JP6119072B1 - Remote medical care support system, remote medical care support server, and remote medical care support method - Google Patents

Abstract

To provide a telemedicine support system capable of prompting a remote medical examinee to improve lifestyle habits. A telemedicine support system recognizes a target behavior of a target examinee based on medical chart information, transmits the target behavior to a first user terminal, and receives the target behavior of the target examinee for the target behavior included in the chart information. Recognizing the degree of compliance, and when the degree of compliance is equal to or higher than the prescribed level of compliance, the medical cost for determining the medical cost for the subject patient so that it is less than or equal to the medical cost when the degree of compliance is less than the prescribed level of compliance A determination unit. [Selection] Figure 7A

Description

  The present invention relates to a remote medical care support system, a remote medical care support server, and a remote medical care support method.

  Conventionally, remote medical treatment is known in which a doctor treats a patient via an information communication technology (see, for example, Patent Document 1).

  In telemedicine, in general, personnel costs can be reduced by automating points such as acceptance of applicants who wish to receive, management of subjects waiting to be examined, and accounting. For this reason, the examinee can keep the medical expenses lower than the face-to-face medical care by using the remote medical care.

  In particular, patients with chronic diseases need to receive medical care regularly, but remote medical care is most suitable for patients who cannot make time for face-to-face medical care.

JP, 2015-90572, A

  In this way, there is a potential demand for telemedicine, especially for busy patients with chronic diseases, but for patients with chronic diseases, not only medical treatment but also improvement of lifestyle is an important issue. Become.

  Therefore, an object of the present invention is to provide a telemedicine support system, a server, and a method capable of prompting a remote medical examinee to improve lifestyle habits.

The telemedicine support system of the present invention is a network system including one or a plurality of doctor terminals that communicate with a plurality of user terminals and a telemedicine support server,
A storage unit that stores medical available time zone information including a medical available time zone that is a time zone during which a doctor who is a user of the one or more doctor terminals can engage in medical treatment;
Receiving from a first user terminal, which is one of the plurality of user terminals, information including a desired medical examination time zone for which a target examinee who is a user of the first user terminal desires to receive medical examination; By referring to the available time zone information, a doctor in charge who can engage in medical treatment in the desired medical treatment time zone is extracted, and communication between the doctor terminal in charge as the doctor terminal of the doctor in charge and the first user terminal is performed. A medical appointment reception unit that transmits communication establishment information for establishing establishment to one or both of the doctor terminal in charge and the first user terminal;
The patient remark information received from the first user terminal with which communication has been established based on the communication establishment information is output to the doctor terminal in charge, and the doctor remark information input from the doctor terminal in charge is output to the first user. A telemedicine support unit that transmits to the terminal;
Receives medical record information from the doctor terminal or the first user terminal in the current telemedicine for the subject testee, based on the received mosquitoes ruthenate information, recognizes the next target behavior of the target examinee , When the next target action is transmitted to the first user terminal, the degree of compliance of the target examinee with respect to the current target action is recognized based on the chart information, and the degree of compliance is equal to or higher than a predetermined level of compliance A medical cost determination unit for determining a medical cost in the current telemedicine for the target examinee so that the level of compliance is less than or equal to the medical cost when the compliance level is less than the predetermined level of compliance. To do.

  According to the remote medical care support system of the said structure, a medical treatment reservation reception part receives the information including a medical treatment time zone from a 1st user terminal, and refers to the medical treatment time zone information, and it carries out medical treatment in the said medical treatment time zone. Extract possible doctors.

  As a result, a medical appointment is established in a time zone desired by the target examinee and in a time zone convenient for the doctor in charge. For this reason, even if the target examinee does not have the time to receive the face-to-face medical care, it is possible to receive the medical care by specifying the time to receive the medical checkup, thereby reducing the time burden on the target examinee. In addition, since medical care can be performed at a time convenient for the doctor in charge, it is possible to utilize a doctor who is difficult to perform full-time medical care, such as a doctor who is raising a child.

  The medical appointment receiving unit transmits communication establishment information for establishing communication between the doctor in charge and the first user terminal to one or both of the doctor terminal in charge and the first user terminal.

  Then, the telemedicine support unit outputs the examiner remark information received from the first user terminal with which communication has been established based on the communication establishment information, so that the doctor in charge can recognize the recipient remark information.

  Further, the telemedicine support unit transmits the inputted doctor utterance information to the first user terminal to the first user terminal. By outputting this doctor remark information at the first user terminal, the target examinee can recognize the doctor remark information input by the doctor in charge.

  In this way, remote medical care is supported between the target examinee and the doctor in charge.

  Further, according to the remote medical care support system having the above configuration, the target behavior included in the medical chart information received from the doctor terminal is recognized, and the target behavior is transmitted to the first user terminal. By displaying the target behavior on the first user terminal, the target examinee can be made to recognize the target behavior.

  Then, by the medical cost determination unit, for example, the data input by the doctor, the data input by the target examinee, or the analysis of the chart information, etc., the compliance of the target examinee with respect to the target behavior included in the chart information The degree is recognized. When the compliance level is equal to or higher than the predetermined compliance level, the medical cost determination unit determines the medical cost for the target examinee so as to be equal to or less than the medical cost when the compliance level is less than the predetermined compliance level. Is done. Thereby, an incentive for compliance with the target behavior can be given to the target examinee.

  As described above, according to the remote medical care support system configured as described above, it is possible to promote improvement of lifestyle habits by giving an incentive to the target examinee to comply with the target behavior.

In the telemedicine support system of the present invention,
The target behavior is preferably a target behavior including at least one of a target behavior related to eating and drinking, a target behavior related to exercise, and a target behavior related to medical equipment.

According to the remote medical care support system having the above configuration, the target behavior related to eating and drinking, the target behavior related to exercise, and the target behavior related to medical equipment that are presumed to be interested by the target medical examinee are included. Can do. As a result, the target examinee can be encouraged to observe the target behavior.
In the telemedicine support system of the present invention, the medical cost determination unit transmits the next target action and the importance of the next target action to the first user terminal, and the current target action and the current target action The medical cost for the current telemedicine may be determined according to the degree of adherence to the target action and the importance of the current target action.
In the telemedicine support system of the present invention, the medical cost determination unit recognizes the current point based on the degree of adherence to the current target action, and a state in which the current point or the accumulated points is equal to or greater than a predetermined threshold is predetermined. In the case where the condition that the period has been satisfied is satisfied, the medical cost may be determined by applying a discount.
In the telemedicine support system of the present invention, the medical cost determination unit applies a discount when satisfying a condition that a period during which the degree of compliance with the target action of this time is equal to or greater than a predetermined threshold continues for a predetermined period. It may be configured to determine the medical cost.

The whole block diagram of a telemedicine support system. The figure which shows the examinee list memorize | stored in the server memory | storage part. The figure which shows the doctor list memorize | stored in the server memory | storage part. The figure which shows the organization list memorize | stored in the server memory | storage part. The figure which shows the medical treatment assistance information list memorize | stored in the server memory | storage part. The figure which shows the medical examination information list memorize | stored in the server memory | storage part. The figure which shows the reservation information list memorize | stored in the server memory | storage part. The figure which shows the medical treatment time zone information list memorize | stored in the server memory | storage part. The figure which shows the target list memorize | stored in the server memory | storage part. The figure which shows the state log memorize | stored in the server memory | storage part. The whole flowchart of a series of processes of remote medical care support. The flowchart of a reservation reception process. The flowchart of a medical treatment assistance information and sensing information registration process. The first half of the flowchart of the remote medical treatment support process. The latter half of the flowchart of the remote medical treatment support process. The flowchart of a medical expense claim and reward payment process. The flowchart of a medical expenses determination process. The block diagram of a medical examination information screen. The flowchart of an organization burden amount determination process. The flowchart of a tissue medical expenses burden amount data provision process. FIG. 11A is a graph created from tissue medical expense burden data, FIG. 11B is a graph created from first health status data, and FIG. 11C is a graph created from second health status data. The flowchart of a 1st health condition data provision process. The flowchart of a 2nd health condition data provision process.

The telemedicine support system of the present invention will be described with reference to FIGS.

(Remote medical care support system)
The telemedicine support system is a system that supports telemedicine performed between a doctor and a patient.

  As shown in FIG. 1, the remote medical care support system includes a remote medical care support server 1 and one or more doctor terminals 2. Each of the remote medical care support server 1 and the doctor terminal 2 is configured to be able to communicate with each of the first user terminal 3, the second user terminal 5, and one or a plurality of organization terminals 4 via a network such as the Internet. ing. In FIG. 1, one doctor terminal 2, first user terminal 3, tissue terminal 4 and second user terminal 5 are illustrated.

(Remote medical support server)
The telemedicine support server 1 includes a server control unit 11, a server storage unit 12, and a server communication unit 15. A part or all of the computer constituting the remote medical care support server 1 may be constituted by another terminal, for example, a computer constituting the doctor terminal 2. For example, a part or all of the remote medical care support server 1 may be configured by one or a plurality of doctor terminals 2 as mobile stations.

  The server control unit 11 includes an arithmetic processing unit such as a CPU (Central Processing Unit), a memory, an I / O (Input / Output) device, and the like. The server control unit 11 may be configured by a single processor or may be configured by a plurality of processors that can communicate with each other.

