JP6137970B2 - Disease management program and disease management system - Google Patents

Description

  The present invention relates to a disease management system for extracting a patient suspected of having a disease from a medical information database in the medical field and tracking and managing the extracted patient.

  Conventionally, in order to support a doctor's diagnosis, Japanese Patent Application Laid-Open No. 2003-6329 normalizes each test value of a patient test result by a test result normalizing means, and defines a weight defined for each test value for each disease name. A diagnosis support system is disclosed in which product sum values are obtained by multiplying values, and disease names are sorted in descending order of the obtained product sum values and displayed as disease candidates.

JP 2003-6329 A

  However, in the technique disclosed in Patent Document 1, disease candidates for supporting the diagnosis are displayed at the time of diagnosis for one patient, and there is a suspicion of a target disease from a set of all patients. The patient was not extracted.

  In addition, since the amount of information in the medical information database in which medical information such as information indicating a patient and medical information is stored is enormous, if the target information is directly extracted from the set of patients as a whole, it takes time to extract. There is a problem that not only it takes too much, but also the load on the system increases.

  The present invention has been made in view of the above points, and realizes a mechanism for extracting a patient suspected of disease from a vast amount of medical information that occurs every day and encouraging the active intervention of specialists. By adding scores to related examination information and weighting, the accuracy of extraction is increased, and preliminary information is extracted from the medical information database in advance, thereby shortening the extraction time and reducing the system load. It aims to plan.

  Another object of the present invention is to provide a patient with a good medical practice by performing tracking management on an extracted patient as necessary.

The disease management program of the present invention comprises:
Computer
A patient extraction condition storage unit that stores medical information elements set in advance for each desired patient extraction purpose as a plurality of patient extraction conditions for each patient extraction purpose;
A patient extraction unit that extracts patient information that matches the patient extraction condition from a medical information database that stores medical information, and stores the extracted patient information as a plurality of extracted patient information for each patient extraction condition;
One or more pieces of extracted patient information set in advance for each desired event extraction purpose, and a score associated with a description or value of the set extracted patient information for each event extraction purpose A screening template storage unit stored as a plurality of screening templates;
An item is extracted for each patient from one or more of the extracted patient information set in the screening template, and when the description or value of the extracted item is bad, the score is associated with the item, and the sum of the scores If the patient is a predetermined value or more, information indicating the patient, items extracted for each patient from the extracted patient information, and the associated score for a plurality of tracking patients for each screening template A tracking patient candidate extraction unit to be stored in the tracking patient candidate storage unit as candidate information;
The patient with the predetermined condition is removed from the tracked patient candidate information, the remaining patient is set as the tracked patient, and the information indicating the tracked patient and the tracked information indicating the subsequent tracking status are set as a plurality of tracked patient information for each screening template. A tracking patient extraction management unit to be stored in the tracking patient storage unit;
It is characterized by functioning.

  According to the disease management program of the present invention, the patient extraction condition storage unit stores elements related to medical information preset for each patient extraction purpose as a plurality of patient extraction conditions for each patient extraction purpose. When the purpose is used many times, it can be used repeatedly only by setting patient extraction conditions once. Here, the element relating to medical information can serve as a search key when extracting medical information, and a specific disease name, a specific test item, a specific medicine, and the like can be employed. The term “plurality” is intended to distinguish each piece of information, and various units such as folders, files, records, etc. can be adopted as the distinction units (the same applies hereinafter).

  In addition, since the patient extraction unit extracts patient information that matches the patient extraction condition from the medical information database and sets a plurality of extracted patient information for each patient extraction condition, before the information extraction related to the event extraction purpose described later, Preliminary information can be extracted. This eliminates the need to extract final information directly from an enormous amount of medical information, thereby shortening the extraction time and reducing the system load.

  In addition, the screening template storage unit displays one or more pieces of extracted patient information set in advance for each event extraction purpose, and a score associated when the description or value of the set extracted patient information is bad. Since it is stored as a plurality of screening templates each time, when the same event extraction purpose is used many times, it can be used repeatedly only by setting a condition for extracting the event once.

  Moreover, since the tracking patient candidate extraction unit extracts items for each patient from one or more pieces of extracted patient information set in the screening template, information for each patient can be collected. In addition, since it is only necessary to refer to the extracted patient information necessary for each screening template, it is not necessary to refer to the entire medical information for the extraction for the event extraction purpose, thereby shortening the extraction time and the system load. Can be planned.

  The tracking patient candidate extraction unit associates a score with the item when the description or value of the item extracted for each patient is bad, and if the sum of the associated scores is a predetermined value or more, the patient is tracked with the patient. Since it is set as a candidate, weighting by score can be performed for each extracted item, and the reliability of the extraction result can be improved. Further, in order to store information indicating a patient, items extracted for each patient from the extracted patient information, and a score as a plurality of tracking patient candidate information for each screening template in the tracking patient candidate storage unit, The causes can be listed.

  In addition, since the tracking patient extraction management unit removes patients with predetermined conditions from the tracking patient candidate information and uses the remaining patients as tracking patients, noise can be reduced during extraction. In addition, since information indicating the patient of the tracking patient and the tracking information are stored in the tracking patient storage unit as a plurality of tracking patient information for each screening template, subsequent patient tracking is facilitated.

A preferred example of the disease management program of the present invention is:
Creation of extracted patient information from the medical information database by the patient extraction unit and storage in the extracted patient storage unit are performed at predetermined time intervals.

  According to the preferable example of the disease management program of the present invention, the operation related to the patient extraction unit is repeatedly executed every predetermined time, so that it is easy to update the extracted patient information.

