JP6355685B2 - Medical support system - Google Patents

Description

  The present invention relates to a medical support system.

  The following medical support programs are known. This medical assistance program displays a list of accepted medical institutions based on the severity and symptoms of the patient, identifies the treatment method with the highest survival rate according to the severity and symptoms of the patient, It outputs to the device of the hospital of a conveyance destination (for example, patent document 1).

Japanese Unexamined Patent Publication No. 2016-35699

  In the conventional medical support program, the emergency team or the like has to input the severity and symptom of the patient used to identify the destination hospital. For this reason, it was not possible to identify the patient's transport destination until the emergency crew arrived, judged the severity and symptoms of the patient, and completed the input. When a subject develops a brain disease or a heart disease such as a stroke or a stroke, early diagnosis / early treatment is the biggest issue after the onset. However, if the arriving emergency personnel do not have medical knowledge about such diseases, they will be transferred without being properly transported to a specialized hospital, which has led to a decrease in the lifesaving rate. In order to prevent such a situation, when an abnormality occurs in the subject, it is necessary to determine the symptom level at an early stage and identify the transport hospital according to the symptom level. No investigation was made on such a method.

The medical support system according to the present invention is based on vital data acquisition means for acquiring vital data including blood pressure data, pulse data, and electrocardiogram data of the subject, and based on the vital data acquired by the vital data acquisition means, An abnormality detecting means for detecting that the subject may have developed a heart disease or a brain disease as an abnormality of the subject when it is determined that the subject may have developed a heart disease or a brain disease; and an abnormality detecting means When the abnormality is detected by the determination means, the determination means for determining the degree of the symptom of the subject, the current position specifying means for specifying the current position of the subject, and the degree of the symptom of the subject is low by the determination means If judged, a hospital capable of handling low-level medical care in the disease field according to the subject's symptoms and a hospital capable of high-level medical care in the disease field according to the subject's symptoms The hospital closest to the current position of the subject identified by the current location identifying means is selected from among them, identified as the transport destination hospital to which the subject is transported, and the symptom of the subject is highly severe by the judging means If it is determined, the difference between the time required from the current position of the subject to the closest hospital capable of handling advanced medical care and the time required to reach the nearest hospital capable of handling low-grade medical care is set as a preset threshold. When longer, select a hospital close to the current position of the target person identified by the current position identification means from the hospitals capable of handling low-level medical care and hospitals capable of high-level medical care, and identify the target hospital as the destination hospital. When the difference between the time required from the person's current location to the closest hospital capable of handling advanced medical care and the time required to reach the nearest hospital capable of handling low-grade medical care is less than or equal to a preset threshold , From the advanced medical compatible hospitals, currently select a hospital close to the current position of the subject specified by the position specifying means, and conveying destination specifying means for specifying a hospital transport destination, the transport destination specifying means Transport destination information output means for outputting transport destination information related to the hospital of the transport destination specified by the abnormality detecting means, wherein the waveform indicated by the electrocardiogram data indicates a pre-registered characteristic waveform of a heart disease At the time, it was determined that the subject may have developed heart disease, and the numerical values and blood pressure data indicated by the blood pressure data showed the characteristic numerical values and waveforms of pre-registered brain diseases. Sometimes, it is determined that the subject may have developed a brain disease.
The medical support system according to the present invention is also a medical support system including a target person terminal possessed by the target person and a monitoring device connected to the target person terminal via a communication line, From the monitoring device, vital data acquisition means for acquiring vital data including blood pressure data, pulse data, and electrocardiogram data of the subject, vital data transmission means for transmitting the vital data acquired by the vital data acquisition means to the monitoring device, and Based on the instructions, the question output means for outputting a question for confirming the symptom of the target person, the answer data obtaining means for receiving the answer to the question and obtaining the answer data, and the answer obtained by the answer data obtaining means and a response data transmission means for transmitting data to the monitoring device, the monitoring device, vital data received from the target terminal Based on the above, when it is determined that the subject may have developed heart disease or brain disease, the subject may detect that the subject has developed heart disease or brain disease as an abnormality of the subject detection means, when an abnormality is detected by the abnormality detecting means, based on the health care information and vital data recorded on the storage medium for health management subject, to determine the extent of the symptoms of the subject If the degree of the subject's symptoms cannot be determined based on the health management information and vital data, the subject terminal is instructed to output a question, and the subject is based on the answer data received from the subject terminal. a judging means for judging the degree of's symptoms, based on the degree of the symptoms of the subject determined by the determination means, the conveying destination specifying means for specifying a hospital for conveying the subject, the transport destination Patent Transport destination information transmitting means for transmitting transport destination information related to the hospital of the transport destination specified by the means to the target person terminal, and the abnormality detecting means is characterized in that the waveform indicated by the electrocardiogram data is registered in advance. When the target waveform is displayed, it is determined that the subject may have developed heart disease, and the numerical value indicated by the blood pressure data and the waveform indicated by the pulse data are characteristic numerical values of brain diseases registered in advance. When the waveform is shown, it is determined that the subject may have developed a brain disease.

  According to the present invention, when there is a possibility that the subject has developed heart disease or brain disease, the degree of the subject's symptom is determined, and the transport destination hospital according to the degree of the symptom is specified. When the subject develops a heart disease or a brain disease, the degree of the symptom can be determined at an early stage, and the destination hospital according to the degree of the symptom can be specified.

1 is a block diagram illustrating a configuration of an embodiment of a medical support system 10. FIG. 1 is a block diagram showing a configuration of an embodiment of a vital data measuring apparatus 100. FIG. It is a block diagram which shows the structure of one Embodiment of the user terminal. 2 is a block diagram showing a configuration of an embodiment of a monitoring device 300. FIG. It is a flowchart figure which shows the flow of the determination process in a triage process. 4 is a flowchart showing a flow of processing executed by the vital data measuring apparatus 100. FIG. It is a flowchart figure which shows the flow of the measurement data transmission process performed with the user terminal 200. FIG. It is a flowchart figure which shows the flow of the reply data transmission process performed with the user terminal. It is a flowchart figure which shows the flow of the transfer destination hospital information output process performed with the user terminal 200. FIG. FIG. 10 is a flowchart showing a flow of processing executed by the monitoring apparatus 300.

  FIG. 1 is a block diagram showing a configuration of an embodiment of a medical support system 10 in the present embodiment. The medical support system 10 improves the lifesaving rate of the user by specifying a hospital corresponding to the degree of the symptom as a delivery destination when the user develops a heart disease or brain disease such as a stroke or stroke. Objective. The medical support system 10 is attached to a subject who is a health condition monitoring target, and has a vital data measurement device 100 having a function of measuring vital data of the subject, and a user terminal 200 possessed by a user who is the subject. The monitoring device 300 is configured to monitor data transmitted from the user terminal 200 and detect a user abnormality.

  The vital data measuring device 100 has a function of acquiring vital data including user blood pressure data, pulse data, and electrocardiogram data, and transmitting the acquired vital data to the user terminal 200. As the vital data measuring apparatus 100, for example, a wearable terminal that a user wears around a wrist is used. This wearable terminal is equipped with a sensor for performing blood pressure measurement, pulse measurement, and electrocardiogram measurement in a portion in contact with the user's body, and can acquire the user's blood pressure data, pulse data, and electrocardiogram data. ing. Since a technique for measuring a wearer's blood pressure, pulse, and electrocardiogram in a wearable terminal of the type wound around the wrist is well known, description thereof is omitted here.

  FIG. 2 is a block diagram showing a configuration of an embodiment of the vital data measuring apparatus 100 in the present embodiment. The vital data measuring device 100 includes a communication module 101, a vital data measuring unit 102, and a control device 103.

  The communication module 101 is a module for performing communication by connecting to the user terminal 200. For example, a module for Bluetooth (registered trademark) communication is used. In the present embodiment, the vital data measurement device 100 and the communication partner user terminal 200 are paired with Bluetooth (registered trademark) in advance, and are ready for communication.

  The vital data measuring unit 102 includes a sensor for measuring the blood pressure, pulse, and electrocardiogram of the user and its peripheral circuits, and outputs the blood pressure data, pulse data, and electrocardiogram data obtained by the measurement to the control device 103.

  The control device 103 includes a CPU, a memory, and other peripheral circuits, and controls the entire vital data measurement device 100. The memory constituting the control device 103 includes, for example, a volatile memory such as SDRAM and a non-volatile memory such as flash memory. The volatile memory is used as a work memory for the CPU to expand the program when the program is executed and a buffer memory for temporarily recording data. The nonvolatile memory stores data of a program for operating the vital data measuring apparatus 100 and various data used by the program.

  The user terminal 200 is an information terminal possessed by a target person as a user in the present embodiment, and for example, a smartphone, a mobile phone, a tablet terminal, or the like is used. FIG. 3 is a block diagram showing a configuration of an embodiment when a smartphone is used as the user terminal 200 in the present embodiment. In the present embodiment, the user terminal software for executing the processing described below is installed in the smartphone, thereby operating as the user terminal 200 in the present embodiment. The user terminal software program is provided by being published on a server connected via the Internet, and the user himself / herself or a related person such as the user's attending physician or family obtains the program by downloading the user terminal. It is assumed that 200 is installed in advance. Alternatively, the user terminal software program may be provided by being recorded on a recording medium such as a CD-ROM or a DVD-ROM.