  The server control unit 11 reads and executes a predetermined program, thereby performing a medical treatment appointment receiving unit 111, a medical treatment support information registration unit 112, a medical treatment information registration unit 113, a medical cost determination unit 114, and an organization that perform arithmetic processing described later. It functions as a burden determination unit 115 and a data transmission unit 116.

  The server storage unit 12 includes, for example, a storage device such as a ROM (Read Only Memory), a RAM (Random Access Memory), and an HDD (Hard Disk Drive). The server storage unit 12 is configured to store a calculation result of the server control unit 11 or data received by the server control unit 11 via the server communication unit 15.

  The server storage unit 12 includes a examinee list 121, a doctor list 122, an organization list 123, a medical assistance information list 124, a medical examination information list 125, a reservation list 126, a medical care available time zone information list 127, a target list 128, and a status log 129. It is configured to memorize. The information included in each of the examinee list 121, the medical assistance information list 124, the medical examination information list 125, the target list 128, and the status log 129 corresponds to the “medical chart information” of the present invention.

  As shown in FIG. 2A, the examinee list 121 includes a examinee ID column 1211, a examinee name column 1212, a gender column 1213, an age column 1214, a disease name column 1215, a member number column 1216, A contact address column 1217, a burden ratio column 1218, and a settlement information column 1219 are included.

  The examinee ID column 1211 stores an ID (identification) for identifying each examinee. The examinee name column 1212 stores the name and name of each examinee. The sex column 1213 stores the sex of each patient. The age column 1214 stores the age of each patient. The disease name column 1215 stores the disease name of each patient. The member number column 1216 stores the member number assigned to each examinee. This member number includes an ID for identifying the organization to which each examinee belongs. The contact address column 1217 stores contact information of each examinee, for example, an e-mail address. The burden ratio column 1218 stores the self-burden ratio of each examinee for medical expenses. The payment information column 1219 stores information for billing and payment to each of the examinees such as a credit card number and an expiration date.

  The information included in the examinee list 121 can be input, for example, when the examinee registers in the remote medical assistance system.

  The doctor list 122 includes a doctor ID column 1221, a doctor name column 1222, a gender column 1223, a specialized column 1224, a contact address column 1225, and a reward payee information column 1226, as shown in FIG. 2B. .

  The doctor ID column 1221 stores a doctor ID for identifying each doctor. The doctor name column 1222 stores the name and name of each doctor. The sex column 1223 stores the sex of each doctor. The specialty column 1224 stores disease names included in each specialist field of the doctor. Instead, the specialty column 1224 may store names of doctors' specialized fields (for example, “internal medicine”). The contact column 1225 stores the contact information of each doctor, for example, an e-mail address. The reward payee information column 1226 stores, for example, account information as information on payees of each doctor's reward.

  Information included in the doctor list 122 is input, for example, when a doctor registers in the remote medical care system.

  As shown in FIG. 2C, the organization list 123 includes an organization ID column 1231, an organization name column 1232, a settlement information column 1233, and a system use start date column 1234.

  The organization ID column 1231 stores an ID for identifying each organization. The organization name column 1232 stores each organization name. The settlement information column 1233 stores settlement information necessary for billing and settlement such as withdrawal account information or credit card number of each organization. The system use start date column 1234 stores the date (for example, the day when a member of the organization first received telemedicine through the telemedicine support system) when each organization started using the telemedicine support system. Yes.

  The medical assistance information list 124 is a list of medical assistance information registered in advance by the examinee before the medical examination, and as shown in FIG. 2D, the examinee ID column 1241, the registration date / time column 1242, the blood pressure column 1243, and the like. A body temperature column 1244, a weight column 1245, a recent illness column 1246, a recently taken medicine column 1247, and a message column 1248. The medical assistance information list 124 may include a column including information necessary for medical care.

  The examinee ID column 1241 stores the examinee ID. The registration date / time column 1242 stores the date / time when the information was registered. The blood pressure column 1243 stores blood pressure values. The body temperature column 1244 stores a value indicating body temperature. The weight column 1245 stores a value indicating the weight. The recently affected disease column 1246 stores a character string indicating the disease name. The recently consumed medicine column 1247 stores a character string indicating medicine. The message column 1248 stores a character string input by the examinee.

  The examination information list 125 stores a list of examination information related to the examination results in the remote examination. As shown in FIG. 2E, the examination person ID column 1251, the examination date / time column 1252, the symptom / diagnosis result column 1253, and the like. , A prescription content column 1254, a doctor ID column 1255, a medical fee score column 1256, and a doctor comment column 1257.

  The examinee ID column 1251 stores the examinee ID of the examinee to be examined (target examinee). The consultation date and time column 1252 stores the date and time when the target examinee received remote medical examination. The symptom / diagnosis result column 1253 stores opinion information on the target examinee of the doctor in the telemedicine. The prescription content column 1254 stores the name and number of medicines prescribed for the target examinee. The doctor ID column 1255 stores the doctor ID of the doctor (in charge doctor) who examined the subject. The medical fee score column 1256 stores the medical fee score for the target examinee in the remote medical care. The doctor comment column 1257 stores comments from the doctor in charge to the subject patient.

  As shown in FIG. 2F, the appointment list 126 includes a visitor ID column 1261, a doctor ID column 1262, and an appointment time zone column 1263.

  The examinee ID column 1261 stores the examinee ID for which remote medical treatment is reserved. The doctor ID column 1262 stores a doctor ID in charge of the remote medical care. The appointment time zone column 1263 stores the appointment appointment time zone for the remote medical examination.

  The medical care available time zone information list 127 is a list of available medical care time zone information related to the time zones that can be treated by each doctor. As shown in FIG. 2G, a medical doctor ID column 1271 and a medical care available time zone column 1272 are provided. Including.

  The doctor ID column 1271 stores the doctor ID of each doctor. The medical available time zone column 1272 stores the medical available time zone of each doctor.

  As shown in FIG. 2H, the target list 128 includes a target ID column 1281, a visitor ID column 1282, a target column 1283, a registration date / time column 1284, an importance column 1285, and a compliance / achievement level column 1286. Including.

  The target ID column 1281 stores the target ID of each target. The examinee ID column 1282 stores the examinee ID of each examinee. The goal column 1283 stores each goal of the examinee. The registration date / time column 1284 stores the date / time when the target was registered. The importance column 1285 stores the importance of the target. The compliance level / achievement level column 1286 stores the compliance level / achievement level with respect to the target.

  The goal includes, for example, the target behavior of the examinee such as alcohol cessation, exercise or sleep at 22:00. The target may be further expressed by a combination of one or both of a target frequency or a target number of times such as performing a target action three times or more a week or every day and a degree of the target action such as one hour of continuous exercise. . In addition, instead of or in addition to the behavior state of the examinee represented by the target behavior, the target frequency or the number of times, and the degree of the target number of times, the goal is the wearer's wearing state or blood pressure, etc. It may be a target related to the health condition of the examinee represented by a target value of biometric information.

  The importance of the target is represented by a positive integer, for example.

  The degree of compliance / achievement against the target is expressed numerically. For example, the compliance level / achievement level 100 may mean that the target has been achieved 100%. In this case, when the final state is far from the target from the beginning, the degree of compliance / achievement may be zero or a negative numerical value. Further, when the final state exceeds the target, the compliance level / achievement level may be set to 100, or a numerical value exceeding 100 may be set.

  As illustrated in FIG. 2I, the status log 129 includes a target ID column 1291, a user input information column 1292, a sensing information column 1293, and a date / time column 1294.

  The target ID column 1291 stores the target ID of each target. The user input information column 1292 is information input from the examinee, and includes, for example, a target action, a combination of the frequency or number of executions of the target action and the degree of execution of the target action, or a value of the weight of the examinee. Contains information. The sensing information column 1293 is sensing information received from the wearable sensor S, and includes, for example, the activation state of the wearable sensor S, the wearing frequency or frequency estimated from the sensing information, and the sensing information itself. The date / time column 1294 includes the date / time when the examinee input information was input or the date / time when sensing information was received.

  The server communication unit 15 is connected to a public communication network (for example, the Internet) as a network, and communicates with an external terminal such as the doctor terminal 2, the first user terminal 3, the organization terminal 4, and the second user terminal 5. It is configured.

(Doctor terminal)
The doctor terminal 2 includes a doctor terminal control unit 21, a doctor terminal storage unit 22, a doctor terminal output unit 23, a doctor terminal input unit 24, and a doctor terminal communication unit 25.

  The doctor terminal 2 is configured by a computer such as a desktop computer that is designed in size, shape, and weight so as to be installed at a specific location. The doctor terminal 2 may be configured by a computer whose size, shape, and weight are designed so that it can be carried by a doctor D who is a user of the doctor terminal 2, such as a tablet terminal or a smartphone.

  The doctor terminal control unit 21 includes an arithmetic processing device such as a CPU, a memory, an I / O device, and the like. A remote medical care support program downloaded from the remote medical care support server 1 is installed in the doctor terminal control unit 21. When the remote medical care support program is activated, the doctor terminal control unit 21 is configured to execute arithmetic processing described later.

  The doctor terminal storage unit 22 is configured by a storage device such as a ROM, RAM, or HDD. The doctor terminal storage unit 22 is configured to store a doctor ID 221 of a doctor D registered in advance and communication establishment information 222 stored in a reservation reception process described later.

