 100 is saved as “executed”.

  However, the “actual correction” status is originally used for correction when the inspection result information is registered by mistake, and is set to prevent access to the inspection result information from other devices or systems. Status. It is set only during inspection information correction registration. When the inspection information correction registration is completed and the information is saved, the status returns to the original “performed” status. In other words, the performance correction status is a status that can be temporarily shifted to after “executed”.

  The existing system assumes that the inspection is completely completed once the order status 101 is “performed”. That is, the inspection is not performed again. However, retesting may occur in actual medical practice. At that time, since the only means for editing the contents of the order information 100 is to use the “actual correction” status in the existing technology, the article used or the inspection conditions after the completion of the inspection is mistakenly registered. The re-shooting workflow is covered by using the order status 101 of “actual result correction” used in FIG.

JP 2010-194086 A JP 2002-159383 A

  As described above, despite the fact that re-imaging may occur, the system S1 related to the current medical image photographing operation has the following problems.

(1) The workflow is complicated By correcting the inspection results of “Performed”, that is, the failed shot is changed to “Miss Shot”, and the same shot information 120 is added as “Unperformed” shot, and MWM connection to the modality 40 The shot information 120 to be selected is selected, the MWM connection is performed, and the modality 40 receives the patient basic information 110, the examination information 120, and the like, and performs a re-examination examination. When imaging is finished, MPPS connection or manual input is used to input the inspection article, inspection conditions, etc. and register it as inspected, thereby registering the information in the radiation information system 30 and transmitting the information to the hospital information system 20. This is a complicated operation and causes mistakes.

(2) Re-shooting instruction information cannot be registered.
Since there is no means to register the contents of re-shooting, information such as which shot is judged to be re-taken and why re-shooting must be done is usually communicated by oral transmission or memo, so lack of communication・ Make mistakes easily.

(3) The order information 100 can be changed only by the radiation information system 30. When re-imaging is discovered after a time has passed since the completion of the inspection, the re-imaging discovery person is installed at a location away from the radiation information system 30. In many cases, the examination image is referred to by using the imaging system 50 or the hospital information system 20 and the like, and the radiation information system 30 is set at a timing when the order information 100 is to be changed (registration of re-examination instruction information). Although it is conceivable that the order is not used, the order change can be performed only at the terminal on which the radiation information system 30 operates, which is troublesome.

(4) It is not possible to determine whether or not it is the order of re-imaging on the radiation information system 30.
“Actual correction” status originally means that the actual contents of the “performed” order stored in the radiation information system 30 is being changed, and the used articles and inspection conditions that have been registered by mistake. It means that it is in the middle of correcting. In other words, the “actual result correction” status is set only during the correction operation, and when the correction is completed, the status returns to the “photographed” status. Furthermore, since there is no status indicating the re-shooting state, the inspection that must be re-taken is displayed as the “performed” status. Therefore, the radiation information system 30 that manages the examination progress cannot determine that re-imaging is necessary. The re-shoot should be displayed as a test that is incomplete.

In order to solve the above problems, the present invention provides:
(1) a medical imaging apparatus (modality) and a radiation information system (RIS);
When the RIS performs an inspection using the modality, a recording unit that records order information that is information relating to the inspection, and a change that is input from other than the RIS after the order information recorded in the recording unit is set Has prohibition means to prohibit
Further, the RIS receives the inspection start signal and notifies the modality of the information,
The modality is a system related to medical image photographing work in which medical image photographing work is performed based on the notified information.
The system related to the medical image photographing business further includes a re-imaging instruction information registration unit,
The RIS further includes a recapturing instruction information receiving means and a recapturing instruction information storage means,
Re-shooting instruction information is transmitted from the re-shooting instruction information registration means to the RIS,
The re-shooting instruction information is received by the RIS re-shooting instruction information receiving means;
The re-shooting instruction information storage means cancels the prohibition of change of the prohibiting means, and records the received re-shooting instruction information in the recording means,
If it is determined that the examination image taken with the modality is not suitable for diagnosis and it is necessary to take another picture, re-examination instruction information can be transmitted from a device other than the RIS, and the re-examination must be performed. It is possible to know the existence of a test that should not be performed.