A preferred example of the disease management program of the present invention is:
Creation of the tracking patient candidate information by the tracking patient candidate extraction unit and storage in the tracking patient candidate storage unit are performed at predetermined time intervals.

  According to the preferable example of the disease management program of the present invention, the operation related to the follow-up patient candidate extraction unit is repeatedly executed every predetermined time, so that the follow-up patient candidate information can be easily updated.

A preferred example of the disease management program of the present invention is:
When the follow-up patient visits, it is determined whether the corresponding department at the visit of the follow-up patient and the specialized department for the event extraction purpose related to the follow-up patient are the same. Notifying the corresponding department and the specialized department that the patient is visiting the hospital.

According to a preferred example of the disease management program of the present invention, in order to notify a follow-up patient visit to a specialized department for the purpose of event extraction related to the follow-up patient, the specialized department can contact the patient during the patient visit. This will facilitate the active intervention of specialists.

A preferred example of the disease management program of the present invention is:
When changes are made to the follow-up patient information, determine whether the follow-up patient is visiting,
When the follow-up patient has not visited the hospital, the change is made to the follow-up patient information and the specialized department for the event extraction purpose related to the follow-up patient is notified.
Furthermore, a preferable example of the disease management program of the present invention is:
When changes are made to the follow-up patient information, determine whether the follow-up patient is visiting,
When the follow-up patient is in the hospital, the corresponding department at the time of the visit of the follow-up patient and the specialized department for the event extraction related to the follow-up patient are notified that the follow-up patient information has been changed. And

According to a preferred example of the disease management program of the present invention, when a change is made to the follow-up patient information, the change from the special department to the patient is notified to the special department for the purpose of event extraction related to the changed follow-up patient. Can be promptly communicated, and active intervention by specialists is facilitated. Here, the information change includes addition, update, and deletion of information.

The disease management system of the present invention comprises:
A patient extraction condition storage unit that stores medical information elements set in advance for each desired patient extraction purpose as a plurality of patient extraction conditions for each patient extraction purpose;
A patient extraction unit that extracts patient information that matches the patient extraction condition from a medical information database that stores medical information, and stores the extracted patient information as a plurality of extracted patient information for each patient extraction condition;
One or more pieces of extracted patient information set in advance for each desired event extraction purpose, and a score associated with a description or value of the set extracted patient information for each event extraction purpose A screening template storage unit stored as a plurality of screening templates;
An item is extracted for each patient from one or more of the extracted patient information set in the screening template, and when the description or value of the extracted item is bad, the score is associated with the item, and the sum of the scores If the patient is a predetermined value or more, information indicating the patient, items extracted for each patient from the extracted patient information, and the associated score for a plurality of tracking patients for each screening template A tracking patient candidate extraction unit to be stored in the tracking patient candidate storage unit as candidate information;
The patient with the predetermined condition is removed from the tracked patient candidate information, the remaining patient is set as the tracked patient, and the information indicating the tracked patient and the tracked information indicating the subsequent tracking status are set as a plurality of tracked patient information for each screening template. A tracking patient extraction management unit to be stored in the tracking patient storage unit;
It is characterized by providing.

  According to the disease management system of the present invention, the same operational effects as the above-described disease management program can be obtained.

  As described above, according to the disease management program and the disease management system of the present invention, the medical information related to the disease to be extracted is scored and weighted to increase search accuracy and By extracting preliminary information from the information database in advance, the search time can be shortened and the load on the system can be reduced.

  In addition, another effect of the present invention can provide a patient with a good medical practice by performing tracking management on the extracted patient as necessary.

It is a functional block diagram which shows the structure of the disease management system which concerns on one Embodiment of this invention. It is a figure which shows the screen which sets patient extraction conditions. It is a figure which shows the screen which sets a screening template. It is a figure which shows the screen which displays a pursuit patient candidate. It is a figure which shows the screen which displays another pursuit patient candidate. It is a figure which shows the screen which displays a tracking patient list. It is a figure which shows the screen which manages a follow-up patient. It is an operation | movement flowchart of a notification part. It is another operation | movement flowchart of a notification part. It is a figure which shows the data structure of a patient information database. It is a figure which shows the data structure of the extraction patient information extracted from the test | inspection database and a test | inspection database. It is a figure which shows the data structure of the extracted patient information extracted from the disease name database and the disease name database. It is a figure which shows the data structure of follow-up patient candidate information. It is a figure explaining an example of the extraction concept of the information of a disease management system.

  DESCRIPTION OF EMBODIMENTS Hereinafter, embodiments of a disease management system of the present invention will be described in detail with reference to the accompanying drawings. The disease management program according to the present invention is executed on a computer to realize a disease management system.

  FIG. 1 is a diagram showing a configuration of a disease management system 1 according to a preferred embodiment of the present invention, together with a medical information database 80 and a specialized department 90. Moreover, FIG. 14 is a figure which shows an example of the extraction concept of the information of the disease management system of this embodiment.

  First, an example of the information extraction concept of the disease management system of this embodiment will be described with reference to FIG. The vertical axis of the table shown in FIG. 14 describes the test values such as body weight, blood pressure, blood glucose, etc. as elements relating to medical information, and the horizontal axis shows the patient's metabolic disorders, ophthalmic complications, nephropathy, etc. Symptoms are listed for event extraction purposes. And the part which is attached with “◯” indicates that the element and the event extraction purpose are related. For example, in patients with nephropathy, the values of HbA1c, creatinine, and urine protein often become abnormal. Conversely, even in patients who are not currently diagnosed with nephropathy, if the values of HbA1c, creatinine and urine protein are abnormal, nephropathy can be suspected.