  The doctor terminal output unit 23 is configured by a display device such as a liquid crystal panel, and the doctor terminal input unit 24 is configured by a position input device such as a touch pad, which is combined to form a touch panel. In addition to or instead of this, the doctor terminal input unit 24 may include a keyboard. The doctor terminal output unit 23 further includes a speaker. The doctor terminal input unit 24 further includes a microphone.

  The doctor terminal communication unit 25 is configured to communicate with an external terminal such as the remote medical care support server 1 via wired communication or wireless communication in accordance with a communication standard such as WiFi (registered trademark).

(First user terminal)
The first user terminal 3 includes a first user terminal control unit 31, a first user terminal storage unit 32, a first user terminal output unit 33, a first user terminal input unit 34, and a first user terminal communication unit 35. With.

  The first user terminal control unit 31 supports the remote medical examination support downloaded from the organization terminal 4 (or the server of the organization to which the target examinee P belongs or the remote medical assistance server 1) instead of installing the remote medical assistance program. The program is installed. When the remote medical examination support program is started, the first user terminal control unit 31 is configured to execute arithmetic processing described later.

  The first user terminal storage unit 32 stores the examinee ID 321 and the communication establishment information 322 of the target examinee P who is the user of the first user terminal 3 instead of the doctor ID 221 and the communication establishment information 222. Except for the above points, the first user terminal 3 has the same configuration as the doctor terminal 2.

  Further, the wearable sensor S is configured to be worn by the target examinee P. The wearable sensor S recognizes the biological information or behavior information of the target examinee P, the wearing state of the wearable sensor S, and transmits the biological information to the remote medical care support server 1 periodically or according to the operation of the target examinee P. Is configured to do.

  The biological information of the target examinee P is, for example, the blood pressure, heart rate, respiratory rate, body temperature, weight, and height of the target examinee P.

  The behavior information of the target examinee P is, for example, the number of steps of the target examinee P, the time the target examinee P walked, and the time the target examinee P ran.

  The wearable sensor S has an individual communication unit, and may transmit biological information to the remote medical care support server 1 via the communication unit. Instead, for example, the first user terminal 3 by USB or the like is used. To the remote medical care support server 1 via the first user terminal communication unit 35.

(Organization terminal)
The organization terminal 4 includes an organization terminal control unit 41, an organization terminal storage unit 42, an organization terminal output unit 43, an organization terminal input unit 44, and an organization terminal communication unit 45.

  The organization terminal 4 stores the point that the remote medical care support program is not installed, the organization terminal storage unit 42 stores the organization ID 421 of the organization instead of the doctor ID 221, and the organization terminal storage unit 42 stores the communication establishment information 222. Except for this point, it has the same configuration as the doctor terminal 2.

(Second user terminal)
The second user terminal 5 includes a second user terminal control unit 51, a second user terminal storage unit 52, a second user terminal output unit 53, a second user terminal input unit 54, and a second user terminal communication unit 55. With.

  The second user terminal 5 has the same configuration as the doctor terminal 2 except that the telemedicine support program is not installed and the second user terminal storage unit 52 does not store the doctor ID 221 and the communication establishment information 222. Have.

(Overview of a series of remote medical treatment support processes)
With reference to FIG. 3, an overall outline of a series of processing for remote medical assistance will be described.

  The remote medical care support server 1, the doctor terminal 2, and the first user terminal 3 execute a reservation reception process described later (FIG. 3 / STEP 100). By the reservation reception process, the appointment date and time for telemedicine is reserved, and communication establishment information for establishing communication with each other is transmitted to the doctor terminal 2 and the first user terminal 3.

  The remote medical care support server 1, the doctor terminal 2, and the first user terminal 3 execute medical information registration processing and sensing information registration processing described later (FIG. 3 / STEP 200). Through the medical support information and sensing information registration process, the medical support information of the target examinee P is additionally registered in the medical support information list 124 before the remote medical checkup, and the sensing information is additionally registered in the status log 129. This information is shared with the doctor D in charge of remote medical care.

  The remote medical care support server 1, the doctor terminal 2, and the first user terminal 3 execute a remote medical care support process to be described later (FIG. 3 / STEP 300). The doctor terminal 2 and the first user terminal 3 establish communication using the communication establishment information and perform remote medical care support between the doctor D in charge and the target examinee P. After the end of the telemedicine, the doctor terminal 2 transmits the diagnosis information for the target examinee P to the remote diagnosis support server 1 and adds it to the diagnosis information list 125. Further, the next target of the target examinee P is added to the target list 128 by communication between the remote medical care support server 1 and the first user terminal 3.

  The telemedicine support server 1, the doctor terminal 2, and the first user terminal 3 execute a medical billing / reward payment process described later (FIG. 3 / STEP 400). The telemedicine support server 1 recognizes the medical fee for telemedicine based on the medical examination information and target information registered in FIG. 3 / STEP 300, charges the medical fee for telemedicine to the payment institution, and remote medical treatment for the target examinee P The self-pay expenses are charged and the remuneration payment to the doctor D is performed.

  The telemedicine support server 1 executes an organization burden determination process described later (FIG. 3 / STEP 500). The telemedicine support server 1 uses the settlement information of the organization to settle the organization burden.

(Reservation acceptance process)
The reservation acceptance process will be described with reference to FIG.

  First, the doctor terminal control unit 21 determines whether or not a medical available time zone has been input from the doctor D in charge via the doctor terminal input unit 24 (FIG. 4 / STEP 120).

  If the determination result is negative (FIG. 4 / STEP 120... NO), the doctor terminal control unit 21 executes the process of FIG. 4 / STEP 120 again.

  When the determination result is affirmative (FIG. 4 / STEP 120... YES), the doctor terminal control unit 21 is input from the doctor ID of the doctor D in charge registered in the doctor terminal storage unit 22 and the doctor D in charge. Medical available time zone information including a medical available time zone is created and transmitted to the remote medical care support server 1 via the doctor terminal communication unit 25 (FIG. 4 / STEP 121).

  The medical appointment receiving unit 111 determines whether or not medical available time zone information has been received via the server communication unit 15 (FIG. 4 / STEP110).

  If the determination result is negative (FIG. 4 / STEP 110... NO), the medical appointment receiving unit 111 executes the process of FIG. 4 / STEP 110 again.

  If the determination result is affirmative (FIG. 4 / STEP 110... YES), the medical appointment receiving unit 111 stores the received medical available time zone information in the available medical time zone information list 127 shown in FIG. 4 / STEP 111).

  The first user terminal control unit 31 determines whether or not a reservation application operation for designating a desired medical treatment time zone from the target examinee P is detected via the first user terminal input unit 34 (FIG. 4 / STEP 130). .

  Prior to FIG. 4 / STEP 130, the medical appointment receiving unit 111 that has received access from the first user terminal 3 recognizes the name of the subject medical examinee P by referring to the medical examinee list 121, and creates the doctor list 122. A doctor who specializes in the name of the disease is extracted by referring to the extracted list of available doctors by referring to the list of information on available medical hours 127, and the available time zone for the first user is extracted. It may be transmitted to the terminal 3 and output to the first user terminal output unit 33.

  When the determination result is negative (FIG. 4 / STEP 130... NO), the first user terminal control unit 31 executes the process of FIG. 4 / STEP 130 again.

  When the determination result is affirmative (FIG. 4 / STEP 130... YES), the first user terminal control unit 31 is registered in advance in the first user terminal storage unit 32 via the first user terminal communication unit 35. Reservation application information including the examinee ID of the subject examinee P and the desired medical treatment time zone input from the subject examinee P is created and transmitted to the remote examination support server 1 (FIG. 4 / STEP 131).

  The medical appointment receiving unit 111 determines whether or not reservation application information has been received via the server communication unit 15 (FIG. 4 / STEP 112).

  When the determination result is negative (FIG. 4 / STEP 112... NO), the medical appointment receiving unit 111 executes the process of FIG. 4 / STEP 112 again.

  When the determination result is affirmative (FIG. 4 / STEP 112... YES), the medical appointment receiving unit 111 creates the medical examinee list 121, the doctor list 122, and the medical care available time zone information list 127 based on the reservation application information. Referring to FIG. 4 (STEP 113), a doctor in charge who is a doctor who can handle the desired medical treatment time zone indicated in the reservation application information is extracted.

  More specifically, the medical appointment receiving unit 111 refers to the examinee list 121 and recognizes the disease name of the subject examinee P by using the examinee ID of the subject examinee P included in the reservation application information. The medical appointment receiving unit 111 refers to the doctor list 122 and the available medical care time zone information list 127, and can respond to the name of the subject medical examinee P and corresponds to the desired medical treatment time zone included in the reservation application information. Recognize the doctor in charge.

  For example, when the target examinee P is “Oda × M” and the desired medical treatment time zone is “2016/4/19 15:00: 00-15: 15:00”, the medical appointment receiving unit 111 The patient name “high blood pressure” of the target patient P is recognized by referring to the patient list 121 and using the patient ID “1” of the target patient P “Oda × M” included in the reservation application information. Then, the medical appointment reservation unit 111 specializes in the disease name “high blood pressure” of the target examinee P by referring to the doctor list 122 and the available medical care time zone information list 127, and the desired medical treatment time zone “2016/4 / Recognizing the doctor “○ Stone x” that can handle 19 15:00: 00 to 15: 15:00 as a doctor in charge. In addition, the medical treatment reservation reception part 111 may recognize the doctor who can respond from the medical treatment time zone information list 127 and the medical treatment time zone as a doctor in charge.