Furthermore, the present invention relates to the above (1),
(2) The order information includes an order status for identifying a process of inspection,
The order status includes at least a status indicating that the inspection is in progress (status during inspection), a status indicating that the inspection has been completed (completed status), and a status indicating that the retest is necessary (re-shooting status). Have
In response to the input of the inspection start signal in the RIS, the order status is being inspected,
In this state, upon receipt of an inspection completion signal in the RIS, the order status is changed to completed,
From this state, by receiving the recapturing instruction information in the recapturing instruction information receiving means in the RIS, the order status is changed to recapturing,
From this state, upon receiving the input of the inspection start signal again in the RIS, the order status becomes inspecting,
In this state, an order status is completed upon receipt of a second inspection completion signal in the RIS.

Furthermore, the present invention provides the above (1) or (2),
(3) The order information includes inspection basic information and at least one shot information indicating a detailed item of inspection,
The order status is included in the basic examination information,
Each shot information has a shot status,
Further, the re-shooting instruction information storage means sets the shot status corresponding to the inspection detail item to be re-taken and re-taken as “miss shot” and sets new unexecuted shot information. To do.

Furthermore, the present invention provides the above (2) or (3),
(4) The reshooting instruction information registration unit displays a reshooting instruction information input screen which is a graphic user interface (GUI) on a display device connected thereto,
Search for order information registered in the RIS using a part of the order information input from the re-shooting instruction information input screen as a key;
If the order status of the matched order information that matches the search condition is “performed”, the order information is displayed on the re-shooting instruction information input screen using the display device,
In other cases, a warning that re-shooting instruction information cannot be registered is displayed for the relevant examination.

Furthermore, the present invention provides any of the above (1) to (4),
(5) The re-shooting instruction information registration means includes:
The user ID / password or only the user ID is input to the input screen provided on the display device connected to the re-shooting instruction information registration unit, or the function provided in the re-shooting instruction information registration unit is used. And sending the re-shooting instruction information to the RIS,
Only the limited user can register the re-shooting instruction information by using the confirmation means provided in the RIS.

Furthermore, the present invention provides any of the above (1) to (4),
(6) The re-shooting instruction information registration means includes:
When the reshooting instruction information registration unit is activated, by using the device ID confirmation unit, or by receiving the terminal code of the terminal provided in the reshooting instruction information registration unit,
The re-imaging instruction information can be registered only from a specific apparatus by using the confirmation means provided in the RIS.

Furthermore, the present invention provides any of the above (1) to (4),
(7) The re-shooting instruction information registration means includes:
At least one of a reason for re-taking, a handing-over matter, an image not suitable for inspection (schema image), a re-shooting instruction information registrant, and a re-taking instruction information registration terminal name can be transmitted to the RIS together with the re-taking instruction information It is characterized by that.

Furthermore, the present invention provides any of the above (1) to (3),
(8) The recapturing instruction information registration means displays a recapturing instruction information input screen which is a graphic user interface (GUI) using a display device connected thereto,
The re-shooting instruction information input on the re-shooting instruction information input screen is transmitted to the RIS.

Furthermore, the present invention provides any of the above (1) to (8),
(9) The system related to the medical imaging photographing business is further at least one component of a hospital information system (HIS), a radiation information system, an imaging system, an image server (PACS), a reporting system, a data server, and another department system Have
The re-imaging instruction information registering means is provided in at least one of the at least one component, so that the re-imaging instruction information is output from a component other than the RIS in the system related to the medical image photographing business. Is possible.