  Therefore, the disease management system of this embodiment searches and extracts medical information for each element using the elements described in this table as patient extraction conditions. Furthermore, the event extraction purpose described in the table is used as a screening template, and data extracted according to patient extraction conditions with “◯” for each screening template is referred to. Then, based on the referenced data, the patient corresponding to the event extraction purpose is extracted.

  Next, with reference to FIG. 1, the medical information database 80 and the specialized department 90 to which the disease management system 1 of this embodiment is connected will be described. A medical information database 80 (hereinafter, “database” may be referred to as “DB”) is a part of a known medical information management system, and stores a patient information DB 81 that stores information indicating a patient for each patient, Medical record DB 82 that stores examination contents for each patient, nursing record DB 83 that stores nursing contents for each patient, examination DB 84 that stores examination contents for each patient, prescription DB 85 that stores medicines prescribed for each patient, for each patient An injection DB 86 that stores the injections made, a disease name DB 87 that stores the name of each patient, an image DB 88 that stores images taken by the radiation device, ultrasonic device, magnetic resonance device, endoscope, etc. for each patient, A surgery DB 89 or the like that stores the contents of surgery for each patient is provided.

  Here, the patient information DB 81 includes items such as patient ID, name, sex, date of birth, and age as its data structure, and stores information indicating a patient for each patient (see FIG. 10). The examination DB 84 includes items such as a patient ID, a date of examination, examination items, examination values, and the like as its data structure, and stores examination contents for each patient (see FIG. 11A). The disease name DB 87 includes items such as patient ID, date, and disease name as its data structure, and stores the disease name for each patient (see FIG. 12A).

  The specialized department 90 is a department where specialists who can provide high-level medical practice according to the medical condition of each patient are enrolled, and terminals 91a and 91b provided in the department are known medical information management systems like the medical information DB 80. Is part of.

  In FIG. 1, the disease management system 1 of the present embodiment includes a patient extraction condition storage unit 2, a patient extraction unit 3, an extraction patient storage unit 4, a screening template storage unit 5, a follow-up patient candidate extraction unit 6, A tracking patient candidate storage unit 7, a tracking patient extraction management unit 8, a tracking patient storage unit 9, and a notification unit 10 are provided. In each of these configurations, the disease management program according to the present invention is a display of a computer system (not shown) including a control device including a CPU, a storage device including an HDD (Hard disk drive), an LCD (Liquid Crystal Display), and the like. It is realized in cooperation with an input device such as a device, a keyboard, etc., an input / output device that transmits and receives electrical signals to / from an external device, and the like.

  The patient extraction condition storage unit 2 stores a plurality of patient extraction conditions 2a, 2b, 2c, and 2d set in advance for each desired patient extraction purpose. The patient extraction condition is a specific examination item stored in the medical information DB, a comment at the time of a doctor's examination, a disease name, a prescribed medicine type, an element related to medical information such as an abnormal part of image data, and the like. This is a condition for extracting an item related to the search key from the medical information database using the search key as a search key. This patient extraction condition is displayed by a display device (not shown), and a doctor or the like can set the desired patient extraction purpose using the input device (see FIG. 2).

  The patient extraction unit 3 extracts patient information that matches the patient extraction conditions from the medical information database 80 in accordance with the patient extraction conditions 2a, 2b, 2c, and 2d. Here, patient information includes not only an item in which information indicating a patient matching the patient extraction condition is described, but also other items in the record including the item, for example, a test value, a disease name, and the like. Related items, such as other items, are also included. As patient information, the patient's address, name, etc. can be used, but if all of this information is extracted at this time, the information becomes redundant, so the patient ID or patient given to each patient is specified. It is preferable to use other IDs that can be used. Then, the extracted information is stored as extracted patient information 4a, 4b, 4c, 4d in the extracted patient storage unit 4 for each patient extraction condition.

  In addition, the operation of the patient extraction unit 3 can be repeatedly performed every predetermined time, and can always be kept up to date. In addition, in the extraction of information from the medical information database 80, when duplicate information is extracted such as the same patient with the same element, the duplication of information is prevented by enabling only the latest information. Can do.

  The screening template storage unit 5 stores a plurality of screening templates 5a, 5b, 5c, and 5d set in advance for each desired event extraction purpose. The screening template defines one or more extracted patient information to be extracted, and a score to be associated when the description or value of the extracted patient information is bad, and is displayed by a display device (not shown) such as a doctor. Can be set for a desired event extraction purpose using the input device (see FIG. 3). For example, when multiple test results specific to a certain disease appear, multiple extracted patient information extracted based on the patient extraction condition for the purpose of patient extraction is set in the screening template. Relevant inspection results can be selected.

  In addition, the screening templates 5a, 5b, 5c, and 5d store a score associated with the description or value of the extracted patient information, and the score value can be set as appropriate. As a result, a score can be set for each extracted patient information. For example, a small score is set for a less important test result and a large score is set for an important test result, and each of a plurality of test results is weighted. Can do.

  The tracking patient candidate extraction unit 6 extracts items for each patient from one or more pieces of extracted patient information set in the screening template. That is, for each desired event extraction purpose, for example, one or more items of extracted patient information related to a certain disease can be extracted together for each patient. Further, when the description or value of the extracted item is bad, a score is associated with the item, and when the sum of the scores is equal to or greater than a predetermined value, the patient is set as a follow-up patient candidate.