  The medical appointment receiving unit 111 adds the examinee ID of the target examinee P, the doctor ID of the doctor in charge, and the reserved time zone that is the desired medical time zone to the reservation list 126 (FIG. 4 / STEP 114).

  For example, as shown in the field 1264 of FIG. 2F, the medical appointment receiving unit 111 receives the subject ID “1” of the target examinee P “* da × m” and the doctor ID of the doctor in charge “○ ishi × yuki”. “11” and an appointment time zone “2016/4/19 15:00:00 to 15:15:00”, which is a desired medical treatment time zone, are added to the appointment list 126.

  The medical appointment receiving unit 111 recognizes the contact information of the target medical examiner P with reference to the medical examinee list 121, and that the reservation is received for the contact information of the target medical examiner P via the server communication unit 15. And reservation acceptance information including communication establishment information to the doctor in charge and doctor information of the doctor in charge (FIG. 4 / STEP 115).

  Here, the communication establishment information to the doctor in charge is, for example, information necessary for receiving a remote medical examination by the doctor in charge, for example, using the doctor ID of the doctor in charge and the videophone service by the remote medical assistance server 1. Information such as contact information of the doctor in charge as information for using the external videophone service.

  The first user terminal control unit 31 determines whether or not reservation acceptance information has been received via the first user terminal communication unit 35 (FIG. 4 / STEP 132).

  When the determination result is negative (FIG. 4 / STEP132... NO), the first user terminal control unit 31 executes the process of FIG. 4 / STEP132 again.

  If the determination result is affirmative (FIG. 4 / STEP132... YES), the first user terminal control unit 31 indicates that the reservation included in the reservation reception information has been received and the doctor information of the doctor in charge. While outputting to the output part 33 (FIG. 4 / STEP133), the communication establishment information contained in reservation reception information is memorize | stored in the 1st user terminal memory | storage part 32 (FIG. 4 / STEP134).

  The medical appointment receiving unit 111 refers to the doctor list 122 to recognize the contact information of the doctor in charge D, and sends the contact information of the doctor in charge D to the appointment time zone and the target examinee P via the server communication unit 15. The reservation reservation information including the communication establishment information and the subject information of the subject subject P is transmitted (FIG. 4 / STEP 116).

  Here, the communication establishment information for the target examinee P is, for example, information necessary for receiving a remote medical examination by the target examinee P, and is the same information as the communication establishment information for the doctor in charge.

  The doctor terminal control unit 21 determines whether or not the appointment reservation information has been received via the doctor terminal communication unit 25 (FIG. 4 / STEP 122).

  If the determination result is negative (FIG. 4 / STEP 122... NO), the doctor terminal control unit 21 executes the process of FIG. 4 / STEP 122 again.

  If the determination result is affirmative (FIG. 4 / STEP 122... YES), the doctor terminal control unit 21 sends the reservation time zone included in the reserved reservation information and the examinee information of the subject examinee P to the doctor terminal output unit 23. While outputting (FIG. 4 / STEP123), the communication establishment information contained in charge reservation information is memorize | stored in the doctor terminal memory | storage part 22 (FIG. 4 / STEP124).

  With the above processing, the reservation acceptance processing is completed. 4 / STEP 115 and STEP 132 to STEP 134 may be omitted, and FIG. 4 / STEP 116 and STEP 122 to STEP 124 may be omitted.

(Medical support information and sensing information registration process)
The medical assistance information and sensing information registration process will be described with reference to FIG.

  The first user terminal control unit 31 determines whether or not the medical assistance information has been input via the first user terminal input unit 34 (FIG. 5 / STEP 230). As shown in FIG. 2D, the medical support information is obtained by doctors such as a recent ID, a recently taken medicine, a message, etc. This information includes information that can be used for reference.

  When the determination result is negative (FIG. 5 / STEP 230... NO), the first user terminal control unit 31 executes FIG. 5 / STEP 230 again. The examinee ID may be input by the target examinee P or may be read from the first user terminal storage unit 32.

  If the determination result is affirmative (FIG. 5 / STEP 230... YES), the first user terminal control unit 31 transmits medical support information to the remote medical support server 1 via the first user terminal communication unit 35. (FIG. 5 / STEP231).

  The medical assistance information registration unit 112 determines whether or not medical assistance information has been received via the server communication unit 15 (FIG. 5 / STEP 210).

  If the determination result is negative (FIG. 5 / STEP 210... NO), the medical assistance information registration unit 112 executes FIG. 5 / STEP 210 again.

  When the determination result is affirmative (FIG. 5 / STEP 210... YES), the medical assistance information registration unit 112 adds and registers the medical assistance information to the medical assistance information list 124 and the status log 129 (FIG. 5 / STEP 211). ).

  The wearable sensor S transmits sensing information including the measured or estimated state of the target examinee P to the remote medical care support server 1 (FIG. 5 / STEP 232). The state of the target examinee P measured or estimated includes, for example, biological information such as blood pressure, heart rate, respiratory rate, or body temperature, or a wearing state estimated from the biological information or the operating status of the wearable sensor S. Can be.

  The medical assistance information registration unit 112 determines whether sensing information has been received via the server communication unit 15 (FIG. 5 / STEP 212).

  When the determination result is negative (FIG. 5 / STEP 212... NO), the medical assistance information registration unit 112 executes FIG. 5 / STEP 212 again.

  If the determination result is affirmative (FIG. 5 / STEP 212... YES), the medical assistance information registration unit 112 adds and registers sensing information to the state log 129 (FIG. 5 / STEP 213). The medical assistance information registration unit 112 recognizes the doctor in charge D with reference to the reservation list 126 and recognizes the contact information of the doctor in charge D with reference to the doctor list 122 based on the ID of the examinee included in the medical assistance information. Then, the medical assistance information and sensing information are transmitted to the contact information of the doctor D in charge (FIG. 5 / STEP 214).

  The doctor terminal control unit 21 determines whether or not medical assistance information and sensing information are received (FIG. 5 / STEP 220).

  If the determination result is negative (FIG. 5 / STEP 220... NO), the doctor terminal control unit 21 executes FIG. 5 / STEP 220 again.

  If the determination result is affirmative (FIG. 5 / STEP 220... YES), the doctor terminal control unit 21 outputs medical assistance information and sensing information to the doctor terminal output unit 23 (FIG. 5 / STEP 221).

  With the above processing, the medical assistance information and sensing information registration processing is completed.

(Remote medical treatment support processing)
With reference to FIGS. 6A and 6B, the remote medical care support processing will be described.

  The doctor terminal control unit 21 determines whether or not a connection operation from the doctor D in charge is detected through the doctor terminal input unit 24 (FIG. 6A / STEP 320).

  When the determination result is negative (FIG. 6A / SETP320... NO), the doctor terminal control unit 21 executes the process of FIG. 6A / SETP320 again.

  If the determination result is affirmative (FIG. 6A / SETP320... YES), the doctor terminal control unit 21 creates a connection request from the communication establishment information 222 stored in the doctor terminal storage unit 22, and sends the connection request to the doctor. It transmits to the 1st user terminal 3 via the terminal communication part 25 (FIG. 6A / STEP321).

  The first user terminal control unit 31 determines whether or not a connection request has been received via the first user terminal communication unit 35 (FIG. 6A / STEP 330).

  When the determination result is negative (FIG. 6A / SETP330... NO), the first user terminal control unit 31 executes the process of FIG. 6A / SETP330 again.

  When the determination result is affirmative (FIG. 6A / SETP330... YES), the first user terminal control unit 31 stores the connection request in the first user terminal storage unit 32 and establishes a connection with the doctor terminal 2. A connection establishment notification is sent to notify that it has been done (FIG. 6A / STEP 331).

  The doctor terminal control unit 21 determines whether or not the doctor speech information is input via the doctor terminal input unit 24 (FIG. 6A / STEP 322). For example, the doctor terminal control unit 21 may recognize the remarks of the doctor D in charge input via a microphone as the doctor terminal input unit 24 as doctor remark information. Moreover, the doctor terminal control part 21 may recognize the character string etc. which were input through operation to the keyboard or touch panel as the doctor terminal input part 24 as doctor speech information, for example.

  When the determination result is affirmative (FIG. 6A / STEP 322... YES), the doctor terminal control unit 21 transmits doctor speech information to the first user terminal 3 via the doctor terminal communication unit 25 (FIG. 6A / STEP 323). ).

  When the determination result is negative (FIG. 6A / STEP322... NO), the doctor terminal control unit 21 executes the process of FIG. 6A / STEP324.

  Moreover, after FIG. 6A / STEP331, the 1st user terminal control part 31 determines whether the examinee remark information was input via the 1st user terminal input part 34 (FIG. 6A / STEP332).

  For example, the first user terminal control unit 31 may recognize the remarks of the target examinee P input via a microphone as the first user terminal input unit 34 as the recipient remark information. Moreover, the 1st user terminal control part 31 may recognize the character string etc. which were input through operation to the keyboard as the 1st user terminal input part 34, or a touch panel, for example, as examinee remark information.

  If the determination result is affirmative (FIG. 6A / STEP 332... YES), the first user terminal control unit 31 transmits the patient remark information to the doctor terminal 2 via the first user terminal communication unit 35 (FIG. 6). 6A / STEP333).

  When the determination result is negative (FIG. 6A / STEP 332... NO), the first user terminal control unit 31 executes the process of FIG. 6A / STEP 334.