On the other hand, the present invention
(10) Medical imaging device (modality);
Radiation information system (RIS), and system or apparatus comprising at least one of hospital information system (HIS), imaging system, image server (PACS), reporting system, data server, and other department system (other system or apparatus) Group),
When the RIS performs an inspection using the modality, a recording unit that records order information that is information relating to the inspection, and a change that is input from other than the RIS after the order information recorded in the recording unit is set Has prohibition means to prohibit
Further, the RIS receives the inspection start signal and notifies the modality of the information,
The modality is a system related to medical image photographing work in which medical image photographing work is performed based on the notified information.
At least one of the other systems or device groups has re-shooting instruction information registration means;
The RIS further includes a recapturing instruction information receiving means and a recapturing instruction information storage means,
Re-shooting instruction information is transmitted from the re-shooting instruction information registration means to the RIS,
The re-shooting instruction information is received by the RIS re-shooting instruction information receiving means;
The recapturing instruction information storage means cancels the prohibition of changing the prohibiting means, and records the recapturing instruction information received in the recording means,
When it is determined that the examination image photographed with the modality is not suitable for diagnosis and it is necessary to take another photograph, it is possible to transmit the photographing instruction information from the other system or apparatus, and the re-examination is not performed. It is possible to know the existence of tests that should not be performed.

In addition, the present invention
(11) a medical image photographing apparatus (modality) for performing medical image photographing work;
A radiation information system (RIS) capable of recording examination orders;
A display device for confirming an image photographed by the modality;
One record of the examination order includes basic patient information that is a part of patient information to be examined,
Basic inspection information including the key order number and order status,
And a method of operating RIS in a system related to medical imaging work having at least one shot number and shot information capable of recording a shot status,
The method
Receiving a re-shooting request signal transmitted from outside the RIS;
Upon receiving the order number,
Search for an inspection order using the order number as a key, display a record of the inspection order corresponding to the order number on the re-shooting instruction information input screen in the display device, request input of the shot number,
Receive the shot number of the inspection that needs to be retaken,
Reorder the order status of the corresponding order number
Set new shot information with the shot status of the input shot number as a miss shot and the shot status as unexecuted,
The display device displays that the re-shooting instruction information has been registered.

In view of the current situation in which re-imaging occurs in a system in which medical image photographing is performed,
(1) Simplify the workflow when re-shooting occurs,
(2) Smooth communication between photographers,
It has a remarkable effect.
further,
(3) By having a re-shooting instruction information registration means and receiving a re-shooting request signal transmitted from the outside of the RIS, re-shooting instruction information can be registered from anywhere,
(4) When a re-shooting status is provided in the order status, the technician in charge can be shown that the examination is a re-taking,
(5) When setting the shot status to “miss shot” and setting new shot information in which the shot status is not executed, the inspection record at the time of re-taking is facilitated,
Also,
(6) When the re-imaging instruction information registering means is provided in any system constituting the system in which the medical image is taken, and it is determined that the examination image is not suitable for diagnosis and needs to be re-taken , It is possible to register re-shooting instruction information immediately,
(7) In particular, when the re-shooting instruction information registration means is provided in a device other than the RIS, re-shooting instruction information can be registered from a device other than the RIS.
It has a remarkable effect.

It is drawing which shows the structure of the system in connection with the conventional medical image imaging business. It is drawing which shows the change of 1 record of the order information 100 by the system of FIG. It is drawing which shows one form of a structure of the system in connection with the medical image imaging business by this invention. 6 is a diagram showing an example of a configuration of a system related to a medical image photographing job when a re-imaging instruction information registration unit 150 according to the present invention is provided in a “component”. It is drawing which shows the example of the change of 1 record of the order information 100 by the system of FIG. It is drawing which shows the example of a display of a reshooting instruction information input screen. It is a flowchart which shows the operation example of the radiation information system by this invention.