  Further, the tracking patient candidate extraction unit 6 includes, for each screening template, a plurality of items related to the patient as the tracking patient candidate, information indicating at least the patient, items extracted for each patient from the extracted patient information, and associated scores. The tracking patient candidate information 7a, 7b, 7c, and 7d is stored in the tracking patient candidate storage unit 7, and the tracking patient candidate information can be displayed by a display device (not shown) (see FIGS. 4 and 5). The information indicating the patient here preferably includes not only the patient ID but also information such as the patient's name, sex, date of birth, and age, and the extracted patient information 4a, 4b, 4c, 4d as the extraction source When there is no information indicating these patients, the patient information DB 81 can be referred to as necessary. Moreover, the operation | movement of the follow-up patient candidate extraction part 6 described here can be performed for every predetermined time, and can always be made into the newest state.

  The follow-up patient extraction management unit 8 removes patients with predetermined conditions from the follow-up patient candidate information 7a, 7b, 7c, and 7d, and sets the remaining patients as follow-up patients. The predetermined condition is, for example, when extracting a patient suspected of a specific disease that is the purpose of event extraction, a patient who has already started treatment of the disease from the extracted patients is referred to as a medical record DB 82 or a disease name DB 87. When the value of the item related to the score associated by the follow-up patient candidate extraction unit 6 appears when a specific medicine is taken, the medicine is prescribed by referring to the prescription DB 85 or the like. For a patient who has been treated, the score is excluded from the accumulation target. In addition, in order to remove a patient having a predetermined condition, a specific patient can be arbitrarily removed by operating the input device by a doctor or the like from the tracked patient candidate information displayed on the display device.

  Further, the tracking patient extraction management unit 8 stores information indicating the patient of the tracking patient and tracking information in the tracking patient storage unit 9 as a plurality of tracking patient information 9a, 9b, 9c, 9d for each screening template. The information indicating this patient is the same as the follow-up patient candidate information 7a, 7b, 7c, 7d. The tracking information is intended to be information that can grasp the tracking status of the patient, such as the date of the information, who wrote it, initial registration, start of guidance, tracking status such as contacted, and comments. The tracking patient information can be displayed by a display device (not shown). As a form of this display, a list of all tracked patients is displayed (see FIG. 6), a list of patients for each tracked patient information 9a, 9b, 9c, 9d is displayed, or each tracked patient is individually displayed. For example, it is possible to display the tracking patient information in detail (see FIG. 7). Furthermore, when the doctor or the like changes the displayed tracking patient information using the input device, the change is reflected in the tracking patient information and stored in the tracking patient storage unit.

  The notification unit 10 includes means for monitoring the tracking patient candidate storage unit 7 and the tracking patient storage unit 9 via the tracking patient extraction management unit 8 or directly. When changes are made to the follow-up patient candidate information 7a, 7b, 7c, 7d or the follow-up patient information 9a, 9b, 9c, 9d, it is determined whether or not a patient related to the change has come to the hospital. If it is, the specialized department 90 for each event extraction purpose and the terminal provided in the department at the time of visit are notified.

  In addition, the notification unit 10 includes means for detecting that visit information indicating that a patient included in the tracked patient information 9a, 9b, 9c, 9d has visited the medical information DB 80. When an included patient visits, the patient's visit is notified to the specialized department 90 for each event extraction purpose and the terminals provided in the corresponding department at the time of the visit.

  Next, based on the function of each component described above, the operation of the disease management system of the present embodiment will be described with reference to FIGS.

  2 shows a screen for setting patient extraction conditions in the disease management system 1 of the present embodiment, FIG. 3 shows a screen for setting a screening template, FIGS. 4 and 5 show screens for displaying candidate patient information, and FIGS. Shows a screen displaying the tracking patient information. FIG. 8 is a flowchart showing the operation of the notification unit for notifying the specialized department of the change when the follow-up patient candidate information or the follow-up patient information is changed, and FIG. 9 shows the visit when the follow-up patient visits. It is a flowchart which shows operation | movement of the notification part which notifies a specialized department. 10 is a data structure of a patient information DB in which information indicating a patient is stored, FIG. 11 is a data structure of extracted patient information extracted from the examination DB and the examination DB, and FIG. 12 is from the disease name DB and the disease name DB. FIG. 13 shows the data structure of the extracted patient information, and FIG. 13 shows the data structure of the extracted patient information.

  First, a patient extraction condition setting screen 20 for setting patient extraction conditions displayed on a display device (not shown) will be described with reference to FIG. The patient extraction condition setting screen 20 of FIG. 2 includes search template lists 21a, 21b, 21c, and 21d, an execution task setting unit 22, a result output name input unit 23, and an execution registration button 24. The search template lists 21a, 21b, 21c, and 21d are for setting the search conditions hierarchically from left to right. For example, when trying to extract a patient with a high HbA1c value as one of the elements related to medical information, “HbA1c high value” is entered in the examination column of the search template list 21a on the left. Here, “examination”, “disease name”, “medical record” and the like described as menus in the search template list are associated with the examination DB 84, the disease name DB 87, and the medical chart DB 82 of the medical information DB 80, respectively. That is, as shown in FIG. 2, when “HbA1c high value” is input in the examination column of the search template list 21a, the patient extraction unit 3 described later searches the examination DB 84. However, the association between the menu description and the medical information DB is merely an example, and the menu description may not match the DB name. Further, a plurality of DBs can be referred to depending on the description of the menu.