  The user terminal 200 includes a touch panel 201, a communication module 202, a GPS module 203, and a control device 204.

  The touch panel 201 is an electronic component that combines a display device such as a liquid crystal panel and a position input device such as a touch pad, and is an input device that can operate the device by pressing a display on the screen. For example, the operator of the user terminal 200 can operate the user terminal 200 by touching or sliding display items such as buttons and menus displayed on the liquid crystal panel using a finger or a touch pen. The touch panel 201 detects an operation such as a touch or a slide by the operator and outputs a detection signal to the control device 204.

  The communication module 202 is a module for connecting the user terminal 200 to the Internet by wireless or wired via a LAN or a cellular phone communication network, and a module for short-range wireless communication for communicating with the vital data measuring apparatus 100 Including. The user terminal 200 can communicate with the monitoring device 300 by connecting to the Internet via the communication module 202. Further, the user terminal 200 can communicate with the previously paired vital data measurement device 100 via the communication module 202.

  The GPS module 203 is a module for communicating with a GPS satellite and receiving positioning information for specifying the current position from the GPS satellite, and includes an antenna, a control circuit, and the like for communicating with the GPS satellite. .

  The control device 204 includes a CPU, a memory, and other peripheral circuits, and controls the entire user terminal 200. Note that the memory constituting the control device 204 includes, for example, a volatile memory such as SDRAM and a non-volatile memory such as flash memory. The volatile memory is used as a work memory for the CPU to expand the program when the program is executed and a buffer memory for temporarily recording data. The nonvolatile memory stores firmware for operating the user terminal 200 and software program data for operating various applications. In the present embodiment, the above-described user terminal software program is recorded in this nonvolatile memory.

  The monitoring device 300 is a device connected to the Internet, and for example, a personal computer or a server is used. FIG. 4 is a block diagram showing a configuration of an embodiment when a server device is used as the monitoring device 300 in the present embodiment. The monitoring device 300 includes a connection interface 301, a control device 302, and a storage medium 303.

  The connection interface 301 is an interface for connecting the monitoring apparatus 300 to a communication line such as the Internet. For example, a wired LAN module for connecting to the Internet by wire, a wireless LAN module for connecting to the Internet wirelessly, or the like. Is used. In the present embodiment, the monitoring apparatus 300 communicates with the user terminal 200 via the connection interface 301.

  The control device 302 includes a CPU, a memory, and other peripheral circuits, and controls the entire monitoring device 300. In addition, the memory which comprises the control apparatus 302 is volatile memories, such as SDRAM, for example. This memory is used as a work memory for the CPU to expand the program when the program is executed and a buffer memory for temporarily recording data. For example, data read via the connection interface 301 is temporarily recorded in the buffer memory.

  The storage medium 303 is a storage medium for recording various data stored by the monitoring device 300, data of a program to be executed by the control device 302, and the like, for example, HDD (Hard Disk Drive) or SSD (Solid State Drive). ) Etc. are used. The program data recorded in the storage medium 303 is provided by being recorded on a recording medium such as a CD-ROM or DVD-ROM, or provided via a network, and stores the program data acquired by the operator. By installing in the medium 303, the control device 302 can execute the program.

  In the medical support system 10 according to the present embodiment, the user who owns the user terminal 200 registers his / her health management information in order to use the medical support system 10. For this purpose, the user activates the user terminal software on the user terminal 200 and registers information related to his / her health management on the information registration screen displayed on the touch panel 201. The health management information related to the user's health management includes, for example, name, gender, date of birth, height, weight, blood type, presence / absence of smoking, medical history, medication in medication, and data indicating the health status of the user . The data indicating the user's health condition includes data related to the onset of brain disease and heart disease, and includes, for example, the value of LDL cholesterol and the value of triglyceride obtained by examination in advance.

  When the user inputs health management information on the information registration screen and instructs registration, the control device 204 transmits the input health management information to the monitoring device 300. In the monitoring device 300, when receiving the health management information from the user terminal 200, the control device 302 issues information for uniquely identifying the user, for example, a user ID, and stores the user ID and the health management information in association with each other. Recording on the medium 303. In addition, the control device 302 transmits the issued user ID to the user terminal 200. In the user terminal 200, the control device 204 records the user ID received from the monitoring device 300 in the memory. Thereby, the registration of the user information to the monitoring apparatus 300 is completed, and the user can use the medical support system 10.

  In addition, when the user's own health management information is changed, the user can appropriately display the information registration screen to correct the health management information. The corrected health management information is transmitted to the monitoring device 300, and the control device 302 updates the health management information of the user with the corrected information.

  In order to use the medical support system 10, the user wears the vital data measurement device 100 that has been paired with the user terminal 200 in advance. In this embodiment, since a wearable terminal of a type that is wound around the wrist is assumed, the user wears the vital data measurement device 100 on the wrist. Thereby, the measurement of the vital data of the user by the vital data measuring device 100 is started.

  The control device 103 of the vital data measuring apparatus 100 acquires user vital data input via the vital data measuring unit 102, and transmits the acquired vital data to the user terminal 200 via the communication module 101. Although the transmission timing of vital data is not particularly limited, the control device 103 may always continue to acquire and transmit vital data, such as every 1 minute, every 5 minutes, or every 10 minutes. The data may be transmitted to the user terminal 200 at predetermined time intervals set in advance. The time interval for transmitting vital data may be arbitrarily set by the user or an operator such as the user's family or the attending physician.

  In the user terminal 200, when receiving the vital data from the vital data measuring apparatus 100, the control device 204 displays the received vital data, information for identifying the user, for example, the user ID described above, and the current position of the user terminal 200. The measurement data including the current position information is transmitted to the monitoring device 300 via the communication module 202. Note that the control device 204 acquires current position information indicating the current position of the user terminal 200 based on the output from the GPS module 203.

  In the monitoring device 300, when the control device 302 receives the measurement data from the user terminal 200, based on the vital data included in the received measurement data, whether or not there is a possibility that the user has developed a heart disease or a brain disease. If it is determined that there is a possibility that the user has developed a heart disease or a brain disease, an abnormality of the user is detected. Here, a process for detecting a user abnormality will be described.

  In order to detect user abnormalities, characteristic ECG waveform data of patients with heart disease, characteristic blood pressure values of patients with brain disease, and characteristics of patients with brain disease A pulse wave waveform is recorded in the storage medium 303 in advance. When the control device 302 detects that the waveform indicated by the electrocardiogram data included in the vital data indicates a characteristic waveform of the heart disease registered in the storage medium 303 in advance, the user has developed the heart disease. It is determined that there is a possibility, and a user abnormality is detected. In addition, when the waveform of the blood pressure data and the pulse wave data included in the vital data indicates the characteristic values and waveforms of the brain disease registered in the storage medium 303 in advance, Determines that there is a possibility of developing a brain disease, and detects an abnormality of the user.

  When the control device 302 detects an abnormality of the user, the control device 302 performs a triage process described below, so that the user can have a highly medical-compatible hospital corresponding to advanced medical care in the disease field in which the user develops, and the user It is determined which of the hospitals capable of handling low-level medical care corresponding to low-level medical care in the disease field where the disease has developed, and the destination hospital for the user is determined. In this embodiment, even when a user can be treated at a hospital capable of low medical care, a hospital capable of high medical care is closer to the current position of the user than a hospital capable of low medical care. In order to improve the lifesaving rate, the patient will be transported to a hospital capable of handling advanced medical care.

  In the present embodiment, in the triage process, the control device 302 determines the degree of the user's symptom based on the user's health management information and vital data, and determines the destination hospital, and the user terminal 200, a question for confirming the user's symptom is output to the user's family and emergency personnel, and the control device 302 determines the level of the user's symptom based on the answer data obtained thereby, and conveys it. There is an interrogation type triage process that determines the previous hospital.

  In the present embodiment, when detecting abnormality of the user, the control device 302 executes the automatic triage process when the automatic triage process based on the user's health management information and vital data is possible, The destination hospital for the user is determined early. On the other hand, when the health management information and vital data information are insufficient and the user's transport destination hospital cannot be determined by automatic triage processing, a question for checking the user's symptoms via the user terminal 200 Is output, waits for reception of answer data from the user terminal 200, executes an inquiry type triage process, and determines a transport destination hospital according to the user's symptom.

  Hereinafter, the automatic triage process and the inquiry type triage process in this embodiment will be described. In order to determine the destination hospital by triage processing, hospital information data relating to the hospital is recorded in the storage medium 303 in advance. The hospital information includes the name of the hospital, location information (longitude / latitude) indicating the location of the hospital, availability of advanced medical care / low-degree medical care for each disease area, emergency medical response time zone, email address, telephone number, and disease area Information on the specialists, the number of beds and their availability, the number of operating rooms and their availability. The information regarding the specialist for each disease field includes the name of the doctor, the specialized field, and the mobile phone number. The number of beds includes the number and availability of each special treatment room such as a general treatment room, stroke intensive care room, respiratory disease intensive care room, and pediatric intensive care room.

  The hospital information is input on an external terminal such as a terminal operated by an administrator of the medical support system 10 or a terminal installed in each hospital, and is transmitted to the monitoring apparatus 300, and the control apparatus 302 stores the storage medium 303. To be recorded. The hospital information is updated to the latest information from the above external terminal as needed.