Communication network such as LAN line 10
Hospital Information System (HIS) 20
Radiation Information System (RIS) 30
Recording means in RIS 31
Modality 40
Modality console 41
Image inspection system 50
Image data server (PACS) 60
Reporting system 70
Any data server (not shown)
Optional other department system (not shown)
Display device 80
Order information 100
Order status 101
Basic patient information 110
Inspection information 120
Basic examination information 130
Shot information 140
Shot status 141
Re-shooting instruction information registration means 150
Re-shooting instruction information input screen 151
Re-shooting instruction information receiving means 152
Re-shooting instruction information storage means 153

Next, the configuration of a system related to medical image photographing work according to the present invention will be described.
FIG. 3 is a diagram showing an example of the system configuration of the system S2 related to medical image photographing work according to the present invention. As in the system of FIG. 1, the hospital information system (HIS) 20, the radiation information system (RIS) 30, the modality 40, the detection are connected to each other via a communication network 10 such as a LAN line so that data communication is possible. An image system 50, an image data server (PACS) 60, a reporting system 70, an arbitrary data server (not shown), and an optional other department system (not shown) are configured. Furthermore, a display device 80 is connected to a system that needs to refer to an inspection image, as in the system of FIG.

However, each device or system of the present invention is different from that of FIG. 1 in the following points.
(1) The system S2 related to the medical image photographing business is provided with a re-imaging instruction information registration unit 150. Although described as an independent device in FIG. 3, the re-imaging instruction information registering means 150 is a device or system in a system related to a medical imaging operation as shown in FIG. Systems or devices connected to a communication network 10 such as a LAN line, such as a hospital information system 20, a radiation information system 30, an imaging system 50, a PACS 60, a reporting system 70, etc. It is preferred that at least one of the devices or systems is referred to as a “component”. In particular, it is convenient to provide the apparatus in a device other than the radiation information system 30. When the re-shooting instruction information registration means is provided in the “component”, a re-shooting instruction information input screen 151 that is a graphic user interface (GUI) is displayed on the display device 80 provided in the “component”. The re-imaging instruction information displayed on the re-imaging instruction information input screen is transmitted to the radiation information system 30. If the reshooting instruction information registration unit 150 is provided as an independent device, the reshooting instruction information input screen 151 can be displayed by connecting the display device 80 to the unit.
(2) The radiation information system 30 includes a re-imaging instruction information receiving unit 152 that receives information related to re-imaging, and a re-imaging instruction information storage unit 153 that is a storage unit. The reshooting instruction information transmitted from the reshooting instruction information registration unit 150 is registered in the recording unit 31 by the reshooting instruction information storage unit 153, and the order status 101 of the registered order is “retaken”. State. As a result, regarding the instruction to change the examination that is in the “executed” status to the “re-photographing” status, the prohibition means (not shown) for prohibiting the change of the order information 100 is canceled and can be changed.

(Details of processing)
Also in the system shown in FIGS. 3 and 4, the change of one record of the order information 100 from the new inspection (not performed) to the end of inspection (completed) is the same as the process in the prior art. The record in FIG. 5 (1) is in the inspection end stage, which is exactly the same as FIG. 2 (2). However, the handling of re-shooting after that is different. The following procedure will be described by taking as an example a case where the chest front photograph is found to be defective.

1. Input of re-shooting instruction information The re-shooting instruction information registration unit 150 is activated. (Hereinafter, in consideration of the case where the recapturing instruction information registration unit 150 is mounted on the “component”, the “component” on which the recapturing instruction information registration unit is mounted and activated is referred to as a “transmission source”. When the re-shooting instruction information registration unit 150 is activated, a re-shooting instruction information input screen 151 is displayed on the display device 80 of the transmission source.

  At this time, the user ID and password are input using an ID / password input screen (not shown) or the like, and an arbitrary confirmation means (not shown) of the re-shooting instruction information registration means 150 is used, which is limited. It may be constructed so that only the user can execute the subsequent steps, that is, the re-shooting instruction information. At this time, the identification of the user may be constructed so as to use the user ID and the password, or may be constructed so that the determination can be made using only the user ID and the process can proceed to the next step.

  In this way, it is possible to identify a user who intends to perform reshooting instruction information, determine its legitimacy, and register that user as a reshooting instruction information registrant. It is possible to register the photographing instruction information, clarify the registrant of the re-taking instruction information, and enhance the security of the system.

  Further, when the reshooting instruction information registration unit 150 is activated alternatively or in combination, the reshooting instruction information registration unit 150 is provided with an arbitrary device ID confirmation unit (not shown), so that a specific It is also possible to execute the re-shooting instruction information only from the apparatus. Further, it may be possible to determine whether re-shooting instruction information can be registered by receiving the input of the terminal code of the transmission source terminal.