  If it is desired to perform extraction under this patient extraction condition every predetermined time, a check mark is given to the task valid selection unit 25 of the execution task setting unit 22, a task type input unit 26, a reference time input unit 27, an interval input. A desired condition is input to the unit 28 and the notification destination address input unit 29. Furthermore, when an output name is input to the result output name input unit 23, and "HbA1c high value" having the same name as the patient extraction condition and the registration execution button 24 is operated with an input device such as a mouse, these input items are the patient It is memorize | stored in the patient extraction condition memory | storage part 2 as extraction conditions, and is performed by the patient extraction part 3 mentioned later at predetermined intervals. Similarly, a plurality of patient extraction conditions relating to other patient extraction purposes can be created and stored in the patient extraction condition storage unit. In addition to the “elapsed time” shown in the figure, a task type in units of days, weeks, months, and the like can be input to the task type input unit 26.

  Here, it is also possible to set patient extraction conditions combining a plurality of elements by using the search template lists 21a, 21b, 21c, and 21d in a hierarchical manner. For example, if you want to extract (1) patients who visited for a specific period, (2) patients who visited the internal medicine department, and (3) patients who have been prescribed medicine A, search template elements (1) Patient: Date of consultation June, 2013 x Day to July, XX day (2) Examination subject: Internal medicine, (3) Prescription: Drug A Thus, the logical product of a plurality of elements can be taken as the patient extraction condition. In some cases, a part of the above condition may be a logical sum of a plurality of elements such as (3) a patient who is prescribed medicine A or medicine B. Further, a part of the condition may be a logical negation of the elements such as (3) a patient who is not prescribed medicine A.

  The patient extraction unit 3 extracts a corresponding patient from the medical information DB 80 based on the patient extraction condition described above. For example, as shown in FIG. 2, if the patient extraction condition is “high value of HbA1c” of “examination”, the examination DB shown in FIG. 11A is searched, and an item (“ (* 1) record) is extracted. Then, as shown in FIG. 11B, the extracted patient information including the patient ID, the test date, the test item, and the test value is created. Here, the extracted patient is extracted as “HbA1c high value” having the same name as the patient extraction condition. Store in the storage unit.

  Similarly, if the patient extraction condition is “high creatinine”, the extracted patient information shown in FIG. 11C, and if the patient extraction condition is “urine protein”, the extracted patient information and patient extraction conditions shown in FIG. If “blood glucose level”, the extracted patient information shown in FIG. 11E, and if the patient extraction condition is “urea”, the extracted patient information shown in FIG. 11F and the patient extraction condition are “GOT”. A plurality of pieces of extracted patient information for each patient extraction condition are created and stored in the extracted patient storage unit 4 as the extracted patient information shown in FIG. At this time, for each item whose description or value is abnormal (bad), a flag indicating that it is an abnormal value can be attached (a record with “* 10”).

  Similarly, when a specific disease name is a patient extraction condition, if the patient extraction condition is “diabetes” from the disease name DB shown in FIG. 12A, the extracted patient information and the patient extraction condition shown in FIG. If “kidney failure”, the extracted patient information shown in FIG. 12C is created. If the patient extraction condition is “cirrhosis”, the extracted patient information shown in FIG. 12D is created and stored in the extracted patient storage unit 4. Is done.

  Next, the screening template creation screen 40 for setting the screening template conditions will be described with reference to FIG. The screening template creation screen 40 of FIG. 3 is displayed by a display device (not shown) and includes an extracted patient information list 41, a screening template setting unit 42, a registration button 48, and a close button 49. The extracted patient information list 41 displays a plurality of extracted patient information for each patient extraction condition stored in the extracted patient storage unit 4 described above. Since the patient extraction condition and the extracted patient information are in a pair relationship, the patient extraction condition may be set in the extracted patient information list 41 instead of the extracted patient information, and the corresponding extracted patient information may be referred to.

  The screening template setting unit 42 includes a name input unit 43, an extracted patient information selection column 44, a score input column 45, an overall score display unit 46, and a threshold score input unit 47.

  The name input field 43 is used to input a name for the purpose of event extraction, and the name is arbitrarily determined. For example, “suspected nephropathy” is input in FIG. The extracted patient information selection field 44 is used to select desired extracted patient information from the extracted patient information list 41, and extracted patient information that matches the purpose of event extraction is selected. In FIG. 3, extracted patient information of “high HbA1c”, “high creatinine”, and “urine protein” related to nephropathy is selected.

  In the score input field 45, when the description or value of the selected extracted patient information is defective, an arbitrary score associated with the item of the defective is input, and the importance of the extracted patient information for the purpose of event extraction is input. It will be scored accordingly. In FIG. 3, “high HbA1c” has the highest importance for “suspected nephropathy”, score 60, “high creatinine” has the highest importance, score 50, and “urine protein” is the most important. Score 30 is associated with low importance. In this way, since the score value can be attached according to the importance of the extracted patient information for the purpose of event extraction, each test item can be weighted and the accuracy of event extraction such as suspicion of disease can be improved. Can do.

  The overall score display unit 46 displays the sum of the scores input in the score input field 45. In FIG. 3, since scores of 60, 50, and 30 are input, 140, which is the sum of them, is displayed. The threshold score input unit 47 determines the number of sums of scores associated when the description or value of the selected extracted patient information is bad, and determines the patient as a follow-up patient candidate. An arbitrary value is set for each extraction purpose. Since “50” is input here, if the sum of the scores is 50 or more, it is determined as a follow-up patient candidate.

  When the registration button 48 is operated by a doctor or the like, the contents input so far to the screening template setting unit 42 are stored in the screening template storage unit 5 as a screening template.