  The control device 302 reads the user's health management information from the storage medium 303 based on the user ID included in the measurement data received from the user terminal 200. Then, the control device 302 performs automatic triage processing based on the read health management information and the vital data received from the user terminal 200, and transports the user to either a medical care hospital or a low medical serviceable hospital. Determine what to do.

  In the automatic triage process, the control device 302 digitizes the determination results for the following determination items (A1) to (A10), and calculates the total value as an index value indicating the degree of the user's symptom. In the present embodiment, a score corresponding to the determination result is assigned to the following determination items (A1) to (A10), and the total value of the scores for the determination items (A1) to (A10) is automatically triaged. An example of calculating the index value indicating the degree of the user's symptom in the process will be described. Since the score is set so that the total value becomes higher as the possibility of becoming severe when the user develops a brain disease or heart disease, the higher the total value, the more the degree of the user's symptoms Means that it is likely to be heavy.

(A1) Based on the data indicating the health condition of the user, when the value of LDL cholesterol is 140 mg / dL or more, the score is set to 0.5.
(A2) If the triglyceride value is 150 mg / dL or more based on the data indicating the health condition of the user, the score is set to 0.5.
(A3) If the user is a smoker, the score is 2.5.
(A4) When cerebral infarction is included in the user's past history, the score is set to 0.5.
(A5) When the user's age is 70 years or older, the score is set to 0.5.
(A6) Based on the data indicating the user's health status, when the value of HB1AC is 6.5 mg / dL or more and the user's past history includes diabetes, the score is set to 0.5.
(A7) When the BMI value calculated based on the height and weight of the user is 25 or more, the score is set to 0.5.
(A8) If the user's past history includes heavy drinking, the score is 0.25.
(A9) If the blood pressure when a user abnormality is detected is 140/90 mmhg or more, the score is 1.
(A10) The score is set to 1 when an arrhythmia such as atrial fibrillation occurs in the electrocardiogram data when a user abnormality is detected.

  The control device 302 executes the processing according to the flow shown in FIG. 5, and thereby, based on the total score based on the determination items (A1) to (A10) calculated in the above processing, the control device 302 can adjust the level of the user's symptoms. Specify the delivery destination. The process shown in FIG. 5 will be described later.

  In the inquiry type triage process, the control device 302 obtains answer data for the following question items (B1) to (B12), and identifies the transport destination hospital of the user based on the answer data. When the control device 302 cannot determine any of the determination items (A1) to (A10) in the automatic triage process, the control device 302 causes the user terminal 200 to display the user's symptom in order to execute the inquiry type triage process. Instruct the output of a question to confirm.

  In the user terminal 200, the control device 204, when instructed to output a question from the monitoring device 300, outputs the question content corresponding to the question items (B1) to (B12) below to the touch panel 201 for display. The control device 204 transmits response data indicating the content of the response to the monitoring device 300 after receiving an input of an answer to each question item. In addition, the question content according to the question items (B1) to (B12) below may be recorded in advance in a memory included in the user terminal 200 or may be acquired from the monitoring device 300. In the following questions, a patient means a user who is a subject. Moreover, the following question content is not limited to the following wording, as long as substantially the same answer can be obtained. Of the following question items, for items that can specify an answer based on the user's health management information, the answer data may be acquired based on the user's health management information without asking a question.

(B1) Do patients use anticoagulants or blood diluents?
(B2) What is the patient's age?
(B3) Has anyone confirmed the onset of the patient?
(B4) When was the last time the patient was fine?
(B5) Does the patient have facial paralysis symptoms?
(B6) Does the patient have arm paralysis symptoms?
(B7) Is the utterance content strange?
(B8) Ask the patient three common names. Did you say that?
(B9) Ask the patient, “Show me two fingers.” Did you do it correctly?
(B10) Does the patient have symptoms of eyeball displacement?
(B11) Ask the patient, "Do you have any subjective symptoms?" Did you have any subjective symptoms?
(B12) Ask the patient, “Who is this arm?” Did you answer correctly?

  In response to the question item (B1), an operator such as a family member or an ambulance crew selects “Yes” or “No” and answers. For the question item (B2), the operator selects and answers either “80 years or older” or “under 80 years”. In response to the question item (B3), when there is a person who has confirmed the onset of the user, the time when the person has confirmed the onset is answered. In response to the question item (B4), a time at which the user can confirm that he / she was fine at the end is answered. For the question item (B5), the operator selects and answers either “no symptom” or “slightly symptomatic”. In response to the question item (B6), the operator selects and answers any of “no symptom”, “with symptom”, and “very symptom”. For the question item (B7), the operator selects and answers either “not funny” or “funny”. In response to the question item (B8), the operator selects and answers either “I could say” or “I can't say”. The question item of (B9) is output when “no symptom” is selected in (B6). On the other hand, the operator selects either “correctly done” or “cannot be correct”. Answer. In response to the question item of (B10), the operator selects and answers any of “no symptoms”, “symptoms on one side”, and “symptoms on both sides”. The question item of (B11) is output when “with symptom” or “very symptom” is selected in (B6), whereas the operator selects “no symptom” or “with symptom”. Select one to answer. The question item of (B12) is output when “with symptom” or “very symptomatic” is selected in (B6). On the other hand, the operator selects “correct answer” or “incorrect answer”. Select one and answer.

  When the control device 302 receives the answer data for the question items (B1) to (B12), the control device 302 quantifies the answer results for the answer data for the question items (B5) to (B12), and sums these values. The value is calculated as an index value indicating the degree of the user's symptom. In this Embodiment, as shown below, the score according to the answer content is assigned to the question items (B5) to (B10), and the total score value for the question items (B5) to (B10) Is calculated as an index value indicating the degree of the user's symptom in the inquiry type triage process. Since the score is set so that the total value becomes higher as the possibility of becoming severe when the user develops a brain disease or heart disease, the higher the total value, the more the degree of the user's symptoms Means that it is likely to be heavy.

If the answer to the question item (B5) is “lightly symptomatic”, the score is 1.
For the question item (B6), the score is 1 if the answer is “symptomatic” and the score is 2 if the answer is “very symptomatic”.
When the answer to the question item (B7) is “Funny”, the score is 1.
If the answer to the question item (B8) is “I cannot say”, the score is 1.
If the answer to the question item (B9) is “not correct”, the score is 1.
For the question item (B10), if the answer is “symptoms in one eye”, the score is 1, and if the answer is “symptoms in both eyes”, the score is 2.
If the answer to the question item (B11) is “Symptom”, the score is 1.
If the answer to the question item (B12) is “incorrect”, the score is 1.

  The control device 302 executes the process according to the flow shown in FIG. 5, and thereby, based on the answer contents for the questions (B1) to (B4) calculated in the above process and the question items (B5) to (B12). Based on the total score, the transport destination corresponding to the user's symptom level is specified.

  Next, the determination process performed in order to identify the transfer destination hospital in an automatic triage process and an inquiry type triage process is demonstrated using the flow shown in FIG. In FIG. 5, an arrow indicated by a solid line indicates an affirmative determination (YES), and an arrow indicated by a dotted line indicates a negative determination (NO).

  In step S10, the control device 302 determines whether the user is taking an anticoagulant or a blood diluent. In the case of automatic triage, the control device 302 determines whether or not the user is taking an anticoagulant or a blood diluent based on information on the medicine being taken included in the user's health management information. In the case of the inquiry type triage, the control device 302 determines whether or not the user is taking an anticoagulant or a blood diluent based on the answer data to the question item (B1). If a positive determination is made in step S10, the process proceeds to step S20.

  In step S20, the control device 302 determines whether or not the score in the automatic triage process described above or the score in the inquiry type triage process is smaller than 2. In step S20, in the case of a user taking an anticoagulant or a blood diluent, if the score in the automatic triage process or the score in the inquiry type triage process is smaller than 2, the degree of the user's symptom is severe. If it can be determined that the score is 2 or more, the user's symptom level can be determined to be severe.

  When an affirmative determination is made in step S20, the process proceeds to step S30, and the control device 302 conveys the user to the closest one of the low-level medical support hospital and the high-level medical support hospital in the disease field where the user developed. Judge that it should be. As a result, for users who have a high possibility of not having severe symptoms (low severity), priority is given to transport to the hospital as soon as possible, and it is closer to either a hospital that can handle low medical care or a hospital that can handle high medical care. It can be determined that it should be conveyed to the direction.

  On the other hand, if a negative determination is made in step S20, the process proceeds to step S40. In step S40, the control device 302 determines that the difference between the required time (CSC) from the current position of the user to the closest hospital capable of high medical care and the required time (PSC) to the nearest low medical care capable hospital is: It is determined whether or not it is longer than a preset threshold value T1. The required time (CSC) from the current position of the user to the nearest hospital capable of handling advanced medical care (CSC) and the required time to the nearest hospital capable of handling low-grade medical care (PSC) are included in the information on the current position of the user and the hospital information. Specified based on location information indicating the location of the hospital.