  In this way, it is possible to accept reshooting instruction information only from terminals that are allowed to reshoot, and by limiting the terminals that can register instructions, it is possible to further enhance system security It becomes.

  Information for identifying an examination, that is, a part of the order information 100, for example, an order number, is input on the re-examination instruction information input screen 151, and the examination order registered in the radiation information system 30 is searched using this information as a key. To do. If the order status 101 of the order that matches the search condition and further matches is “performed”, it is displayed on the re-shooting instruction information input screen related to the order information 100 on the display device 80 of the transmission source. Displays a warning that the re-shooting instruction information cannot be input to the corresponding examination.

  At this time, the information for identifying the examination used for the search can be notified to the radiation information system 30 using the examination identification information transmission function (not shown) of the transmission source.

  By doing so, it is possible to automatically display the re-examination instruction information input screen 151 for the inspection without the re-examination instruction information registrant inputting the inspection identification information, and labor saving of input is required. And input errors can be prevented.

  In the display device 80 of the transmission source, the reshooting instruction information input screen 151 related to the order information 100 is displayed on the display apparatus 80. With reference to this, the reshooting instruction information input person inputs reshooting instruction information. FIG. 6 shows a display example of the reshooting instruction information input screen 151. In the case of this example, the check box corresponding to the chest front examination to be re-examined is checked and the save button is clicked, so that the re-examination instruction information is transmitted to the radiation information system 30.

  At this time, if necessary, it is possible to input a comment such as a reason for re-taking or a matter to be handed over, a re-shooting instruction information registrant, a re-taking instruction information registration terminal name, etc. Convenient. At this time, an examination image determined to be unsuitable for diagnosis is added as a schema image, a mark such as a mark is marked at a position determined to be unsuitable, and the information can be transmitted to the radiation information system 30 together. Convenient.

  By doing this, it is possible to accurately communicate the reason for the re-shooting and the matters to be handed over to the technician in charge of the re-scanning inspection, further clarify the registrant of the re-shooting instruction information, and strengthen the system security. Become.

  Note that a system may be constructed so that reshooting instruction information can be input without using the reshooting instruction information input screen 151. In that case, a re-examination instruction information registration means (not shown) as a transmission source specifies and registers an examination to be re-examined, that is, a chest front examination. The registered information is transmitted to the radiation information system 30, and the radiation information system 30 receives and records the information using the reimaging instruction information receiving unit 152 and the reimaging instruction information storage unit 153. At this time, if necessary, it is possible to input a comment such as a reason for re-taking or a handoff item, a schema, a re-shooting instruction information registrant, a re-shooting instruction information registration terminal name, etc. This is convenient.

  By doing so, it is possible to specify the examination to be re-examined and register the re-imaging instruction information in the radiation information system 30 without using the re-imaging instruction information input screen 151.

2. Registration of Reimaging Instruction Information When the reimaging instruction information receiving unit 152 of the radiation information system 30 receives the reimaging instruction information, the instruction contents received by the reimaging instruction information storage unit 153 are stored. The stored result is shown in FIG. The order status 101 of the record is set to the “re-taken” state, the chest front examination in the shot information 140 sets the shot status 141 as a miss shot, and a new unexecuted chest front examination (shot number 003) item is set. Is done. In the saved contents, in addition to comments and schemas entered on the reshooting instruction information input screen, such as reasons for reshooting and matters to be sent, reshooting instruction information was entered to clarify who issued the reshooting instruction and when. It is also possible to include a user name, a re-shooting registration date, a transmission source device ID, and the like. In the figure, Jiro Sakuren is recorded as the re-shooting instruction information registrant, 16:00 on January 31, 2011 is recorded as the re-shooting registration date and time, and PC01 is further recorded as the transmission source apparatus ID.