  The tracking patient candidate extraction unit 6 extracts items for each patient from one or more set extracted patient information based on the above-described screening template. For example, in the screening template for the purpose of extracting the event “suspected nephropathy” shown in FIG. 3, three pieces of extracted patient information “high HbA1c”, “high creatinine”, and “urine protein” are set. Then, the follow-up patient candidate extraction unit 6 performs, for each patient, from the three extracted patient information of “high HbA1c”, “high creatinine”, and “urine protein” shown in FIGS. 11 (B), (C), and (D). The three extracted patient information items are collected.

  Then, it is determined whether or not the description or value of the extracted patient information is defective. If the extracted patient information is defective, the score set in the screening template is associated with the item, and an intermediate state as shown in FIG. Data is created (inspection value of record with “* 10” is bad). Next, the sum of the scores of the associated patients is compared with the score threshold value “50” set in the screening template, and the patients whose patient IDs 102 and 109 have the associated score sum equal to or higher than the score threshold are tracked. Candidate. Then, the tracking patient candidate information as shown in FIG. 13B is stored in the tracking patient candidate storage unit 7.

  Next, a tracking patient candidate list screen 50 that displays tracking patient candidate information will be described with reference to FIGS. The tracking patient candidate list screen 50 shown in FIGS. 4 and 5 includes a screening template list 51 and a tracking patient candidate information list 54. The screening template list 51 displays the screening template names 52 stored in the screening template storage unit 5 and the number of extracted patients 53.

  The tracked patient candidate information list 54 displays the tracked patient candidate information extracted by the tracked patient candidate extraction unit 6 and accesses the patient information display field 55, the tracking index display field 56, the score display field 57, and the medical information DB 80. An open button 58 for referring to detailed medical information of the patient, and a tracking management registration button 59 for manually setting the patient as a tracking patient are provided.

  The patient information display field 55 displays information indicating a patient with reference to the patient information DB 81 based on the patient ID in the tracked patient candidate information. The tracking index display field 56 displays the description and value of the item of the tracking patient candidate information. When the description or value is bad, the description or value is shaded and displayed by a viewer such as a doctor. I understand that there is. The score display column 57 displays the sum of scores for each patient described in the follow-up patient candidate information.

  The open button 58 is operated by a doctor or the like and can refer to details such as examination information of the patient. The tracking management registration button 59 is a button for manually setting the patient as a tracking patient without using the tracking patient extraction management unit 8 described later, and the patient is included in the tracking patient information by an operation of a doctor or the like. . In FIG. 4, a screening template of “suspected nephropathy” is selected, and detailed information such as patient IDs 102 and 109 is displayed in the tracking patient candidate information list as the tracking patient candidate information. From these displays, for example, the patient ID 102 is suspected of having nephropathy, and the reason is that the values of “HbA1c” and “creatinine” are poor.

  Further, in FIG. 5, the screening template “insufficient examination” is selected, and detailed information such as the patient IDs 106 and 103 is displayed in the tracked patient candidate information list 54. From these displays, for example, it can be seen that the patient ID 106 is suffering from diabetes and renal failure but has not been tested for “blood glucose level” and “urea” necessary for each disease.

  In order to extract such patients who have not undergone the necessary examination, a plurality of patient extraction conditions, that is, the elements of the search template shown in FIG. For example, if an attempt is made to extract no blood glucose level test for a diabetic patient, the elements of the search template are described as (1) disease name: diabetes (2) test: blood glucose level not described.

  Then, the patient extraction unit first creates extracted patient information related to the diabetic patient shown in FIG. 12B and extracted patient information related to the blood glucose level shown in FIG. Next, referring to the extracted patient information related to the diabetic patient and the extracted patient information related to the blood glucose level, the patient described in the extracted patient information related to the diabetic patient and not described in the extracted patient information related to the blood glucose level Extract the ID. This makes it possible to create extracted patient information related to a patient who has been diagnosed with diabetes but has not been tested for blood sugar levels.

  Similarly, in order to extract the leak of the urea test for the patient with renal failure, the extracted patient information related to the renal failure patient shown in FIG. 12C and the extracted patient information related to the urea shown in FIG. What is necessary is just to use extraction patient information concerning the cirrhosis patient shown in FIG. 12D and extraction patient information concerning the GOT shown in FIG. . Note that instead of the extracted patient information shown in FIGS. 11E, 11F, and 11G, the examination DB shown in FIG.

  The follow-up patient extraction management unit 8 excludes patients with predetermined conditions from the follow-up patient candidate information 7a, 7b, 7c, and 7d extracted by the above-described follow-up patient candidate extraction unit 6, and sets the remaining patients as follow-up patients. The patient information is stored in the tracking patient storage unit as tracking patient information. As a predetermined condition for excluding this patient, for example, when the event extraction purpose of the screening template is a certain disease suspect, the patient already diagnosed with the disease can be excluded with reference to the disease name DB 87. In addition, if the extracted patient information relates to the test value, the patient whose test value becomes poor by taking a specific medicine, or the test value is poor, but the specific drug has already been used for that purpose. Patients taking can be excluded with reference to the prescription DB 85.

  In addition, when the tracking patient information 9a, 9b, 9c, 9d is changed, the tracking patient extraction management unit 8 stores the change in the tracking patient storage unit 9. This change includes the registration and follow-up of the follow-up patient by the hospital after registration as a follow-up patient, and the addition of information such as date and comments, or the peripheral of registration as a follow-up patient due to patient death, etc. Is mentioned.

  Next, with reference to FIGS. 6 and 7, a screen showing the tracking patient information displayed by the tracking patient extraction management unit 8 and a display device (not shown) will be described. 6 is a tracking patient list screen 60 displaying all the tracking patients, and FIG. 7 is a tracking management screen 70 for displaying and editing the details of each tracking patient.