  In FIG. 6A / STEP324, the doctor terminal control unit 21 determines whether or not the patient remark information is received from the first user terminal 3 via the doctor terminal communication unit 25.

  If the determination result is affirmative (FIG. 6A / STEP 324... YES), the doctor terminal control unit 21 outputs the received patient remark information to the doctor terminal output unit 23 (FIG. 6A / STEP 325).

  When the determination result is negative (FIG. 6A / STEP324... NO) or after the process of FIG. 6A / STEP325, the doctor terminal control unit 21 executes the process of FIG. 6A / STEP326.

  In FIG. 6A / STEP 326, the doctor terminal control unit 21 determines whether an end operation has been detected via the doctor terminal input unit 24 or the connection with the first user terminal 3 has been disconnected.

  If the determination result is affirmative (FIG. 6A / STEP 326... YES), the doctor terminal control unit 21 executes the process of FIG. 6A / STEP 327.

  When the determination result is negative (FIG. 6A / STEP 326... NO), the doctor terminal control unit 21 executes the process of FIG. 6A / STEP 322.

  In FIG. 6A / STEP334, the 1st user terminal control part 31 determines whether the doctor speech information was received from the doctor terminal 2 via the 1st user terminal communication part 35. FIG.

  If the determination result is affirmative (FIG. 6A / STEP 334... YES), the first user terminal control unit 31 outputs the received doctor speech information to the first user terminal output unit 33 (FIG. 6A / STEP 335).

  When the determination result is negative (FIG. 6A / STEP 334... NO) or after the process of FIG. 6A / STEP 335, the first user terminal control unit 31 executes the process of FIG. 6A / STEP 336.

  In FIG. 6A / STEP336, the 1st user terminal control part 31 detects completion | finish operation via the 1st user terminal input part 34, or determines whether the connection with the doctor terminal 2 was cut | disconnected.

  When the determination result is affirmative (FIG. 6A / STEP 336... YES), the first user terminal control unit 31 transmits a disconnection notification to the doctor terminal 2 via the first user terminal communication unit 35 (FIG. 6). 6A / STEP337).

  When the determination result is negative (FIG. 6A / STEP 336... NO), the first user terminal control unit 31 executes the process of FIG. 6A / STEP 332.

  In FIG. 6A / STEP327, the doctor terminal control part 21 transmits a cutting | disconnection notification with respect to the 1st user terminal 3 via the doctor terminal communication part 25. FIG.

  The doctor terminal control unit 21 creates diagnosis information for the target examinee P based on information input via the doctor terminal input unit 24 (FIG. 6B / STEP 328). The information input via the doctor terminal input unit 24 includes symptoms / diagnosis results, prescription contents, medical remuneration scores, and doctor comments. The medical examination information for the target medical examiner P includes the medical examiner ID included in the communication establishment information, the medical examination date and time that is the time when the connection establishment notification is received, the symptom / diagnosis result, the prescription content, and the doctor ID of the doctor D in charge. And the medical remuneration score, the doctor's comment, the target candidate of the target patient P, and the degree of compliance and achievement of the target of the target patient P. Of these, the medical treatment reward score is a score corresponding to the medical examination contents of the doctor. The medical fee score may be a medical fee score used in a general insurance system.

  For example, the examination information for the target examinee P “○ da × M” includes the examinee ID “1”, the date and time of reception “2016/4/19 15:00,” and the symptom / diagnosis result “hypertension reducing drug”. ”, Prescription content“ medicine 12 capsules / 30 meals per day ”, doctor ID“ 11 ”of the doctor in charge D, medical remuneration score“ 100 ”, doctor comment“ Reserve alcohol and salt in this condition Let's consciously take in habitual exercise. "And the next target candidate of the target examinee P" No more than three days a week "and the importance" 100 ", and the current target of the target examinee P The degree of compliance / achievement level “100” is included.

  The next target candidate of the target examinee P includes a target in the same format as the target included in the target column 1283 and the importance with respect to the target. The importance with respect to the goal may be specified by a doctor or may be determined in advance. The degree of compliance / achievement of the target of the target examinee P may be input by a doctor, or may be determined based on user input information or sensing information.

  The doctor terminal control unit 21 transmits the created examination information to the remote medical care support server 1 via the doctor terminal communication unit 25 (FIG. 6B / STEP 329).

  Note that the examination information input from the target examinee P to the first user terminal 3 may be transmitted to the remote examination support server 1.

  The examination information registration unit 113 determines whether or not the examination information is received via the server communication unit 15 (FIG. 6B / STEP 310).

  If the determination result is negative (FIG. 6B / STEP 310... NO), the diagnosis information registration unit 113 executes the process of FIG. 6B / STEP 310 again.

  When the determination result is affirmative (FIG. 6B / STEP 310... YES), the medical examination information registration unit 113 obtains information other than the next goal candidate and the degree of compliance / achievement of the current goal among the received medical examination information. In addition to the examination information list 125, the degree of compliance / achievement of the current goal is registered in the goal list 128 (FIG. 6B / STEP 311). For example, the field 1258 shown in FIG. 2E is added to the examination information list 125 as examination information for the target examinee P “○ da × m”. In addition, the degree of compliance / achievement of the current goal is registered at a location corresponding to the goal ID in the degree of compliance / achievement column 1286 of the goal list 128.

  The examination information registration unit 113 transmits the next target candidate to the first user terminal 3 via the server communication unit 15 (FIG. 6B / STEP 312).

  The first user terminal control unit 31 determines whether or not the next target candidate has been received (FIG. 6B / STEP 338).

  When the said determination result is negative (FIG. 6B / STEP338 ... NO), the 1st user terminal control part 31 performs the process of FIG. 6B / STEP338 again.

  If the determination result is affirmative (FIG. 6B / STEP 338... YES), the first user terminal control unit 31 displays the next target confirmation screen (FIG. 6B / STEP 339).

  The first user terminal control unit 31 transmits the next target input through the first user terminal input unit 34 to the remote medical care support server 1 through the first user terminal communication unit 35 (FIG. 6B / STEP 340). .

  The examination information registration unit 113 determines whether or not the next target has been received via the server communication unit 15 (FIG. 6B / STEP 313).

  When the determination result is negative (FIG. 6B / STEP 313... NO), the diagnosis information registration unit 113 executes the process of FIG. 6B / STEP 313 again.

  If the determination result is affirmative (FIG. 6B / STEP 313... YES), the diagnosis information registration unit 113 registers the received target in the target list 128 together with the examinee ID of the target examinee P and the registration date and time (current time). (FIG. 6B / STEP 314).

  The diagnosis information registration unit 113 omits STEPs 312 to 313 and STEPs 338 to 340, and registers the target candidates received from the doctor terminal 2 of the doctor in charge together with the examinee ID and registration date and time of the target examinee P in the goal list. Also good. Further, the examination information registration unit 113 omits STEPs 312 to 313 and STEP 338 and registers the target received from the first user terminal 3 of the target examinee P in the target list 128 together with the examinee ID and registration date and time of the target examinee P. May be.

  In addition, the examination information registration unit 113 uses the target derived from the disease name and state of the target examinee as the target of the target examinee P based on the information stored in the server storage unit 12, and the examinee ID of the target examinee P The registration date and time may be registered in the target list 128. For example, the disease name of the target examinee P identified from the examinee list 121 or the chart information is “high blood pressure”, and the blood pressure of the target examinee P identified from the chart information is “160 to 100”, which is stored in the server memory. Consider a case where the desired blood pressure stored in the unit 12 is “130 to 70”. In this case, for example, the diagnosis information registration unit 113 specifies the target of the disease name “high blood pressure” as “blood pressure” based on the correspondence table (not shown), and sets the blood pressure “130 to 70” as the target of the target examinee P. Both the examinee ID of the subject examinee P and the registration date and time may be registered in the target list 128. The medical examination information registration unit 113 is based on the blood pressure standard “10” stored in the server storage unit 12 for a predetermined period of time and sets “150 to 90” as the target of the target medical examinee. Both the registration date and time may be registered in the target list 128. In addition, the examination information registration unit 113 registers and registers the examinee ID of the target examinee P with the target behavior associated with the disease name “high blood pressure” based on a correspondence table (not shown) or wearing of a wearable device as the target of the target examinee P. Both the date and time may be registered in the target list 128.

  Thus, the telemedicine support process ends.

(Medical billing / reward payment processing)
With reference to FIG. 7A, the medical billing / reward payment process will be described.

  The medical cost determination unit 114 determines the medical cost of the target examinee P by executing a medical cost determination process described later (FIG. 7A / STEP 401). In the medical cost determination process, the medical cost determination unit 114 determines the next goal, the current goal, the importance of the next goal, the importance of the current goal, the degree of compliance / achievement of the current goal, the current point and the cumulative total. Recognize target information including points.

  Based on the medical cost determined in FIG. 7A / STEP 401 and the burden ratio included in the user information, the medical cost determining unit 114 determines the self-medical cost burden of the target examinee P (FIG. 7A / STEP 410).

  The medical cost determining unit 114 first sets the target medical information that has been read from the self-medical cost burden of the target medical examiner P determined through the server communication unit 15, the medical examination information of the target medical examiner P, and the target list 128 and the state log 129. It transmits to the user terminal 3 (FIG. 7A / STEP411). The first user terminal control unit 31 determines whether each information is received via the first user terminal communication unit 35 (FIG. 7A / STEP 430).