  When the order status is changed to re-examination, the re-examination order can be confirmed on the examination list screen etc. with the existing function of the radiation information system 30 and the order status 101 is changed to another system such as the hospital information system 20 as appropriate. Can be notified.

3. Re-examination inspection start After confirming the re-examination instruction information registered by the medical radiographer, the radiological information system 20 is operated to select the re-imaging order and perform the inspection start process, thereby starting the re-examination inspection. By performing the inspection start process, the order status 101 of the corresponding inspection is changed to “under inspection” ((3) in FIG. 5). Thereafter, the inspection flow is the same as in the normal state.

4). Inspection completion After performing the inspection using the modality 40, the use of the inspection and the inspection conditions are registered in the radiation information system 30, and the inspection result information is transmitted to the hospital information system 20, thereby informing the end of the inspection. At the same time, accounting can be made. This is the same as a normal inspection that is not a re-shoot.

An example of the registration operation at the time of re-imaging of the radiation information system 30 of the present invention is shown below. FIG. 7 is a flowchart of the process. Among these, S303, S305, S307, S309, S323, S329, and S399 are optional steps that can be omitted as necessary.
(1) An activation instruction for the re-shooting instruction information registration unit 150 is received from the transmission source system. (S301) The transmission source is a system capable of confirming the inspection image, for example, HIS20, RIS30, imaging system 50, PACS60, reporting system 70, etc., which are provided with re-imaging instruction information registration means 150. Shall be kept.
(2) A transmission source terminal code is input from the transmission source system or device or a notification from the transmission source function is received (S303), and it is determined whether or not the transmission source is a terminal capable of re-shooting registration (S305). If the transmission source is a terminal that cannot be registered again, the process jumps to step (16) (S399).
(3) Input of the user ID and password of the user operating the transmission source, or notification from the function of the transmission source. (S307)
(4) Further, the legitimacy of the user is determined based on the user ID and password (S309). If it is a valid user, the process jumps to the next step, and otherwise jumps to step (16).
(5) Requests the sender to input inspection key information such as an order number or receives a notification from the input or the function of the sender (S311)
(6) Search for an inspection order using inspection key information such as the entered order number. (S313)
(7) It is determined whether the examination order is registered in the radiation information system 30 (S315). If it exists, go to the next step, otherwise go to step (16).
(8) It is determined whether the order status 101 of the corresponding inspection order is “performed” status (S317). If it is “performed”, the process jumps to the next step, and if not, the process jumps to step (16).
(9) The corresponding examination order information 100 is transmitted to the transmission source, a re-shooting instruction information input screen is displayed to the transmission source, and a shot input is requested using a shot designation check box or the like. (S319)
(10) Receives an input of a shot designation check box for an examination that needs to be re-taken, a re-shooting instruction information comment, a re-shooting registrant, a transmission source apparatus ID, a key image, and the like. (S321)
(11) While the information is being input, it is determined whether the inspection order information 100 has been modified by another function or system (S323). If it has not been corrected, the process jumps to the next step, and if it has been corrected, the process jumps to step (16).
(12) The order status 101 of the corresponding examination is set to the “re-photograph” state (S325).
(13) A new shot item is set in which the shot status 141 of the input shot is set to “miss shot” and the shot status 141 is set to the “unexecuted” state. (S327) At this time, the target records in the radiation information system 30 are as described in FIG.
(14) If necessary, the re-shooting registrant name, the transmission source apparatus ID, and the re-shooting instruction information registration date input in S321 are registered (S329).
(15) On the screen of the transmission source terminal, a screen indicating that the content of the re-shooting instruction information has been registered is displayed (S331), and the process ends.
(16) A re-imaging request rejection signal is transmitted to the transmission source terminal (S399). A screen (not shown) indicating that registration is not possible is displayed on the screen of the transmission source terminal, and the processing is completed.

  According to the present invention, when an examination that requires re-imaging is found, it is possible to register in the radiation information system 30 that re-imaging is necessary for the examination. In other words, it becomes possible for the inspecting engineer to confirm that the reshooting has been registered along with the inspection. Furthermore, the radiation information system 30 according to the present invention receives and registers the re-imaging instruction, so that the inspecting engineer can know that re-imaging is registered and re-examination must be performed. . In addition, the existing function of the radiation information system 30 can notify that another imaging such as the hospital information system 20 has been registered for the relevant examination.