  The tracked patient list screen 60 in FIG. 6 shows a patient display column 61 for displaying a patient ID, a management start date display column 62 for displaying a date when management is started as a tracked patient, and the management purpose of the tracked patient. A management purpose display field 63 to be displayed, a status display field 64 to display the status of the patient, a remarks display field 65 to display other comments, and further, after an arbitrary patient is selected by an operation of an input device such as a mouse by a doctor or the like An open button 66 capable of confirming the details of the medical information of the patient by operating and a tracking management button 67 for opening a tracking management screen 70 capable of displaying and editing the details of the management state of the tracking patient are provided. Although all the follow-up patients are displayed here, the patients in the follow-up patient information unit extracted for each event extraction purpose may be displayed.

  7 includes a patient information display field 71, a tracking management display editing field 72, a comment description part 73, a tracking status setting part 74, a return button 75, and a comment registration button 76. The patient information display column 71 displays information indicating a patient, and patient ID, name, sex, date of birth, and the like are displayed. The tracking management display edit column 72 displays events after the initial registration of the patient as a tracking patient, and edits additions, etc. as necessary. Tracking status, comments, etc. are displayed. The comment description unit 73, the tracking status setting unit 74, and the comment registration button 76 are used for adding a new event or editing an already described event, and an event can be added and edited by an input device operated by a doctor or the like. Made. The return button 75 can be returned to the tracked patient list screen 60 shown in FIG.

  Next, the operation flow of the notification unit 10 will be described with reference to FIGS. As shown in FIG. 8, the notification unit 10 determines whether the tracking patient candidate information 7a, 7b, 7c, 7d or the tracking patient information 9a, 9b, 9c, 9d has been changed via the tracking patient extraction management unit 8. Or directly referring to the follow-up patient candidate storage unit 7 and the follow-up patient storage unit 9 (S1110). If there is no change, the process is terminated and the system waits for the next program execution cycle (S1180). When there is a change, it is determined with reference to the medical information DB 80 whether or not a patient related to the change is visiting (S1120). When the patient is not visiting the hospital, refer to the event extraction purpose of the screening template candidate 5a, 5b, 5c, 5d related to the follow-up patient candidate information or the follow-up patient information, and specify the specialized department 90 for the event extraction purpose ( S1130). And it notifies that there was a change in the terminals 91a and 91b of the specified specialized department 90 (S1140). On the other hand, when the patient concerned visits, the medical information DB80 is referred and the corresponding department at the time of the said patient visit is specified (S1150). Further, the same processing as in step S1130 is performed to identify a specialized department for event extraction (S1160). Then, the terminal of the identified corresponding department and specialized department is notified that the tracking patient candidate information or the tracking patient information has been changed (S1170).

  Also, as shown in FIG. 9, the notification unit 10 refers to the medical information DB 80 and monitors whether or not the follow-up patient is visiting (S1210). If not, the process ends and waits for the next program execution cycle (S1260). When the patient is visiting the hospital, the medical information DB 80 is referred to and the corresponding department at the time of visit of the follow-up patient is specified (S1220). Next, referring to the event extraction purpose of the screening templates 5a, 5b, 5c, and 5d related to the follow-up patient information in which the follow-up patient is recorded, the specialized department for the event extraction purpose is specified (S1230). Next, it is determined whether or not the corresponding department at the visit and the specialized department are the same (S1240). When the identified corresponding department is the same as the specialized department, there is no need to notify it, so the processing is terminated as it is, and it waits until the next program execution cycle (S1260). When the identified corresponding department is not the same as the specialized department, the follow-up patient's visit is notified to the corresponding department of the traced patient and the terminals 91a and 91b of the specialized department 90 (S1250).

  As described above, according to the disease management system of the present embodiment, preliminary extraction of data is performed in the patient extraction unit, so compared with a case where target data is extracted directly from the medical information DB. The extraction time can be shortened and the load on the system can be reduced. In addition, by creating patient extraction conditions by combining multiple elements that extract patients, patients can be extracted efficiently even in hospitals with a large number of patients, and the search template list for setting patient extraction conditions By setting a desired period, it is also possible to extract a patient suspected of having a disease by evaluating data for the period. In addition, by setting the search template hierarchically, patients can be extracted from various cut ends.

  In addition, the extracted patient information can be arbitrarily selected by the screening template, and the accuracy of extraction can be increased by weighting with the score attached to the data in the extracted patient information. In addition, a list of patients extracted for each event extraction purpose can be confirmed by tracking patient candidate information. For example, a doctor or the like can see a list of patients suspected of having a specific disease. it can.

  In addition, when a change is made to the follow-up patient candidate information or the follow-up patient information by the notification unit, if a patient related to the change has visited the hospital, in order to notify the specialized department for each event extraction purpose, for example, When a patient who has come to the hospital undergoes an examination, and as a result of the examination, a suspicion of a disease other than the original purpose of the visit occurs, a follow-up by the specialized department of the suspicion of the disease can be performed promptly. Similarly, when a follow-up patient visits by the notification unit, the specialized department for each event extraction purpose is notified of the visit of the patient, so the follow-up by the specialized department can be performed reliably.

  In addition, the disease management program and disease management system of this embodiment mentioned above are the illustrations of this invention, and can change the structure suitably in the range which does not deviate from the meaning of invention.