  When the determination result is negative (FIG. 7A / STEP430... NO), the first user terminal control unit 31 executes the process of FIG. 7A / STEP430 again.

  When the determination result is affirmative (FIG. 7A / STEP 430... YES), the first user terminal control unit 31 displays the received diagnosis information screen 6 including each received information as shown in FIG. It outputs to the output part 33 (FIG. 7A / STEP431).

  The examination information screen 6 is configured as a Web screen, for example, and includes a examinee name display 611, a examinee ID display 612, a doctor name display 621, a doctor ID display 622 of the doctor in charge, and a photograph display 623 of the doctor in charge. Receiving date and time display 631, symptom / diagnosis result display 632, prescription content display 641, prescription content shipping display 642, doctor comment 651, current self-health expense display 661, and next appointment display 671 , And a target display 680.

  The target display 680 includes a current target display 681, a current target importance display 682, a current target compliance / achievement level display 683, a current point display 684, a cumulative point display 685, and a next time. The target display 686 for the next time and the importance level display 687 for the next target are included.

  The current point display 684 or the accumulated point display 685 may include a discount display, respectively, when a medical cost discount can be received.

  In FIG. 8, the current point display 684 includes a 5% discount display with the current point, and the cumulative point display 685 includes a 5% discount display with the cumulative point.

  When the first user terminal control unit 31 detects a click on the prescription content shipment display 642 via the first user terminal input unit 34, the first user terminal control unit 31 displays a screen for transmitting the prescription content that cannot be edited to the pharmacy by e-mail or the like. . In addition to or instead of this, the first user terminal control unit 31 may transmit a file in which an electronic signature is added to the prescription content to the first user terminal 3. Further, when the first user terminal control unit 31 detects that the next reservation display 671 is clicked through the first user terminal input unit 34, the first user terminal control unit 31 displays a reservation reception screen and executes the processing of FIG.

  After FIG. 7A / STEP 411, the medical cost determination unit 114 uses the payment information of the target patient P included in the patient list 121 to settle the self-medical cost burden of the target patient P (FIG. 7A / STEP 412). ). For example, the medical cost determination unit 114 transmits the credit information included in the payment information of the target examinee P and the self-medical cost burden to the payment server identified from the credit information, thereby Make a payment.

  The medical cost determination unit 114 determines the medical fee of the doctor D in charge using the medical cost and a predetermined formula (FIG. 7A / STEP 413).

  The medical expense determination unit 114 transmits medical reward data to the doctor terminal 2 via the server communication unit 15 (FIG. 7A / STEP 414).

  The medical cost determination unit 114 uses the remuneration payee information of the doctor D in charge included in the doctor list 122 to perform payment of remuneration for the doctor D in charge (FIG. 7A / STEP 415). For example, the medical expense determination unit 114 performs settlement of payment of the remuneration for the doctor D in charge by transmitting the account information of the doctor D in charge and the medical fee to the bank server specified from the account information.

  Further, the doctor terminal control unit 21 determines whether or not medical reward data has been received via the doctor terminal communication unit 25 (FIG. 7A / STEP 420).

  When the determination result is negative (FIG. 7A / STEP 420... NO), the doctor terminal control unit 21 executes the process of FIG. 7A / STEP 420 again.

  When the determination result is affirmative (FIG. 7A / STEP 420... YES), the doctor terminal control unit 21 outputs a medical reward screen including the received medical reward data to the doctor terminal output unit 23 (FIG. 7A / STEP 421). .

  Thus, the medical billing / reward payment processing is completed.

(Medical cost decision processing)
Next, with reference to FIG. 7B, medical cost determination processing will be described.

  The medical expense determination unit 114 recognizes the current medical treatment reward score by referring to the medical examination information list 125 based on the medical examinee ID of the target medical examinee P and the current date and time (FIG. 7B / STEP 4011).

  The medical expenses determination unit 114 recognizes the medical expenses during the face-to-face medical care based on the current medical treatment reward score (FIG. 7B / STEP 4012). For example, in the normal insurance system, the medical expenses determination unit 114 recognizes the medical expenses for the current medical treatment reward score and the face-to-face medical care as the medical expenses for the face-to-face medical care.

  Based on the current medical treatment reward score, the medical cost determination unit 114 recognizes the medical cost at the time of remote medical treatment so as to be lower than the medical cost at the time of face-to-face medical care (FIG. 7B / STEP 4013). For example, the medical expenses determination unit 114 may calculate the medical expenses at the remote medical treatment by multiplying the medical expenses at the face-to-face medical care by a predetermined positive number less than 1, or may calculate the predetermined medical expenses from the medical expenses at the face-to-face medical treatment. The medical cost at the time of telemedicine may be calculated by subtracting the amount of.

  The medical cost determination unit 114 recognizes the degree of compliance / achievement of the current goal and the importance of the current goal by referring to the goal list 128 based on the examinee ID of the subject examinee P and the current date and time. From these, the current point and the accumulated points are recognized (FIG. 7B / STEP 4014). The medical cost determination unit 114 recognizes the goal with the newest registration date as the next goal, and recognizes the goal with the next newest registration date as the current goal.

  This point is determined so that the higher the degree of compliance and achievement of this goal, the higher the point. For example, the current point can be calculated by the following equation (1).

  Here, TP is the current point, PI is the importance of the current goal, and LA is the degree of compliance and achievement (%) of the current goal.

  The accumulated point may be the accumulated value of each time point stored in the server storage unit 12 or may be a value calculated by the same formula as the current point.

  The medical cost determination unit 114 applies a discount according to the current or cumulative points to reduce the medical cost (FIG. 7B / STEP 4015).

  For example, the medical cost determination unit 114 may apply a predetermined discount when the first condition that the current point is equal to or greater than the first point threshold is satisfied. Moreover, the medical expenses determination part 114 may apply a predetermined discount, when satisfy | filling the 2nd condition that a cumulative point becomes more than a 2nd point threshold value. The medical cost determination unit 114 may apply a predetermined discount when the third condition that a state in which the current point or the accumulated point is equal to or greater than the third point threshold value continues for a predetermined period is satisfied. In addition to the discount according to the current or cumulative points, the medical cost determination unit 114 applies a discount when the fourth condition that the degree of compliance / achievement of a specific target is greater than or equal to a predetermined value is satisfied. Also good. In addition, the medical cost determination unit 114 may apply a discount when the fifth condition that a period in which the degree of compliance / achievement of a specific target is greater than or equal to a predetermined period has been satisfied.

  The medical cost determination unit 114 may reduce a certain percentage (for example, 5%) according to the current or cumulative points as a discount, or a certain amount (for example, 500 yen) according to the current or cumulative points. May be reduced. When the discount is applied, the medical cost determination unit 114 may subtract a predetermined point from the accumulated point and store the accumulated point or the fact that the server point is subtracted in the server storage unit 12.

  As described above, medical expenses are appropriately determined.

(Organization burden determination process)
With reference to FIG. 9, the organization burden amount determination process will be described.

  The organization burden amount determination unit 115 calculates the organization burden ratio, which is the burden ratio of the organization to which the target examinee P belongs, from the burden ratio of the target examinee P included in the examinee list 121, and is calculated in FIG. 7B / STEP 4012. An amount obtained by multiplying the medical cost at the time of the face-to-face medical treatment by the tissue burden ratio is recognized as a reference tissue medical cost burden amount which is a burden amount of the organization at the time of the face-to-face medical care (FIG. 9 / STEP 510).

  The organization burden amount determination unit 115 recognizes the organization medical cost burden amount, which is the burden amount of the organization at the time of telemedicine, by multiplying the medical cost of telemedicine calculated in FIG. 7B / STEP 4013 by the tissue burden ratio ( FIG. 9 / STEP511).

  The tissue burden determining unit 115 determines a part of the difference between the reference tissue medical cost burden and the tissue medical cost burden at the time of telemedicine as the system usage cost (FIG. 9 / STEP 512). For example, the organization burden determining unit 115 determines 50% of the difference between the reference organization medical cost burden and the tissue medical cost burden of the target examinee P as the system usage cost.

  The organization burden amount determination unit 115 determines whether or not the number of users per unit period of a person belonging to the organization is a predetermined number or more (FIG. 9 / STEP 513). For example, the organization burden determining unit 115 recognizes a person who belongs to the same organization as the organization to which the target examinee P belongs by referring to the examinee list 121. The organization burden determining unit 115 recognizes the number of users of the telemedicine system before the unit period “one month” from the current time among those recognized in this way. The organization burden determination unit 115 determines whether or not the number of users is equal to or greater than a predetermined number.

  If the determination result is affirmative (FIG. 9 / STEP 513... YES), the organization burden amount determination unit 115 reduces the organization medical cost burden amount and the system usage cost (FIG. 9 / STEP 514).

  After the processing of FIG. 9 / STEP 514 or when the determination result of FIG. 9 / STEP 513 is negative (FIG. 9 / STEP 513... NO), the organization burden amount determination unit 115 performs the target medical examination included in the medical examinee list 121. Recognizing the organization ID of the person P and using the settlement information of the organization specified from the organization ID included in the organization list 123, the total amount of the organization medical cost burden and the determined system usage cost is settled ( FIG. 9 / STEP 515).

  Thus, the organization burden settlement process is completed.