  It should be noted that the order status 101 is “Not implemented”, “Received”, “Inspecting”, “Performed”, “Temporary save”, “Actual correction”, “Retake”, “Not performed”, “Performed” The shot statuses “miss shot” and “stop” are used, but the names of the statuses are not limited to these, and different names can be used as appropriate.

  In order to operate various apparatuses and systems in order to realize the functions of the above-described embodiments, program codes of software for realizing the functions of the above-described embodiments are supplied to the computers in the respective apparatuses or systems. What was implemented by operating said various apparatuses and systems according to the program stored in the said computer is also contained under the category of this invention.

  In this case, the program code of the software itself realizes the functions of the above-described embodiments, and the program code itself and means for supplying the program code to the computer, for example, the program code are stored. The recorded medium constitutes the present invention. As a recording medium for storing the program code, for example, a flexible disk, a hard disk, an optical disk, a magneto-optical disk, a CD-ROM, a magnetic tape, a nonvolatile memory card, a ROM, or the like can be used.

  When the present invention is applied to the recording medium, the recording medium stores program codes corresponding to the flowcharts described above.

  The embodiments of the present invention have been described above. Obviously, modifications may be made to the invention without departing from the scope of the invention as set forth in the appended claims.

Claims (11)

A medical imaging device (modality) and a radiation information system (RIS);
When the RIS performs an inspection using the modality, a recording unit that records order information that is information relating to the inspection, and a change that is input from other than the RIS after the order information recorded in the recording unit is set Has prohibition means to prohibit
Further, the RIS receives the inspection start signal and notifies the modality of the information,
The modality is a system related to medical image photographing work in which medical image photographing work is performed based on the notified information.
The system related to the medical image photographing business further includes a re-imaging instruction information registration unit,
The RIS further includes a recapturing instruction information receiving means and a recapturing instruction information storage means,
Re-shooting instruction information is transmitted from the re-shooting instruction information registration means to the RIS,
The re-shooting instruction information is received by the RIS re-shooting instruction information receiving means;
The re-shooting instruction information storage means cancels the prohibition of change of the prohibiting means, and records the received re-shooting instruction information in the recording means,
If it is determined that the examination image taken with the modality is not suitable for diagnosis and it is necessary to take another picture, re-examination instruction information can be transmitted from a device other than the RIS, and the re-examination must be performed. A system related to medical imaging work that makes it possible to know the existence of unavoidable tests. The order information includes an order status that identifies an inspection process,
The order status includes at least a status indicating that the inspection is in progress (status during inspection), a status indicating that the inspection has been completed (completed status), and a status indicating that the retest is necessary (re-shooting status). Have
In response to the input of the inspection start signal in the RIS, the order status is being inspected,
In this state, upon receipt of an inspection completion signal in the RIS, the order status is changed to completed,
From this state, by receiving the recapturing instruction information in the recapturing instruction information receiving means in the RIS, the order status is changed to recapturing,
From this state, upon receiving the input of the inspection start signal again in the RIS, the order status becomes inspecting,
2. The system according to claim 1, wherein the order status is completed upon receiving a second inspection completion signal input in the RIS from this state. The order information includes inspection basic information and at least one shot information indicating a detailed item of inspection,
The order status is included in the basic examination information,
Each shot information has a shot status,
Furthermore, the recaptured instruction information storage means, the shot status corresponding to recaptured test detailed items of interest to the "miss shots" and sets the shot information of the new unexecuted state, according to claim 2 system. The reshooting instruction information registration means displays a reshooting instruction information input screen which is a graphic user interface (GUI) on a display device connected thereto,
Search for order information registered in the RIS using a part of the order information input from the re-shooting instruction information input screen as a key;
If the order status of the matched order information that matches the search condition is “performed”, the order information is displayed on the re-shooting instruction information input screen using the display device,
In other cases, a warning that re-shooting instruction information cannot be registered for the relevant examination is displayed.
The system according to claim 2 or 3. The re-shooting instruction information registration means includes