  If the user is taking anticoagulant or blood diluent and the score is 2 or higher, the user's symptom may be severe, so the person who has been transported to a hospital that can handle highly medical care Is considered preferable. However, even in such a situation, the required time (CSC) from the current position of the user to the nearest hospital capable of handling advanced medical care (CSC) and the required time to the nearest hospital capable of handling low-grade medical care (PSC) are predetermined times. In the case where these are different, there is a case where priority should be given to transporting to a hospital at an early stage without being bound by transport to a hospital capable of handling advanced medical care. The value of the threshold value T1 is set in view of such circumstances, and in this embodiment, for example, 30 minutes is set as the threshold value T1. The threshold T1 is set to an optimum value in view of the above circumstances, and is not limited to 30 minutes.

  When an affirmative determination is made in step S40, the process proceeds to step S30, and the control device 302 conveys the user to the closest one of the low-grade medical support hospital and the high-grade medical support hospital in the disease field where the user developed. Judge that it should be. As a result, the user has a high total score and is likely to have severe symptoms (high severity), but the time required to the nearest highly medical care capable hospital (CSC) and the closest low medical care are possible. If the difference from the time required to the hospital (PSC) is longer than the predetermined threshold value T1, one of the hospitals capable of handling low-level medical care and hospitals capable of handling high-level medical care is given priority in order to prioritize transport to the hospital early. It can be determined that it should be transported closer.

  On the other hand, if a negative determination is made in step S40, the process proceeds to step S50, and the control device 302 determines that the user should be transported to a hospital capable of handling advanced medical care in the disease field in which the user has developed. As a result, a user who has a high score and a high possibility of severe symptoms is required for a time required to the nearest hospital capable of high medical care (CSC) and a time required to the nearest low medical care available hospital (PSC). When the difference is short, it can be determined that the patient should be transported to a hospital capable of handling advanced medical care that can be treated according to the user's degree of symptom.

  If a negative determination is made in step S10, the process proceeds to step S60. In step S60, the control device 302 determines whether or not the user's age is 80 or older. In the case of automatic triage, the control device 302 determines whether or not the user's age is 80 years or older based on the date of birth included in the user's health management information. Further, in the case of the inquiry type triage, the control device 302 determines whether or not the user's age is 80 years or older based on the answer data to the question item (B2). If a positive determination is made in step S60, the process proceeds to step S70.

In step S70, the control device 302 calculates an expected elapsed time from when an abnormality is detected by the user until the user is transported to the hospital, and determines whether or not the calculated expected elapsed time is longer than a threshold IVtPA1. The expected elapsed time from when an abnormality is detected by the user until the user is transported to the hospital is calculated by the following equation (1). The threshold IVtPA1 is set based on the allowable time until the administration of the thrombolytic drug (t-PA). This allowable time is generally within 270 minutes, but since there is a clinical test result of less than 180 minutes for those over 80 years old, the threshold IVtPA1 is set to 180 minutes here.
Estimated elapsed time until transportation = current time−time when user abnormality is detected + shortest arrival time to hospital capable of low-level medical care or hospital capable of high-level medical care in the disease field where the user develops (1)

  In the formula (1), the time when the user's abnormality is detected is the time when the user's abnormality is detected based on the user's vital data in the case of automatic triage. In the case of the inquiry type triage, the time obtained as the answer data for the question item (B3) is obtained, and no answer is given to the question item (B3), and the answer data for the question item (B4) is obtained. If it is, the time acquired as the answer data for the question item (B4) is used.

  When an affirmative determination is made in step S70, the process proceeds to step S80, and the control device 302 determines whether the score in the above-described automatic triage process or the score in the inquiry type triage process is smaller than 2. In step S80, in a user who is not over 80 years old who is not taking an anticoagulant or a blood diluent, when the estimated elapsed time until transportation is longer than the allowable time until thrombolytic drug (t-PA) administration. When the score in the automatic triage process or the score in the inquiry type triage process is smaller than 2, the degree of the user's symptom can be determined to be low, and when the score is 2 or more, the degree of the user's symptom Can be determined to be severe.

  When an affirmative determination is made in step S80, the process proceeds to step S90, and the control device 302 transports the user to the closest one of the low-degree medical support hospital and the high medical support hospital in the disease field where the user has developed. Judge that it should be. As a result, for users who are highly likely not to have symptoms, priority should be given to transport to the hospital as soon as possible, and transport to the closest of the hospitals that can handle low-level medical care and hospitals that can support high-level medical care. Can be determined.

  On the other hand, if a negative determination is made in step S80, the process proceeds to step S100. In step S100, the control device 302 determines whether or not the score in the above-described automatic triage process or the score in the inquiry type triage process is 4 or more. When an affirmative determination is made in step S100, the process proceeds to step S110, and the control device 302 determines the required time (CSC) from the current position of the user to the closest hospital capable of handling high medical care and the nearest hospital capable of handling low medical care. It is determined whether or not the difference from the required time (PSC) is longer than a preset threshold value T2.

  In view of the situation where the user is not taking anticoagulant or blood diluent, the age is 80 years or older, the estimated elapsed time to transport is longer than 180 minutes, and the score is 4 or more, the user's symptoms It is considered that it is preferable that the user is transported to a hospital capable of handling advanced medical care. However, even in such a situation, the required time (CSC) from the current position of the user to the nearest hospital capable of handling advanced medical care (CSC) and the required time to the nearest hospital capable of handling low-grade medical care (PSC) are predetermined times. In the case where these are different, there is a case where priority should be given to transporting to a hospital at an early stage without being bound by transport to a hospital capable of handling advanced medical care. The value of the threshold value T2 is set in view of such circumstances, and in this embodiment, for example, 60 minutes is set as the threshold value T2. The threshold value T2 is set to an optimum value in view of the above circumstances, and is not limited to 60 minutes.

  When an affirmative determination is made in step S110, the process proceeds to step S90, and the control device 302 transports the user to the closest one of the low-grade medical capable hospital and high-grade medical capable hospital in the disease field in which the user has developed. Judge that it should be. Thus, although the user has a high total score value and is likely to have a severe symptom, the time required to the nearest hospital capable of high medical care (CSC) and the time required to the nearest low medical care available hospital When the difference from (PSC) is longer than the threshold value T2, in order to give priority to the transfer to the hospital at an early stage, it should be transferred to either the hospital that can handle low medical care or the hospital that can handle high medical care. Can be determined.

  On the other hand, when a negative determination is made in step S110, the process proceeds to step S130, and the control device 302 determines that the user should be transported to a hospital capable of highly medical treatment in the disease field where the user has developed. As a result, a user who has a high score and a high possibility of severe symptoms is required for a time required to the nearest hospital capable of high medical care (CSC) and a time required to the nearest low medical care available hospital (PSC). When the difference is short, it can be determined that the patient should be transported to a hospital capable of handling advanced medical care that can be treated according to the user's degree of symptom.

  On the other hand, if a negative determination is made in step S100, the process proceeds to step S120, and the control device 302 determines the required time (CSC) from the current position of the user to the nearest hospital capable of handling highly medical care and the nearest low-grade medical support. It is determined whether or not the difference from the required time (PSC) to a possible hospital is longer than a preset threshold value T3.

  Considering the situation where the user is not taking anticoagulant or blood diluent, the age is 80 years old or more, the estimated elapsed time to transport is longer than 180 minutes, and the score is 2 or more and less than 4, Since it is possible that the degree of symptom is severe, it is considered preferable to transport the user to a hospital capable of handling advanced medical care. However, even in such a situation, the required time (CSC) from the current position of the user to the nearest hospital capable of handling advanced medical care (CSC) and the required time to the nearest hospital capable of handling low-grade medical care (PSC) are predetermined times. In the case where these are different, there is a case where priority should be given to transporting to a hospital at an early stage without being bound by transport to a hospital capable of handling advanced medical care. The value of the threshold T3 is set in view of such circumstances, and in this embodiment, for example, 30 minutes is set as the threshold T3. Note that the threshold T3 is set to an optimum value in view of the above circumstances, and is not limited to 30 minutes.

  When an affirmative determination is made in step S120, the process proceeds to step S90, and the control device 302 transports the user to the closest one of the low-level medical support hospital and the high-level medical support hospital in the disease field where the user developed. Judge that it should be. Thus, although the user has a high total score value and is likely to have a severe symptom, the time required to the nearest hospital capable of high medical care (CSC) and the time required to the nearest low medical care available hospital If the difference from (PSC) is longer than the threshold value T3, in order to give priority to transporting to the hospital early, it should be transported to the closest of the hospital that can handle low medical care and the hospital that can handle high medical care. Can be determined.

  On the other hand, when a negative determination is made in step S120, the process proceeds to step S130, and the control device 302 determines that the user should be transported to a hospital capable of highly medical treatment in the disease field where the user has developed. As a result, a user who has a high score and a high possibility of severe symptoms is required for a time required to the nearest hospital capable of high medical care (CSC) and a time required to the nearest low medical care available hospital (PSC). When the difference is short, it can be determined that the patient should be transported to a hospital capable of handling advanced medical care that can be treated according to the user's degree of symptom.

  When a negative determination is made in step S70, the process proceeds to step S140, and the control device 302 determines whether the score in the automatic triage process or the score in the inquiry type triage process is smaller than 4. In step S140, in a user who is over 80 years old who is not taking an anticoagulant or blood diluent, the estimated elapsed time until transportation is less than the allowable time until administration of a thrombolytic drug (t-PA). If the score in the automatic triage process or the score in the inquiry type triage process is less than 4, the user's symptom degree can be determined to be low, and if the score is 4 or more, the user It can be determined that the severity of symptoms is severe.