(Organization medical expenses burden data provision processing)
Next, with reference to FIG. 10 and FIG. 11A, a tissue medical cost burden data provision process for providing time series data of the tissue medical expenses burden of the organization to the person in charge W of the organization will be described.

  The tissue terminal control unit 41 determines whether a display request operation for tissue medical expense burden data is input via the tissue terminal input unit 44 (FIG. 10 / STEP 640).

  When the determination result is negative (FIG. 10 / STEP 640... NO), the organization terminal control unit 41 executes the process of FIG. 10 / STEP 640 again.

  If the determination result is affirmative (FIG. 10 / STEP 640... YES), the organization terminal control unit 41 sends an organization medical cost burden data request including the organization ID stored in the organization terminal storage unit 42 to the organization terminal communication. It is transmitted to the remote medical care support server 1 via the unit 45 (FIG. 10 / STEP 641).

  The data transmission unit 116 determines whether or not the tissue medical cost burden data request is received via the server communication unit 15 (FIG. 10 / STEP 610).

  If the determination result is negative (FIG. 10 / STEP 610... NO), the data transmission unit 116 executes the process of FIG. 10 / STEP 610 again.

  When the determination result is affirmative (FIG. 10 / STEP 610... YES), the data transmission unit 116 refers to the examinee list 121 from the organization ID included in the tissue medical expense burden data request and belongs to the organization. The examinee ID of the examinee who is performing is specified (FIG. 10 / STEP 611). For example, the data transmission unit 116 refers to the examinee list 121 shown in FIG. 2A from the organization ID “101” included in the tissue medical cost burden data request from the organization “A company”, and starts the member number The patient IDs “1” and “3” of the examinees “Oda × M” and “X River Omi” whose organization ID “101” is included are identified.

  The data transmission unit 116 refers to the examination information list 125 and recognizes the examination information including the identified examinee ID (FIG. 10 / STEP 612).

  For example, the data transmission unit 116 extracts and recognizes the fields having the examinee IDs “1” and “3” from the diagnosis information list 125 shown in FIG. 2E.

  The data transmission unit 116 calculates the amount of tissue medical cost burden for each unit period based on the recognized medical examination information (FIG. 10 / STEP 613).

  For example, the data transmission unit 116 adds up the recognized amount of tissue medical expenses per unit period “1 month” in the same manner as in FIG. Recognize the forehead.

  The data transmission unit 116 recognizes the reference tissue medical cost burden for each unit period of the organization based on the recognized examination information (FIG. 10 / STEP 614). For example, the data transmission unit 116 adds the reference tissue medical cost burdens recognized by the same method as in FIG. 9 / STEP 510 for each unit period “1 month”, so that the standard for each unit period “1 month” is obtained. Recognize the amount of tissue medical expenses. The data transmitting unit 116 calculates a part of the difference between the reference tissue medical cost burden for each unit period and the tissue medical cost burden for each unit period as a system usage cost for each unit period (FIG. 10 / STEP 615). .

  The data transmission unit 116 creates time-series tissue medical cost burden data based on the reference tissue medical cost burden for each unit period, the tissue medical cost burden for each unit period, and the system usage cost for each unit period. (FIG. 10 / STEP 616).

  FIG. 11A is a line graph in chronological order of the tissue medical cost burden included in the tissue medical cost burden data. The vertical axis in FIG. 11A is the amount of money, and the horizontal axis in FIG. 11A is the period. The broken line is a graph showing the transition of the reference tissue medical cost burden, the one-dot chain line is the graph showing the transition of the tissue medical expenses burden, and the two-dot chain line is the amount of the system medical expenses plus the system usage cost It is a graph which shows a transition.

  The data transmitting unit 116 transmits the created tissue medical cost burden data to the tissue terminal 4 via the server communication unit 15 (FIG. 10 / STEP 617).

  The organization terminal control unit 41 determines whether or not tissue medical expense burden data has been received via the organization terminal communication unit 45 (FIG. 10 / STEP 642).

  When the determination result is negative (FIG. 10 / STEP 642... NO), the organization terminal control unit 41 executes the process of FIG. 10 / STEP 642 again.

  If the determination result is affirmative (FIG. 10 / STEP 642... YES), the tissue terminal control unit 41 outputs the received tissue medical cost burden data to the tissue terminal output unit 43, for example, in the form of a graph shown in FIG. (FIG. 10 / STEP 643).

  Thus, the tissue medical cost burden data providing process is completed.

(First health condition data provision process)
With reference to FIG. 11B and FIG. 12, the 1st health condition data provision process which provides the data which show the time-sequential change of the health condition of object examinee P with respect to the 1st user terminal 3 of object examinee P is performed. explain.

  The first user terminal control unit 31 determines whether or not a display request operation for the first health condition data is input via the first user terminal input unit 34 (FIG. 12 / STEP 730).

  When the determination result is negative (FIG. 12 / STEP 730... NO), the first user terminal control unit 31 executes the process of FIG. 12 / STEP 730 again.

  When the determination result is affirmative (FIG. 12 / STEP 730... YES), the first user terminal control unit 31 includes the first examinee ID of the subject examinee P stored in the first user terminal storage unit 32. The health condition data request is transmitted to the remote medical care support server 1 via the first user terminal communication unit 35 (FIG. 12 / STEP 731).

  The data transmission unit 116 determines whether or not the first health condition data request has been received via the server communication unit 15 (FIG. 12 / STEP 710).

  If the determination result is negative (FIG. 12 / STEP 710... NO), the data transmission unit 116 executes the process of FIG. 12 / STEP 710 again.

  If the determination result is affirmative (FIG. 12 / STEP 710... YES), the data transmission unit 116 determines the medical assistance information list 124 based on the examinee ID of the subject examinee P included in the first health condition data request. Then, referring to the examination information list 125, the medical assistance information and the examination information including the examinee ID are recognized (FIG. 12 / STEP 711). Even if the data transmission unit 116 does not receive the first health condition data request, the data transmission unit 116 periodically performs the processing of FIG. You may transmit 1st health condition data previously.

  For example, the data transmission unit 116 extracts and recognizes information of the field that is the subject ID “1” of the target examinee P from the medical assistance information list 124 and the examination information list 125 illustrated in FIGS. 2D and 2E. .

  Based on the recognized information, the data transmission unit 116 recognizes the time-series health state of the target medical examinee P at each medical examination time point and information on the medicine prescribed for the target medical examinee P (FIG. 12 / STEP 712).

  For example, the data transmission unit 116 refers to the medical assistance information list 124 to recognize the blood pressure of the target medical examinee P at each medical examination time point, and refers to the medical examination information list 125 to recognize the number of medicines taken per day. May be. It should be noted that the health status of the medical assistance information having the registration date and time closest to the date and time of diagnosis included in the diagnosis information list 125 can be recognized as the health status of the target patient P at the time of the diagnosis. Further, the item “blood pressure” of the health condition to be recognized may be determined by referring to a correspondence table (not shown) based on the disease name “hypertension” of the target patient P in the patient list 121. Instead of this, the data transmission unit 116 may recognize one of the time-series health state of the target medical examinee P at each time of medical examination and information on the medicine prescribed to the target medical examinee P.

  The data transmission unit 116 creates time-series first health condition data based on the time-series health condition of the target examinee P at each point of visit and the information on the medicine prescribed to the target examinee P ( FIG. 12 / STEP 713).

  The data transmission unit 116 transmits the created first health condition data to the first user terminal 3 via the server communication unit 15 (FIG. 12 / STEP 714).

  The first user terminal control unit 31 determines whether or not the first health condition data has been received via the first user terminal communication unit 35 (FIG. 12 / STEP 732).

  If the determination result is negative (FIG. 12 / STEP 732... NO), the first user terminal control unit 31 executes the process of FIG. 12 / STEP 732 again.

  If the determination result is affirmative (FIG. 12 / STEP 732... YES), the first user terminal control unit 31 converts the received first health condition data into, for example, the graph shown in FIG. 33 (FIG. 12 / STEP 733).

  FIG. 11B is a graph created based on the first health condition data. The left vertical axis in FIG. 11B is blood pressure, the right vertical axis in FIG. 11B is the number of medicines taken per day, and the horizontal axis in FIG. 11B is the period. The solid line is a graph showing the blood pressure transition, and the broken line is a graph showing the transition of the number of medicines taken per day. In addition, a point t1 indicating each consultation time point in a part of the graph includes a link to the examination information screen in which the link of the prescription content transmission display is deleted from the examination information screen shown in FIG.

  Thus, the first health condition data provision process ends.

(Second health status data provision process)
Referring to FIG. 11C and FIG. 13, the remote medical treatment related to the disease name designated by the prospective examiner UP to the second user terminal 5 of the prospective examiner UP who does not use the remote medical treatment support service of the remote medical assistance server 1. The second health condition data providing process for providing second health condition data indicating the time-series transition of the health condition of the support service user (examinee) will be described.

  The second user terminal control unit 51 determines whether or not a second health condition data display request operation including designation of a disease name is input via the second user terminal input unit 54 (FIG. 13 / STEP 850).

  If the determination result is negative (FIG. 13 / STEP 850... NO), the second user terminal control unit 51 executes the process of FIG. 13 / STEP 850 again.

  If the determination result is affirmative (FIG. 13 / STEP 850... YES), the second user terminal control unit 51 sends a second health condition data request including the specified disease name via the second user terminal communication unit 55. To the remote medical care support server 1 (FIG. 13 / STEP 851).