The user ID / password or only the user ID is input to the input screen provided on the display device connected to the re-shooting instruction information registration unit, or the function provided in the re-shooting instruction information registration unit is used. And sending the re-shooting instruction information to the RIS,
The system according to any one of claims 1 to 4, wherein only a limited user can register re-shooting instruction information using a confirmation unit provided in the RIS. The re-shooting instruction information registration means includes
When the reshooting instruction information registration unit is activated, by using the device ID confirmation unit, or by receiving the terminal code of the terminal provided in the reshooting instruction information registration unit,
The system according to any one of claims 1 to 4, wherein re-examination instruction information can be registered only from a specific apparatus by using a confirmation unit provided in the RIS. The re-shooting instruction information registration means includes
At least one of a reason for re-taking, a handing-over matter, an image not suitable for inspection (schema image), a re-shooting instruction information registrant, and a re-taking instruction information registration terminal name can be transmitted to the RIS together with the re-shooting instruction information; The system according to any one of claims 1 to 4. The reshooting instruction information registration means displays a reshooting instruction information input screen which is a graphic user interface (GUI) using a display device connected thereto,
The system according to any one of claims 1 to 3, wherein the re-imaging instruction information input on the re-imaging instruction information input screen is transmitted to the RIS. The system related to the medical imaging operation further includes at least one component of a hospital information system (HIS), a radiation information system, an imaging system, an image server (PACS), a reporting system, a data server, and another department system. ,
The re-imaging instruction information registering means is provided in at least one of the at least one component, so that the re-imaging instruction information is output from a component other than the RIS in the system related to the medical image photographing business. 9. A system according to any one of the preceding claims, which is possible. Medical imaging device (modality), and
Radiation information system (RIS), and system or apparatus comprising at least one of hospital information system (HIS), imaging system, image server (PACS), reporting system, data server, and other department system (other system or apparatus) Group),
When the RIS performs an inspection using the modality, a recording unit that records order information that is information relating to the inspection, and a change that is input from other than the RIS after the order information recorded in the recording unit is set Has prohibition means to prohibit
Further, the RIS receives the inspection start signal and notifies the modality of the information,
The modality is a system related to medical image photographing work in which medical image photographing work is performed based on the notified information.
At least one of the other systems or device groups has re-shooting instruction information registration means;
The RIS further includes a recapturing instruction information receiving means and a recapturing instruction information storage means,
Re-shooting instruction information is transmitted from the re-shooting instruction information registration means to the RIS,
The re-shooting instruction information is received by the RIS re-shooting instruction information receiving means;
The recapturing instruction information storage means cancels the prohibition of changing the prohibiting means, and records the recapturing instruction information received in the recording means,
When it is determined that the examination image photographed with the modality is not suitable for diagnosis and it is necessary to take another photograph, it is possible to transmit the photographing instruction information from the other system or apparatus, and the re-examination is not performed. A system related to medical imaging work that makes it possible to know the existence of tests that should not be performed. A medical imaging device (modality) where medical imaging operations are performed;
A radiation information system (RIS) capable of recording examination orders;
A display device for confirming an image photographed by the modality;
One record of the examination order includes basic patient information that is a part of patient information to be examined,
Basic inspection information including the key order number and order status,
And a method of operating RIS in a system related to medical imaging work having at least one shot number and shot information capable of recording a shot status,
The method
Receiving a re-shooting request signal transmitted from outside the RIS;
Upon receiving the order number,
Search for an inspection order using the order number as a key, display a record of the inspection order corresponding to the order number on the re-shooting instruction information input screen in the display device, request input of the shot number,
Receive the shot number of the inspection that needs to be retaken,
Reorder the order status of the corresponding order number
Set new shot information with the shot status of the input shot number as a miss shot and the shot status as unexecuted,
Displaying on the display device that re-shooting instruction information has been registered.

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