  When an affirmative determination is made in step S140, the process proceeds to step S150, and the control device 302 conveys the user to the closest one of the hospitals capable of handling low medical care and hospitals capable of handling high medical care in the disease field where the user has developed. Judge that it should be. As a result, for users who are highly likely not to have symptoms, priority should be given to transport to the hospital as soon as possible, and transport to the closest of the hospitals that can handle low-level medical care and hospitals that can support high-level medical care. Can be determined.

  On the other hand, if a negative determination is made in step S140, the process proceeds to step S160. In step S160, the control device 302 determines that the difference between the required time (CSC) from the current position of the user to the closest hospital capable of handling advanced medical care (PSC) and the required time (PSC) to the nearest hospital capable of handling low-grade medical care is It is determined whether or not it is longer than a preset threshold value T4.

  Considering the situation where the user is not taking an anticoagulant or blood diluent, the age is 80 years or older, the estimated elapsed time to transport is 180 minutes or less, and the score is 4 or more, Since the degree of the user's symptom may be severe, it is preferable to transport the user to a hospital capable of handling advanced medical care. However, even in such a situation, the required time (CSC) from the current position of the user to the nearest hospital capable of handling advanced medical care (CSC) and the required time to the nearest hospital capable of handling low-grade medical care (PSC) are predetermined times. In the case where these are different, there is a case where priority should be given to transporting to a hospital at an early stage without being bound by transport to a hospital capable of handling advanced medical care. The value of the threshold value T4 is set in view of such circumstances, and in this embodiment, for example, 30 minutes is set as the threshold value T4. The threshold T4 is set to an optimum value in view of the above circumstances, and is not limited to 30 minutes.

  When an affirmative determination is made in step S160, the process proceeds to step S150, and the control device 302 conveys the user to the closer one of the hospitals capable of handling low-grade medical care and hospitals capable of handling high-grade medical care in the disease field where the user developed. Judge that it should be. Thus, although the user has a high total score value and is likely to have a severe symptom, the time required to the nearest hospital capable of high medical care (CSC) and the time required to the nearest low medical care available hospital If the difference from (PSC) is longer than the threshold value T4, in order to give priority to transporting to the hospital early, it should be transported to the closest of the hospital capable of low medical treatment and hospital capable of high medical care. Can be determined.

  On the other hand, when a negative determination is made in step S160, the process proceeds to step S170, and the control device 302 determines that the user should be transported to a hospital capable of highly medical treatment in the disease field where the user has developed. As a result, a user who has a high score and a high possibility of severe symptoms is required for a time required to the nearest hospital capable of high medical care (CSC) and a time required to the nearest low medical care available hospital (PSC). When the difference is short, it can be determined that the patient should be transported to a hospital capable of handling advanced medical care that can be treated according to the user's degree of symptom.

  Next, processing when a negative determination is made in step S60 will be described. If a negative determination is made in step S60, the process proceeds to step S180. In step S180, the control device 302 calculates an expected elapsed time from when an abnormality is detected by the user according to equation (1) until the user is transported to the hospital, and determines whether the calculated expected elapsed time is longer than a threshold IVtPA2. judge. As described above, since the allowable time until administration of a general thrombolytic drug (t-PA) is within 270 minutes, the threshold IVtPA2 in step S180 is set to 270 minutes.

  When an affirmative determination is made in step S180, the process proceeds to step S190, and the control device 302 determines whether the score in the above-described automatic triage process or the score in the inquiry type triage process is smaller than 2. In step S190, in a user under the age of 80 who is not taking an anticoagulant or blood diluent, when the estimated elapsed time until transportation is longer than the allowable time until thrombolytic drug (t-PA) administration. When the score in the automatic triage process or the score in the inquiry type triage process is smaller than 2, it can be determined that the degree of the user's symptom is low, and when the score is 2 or more, the symptom of the user It can be determined that the degree of is severe.

  When an affirmative determination is made in step S190, the process proceeds to step S200, and the control device 302 conveys the user to the closer one of the hospitals capable of handling low medical care and hospitals capable of handling high medical care in the disease field in which the user has developed. Judge that it should be. As a result, for users who are highly likely not to have symptoms, priority should be given to transport to the hospital as soon as possible, and transport to the closest of the hospitals that can handle low-level medical care and hospitals that can support high-level medical care. Can be determined.

  On the other hand, if a negative determination is made in step S190, the process proceeds to step S210. In step S210, the control device 302 determines whether or not the score in the above-described automatic triage process or the score in the inquiry type triage process is 4 or more. When an affirmative determination is made in step S210, the process proceeds to step S220, and the control device 302 determines the required time (CSC) from the current position of the user to the nearest highly medical care available hospital and the nearest low medical care available hospital. It is determined whether or not the difference from the required time (PSC) is longer than a preset threshold value T5.

  In view of the situation where the user is not taking anticoagulant or blood diluent, the age is less than 80 years, the estimated elapsed time to transport is longer than 270 minutes, and the score is 4 or more, Since it is possible that the degree of symptom is severe, it is considered preferable to transport the user to a hospital capable of handling advanced medical care. However, even in such a situation, the required time (CSC) from the current position of the user to the nearest hospital capable of handling advanced medical care (CSC) and the required time to the nearest hospital capable of handling low-grade medical care (PSC) are predetermined times. In the case where these are different, there is a case where priority should be given to transporting to a hospital at an early stage without being bound by transport to a hospital capable of handling advanced medical care. The value of the threshold T5 is set in view of such circumstances, and in this embodiment, for example, 60 minutes is set as the threshold T5. The threshold T5 is set to an optimum value in view of the above circumstances, and is not limited to 60 minutes.

  When an affirmative determination is made in step S220, the process proceeds to step S200, and the control device 302 conveys the user to the closest one of the hospital capable of handling low medical care and the hospital capable of handling high medical care in the disease field where the user developed. Judge that it should be. Thus, although the user has a high total score value and is likely to have a severe symptom, the time required to the nearest hospital capable of high medical care (CSC) and the time required to the nearest low medical care available hospital If the difference from (PSC) is larger than the threshold value T5, in order to give priority to the transfer to the hospital at an early stage, it should be transferred to either the hospital that can handle low medical care or the hospital that can handle high medical care, whichever is closer Can be determined.

  On the other hand, when a negative determination is made in step S220, the process proceeds to step S240, and the control device 302 determines that the user should be transported to a hospital capable of highly medical treatment in the disease field where the user has developed. As a result, a user who has a high score and a high possibility of severe symptoms is required for a time required to the nearest hospital capable of high medical care (CSC) and a time required to the nearest low medical care available hospital (PSC). When the difference is short, it can be determined that the patient should be transported to a hospital capable of handling advanced medical care that can be treated according to the user's degree of symptom.

  On the other hand, if a negative determination is made in step S210, the process proceeds to step S230, and the control device 302 determines the required time (CSC) from the current position of the user to the closest hospital capable of handling advanced medical care and the closest low medical treatment available. It is determined whether or not the difference from the required time (PSC) to a possible hospital is longer than a preset threshold value T6.

  Considering the situation where the user is not taking an anticoagulant or blood diluent, the age is less than 80 years, the estimated elapsed time to transport is longer than 270 minutes, and the score is 2 or more and less than 4. Since the degree of the user's symptom may be severe, it is considered preferable to transport the user to a hospital capable of handling advanced medical care. However, even in such a situation, the required time (CSC) from the current position of the user to the nearest hospital capable of handling advanced medical care (CSC) and the required time to the nearest hospital capable of handling low-grade medical care (PSC) are predetermined times. In the case where these are different, there is a case where priority should be given to transporting to a hospital at an early stage without being bound by transport to a hospital capable of handling advanced medical care. The value of the threshold T6 is set in view of such circumstances, and in this embodiment, for example, 30 minutes is set as the threshold T6. The threshold T6 is set to an optimum value in view of the above circumstances, and is not limited to 30 minutes.

  When an affirmative determination is made in step S230, the process proceeds to step S200, and the control device 302 transports the user to the closest one of the low-degree medical support hospital and the high medical support hospital in the disease field where the user developed. Judge that it should be. Thus, although the user has a high total score value and is likely to have a severe symptom, the time required to the nearest hospital capable of high medical care (CSC) and the time required to the nearest low medical care available hospital If the difference from (PSC) is longer than the threshold value T6, in order to give priority to transporting to the hospital early, it should be transported to the closest of the hospital capable of low medical treatment and hospital capable of high medical care. Can be determined.

  On the other hand, when a negative determination is made in step S230, the process proceeds to step S240, and the control device 302 determines that the user should be transported to a hospital capable of highly medical treatment in the disease field where the user has developed. As a result, a user who has a high score and a high possibility of severe symptoms is required for a time required to the nearest hospital capable of high medical care (CSC) and a time required to the nearest low medical care available hospital (PSC). When the difference is short, it can be determined that the patient should be transported to a hospital capable of handling advanced medical care that can be treated according to the user's degree of symptom.

  When a negative determination is made in step S180, the process proceeds to step S250, and the control device 302 determines whether or not the score in the above-described automatic triage process or the score in the inquiry type triage process is smaller than 4. In step S250, in a user younger than 80 years who is not taking an anticoagulant or blood diluent, the estimated elapsed time until transportation is less than the allowable time until thrombolytic drug (t-PA) administration. If the score in the automatic triage process or the score in the inquiry type triage process is less than 4, the user's symptom degree can be determined to be low, and if the score is 4 or more, the user It can be determined that the severity of symptoms is severe.

  When an affirmative determination is made in step S250, the process proceeds to step S260, and the control device 302 conveys the user to the closest one of the low-level medical support hospital and the high-level medical support hospital in the disease field where the user developed. Judge that it should be. As a result, for users who are highly likely not to have symptoms, priority should be given to transport to the hospital as soon as possible, and transport to the closest of the hospitals that can handle low-level medical care and hospitals that can support high-level medical care. Can be determined.

  On the other hand, if a negative determination is made in step S250, the process proceeds to step S270. In step S270, the controller 302 determines that the difference between the required time (CSC) from the current position of the user to the closest hospital capable of high medical care (CSC) and the required time (PSC) to the closest low medical care capable hospital is It is determined whether or not it is longer than a preset threshold value T7.

  Considering the situation where the user is not taking anticoagulant or blood diluent, the age is less than 80 years old, the estimated elapsed time to transport is 270 minutes or less, and the score is 4 or more, Since the degree of the user's symptom may be severe, it is preferable to transport the user to a hospital capable of handling advanced medical care. However, even in such a situation, the required time (CSC) from the current position of the user to the nearest hospital capable of handling advanced medical care (CSC) and the required time to the nearest hospital capable of handling low-grade medical care (PSC) are predetermined times. In the case where these are different, there is a case where priority should be given to transporting to a hospital at an early stage without being bound by transport to a hospital capable of handling advanced medical care. The value of the threshold T7 is set in view of such circumstances, and in this embodiment, for example, 30 minutes is set as the threshold T7. Note that the threshold T7 is set to an optimum value in view of the above circumstances, and is not limited to 30 minutes.

  When an affirmative determination is made in step S270, the process proceeds to step S260, and the control device 302 conveys the user to the closest one of the hospital capable of handling low medical care and the hospital capable of handling high medical care in the disease field in which the user has developed. Judge that it should be. Thus, although the user has a high total score value and is likely to have a severe symptom, the time required to the nearest hospital capable of high medical care (CSC) and the time required to the nearest low medical care available hospital If the difference from (PSC) is longer than the threshold value T7, in order to give priority to transporting to the hospital early, it should be transported to the closest of the hospital capable of handling low medical care and the hospital capable of handling high medical care. Can be determined.

  On the other hand, when a negative determination is made in step S270, the process proceeds to step S280, and the control device 302 determines that the user should be transported to a highly medical-capable hospital in the disease field where the user has developed. As a result, a user who has a high score and a high possibility of severe symptoms is required for a time required to the nearest hospital capable of high medical care (CSC) and a time required to the nearest low medical care available hospital (PSC). When the difference is short, it can be determined that the patient should be transported to a hospital capable of handling advanced medical care that can be treated according to the user's degree of symptom.

  The control device 302 determines the user's destination hospital based on the result of executing the processing shown in FIG. Specifically, if the control device 302 determines that the user should transport to a hospital capable of handling advanced medical care that can cope with the disease field in which the user develops, based on the hospital information recorded in the storage medium 303, A hospital that can handle advanced medical care in the field of disease in which the user has developed and that is closest to the current location of the user is determined as the user's destination hospital. On the other hand, when it is determined that the control device 302 should transport the hospital to the lower medical care capable hospital corresponding to the disease field in which the user develops or the hospital capable of high medical care, it is recorded in the storage medium 303. Based on the information on the hospital, the user is transported to the hospital where the location of the hospital is the closest to the user's current position among the hospitals that can cope with the disease field where the user has developed It is decided as a prior hospital.

  When the control device 302 determines the transport destination hospital of the user, the control device 302 transmits information for specifying the determined transport destination hospital to the user terminal 200. The information for specifying the destination hospital to be transmitted to the user terminal 200 includes information such as a hospital name, hospital location information, and a telephone number, for example.

  In the user terminal 200, when receiving the information for specifying the transport destination hospital from the monitoring device 300, the control device 204 outputs the received information to the touch panel 201 for display. Accordingly, a person who transports a user such as an ambulance crew to the hospital can check the information displayed on the touch panel 201 of the user terminal 200 and can grasp the hospital to which the user should be transported.

  When the control device 302 determines the transport destination hospital of the user, the control device 302 specifies the mail address of the transport destination hospital based on the hospital information recorded in the storage medium 303, and relates to the user who transports the mail addressed to the specified mail address. Send carrier information. Here, the carrier information includes the above-described health management information, vital data, data indicating the determination result for each determination item (A1) to (A10), or each question item (B1) to (B12) The data indicating the answer contents are included. As a result, the destination hospital can grasp in advance the health management information, vital data, and data indicating the triage result of the patient scheduled to be accepted. In the transport destination hospital, it is possible to prepare a reception system suitable for the user's symptoms in advance, and the user can receive appropriate treatment early at the transport destination, so that the lifesaving rate of the user can be improved. .

  FIG. 6 is a flowchart showing a flow of processing executed by the vital data measurement apparatus 100 in the present embodiment. As described above, the process shown in FIG. 6 is executed by the control device 103 as a program that is activated at a preset transmission timing of vital data.

  In step S <b> 310, the control device 103 acquires user vital data input via the vital data measurement unit 102. Thereafter, the process proceeds to step S320.

  In step S320, the control apparatus 103 transmits the vital data acquired in step S310 to the user terminal 200 via the communication module 101. Thereafter, the process ends.

  FIG. 7 is a flowchart showing a flow of measurement data transmission processing executed by the user terminal 200 in the present embodiment. The process shown in FIG. 7 is executed by the control device 204 as a program that is activated when user vital data is received from the vital data measurement device 100.

  In step S <b> 410, the control device 204 specifies the current position of the user terminal 200 by acquiring the above-described current position information based on the output from the GPS module 203. Thereafter, the process proceeds to step S420.

  In step S420, the control device 204, the vital data received from the vital data measurement device 100, information for specifying the user, for example, the user ID described above, and the current position indicating the current location of the user terminal 200 specified in step S410. Measurement data including position information is transmitted to the monitoring apparatus 300 via the communication module 202. Thereafter, the process ends.

  FIG. 8 is a flowchart showing a flow of answer data transmission processing executed by the user terminal 200 in the present embodiment. As described above, the process shown in FIG. 8 is executed by the control device 204 as a program that starts when an instruction to output a question for the inquiry type triage process is instructed from the monitoring device 300.

  In step S <b> 510, when the control device 204 is instructed to output a question from the monitoring device 300, the control device 204 outputs and displays the question content corresponding to the question items (B1) to (B12) described above on the touch panel 201. Thereafter, the process proceeds to step S520.

  In step S520, control device 204 determines whether or not input acceptance of answers to each question item has been completed. For example, the screen configuration is such that the operator touches the send button after inputting an answer to each question item, and when the control device 204 detects that the send button is touched, the input to each question item is performed. The determination in step S520 may be performed by checking whether the In addition, as for (B3) and (B4), as long as an answer to one of the questions is obtained, only one of the answers needs to be input for a question item that can be interrogated. To do. If a positive determination is made in step S520, the process proceeds to step S530.

  In step S <b> 530, the control device 204 transmits response data indicating the content of the response received on the touch panel 201 to the monitoring device 300. Thereafter, the process ends.

  FIG. 9 is a flowchart showing the flow of the destination hospital information output process executed by the user terminal 200 in the present embodiment. The process shown in FIG. 9 is executed by the control device 204 as a program that is activated when information for specifying the user's delivery destination hospital is received from the monitoring device 300.

  In step S <b> 610, the control device 204 outputs information for specifying the transfer destination hospital received from the monitoring device 300 to the touch panel 201 for display. Thereafter, the process ends.

  FIG. 10 is a flowchart showing a flow of processing executed by the monitoring apparatus 300 in the present embodiment. The process illustrated in FIG. 10 is executed by the control device 302 as a program that is activated when the measurement data described above is received from the user terminal 200. In FIG. 10, it is assumed that data necessary for processing such as registration of user information and data of hospital information described above is recorded in the storage medium 303 in advance.

  In step S710, as described above, the control device 302 determines whether or not the user has developed heart disease or brain disease based on the user's vital data included in the measurement data received from the user terminal 200. By detecting this, a user abnormality is detected. Thereafter, the process proceeds to step S720.

  In step S720, the control device 302 determines whether or not a user abnormality has been detected as a result of the abnormality detection process in step S710. If a negative determination is made in step S720, the process ends. On the other hand, if a positive determination is made in step S720, the process proceeds to step S730.

  In step S730, the control device 302 determines whether the above-described automatic triage process is possible. In other words, as described above, when the control device 302 determines that determinations for all the determination items (A1) to (A10) are possible based on the user's health management information and vital data, an affirmative determination is made in step S730. to decide. On the other hand, if the control device 302 determines that the health management information or vital data information is insufficient and determination on any of the determination items (A1) to (A10) is impossible, the control device 302 determines in step S730. Make a negative decision.

  When an affirmative determination is made in step S730, the process proceeds to step S740, and as described above, the control device 302 quantifies the determination results for the determination items (A1) to (A10), and calculates the total value of these values for the user. It is calculated as a score for determining the transport destination according to the symptom level. Then, it progresses to step S760 mentioned later.

  On the other hand, when a negative determination is made in step S730, the process proceeds to step S750, and as described above, the control device 302 obtains answer data for the question items (B1) to (B12) from the user terminal 200, The answer result is digitized, and the total value is calculated as a score for determining the transport destination according to the user's symptom level. Thereafter, the process proceeds to step S760.

  In step S760, the control device 302 executes the process shown in FIG. 5 described above based on the score in the automatic triage process calculated in step S740 or the score in the inquiry type triage process calculated in step S750. Based on the result, the destination hospital of the user's symptoms is identified. Thereafter, the process proceeds to step S770.

  In step S770, as described above, the control device 302 transmits information for specifying the determined transfer destination hospital to the user terminal 200. Thereafter, the process proceeds to step S780.

  In step S780, as described above, the control device 302 identifies the mail address of the transport destination hospital based on the hospital information recorded in the storage medium 303, and relates to the user who transports the mail addressed to the identified mail address. Send carrier information. Thereafter, the process ends.

According to the present embodiment described above, the following operational effects can be obtained.
(1) In the user terminal 200 possessed by the target user, the control device 204 acquires vital data including the user's blood pressure data, pulse data, and electrocardiogram data from the vital data measurement device 100, and acquires the acquired vitals. Data is transmitted to the monitoring device 300. In the monitoring device 300, the control device 302 detects an abnormality of the user when it is determined that the subject may have developed a heart disease or a brain disease based on the vital data received from the user terminal 200, When a user's abnormality is detected, the above-described triage process is executed, a transport destination hospital that transports the user is specified based on the degree of the user's symptom, and the specified result is transmitted to the user terminal 200. . As a result, when there is a possibility that the user has developed a heart disease or a brain disease, a triage process is performed to determine the degree of the user's symptom, and the destination hospital according to the degree of the symptom can be specified. it can. As described above, when the subject develops a heart disease or a brain disease, it is possible to quickly transport to an appropriate hospital by specifying a transport destination hospital according to the degree of the user's symptom at an early stage. Therefore, the lifesaving rate of the user can be improved.

(2) The control device 302 determines the degree of the symptom of the user based on the health management information and vital data recorded in the storage medium 303 for the health management of the user. Thus, the automatic triage process can be executed based on the user's health management information and vital data, and the degree of the user's symptom can be determined at an early stage.

(3) Based on the health management information and vital data, the control device 302 digitizes the determination result for each of the predetermined determination items (A1) to (A10), and sums the numerical values specified for each determination item. The degree of the user's symptom is determined by calculating the value as an index value. Thus, if a determination item for determining the degree of the user's symptom and a score corresponding to the determination result for each determination item are set in advance, the index value indicating the degree of the user's symptom is calculated with high accuracy. Can do.

(4) When the automatic triage process based on the health management information and vital data cannot determine the degree of the user's symptom, the control device 302 answers the question for checking the user's symptom from the user terminal 200 Data was acquired, and the degree of the user's symptom was determined based on the acquired answer data. As a result, even if the automatic triage process cannot be executed, the degree of symptoms based on the actual user status confirmed by the ambulance crew and family is determined based on the contents of the answers to the questions for determining the user's symptoms. can do.

(5) Based on the answer data, the control device 302 digitizes the answer results for each of the plurality of question items set in advance, and calculates the total value of the numerical values specified for each question item as an index value. The degree of user's symptom was judged. As a result, if a question item for determining the degree of the user's symptom and a score corresponding to the content of the answer to each question item are set in advance, an index value indicating the degree of the user's symptom can be calculated with high accuracy. Can do.

(6) The control device 302 sends the health management information, vital data, and data indicating the degree of the symptom of the user, i.e., for each determination item (A1) to (A10), to the mail address of the identified transport destination hospital. The carrier information including data indicating the determination result or data indicating the answer content for each question item (B1) to (B12) is transmitted. As a result, the destination hospital can grasp in advance the health management information, vital data, and data indicating the triage result of the patient scheduled to be accepted.

(7) When the control device 302 determines that the severity of the user's symptom is low, the control apparatus 302 can treat a low-degree medical hospital in the disease field corresponding to the user's symptom and the advanced level of the disease field corresponding to the user's symptom. The hospital closest to the current position of the user is selected from the hospitals capable of handling medical care and specified as the destination hospital. As a result, a user who has a high possibility of not having a severe symptom can identify a hospital as a transport destination by prioritizing transport to a hospital in order to increase the lifesaving rate.

(8) When the control device 302 determines that the severity of the user's symptom is high, the time required from the current position of the user to the closest hospital capable of handling advanced medical care and the nearest hospital capable of handling low medical care If the difference from the time required until the time is longer than a preset threshold, select a hospital that is close to the user's current location from hospitals that can handle low-level medical care and hospitals that can support high-level medical care. I specified it as a hospital. In addition, if the difference between the time required from the user's current location to the closest hospital capable of handling advanced medical care and the time required to reach the nearest hospital capable of handling low-grade medical care is less than or equal to a preset threshold, A hospital near the current position of the user is selected from the possible hospitals and specified as the destination hospital. As a result, the user's symptom is likely to be severe, but the difference between the time required to the nearest hospital capable of handling advanced medical care and the time required to reach the nearest hospital capable of handling low-grade medical care is longer than a predetermined threshold. In order to give priority to transporting to a hospital at an early stage, it can be determined that transport should be performed to the closer of the hospital capable of handling low-level medical care or the hospital capable of handling high-level medical care. On the other hand, if the difference between the time required to the nearest hospital capable of handling advanced medical care and the time required to reach the nearest hospital capable of handling low-grade medical care is short, advanced treatment appropriate to the degree of the user's symptoms will be received. As described above, it can be determined that the patient should be transported to a hospital capable of handling advanced medical care.

(9) The control device 302 indicates that when the waveform indicated by the electrocardiogram data included in the user's vital data indicates a pre-registered characteristic waveform of the heart disease, the user determines the heart disease. The user develops a brain disease when it is determined that there is a possibility of the onset, and the numerical value indicated by the blood pressure data and the waveform indicated by the pulse wave data indicate a characteristic value and waveform of a previously registered brain disease. Judged that there was a possibility that. Thereby, a user's abnormality can be detected with high accuracy based on the user's vital data.

(10) In the user terminal 200, the control device 204 acquires viral data from the vital data measurement device 100 that is a wearable terminal worn by the user. This makes it possible to periodically acquire user vital data.

-Modification-
In addition, the medical assistance system of embodiment mentioned above can also be deform | transformed as follows.

(1) In the above-described embodiment, when the control device 302 determines that the user should transport to a hospital capable of handling advanced medical care that can cope with the disease field in which the user develops, the hospital recorded in the storage medium 303 Based on the information, an example has been described in which a hospital capable of handling advanced medical care capable of dealing with a disease field in which a user develops and in which the location of the hospital is closest to the user's current location is determined as the user's transport destination hospital. In addition, when the control device 302 determines that the user should transport to a hospital that is capable of handling low-level medical care that can cope with the disease field in which the user develops or hospital that can handle high-level medical care, the control device 302 records the information in the storage medium 303 Based on the information on the hospital, the user is transported to the hospital where the location of the hospital is the closest to the user's current position among the hospitals that can cope with the disease field where the user has developed An example of determining the previous hospital has been described. However, when determining the transport destination hospital to which the user is transported, the control device 302 determines whether or not the user has developed a specialist regarding the disease field in which the user has developed based on the hospital information recorded in the storage medium 303. It is also judged whether there is a vacant treatment room for the disease field or whether the current time is within the emergency medical treatment time zone, and priority is given to hospitals with specialists, hospitals with vacant treatment rooms, and hospitals that can respond immediately. May be selected.

  In addition, the control device 302 selects a plurality of hospitals in order from the user's current location, or includes a hospital where a specialist is present or a hospital where there is a vacant treatment room, so that a candidate for a hospital as a transport destination of the user is selected. The hospital designated by the emergency personnel on the user terminal 200 may be specified as the transport destination. This makes it possible to present the transport destination options to the emergency personnel. In the unlikely event that there are unacceptable hospitals among the candidates, the ambulance crew can select the destination hospital from among the other candidates.

(2) In the above-described embodiment, when the control device 302 detects a user abnormality, the control device 302 executes the triage process to determine the user's destination hospital. In addition to this, the control device 302 may notify the notification destination registered in advance that the abnormality of the user has been detected. For example, the contact information of the related person such as the user's doctor or family can be registered as a notification destination in the health management information, and the control device 302 can register the notification destination in the user's health management information. Information indicating that a user abnormality has been detected may be transmitted to the notification destination. As a result, related persons such as the attending physician and family can grasp that an abnormality has occurred in the user. When an e-mail address is registered as a contact address, information may be transmitted to the e-mail address. When a mobile phone number is registered, a short message service (SMS) is sent to the mobile phone number. You may make a push notification that you use.

  In addition, when detecting an abnormality of the user, the control device 302 notifies the user that the abnormality has occurred along with the current position of the user to a pre-registered emergency notification destination such as a fire fighting center. It may be. As a result, when an abnormality is detected by the user, an emergency report can be made early. In addition, the ambulance crew who arrives upon receiving the report may operate the user terminal 200 to check the transport destination hospital specified by the automatic triage process or to answer a question for the inquiry type triage process. it can.

  Note that the present invention is not limited to the configurations in the above-described embodiments as long as the characteristic functions of the present invention are not impaired. Moreover, it is good also as a structure which combined the above-mentioned embodiment and a some modification.

DESCRIPTION OF SYMBOLS 10 Medical assistance system 100 Vital data measurement apparatus 101 Communication module 102 Vital data measurement part 103 Control apparatus 200 User terminal 201 Touch panel 202 Communication module 203 GPS module 204 Control apparatus 300 Monitoring apparatus 301 Connection interface 302 Control apparatus 303 Storage medium

Claims (17)

Vital data acquisition means for acquiring vital data including blood pressure data, pulse data, and electrocardiogram data of the subject;
Based on the vital data acquired by the vital data acquisition means, when it is determined that the subject may have developed heart disease or brain disease, the subject has developed heart disease or brain disease. An abnormality detecting means for detecting that there is a possibility that the subject is abnormal;
A determination unit that determines a degree of the symptom of the subject when an abnormality is detected by the abnormality detection unit;
Current position specifying means for specifying the current position of the subject;
When it is determined by the determination means that the level of the subject's symptom is low in severity, a low-level medical-supportable hospital in the disease field corresponding to the subject's symptom and a disease corresponding to the subject's symptom Select a hospital close to the current position of the target person specified by the current position specifying means from hospitals capable of handling advanced medical care in the field, specify the hospital as a transport destination for transporting the target person, and perform the determination If it is determined by the means that the degree of the subject's symptom is severe, the time required from the current position of the subject to the closest hospital capable of high medical treatment and the nearest hospital capable of low medical treatment When the difference from the required time is longer than a preset threshold value, the current position specifying means is specified from the low-level medical support hospital and the high-level medical support hospital. Select the nearest hospital from the current location of the subject person, identify it as the transport destination hospital, and the time required from the subject's current location to the nearest advanced medical care available hospital and the nearest low-grade medical correspondence When the difference from the required time to the hospital is less than or equal to a preset threshold, select a hospital close to the current position of the target person identified by the current position identifying means from the hospitals capable of handling advanced medical care And a transfer destination specifying means for specifying the transfer destination hospital ,
Transport destination information output means for outputting transport destination information on the transport destination hospital specified by the transport destination specifying means,
The abnormality detection means determines that the subject may have developed heart disease when the waveform indicated by the electrocardiogram data indicates a pre-registered characteristic waveform of heart disease, When the numerical value indicated by the blood pressure data and the waveform indicated by the pulse data indicate a characteristic value and waveform of a previously registered brain disease, it is determined that the subject may have developed a brain disease. Medical support system characterized by that. The medical support system according to claim 1,
The determination means determines a symptom level of the subject based on health management information recorded in a storage medium for the health management of the subject and the vital data. . The medical support system according to claim 2,
The determination means digitizes a determination result for each of a plurality of predetermined determination items based on the health management information and the vital data, and calculates a total value of the numerical values specified for the determination items as a symptom of the user's symptom. A medical support system, wherein the degree of the subject's symptom is determined by calculating as an index value indicating the degree. The medical support system according to claim 2 or 3,
A question output means for outputting a question for confirming the symptom of the subject when the degree of the symptom of the subject cannot be determined based on the health management information and the vital data;
Response data acquisition means for receiving an answer to the question and acquiring response data;
The determination means determines the degree of the subject's symptom based on the answer data acquired by the answer data acquisition means. The medical support system according to claim 4,
The determination means quantifies the answer result for each of a plurality of question items set in advance based on the answer data, and the index value indicating the degree of the user's symptom is the total value specified for each question item A medical support system that determines the degree of symptoms of the subject by calculating as In the medical support system according to any one of claims 1 to 5,
Carrier information transmission means for transmitting carrier information including the health management information, the vital data, and data indicating the degree of symptoms of the subject to the destination hospital specified by the destination specification means. A medical support system, further comprising: In the medical support system according to any one of claims 1 to 6,
When the abnormality is detected by the abnormality detection unit, the medical support system further comprises a notification unit that notifies the target person that the abnormality is detected to a notification destination registered in advance. In the medical support system according to any one of claims 1 to 7 ,
The medical support system, wherein the vital data acquisition means acquires the vital data from a wearable terminal having a function of measuring the vital data worn by the subject. A medical support system comprising a subject terminal possessed by the subject and a monitoring device connected to the subject terminal via a communication line,
The target terminal is
Vital data acquisition means for acquiring vital data including blood pressure data, pulse data, and electrocardiogram data of the subject;
Vital data transmission means for transmitting the vital data acquired by the vital data acquisition means to the monitoring device ;
Question output means for outputting a question for confirming the symptom of the subject based on an instruction from the monitoring device;
Answer data obtaining means for accepting an answer to the question and obtaining answer data;
Response data transmission means for transmitting the response data acquired by the response data acquisition means to the monitoring device ,
The monitoring device
Based on the vital data received from the subject terminal, the subject may have developed heart disease or brain disease when it is determined that the subject may have developed heart disease or brain disease An abnormality detecting means for detecting that there is an abnormality of the subject,
When an abnormality is detected by said abnormality detecting means, on the basis of the vital data and the health management information recorded in the storage medium for the healthcare of the subject, to determine the extent of the symptoms of the subject If the degree of the subject's symptom cannot be determined based on the health management information and the vital data, the target terminal is instructed to output the question, and received from the target terminal. based on the response data, a determination means for determining the degree of the symptoms of the subject,
Based on the degree of the symptom of the subject determined by the determining unit, a destination identifying unit that identifies a destination hospital that transports the subject,
Transport destination information transmitting means for transmitting transport destination information related to the transport destination hospital specified by the transport destination specifying means to the target terminal,
The abnormality detection means determines that the subject may have developed heart disease when the waveform indicated by the electrocardiogram data indicates a pre-registered characteristic waveform of heart disease, When the numerical value indicated by the blood pressure data and the waveform indicated by the pulse data indicate a characteristic value and waveform of a previously registered brain disease, it is determined that the subject may have developed a brain disease. Medical support system characterized by that. The medical support system according to claim 9 , wherein
The target terminal is
Transport destination information receiving means for receiving the transport destination information from the monitoring device;
A medical support system, further comprising: transport destination information display means for displaying the transport destination information received by the transport destination information receiving means on a display device. The medical support system according to claim 9 or 10 ,
The determination means digitizes a determination result for each of a plurality of predetermined determination items based on the health management information and the vital data, and calculates a total value of the numerical values specified for the determination items as a symptom of the user's symptom. A medical support system, wherein the degree of the subject's symptom is determined by calculating as an index value indicating the degree. In the medical support system according to any one of claims 9 to 11 ,
The determination means quantifies the answer result for each of a plurality of question items set in advance based on the answer data, and the index value indicating the degree of the user's symptom is the total value specified for each question item A medical support system that determines the degree of symptoms of the subject by calculating as In the medical support system according to any one of claims 9 to 12 ,
The monitoring device
Carrier information transmission means for transmitting carrier information including the health management information, the vital data, and data indicating the degree of symptoms of the subject to the destination hospital specified by the destination specification means. A medical support system, further comprising: The medical support system according to any one of claims 9 to 13 ,
The monitoring device
When the abnormality is detected by the abnormality detection unit, the medical support system further comprises a notification unit that notifies the target person that the abnormality is detected to a notification destination registered in advance. In the medical support system according to any one of claims 9 to 14 ,
The target person terminal further includes a current position specifying means for specifying the current position of the target person,
If the determination means determines that the degree of the symptom of the subject is low in severity, the transport destination specifying means, the hospital capable of handling low-grade medical care in the disease field according to the symptom of the subject and the target Selecting a hospital closest to the current position of the target person identified by the current position identifying means from among hospitals capable of handling advanced medical care in the field of disease according to the symptoms of the person, and identifying it as the transport destination hospital A medical support system characterized by The medical support system according to claim 15 , wherein
In the case where the determination means determines that the degree of the subject's symptom is severe, the transport destination specifying means, the time required from the current position of the target person to the nearest highly medical care capable hospital, When the difference between the time required to the nearest hospital capable of handling low medical care is longer than a preset threshold value, the current position specifying means is selected from the hospital capable of handling low medical care and the hospital capable of handling high medical care. A hospital closest to the current position of the subject identified by the above is selected, identified as the transport destination hospital, and the time required from the current location of the subject to the nearest advanced medical care available hospital is the closest low When the difference from the required time to the hospital capable of medical treatment is equal to or less than a preset threshold value, the current position specifying means is selected from the hospitals capable of medical treatment. Medical support system, characterized in that by selecting the nearest hospital from the current position of the constant has been the subject is specified as the hospital of the transfer destination. The medical support system according to any one of claims 9 to 16 ,
The medical support system, wherein the vital data acquisition means acquires the vital data from a wearable terminal having a function of measuring the vital data worn by the subject.

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