1 .... Disease management system, 2 .... Patient extraction condition storage unit, 2a, 2b, 2c, 2d ... Patient extraction condition, 3 .... Patient extraction unit, 4 .... Extract patient storage unit, 4a, 4b, 4c, 4d... Extracted patient information, 5... Screening template storage unit, 5a, 5b, 5c, 5d. , 7d, tracking patient candidate information, 8. tracking patient extraction management unit, 9 tracking patient storage unit, 9a, 9b, 9c, 9d tracking patient information, 10 notification unit,
20 ... Patient extraction condition setting screen, 21a, 21b, 21c, 21d ... Search template list, 22 ... Execution task setting part, 23 ... Result output name input part, 24 ... Execution registration button, 25 ... Task Effective selection part, 26 .. Task type input part, 27 .. Reference time input part, 28 .. Interval input part, 29 .. Notification address input part,
40 ... Screening template creation screen, 41 ... Extracted patient information list, 42 ... Screening template setting section, 43 ... Name input section, 44 ... Extracted patient information selection field, 45 ... Score input field, 46 ... Total score display section, 47... Threshold score input section, 48 .. registration button, 49 .. close button,
50..Patient candidate list screen 51.Screening template list 52.Name 53.Number of patients 54.Patient candidate information list 55.Patient information display column 56.Tracking indicator display Field 57..Score display field 58..Open button 59..Tracking management registration button 60..Tracked patient list screen 61..Patient display field 62..Management start date display field 63..Management Purpose display field, 64 ... Status display field, 65 ... Remarks display field, 66 ... Open button, 67 ... Tracking management button,
70 .. Tracking management screen, 71 .. Patient information display column, 72 .. Tracking management display edit column, 73 .. Comment entry section, 74 .. Tracking status setting section, 75. button,
80 ... Medical information DB, 81 ... Patient information DB, 82 ... Medical record DB, 83 ... Nursing record DB, 84 ... Exam DB, 85 ... Prescription DB, 86 ... Injection DB, 87 ... Disease name DB , 88 ... Image DB, 89 ... Surgery DB, 90 ... Special department, 91a, 91b ... Terminal

Claims (7)

Computer
A patient extraction condition storage unit that stores medical information elements set in advance for each desired patient extraction purpose as a plurality of patient extraction conditions for each patient extraction purpose;
A patient extraction unit that extracts patient information that matches the patient extraction condition from a medical information database that stores medical information, and stores the extracted patient information as a plurality of extracted patient information for each patient extraction condition;
One or more pieces of extracted patient information set in advance for each desired event extraction purpose, and a score associated with a description or value of the set extracted patient information for each event extraction purpose A screening template storage unit stored as a plurality of screening templates;
An item is extracted for each patient from one or more of the extracted patient information set in the screening template, and when the description or value of the extracted item is bad, the score is associated with the item, and the sum of the scores If the patient is a predetermined value or more, information indicating the patient, items extracted for each patient from the extracted patient information, and the associated score for a plurality of tracking patients for each screening template A tracking patient candidate extraction unit to be stored in the tracking patient candidate storage unit as candidate information;
The patient with the predetermined condition is removed from the tracked patient candidate information, the remaining patient is set as the tracked patient, and the information indicating the tracked patient and the tracked information indicating the subsequent tracking status are set as a plurality of tracked patient information for each screening template. A tracking patient extraction management unit to be stored in the tracking patient storage unit;
Disease control program characterized by functioning.   2. The disease management program according to claim 1, wherein the extraction of patient information from the medical information database by the patient extraction unit and the storage in the extraction patient storage unit are performed at predetermined time intervals.   The disease management program according to claim 1 or 2, wherein creation of the tracking patient candidate information by the tracking patient candidate extraction unit and storage in the tracking patient candidate storage unit are performed every predetermined time.   When the follow-up patient visits, determine whether the follow-up patient visit department and the specialized department for the event extraction purpose related to the follow-up patient are the same,
  The disease management program according to any one of claims 1 to 3, wherein if it is not the same, the corresponding department and the specialized department are notified that the follow-up patient is visiting the hospital.   When changes are made to the follow-up patient information, determine whether the follow-up patient is visiting,
  4. If the follow-up patient has not visited the hospital, a notification is made to the specialized department for the purpose of event extraction related to the follow-up patient that the follow-up patient information has been changed. The disease management program according to item 1.   When changes are made to the follow-up patient information, determine whether the follow-up patient is visiting,
  When the follow-up patient is in the hospital, the corresponding department at the time of the visit of the follow-up patient and the specialized department for the event extraction related to the follow-up patient are notified that the follow-up patient information has been changed. The disease management program according to any one of claims 1 to 3. A patient extraction condition storage unit that stores medical information elements set in advance for each desired patient extraction purpose as a plurality of patient extraction conditions for each patient extraction purpose;
A patient extraction unit that extracts patient information that matches the patient extraction condition from a medical information database that stores medical information, and stores the extracted patient information as a plurality of extracted patient information for each patient extraction condition;
One or more pieces of extracted patient information set in advance for each desired event extraction purpose, and a score associated with a description or value of the set extracted patient information for each event extraction purpose A screening template storage unit stored as a plurality of screening templates;
An item is extracted for each patient from one or more of the extracted patient information set in the screening template, and when the description or value of the extracted item is bad, the score is associated with the item, and the sum of the scores If the patient is a predetermined value or more, information indicating the patient, items extracted for each patient from the extracted patient information, and the associated score for a plurality of tracking patients for each screening template A tracking patient candidate extraction unit to be stored in the tracking patient candidate storage unit as candidate information;
The patient with the predetermined condition is removed from the tracked patient candidate information, the remaining patient is set as the tracked patient, and the information indicating the tracked patient and the tracked information indicating the subsequent tracking status are set as a plurality of tracked patient information for each screening template. A tracking patient extraction management unit to be stored in the tracking patient storage unit;
A disease management system comprising:

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