  The data transmission unit 116 determines whether or not the second health condition data request has been received via the server communication unit 15 (FIG. 13 / STEP 810).

  If the determination result is negative (FIG. 13 / STEP 810... NO), the data transmission unit 116 executes the process of FIG. 13 / STEP 810 again.

  When the determination result is affirmative (FIG. 13 / STEP 810... YES), the data transmission unit 116 refers to the examinee list 121 from the disease names included in the second health condition data request, and is associated with the disease names. The patient ID is recognized (FIG. 13 / STEP 811).

  For example, the data transmission unit 116 refers to the examinee list 121 from the disease name “high blood pressure” included in the second health condition data request, and recognizes the examinee ID “1” associated with the disease name “high blood pressure”. .

  With reference to the medical assistance information list 124 and the medical examination information list 125, the field including the examinee ID is recognized (FIG. 13 / STEP812).

  For example, the data transmission unit 116 extracts and recognizes information on the field having the examinee ID “1” from the medical assistance information list 124 and the medical examination information list 125 illustrated in FIGS. 2D and 2E.

  Based on the recognized information, the data transmission unit 116 recognizes the time-series health status of each examinee at each visit time point and information on the medicine prescribed to each examinee (FIG. 13 / STEP813).

  For example, the data transmission unit 116 refers to the medical assistance information list 124 to recognize the blood pressure of each medical examinee at each medical examination time, and refers to the medical examination information list 125 to recognize the number of medicines taken per day. Also good. It should be noted that the health status of the medical assistance information having the registration date and time closest to the date and time of diagnosis included in the diagnosis information list 125 can be recognized as the health status of each patient at the time of the diagnosis. The item “blood pressure” of the recognition target health condition may be determined by referring to a correspondence table (not shown) based on the designated disease name “high blood pressure”. Instead of this, the data transmission unit 116 may recognize one of the time-series health state of each examinee at each visit time point and information on the medicine prescribed to each examinee.

  The data transmission unit 116 creates time-series second health condition data based on the health condition of each examinee at each point of visit and information on the medicine prescribed to each examinee (FIG. 13 / STEP 814).

  The data transmission unit 116 transmits the created second health condition data to the second user terminal 5 via the server communication unit 15 (FIG. 13 / STEP 815).

  The second user terminal control unit 51 determines whether or not the second health condition data is received via the second user terminal communication unit 55 (FIG. 13 / STEP852).

  When the determination result is negative (FIG. 13 / STEP852... NO), the second user terminal control unit 51 executes the process of FIG. 13 / STEP852 again.

  When the determination result is affirmative (FIG. 13 / STEP852... YES), the second user terminal control unit 51 converts the received second health condition data into the graph shown in FIG. It outputs to the part 53 (FIG. 13 / STEP853).

  FIG. 11C is a line graph showing a time-series transition of the health state for each patient included in the second health state data. The left vertical axis in FIG. 11C is the blood pressure, and the horizontal axis in FIG. 11C is the period. The graph of each examinee may be a graph showing the transition of the health state for a certain period (for example, one year) starting from each consultation start date. The solid line, the alternate long and short dash line, and the alternate long and two short dashes line are graphs showing the transition of blood pressure for each patient. In addition, at the point t2 indicating each consultation time point in each graph, the personal information such as the name of the examinee and the examinee ID, the prescription content transmission display, the reservation reception display, etc. are deleted from the examination information screen shown in FIG. A link to the consultation information screen is included.

  Thus, the second health condition data transmission process ends.

  DESCRIPTION OF SYMBOLS 1 ... Remote medical care support server, 2 ... Doctor terminal, 3 ... 1st user terminal (user terminal), 4 ... Organization terminal, 111 ... Medical treatment reservation reception part, 112 ... Medical care support information registration part, 113 ... Medical examination information registration part, 114. Medical cost determining unit 115 115 Organization burden determining unit 116 Data transmitting unit 12 Server storage unit 121 Patient list 122 Doctor list 123 Organization list 124 Medical support information list 125: Examination information list, 126: Reservation list, 127: Medical treatment available time zone information list, 128: Target list, 129: Status log, 21: Doctor terminal control unit (remote medical care support unit)

Claims (7)

A network system comprising one or more doctor terminals that communicate with a plurality of user terminals and a remote medical assistance server,
A storage unit that stores medical available time zone information including a medical available time zone that is a time zone during which a doctor who is a user of the one or more doctor terminals can engage in medical treatment;
Receiving from a first user terminal, which is one of the plurality of user terminals, information including a desired medical examination time zone for which a target examinee who is a user of the first user terminal desires to receive medical examination; By referring to the available time zone information, a doctor in charge who can engage in medical treatment in the desired medical treatment time zone is extracted, and communication between the doctor terminal in charge as the doctor terminal of the doctor in charge and the first user terminal is performed. A medical appointment reception unit that transmits communication establishment information for establishing establishment to one or both of the doctor terminal in charge and the first user terminal;
The patient remark information received from the first user terminal with which communication has been established based on the communication establishment information is output to the doctor terminal in charge, and the doctor remark information input from the doctor terminal in charge is output to the first user. A telemedicine support unit that transmits to the terminal;
Receives medical record information from the doctor terminal or the first user terminal in the current telemedicine for the subject testee, based on the received mosquitoes ruthenate information, recognizes the next target behavior of the target examinee , When the next target action is transmitted to the first user terminal, the degree of compliance of the target examinee with respect to the current target action is recognized based on the chart information, and the degree of compliance is equal to or higher than a predetermined level of compliance A medical cost determination unit for determining a medical cost in the current telemedicine for the target examinee so that the level of compliance is less than or equal to the medical cost when the compliance level is less than the predetermined level of compliance. Telemedicine support system. The telemedicine support system according to claim 1,
The telemedicine support system, wherein the target behavior is a target behavior including at least one of a target behavior related to eating and drinking, a target behavior related to exercise, and a target behavior related to medical equipment.   The telemedicine support system according to claim 1 or 2,
  The medical cost determining unit transmits the next target action and the importance of the next target action to the first user terminal, and the current target action, the degree of compliance with the current target action, and the current target action. A telemedicine support system configured to determine a medical cost for the current telemedicine according to the importance of the target action. In the telemedicine support system according to any one of claims 1 to 3,
  The medical cost determination unit recognizes the current point based on the degree of compliance with the current target behavior,
It is configured to determine the medical cost by applying a discount when the condition that the state where the current point or the cumulative point is equal to or greater than a predetermined threshold lasts for a predetermined period is satisfied. Telemedicine support system. In the telemedicine support system according to any one of claims 1 to 4,
  The medical cost determination unit is configured to determine the medical cost by applying a discount when satisfying a condition that a period in which the degree of compliance with the target action of this time is a predetermined threshold or more continues for a predetermined period Telemedicine support system characterized by A telemedicine support server that communicates with a plurality of user terminals and one or more doctor terminals,
A storage unit that stores medical available time zone information including a medical available time zone that is a time zone during which a doctor who is a user of the one or more doctor terminals can engage in medical treatment;
Receiving from a first user terminal, which is one of the plurality of user terminals, information including a desired medical examination time zone for which a target examinee who is a user of the first user terminal desires to receive medical examination; By referring to the available time zone information, a doctor in charge who can engage in medical treatment in the desired medical treatment time zone is extracted, and communication between the doctor terminal in charge as the doctor terminal of the doctor in charge and the first user terminal is performed. A medical appointment reception unit that transmits communication establishment information for establishing establishment to one or both of the doctor terminal in charge and the first user terminal;
Receives medical record information from the doctor terminal or the first user terminal in the current telemedicine for the subject testee, based on the received mosquitoes ruthenate information, recognizes the next target behavior of the target examinee , When the next target action is transmitted to the first user terminal, the degree of compliance of the target examinee with respect to the current target action is recognized based on the chart information, and the degree of compliance is equal to or higher than a predetermined level of compliance A medical cost determination unit for determining a medical cost in the current telemedicine for the target examinee so that the level of compliance is less than or equal to the medical cost when the compliance level is less than the predetermined level of compliance. Telemedicine support server. Included is information that includes a medical time period that is a time period during which a doctor who is a user of the one or more doctor terminals can engage in medical care, communicates with a plurality of user terminals and one or more doctor terminals. A method performed by a remote medical assistance server including a storage unit that stores medical available time zone information,
Receiving, from a first user terminal, which is one of the plurality of user terminals, information including a desired medical treatment time zone for which a target examinee who is a user of the first user terminal desires to receive medical examinations;
Extracting a doctor in charge who can engage in medical treatment in the desired medical treatment time zone with reference to the medical available time zone information;
Transmitting communication establishment information for establishing communication between a doctor terminal in charge of the doctor terminal of the doctor in charge and the first user terminal to one or both of the doctor terminal in charge and the first user terminal;
Receiving a medical record information in the current telemedicine for the charge et al or the doctor terminal or the first user terminal skilled said subject testee,
Recognizing the next target behavior of the target examinee based on the received medical record information ;
Transmitting the next target action to the first user terminal;
Recognizing the subject's compliance with the target behavior based on the chart information;
When the compliance level is equal to or higher than the predetermined compliance level, the medical cost in the current remote medical care for the target examinee is determined so as to be equal to or lower than the medical cost when the compliance level is less than the predetermined compliance level. And a telemedicine support method comprising the steps of: