JP6801922B2 - Medical records management system, equipment, methods and programs - Google Patents

Description

The present invention relates to a medical record management system for managing medical records, a medical record management device, a medical record management method, and a medical record management program.

Medical information such as the patient's physical condition, medical condition, and treatment that the medical staff has learned in the patient's medical treatment is stored as a medical record in a medical institution or the like for a certain period of time. Here, the medical record is not limited to the medical record (medical record) in which the doctor records matters related to the predetermined medical treatment, and is created, recorded or stored for the physical condition, medical condition, treatment, etc. of the patient obtained in the process of the medical treatment. A record of documents, images, etc. Medical records were created during the course of medical care and other processes, such as prescriptions, surgical records, nursing records, laboratory findings, X-ray photographs, referral letters, and records of medical care progress during hospitalization for discharged patients. Includes any medium in which information about the patient is recorded. When medical information is recorded on an electronic medium, the set of encoded data recorded as medical information on the electronic medium corresponds to the medical record.

By the way, according to the Medical Practitioners Law, doctors are obliged to keep medical records for 5 years in the administrator of hospitals or clinics. For hospital or clinic managers, in addition to medical records, other medical records (surgery records, test results, X-rays, etc.) for 2 years, and benefits other than medical records in insurance medical treatment Books and documents are obliged to be preserved for 3 years from the date of completion.

Therefore, the medical institution must keep medical records and other medical records that are obliged to be preserved for at least the period for which the obligation to preserve is imposed (hereinafter referred to as the obligation to preserve period). The Medical Practitioners Law has provisions for storage obligations, but not for disposal obligations. Therefore, the medical institution can keep the medical records that have exceeded the storage obligation period, but can also discard them.

In some relatively large hospitals such as regional medical support hospitals and special function hospitals, in order to analyze past medical information and use it for current medical treatment, or to respond to proceedings or medical record inquiries from past patients. , There are places where medical records are stored for a long time by introducing electronic medical records. However, many privately-owned clinics that provide primary medical care keep paper-based medical records as they are. In order to reduce the cost of such storage, many clinics currently discard medical records whose storage obligation period has expired. Especially in small clinics, medical records that are not obliged to be stored may be discarded due to problems such as storage location as well as cost. As an example, when the hospital is closed due to the retirement of a doctor, medical records that are not obliged to be preserved may be discarded.

On the other hand, the period covered by the follow-up survey (hereinafter referred to as the follow-up period) in which the insurance company investigates the authenticity of the content of notifications and claims from applicants and subscribers is the past 5 from the present. The period may include more than a year. In this follow-up survey, the insurance company will investigate the hospital visit history and medical history of the targeted applicants and subscribers in order to inquire about the content of the notification and the content of the claim. In addition to medical institutions, there are other types of institutions such as this insurance company that require medical records of more than 5 years ago.

More specifically, the follow-up period in an insurance company is often from the start of the designated notification period specified at the time of enrollment to the cancellation deadline, which is the prescription for canceling the insurance contract due to a breach of the notification obligation. The designated notification period is generally 5 to 7 years. In addition, the deadline for cancellation due to a breach of notification obligation is two or five years from the start date of liability, or indefinite (no statute of limitations) if the content of the breach of notification obligation is serious. Therefore, the start of the follow-up period is often 5 to 7 years before enrollment. The start of the follow-up period will be a point in the past, based on the time of inquiry.

For example, if the designated notification period is 5 years and there is a reason for payment after the liability start date, but there is no reason for payment, the insurance claim will be claimed for another reason after the cancellation deadline (2 years from the liability start date) is exceeded. Suppose there was. In order for the insurance company to determine the validity of the claim, not only the truth of the reason for the claim, but also the presence or absence of the breach of the notification obligation of this subscriber and the cancellation deadline if there is a breach of the notification obligation. It is necessary to investigate whether it is exceeded. Therefore, this survey requires medical records during the designated notification period and during the period from the start date of liability that determines the cancellation deadline to the expiration of two years. That is, medical records for about 7 years (the elapsed period from the responsibility start date to the request (about 2 years) + the designated notification period before joining (5 years)) are required from the present time when the investigation is started.

As a longer example, even if the claim is made after 5 years, which is the cancellation deadline when there is a reason for payment from the liability start date, if you try to investigate whether there is a serious violation of the notification obligation, it will be 10 years from the present time. It is possible that medical records will be required before the above (the elapsed period from the liability start date to the request (more than 5 years) + the designated notification period before joining (5 years)).

FIG. 15 is an explanatory diagram showing the relationship between the follow-up period by such an insurance company and the retention obligation period of medical records in a medical institution. As shown in FIG. 15, when an insurance company makes an inquiry to a medical institution for an investigation (at the time of inquiry in the figure), there is a case where the required medical record has already been discarded.

As a technique related to the storage of medical records and provision to other institutions, for example, there is a technique described in Patent Documents 1 and 2. Patent Document 1 includes an apparatus including a first storage means for collectively storing copies of electronic medical records of a plurality of medical institutions, a second storage means for storing information for provision, and a processing means. The method of providing the electronic medical record is described. In the method, the processing means acquires the electronic medical record of the referral patient from the first storage means and adds the information of the referral destination medical institution to the second storage means in response to the request from the referral source medical institution. Remember in. In addition, the processing means searches the second storage device and transmits the corresponding medical information in response to the inquiry request from the referral destination medical institution.

Further, Patent Document 2 describes a medical information distribution method that is said to have versatility and maintainability. In the method described in Patent Document 2, the medical information distribution server takes in medical information data in a format other than a general-purpose image format as created by an electronic medical record system and stores it in a storage. Then, the medical information distribution server converts the medical information data stored in the storage into image data in response to the distribution request from the reference terminal, and attaches modification prevention information to the image data to prevent modification. And deliver.

Japanese Unexamined Patent Publication No. 11-1439356 JP-A-2007-295417

As described above, there is a period in which the period in which the medical record is in demand and the period in which the medical record can be reliably provided do not overlap, that is, a period in which the medical record may not be provided even if there is demand. Therefore, for example, even if the insurance company obtains the consent of the survey subject to disclose information on the medical records, there is a problem that the necessary medical records do not remain. Also, for example, even if the necessary medical records are fortunately left, it is difficult for the insurance company to reach the medical records if the medical records are related to the medical history not notified by the surveyed person. There is.

There is a demand for medical records that are not obliged to be preserved even at the medical institution that created the medical records. However, there is a problem that it is a heavy burden for medical institutions, especially small clinics, to keep medical records that are not obliged to be preserved.

In order to solve these problems, medical records including non-retention medical records created by many medical institutions including small clinics can be stored for a relatively long period of time, and non-medical institutions themselves Based on the authority given to, it is effective to provide a mechanism that allows the desired medical records to be freely referred to from the stored ones.

In addition, Patent Document 1 discloses the concept of a backup center that collectively manages the duplication of electronic medical records stored by a plurality of medical institutions, and then uses such a backup center to refer to the referral source. It describes how to pass medical records from a medical institution to the referral destination medical institution. However, this method has a problem that only electronic medical records stored by medical institutions are targeted, and medical records of medical institutions to which electronic medical records have not been introduced cannot be obtained.

Further, in this method, in response to a request from the referral source medical institution, the referral destination medical institution information is attached to the referral patient's electronic medical record and stored in the second storage means. In this method, the information provided is not created unless the referral institution knows the referral institution, so it cannot be used for a survey to know the existence of medical records of a specific individual such as an insurance company.

Furthermore, in reality, when considering the long-term storage of electronic medical records of a plurality of medical institutions that are not obliged to store, there arises a cost problem such as who will bear the cost of storage. For example, the users who enjoy the benefits by the method described in Patent Document 1 are only three users, the referral destination medical institution, the referral source medical institution, and the referral patient. It is unlikely that these three users will bear the cost of storing electronic medical records due to the benefits of this method associated with opportunities such as hospital transfers, which are not so common for many patients.

From the viewpoint of such cost burden, we think that the above mechanism that includes institutions other than medical institutions as users is effective, but in order to realize such a mechanism, medical records and other individuals in storage It is important to achieve both confidentiality of information and accessibility that allows institutions other than medical institutions to freely refer to desired medical records from the stored ones based on the authority given to them. Furthermore, it is preferable that the confidentiality of the personal information, the accessibility of the stored data, and the integrity of the data (prevention of falsification) are compatible with each other.

Here, the accessibility is based on the assumption that, for example, an insurance company refers to the medical record, and a plurality of institutions do not need to know the fact of the consultation or the medical institution to be consulted within the scope of their respective authority. , To find the desired medical record from the stored. In addition, accessibility may include, for example, that the medical institution on the registering side can easily register regardless of the recording format of the medical record.

In addition, Patent Document 2 describes an example of a method of distributing medical information while achieving both versatility and maintainability of data. However, this method adds access information and alteration prevention information to the medical information data in a format other than the general-purpose image format in response to the distribution request from the reference terminal, so that the medical information data stored in the storage is not sufficiently preserved. .. Further, the method described in Patent Document 2 does not take into consideration the compatibility between the confidentiality of personal information and the accessibility of data as described above, and further, the compatibility between these and the integrity of data.

In view of the above-mentioned problems, an object of the present invention is to store medical records of a plurality of medical institutions and to institutions other than medical institutions, while at least achieving both confidentiality of personal information, accessibility of data, and integrity of data. Is to realize the services provided by. More specifically, an object of the present invention is to be able to store medical records of a plurality of medical institutions including medical records that are not obliged to be preserved for a relatively long period of time, and the authority given to the plurality of institutions including different industries. It is to provide a medical record management system, a medical record management device, a medical record management method, and a medical record management program that can refer to a desired medical record based on the above.

The medical record management system according to the present invention stores information that associates at least the first storage means for storing the image data of the medical record provided by the medical institution with the target patient of the medical record and the image data of the medical record. Each time the second storage means and the medical institution provide the image data of the medical record of the patient of the medical institution, the first storage means corresponds to the record identification information for identifying the medical record and the image data. A medical record that includes record identification information and a summary of image data in a predetermined blockchain that is stored together and a new block is added through processing according to a predetermined consensus algorithm in which two or more nodes participate. A registration means that adds a block and stores the patient identification information that identifies the patient and the block specific information that can identify the medical record block in association with the second storage means, and a registration means other than the medical institution. In response to a request from a user including a third-party institution, which is an institution, the image data of the medical record of the designated patient is searched and provided from the image data of the medical record stored in the first storage means. It is characterized by having a means of providing the data.

Further, the medical record management system according to the present invention is constructed in a secure environment and is constructed in a secure environment as a first storage means for storing at least image data of medical records provided by a medical institution, and is used for medical records. From a second storage means that stores information that associates the target patient with image data of medical records, a third storage means that a node operated by a third-party institution other than a medical institution has, and a medical institution. Each time the image data of the medical record of the patient of the medical institution is provided, the record identification information for identifying the medical record and the image data are stored in association with each other in the first storage means, and the third storage is performed. The means stores the medical record block including the record identification information and the summary of the image data, and the second storage means stores the patient identification information for identifying the patient and the block identification which is the information that can identify the medical record block. In the image data of the medical record stored in the first storage means in response to a request from a user including a registration means for storing information in association with a third-party institution other than a medical institution. It is characterized in that it is provided with a providing means for searching and providing image data of medical records of a patient designated by.

In the medical care record management device according to the present invention, every time the medical institution provides image data of the medical care record of the patient of the medical institution, the record identification information for identifying the medical care record and the image are stored in a predetermined first storage means. A summary of record identification information and image data is added to a predetermined blockchain that stores data in association with each other and adds a new block through processing according to a predetermined consensus algorithm in which two or more nodes participate. A registration means for adding a medical record block including the above and storing the patient identification information for identifying the patient and the block specific information which is the information that can identify the medical record block in association with the predetermined second storage means. And, in response to a request from a user including a third-party institution that is an institution other than the medical institution, the medical record of the patient designated from the image data of the medical record stored in the first storage means It is characterized by having a providing means for searching and providing image data.

In the medical record management method according to the present invention, every time the information processing apparatus provides image data of medical records of patients at the medical institution, a record that identifies the medical records in a predetermined first storage means. The recorded identification information and the recorded identification information are stored in a predetermined blockchain in which the identification information and the image data are stored in association with each other and a new block is added through processing according to a predetermined consensus algorithm in which two or more nodes participate. A medical record block including a summary of image data is added, and a patient identification information that identifies a patient and a block specific information that can identify the medical record block are associated with a predetermined second storage means. Medical treatment of a patient designated from the image data of the medical treatment record stored in the first storage means in response to a request from a user including a third-party institution that is an institution other than the medical institution. It is characterized in that the recorded image data is searched and provided.

The medical record management program according to the present invention provides record identification information for identifying medical records in a predetermined first storage means each time a medical institution provides image data of medical records of patients at the medical institution to a computer. And image data are stored in association with each other, and new blocks are added through processing according to a predetermined consensus algorithm in which two or more nodes participate. Record identification information and image data are added to a predetermined blockchain. A medical record block including the summary of the medical record block is added, and the patient identification information for identifying the patient and the block specific information which is the information that can identify the medical record block are stored in association with the predetermined second storage means. Medical treatment of a patient designated from the image data of medical records stored in the first storage means in response to a request from a user including a third-party institution that is an institution other than the medical institution. It is characterized in that a process of searching and providing recorded image data is executed.

According to the present invention, it is possible to realize a service of storing medical records of a plurality of medical institutions and providing services to institutions other than medical institutions, while at least achieving both confidentiality of personal information and accessibility of data.

It is a block diagram which shows the example of the medical record management system of 1st Embodiment. It is a block diagram which shows the configuration example of management node 21. It is explanatory drawing which shows the outline of the data flow of embodiment of this invention. It is explanatory drawing which shows the example of the data structure of the information stored in the blockchain 22, the registration information DB3 and the medical record DB4. It is explanatory drawing which shows an example of the flow of each stage of the medical care record management system 10. It is a sequence diagram which shows an example of the operation of the medical record management system 10. It is a sequence diagram which shows an example of the operation of the medical record management system 10. It is a sequence diagram which shows an example of the operation of the medical record management system 10. It is a sequence diagram which shows an example of the operation of the medical record management system 10. It is explanatory drawing which shows the example of authority check. It is a block diagram which shows another example of a medical record management apparatus 1. It is a block diagram which shows another example of a medical record management apparatus 1. It is a schematic block diagram which shows the structural example of the computer which concerns on embodiment of this invention. It is a block diagram which shows the outline of the medical record management system of this invention. It is explanatory drawing which shows the relationship between the follow-up period by an insurance company and the obligation period for keeping medical records in a medical institution.

Hereinafter, embodiments of the present invention will be described with reference to the drawings. First, the business model leading to the configuration of the medical record management system of the present invention will be briefly described.

The medical record management system according to the present invention receives and stores medical records from medical institutions, and is requested by the medical institution that entrusted the medical records and other institutions that are members of the medical record providing service provided by this system. In some cases, provide medical records that are kept based on the authority given to those institutions.

In the present invention, as one of the institutions that use the system, it is assumed that an institution other than a medical institution such as an insurance company or a research company that desires medical records of a specific individual (hereinafter referred to as a third-party institution). To do. The medical institution side that provides medical records by adding such a third-party institution to the user and making the system configuration so that the third-party institution can distribute and bear the resources or costs for system operation. This system can be used with a relatively low burden even in a small clinic by reducing the introduction cost of the system.

For example, in this system, the usage fee for the medical record reference service provided by this system is free for medical institutions, while the annual membership fee as the usage fee is free for third-party institutions. Etc. may be used as a condition for joining the service. At this time, it is conceivable that the usage fee is a pay-as-you-go system. For example, the usage fee may be set according to the usage amount of the system such as the amount of information provided by the system in the reference service, the number of times of provision, and the number of inquiries.

Further, for example, in this system, as a method of distributing and burdening physical resources related to system operation to a third-party organization, a device operated by the third-party organization to provide some information of medical records that may be disclosed. It may be stored in the (node) and held by a third party.

By providing a service that enables long-term storage and reference of medical records to such medical institutions and third-party institutions other than medical institutions, it is possible to connect the third-party institutions and medical institutions and use the medical records. To increase.

For example, small clinics often provide primary medical care as a family doctor, and are likely to have medical records that cover the medical history of patients in their field of responsibility. By providing a service that can be used even in such a small clinic, it is possible to further increase the utility value of medical records at other institutions. It is also possible to include the patient himself as the service provider.

Next, the technical concept for realizing such a business model will be briefly explained.

Since the present invention is premised on use by different institutions such as a plurality of medical institutions and a plurality of third-party institutions, it is possible to perform distributed management by a plurality of nodes, have high maintainability, and easily connect data to each other. Manage the attribute information of medical records by using the blockchain that has. On the other hand, since the medical record itself is highly confidential, it is managed by storing it in a predetermined storage device constructed in a secure environment.

Further, in the present invention, all medical records are treated as image data so that medical institutions that have not introduced electronic medical records can use them, and a specific format is not required. For example, medical records on paper media and electronic medical records in other formats are registered after being imaged by scanning them with a scanner or converting them to a print data format. This makes it possible to use this system even in a relatively small clinic that does not have an electronic medical record.

Here, the blockchain is a group of data having a predetermined data structure called a block arranged in chronological order, and has a role as a recording ledger that keeps the information recorded in each block. In addition to the information that you want the block churn to hold, each block contains information about one or more previous blocks (hereinafter referred to as the previous block) and information for detecting the presence or absence of tampering (verification information called nonce, signature, etc.). ) And.

In the blockchain management system, when a new block is added to the blockchain, processing according to a predetermined consensus algorithm in which two or more management nodes participate (hereinafter, referred to as consensus processing) is performed. Then, each of the management nodes keeps a copy of the blockchain through the execution of the consensus process.

For example, in PoW (Proof of Work), which is one of the consensus algorithms, "the Hash value of a block is equal to or less than a threshold value (target value)" for each block (data group) including the information of the previous block and the nonce. A rule such as "that" is predetermined, and when a block is added, a process is performed in which a plurality of management nodes simultaneously search for a nonce that satisfies such a rule. By performing such a consensus process, it is possible to have a plurality of management nodes hold a copy of information while ensuring the difficulty of falsification. The consensus algorithm in the blockchain management system is not limited to PoW. For example, in addition to PoW, a consensus algorithm such as BFT (Byzantine fault tolerance) can also be used.

However, since the blockchain also has a feature that replication is held by a plurality of nodes in exchange for the above-mentioned feature, the confidentiality of data is low. Therefore, as described above, highly confidential information is stored in another peripheral system constructed in a secure environment. After that, the peripheral system and the blockchain are linked.

This system classifies non-public information into public information and non-public information each time storage target information such as image data of medical records and attribute information of the medical records is provided by a medical institution. A block containing public information and a summary of non-public information may be added to the blockchain while being stored in the peripheral system. In addition, the image data of the medical record is classified as non-public information. At this time, the block added to the blockchain may include information for identifying non-public information and information for identifying the patient.

The peripheral system is, for example, a system that can be linked with a blockchain in which public information is registered, and is preferably a system with closed internal specifications. In addition, "cooperation" includes at least addition of a block to the blockchain and data reference in the blockchain. In the peripheral system, the authority is checked for access from the user, and only the reference of the information in the range permitted for each user is permitted. In this way, the confidentiality of non-public information is ensured.

Such a blockchain may be used, for example, so that a third-party organization affiliated with the service can freely refer to the blockchain held by any of the management nodes. In addition, if blockchain is used, it is easy to adapt to a dynamic environment such as adding or deleting a node that holds a copy. Therefore, for example, the above node is implemented on a server provided by a third-party organization. Not only can the resources required for operation be distributed to third-party organizations and burdened, but also when a new third-party organization joins, it can be dynamically dealt with.

[Embodiment 1]
Next, an embodiment of the present invention will be described with reference to the drawings. FIG. 1 is a block diagram showing an example of a medical record management system of the present embodiment. As shown in FIG. 1, the medical record management system 10 includes a medical record management device 1, a blockchain management system 2, a registration information DB (database) 3, and a medical record DB 4. Each of these is connected via network 5.

The blockchain management system 2 is a system in which a plurality of nodes share and manage the blockchain as described above. The blockchain management system 2 is illustrated as a system for managing the blockchain, but it may be a system in which a blockchain that can execute a predetermined consensus process and is difficult to be tampered with is shared by terminals in the system as a recording ledger. For example, the detailed configuration and specifications are not particularly limited.

The management node 21 is a node that executes consensus processing in the blockchain management system 2. Each of the management nodes 21 keeps a copy of the blockchain 22 through the execution of the consensus process.

In the blockchain 22 of the present embodiment, every time the image data of the medical record is provided by the medical institution, a recording block including at least a part of the attribute information of the medical record and the summary of the image data of the medical record is registered ( Will be added). The details of the process of adding the recording block to the blockchain 22 will be described later.

The registration information DB 3 stores patient management information that associates a patient who has consented to the provision of medical records to this system with a block including the information of the patient registered in the blockchain 22. The registration information DB 3 searches and verifies, for example, a block in which a summary of public information of the patient, image data of the medical record, and other non-public information is recorded in association with the key information of the patient in the medical record management device 1. Store block management information for.

As patient key information, search information such as medical institution information and patient identifier at the provider medical institution is used by the medical record management device 1 to facilitate the search for the patient to be managed by the registration information DB3. May be memorized. In addition to the above example, the patient key information may be information that identifies a patient (individual) included in the above-mentioned patient information, a Hash value generated from such information, or the like. There may be a plurality of patient key information.

Further, in the present embodiment, the Hash value of the block is used as the block management information.

The registration information DB 3 may store block management information of all blocks in which the storage target information of the patient is recorded in association with the key information of the patient. For example, the registration information DB 3 may store block management information of at least two blocks, a consent information block and a medical record block, which will be described later. The registration information DB 3 may store block management information of two or more medical record blocks when image data of medical records are registered from a plurality of medical institutions or the like for the same patient.

Further, as described above, the registration information DB 3 may further store non-public information about the patient in association with the key information of the patient.

The medical record DB 4 stores at least the image data of the medical record provided by the medical institution. The medical record DB 4 may store predetermined non-public information among the storage target information including the attribute information of the medical record of the patient provided by the medical institution, for example. The image data of the medical record belongs to non-public information.

The attribute information of the medical record that is the information to be stored is, for example, patient information that is information about the patient that is the target of the medical record, medical institution information that is information about the medical institution that created it, date and time of creation, and information about the medical condition. And so on. The information to be stored may include information other than the image data of the medical record and the attribute information thereof, for example, the image data of the consent form regarding the provision of the medical record. From the viewpoint of data confidentiality, the medical record DB 4 may store non-public information excluding information that identifies a patient (individual) among the non-public information. In that case, the medical care memory DB 3 may store, for example, information that can determine the identity of the information at the time of collation, such as the Hash value of the information, instead of the information that identifies the patient (individual).

Non-public information other than the image data of the medical record may be stored in the registration information DB 3 described later. That is, the non-public information may be stored in any storage device of the peripheral system together with the information that can identify the patient or the information corresponding to the information.

Examples of public information include medical institution information and patient information that does not identify an individual (gender, date of birth, diagnosis name, medical treatment start date, medical treatment end date, system license date, license target), etc. Can be mentioned. In addition, examples of non-public information include image data of medical records, image data of consent forms for providing medical records, and patient information in which an institution other than the medical institution that created the information identifies the patient (individual) (name). And the date of birth group, insurance certificate number), etc.

The target patient may be able to set whether the information is public information or non-public information for each item included in the storage target information.

The medical record DB4 has, for example, a management number (hereinafter referred to as a record management number) assigned each time the image data of the medical record is registered, the image data of the medical record, and other non-public information if it exists. Correspond and memorize. The record management number may be an identifier indicating a value unique to any unit in which the image data of the medical record is registered in this system. The record management number is preferably a value randomly assigned to a certain unit, for example. For example, as a record management number, Hash of information obtained by combining information for identifying a medical institution, information for identifying a patient at the medical institution, date and time when target information (image data of medical records) is received, and the like. You may use the value. If the image data of the medical care record is managed by using such a record management number, it is possible to prevent the target patient from being identified from the information in the medical care record DB4.

The record control number may be recorded in the block together with, for example, a summary of the image data to which the record control number corresponds. Here, the "summary" is not particularly limited as long as it is information based on the original information (in this example, non-public information) and can detect the information when it is falsified. The summary may be information obtained by a one-way function, for example, the Hash value of the original information (image data in the above case). By registering a summary of image data and non-public information stored in the medical record DB 4 which is a peripheral system in the block chain 22 in the block chain, it is possible to detect when the information stored in the medical record DB 4 is tampered with. In addition, the registration history of information in the medical care memory DB 3 can be retained on the blockchain.

In addition, the medical record DB 4 may encrypt and store the image data of the medical record and other non-public information in order to further improve the confidentiality of the medical record.

The medical record management device 1 provides the user with an interface for registering, searching, and referencing the storage target information, and executes various controls for registering, searching, and referencing the storage target information in accordance with the request from the user. .. As shown in FIG. 1, the medical record management device 1 may include a patient registration unit 101, a medical record registration unit 102, a registration information inquiry unit 103, and a medical record providing unit 104.

The patient registration unit 101 performs the registration process of the designated patient in response to the request from the medical institution. In this registration process, the patient registration unit 101 receives, for example, at least the information of the requesting medical institution (medical institution information) and the patient information to be registered as the storage target information related to the registration, and those received. Is appropriately registered in the blockchain 22 and the medical record DB4, and then the key information of the patient generated based on the patient information and the block management information are associated with each other and stored in the registration information DB3.

Information registration to the blockchain may be performed by passing the information to be registered in the blockchain 22 to any management node 21 provided in the blockchain management system 2 and requesting the creation of a block.

For example, when the received information includes non-public information, the patient registration unit 101 assigns a record management number to the received non-public information and stores it in the medical record DB4, and then stores the record. The management node 21 may be requested to create a consent information block including a management number, public information, and a summary of non-public information. If the received information does not include non-public information, the patient registration unit 101 may request the management node 21 to create a consent information block including the public information.

When the registration process is completed, the patient registration unit 101 may, for example, reply to the requesting user (terminal of a medical institution, etc.) that the registration has been completed. At this time, the patient registration unit 101 may also return the key information of the patient.

The medical record registration unit 102 performs the registration process of the image data of the medical record of the designated patient in response to the request from the medical institution. In this registration process, the medical record registration unit 102 receives, for example, at least the requesting medical institution information, the patient information, and the image data of the medical record as the storage target information related to the registration, and the received information. Is appropriately registered in the blockchain 22 and the medical record DB4, and then the blockchain 22 is added to the patient management information stored in the registration information DB3 based on the key information of the patient generated based on the patient information. Add the block management information of the block registered in.

The medical record registration unit 102, for example, assigns a record management number to the received medical record image data and other non-public information and stores the record management number in the medical record DB 4, and the record management number, the public information, and the non-public information. The management node 21 may be requested to create a medical record block including a summary of public information. If the received information does not include public information, the medical record registration unit 102 may request the management node 21 to create a medical record block including a record management number and a summary of non-public information. Good.

When such a registration process is completed, the medical record registration unit 102 may, for example, reply to the requesting source (terminal of a medical institution, etc.) that the registration has been completed. At this time, the medical record registration unit 102 may also return the record management number.

The registration information inquiry unit 103 inquires about registration information regarding a designated patient or contractor (individual) in response to a request from a medical institution or a third-party institution. In this inquiry process, the registration information inquiry unit 103 provides information such as whether or not storage target information is registered for the designated patient or individual contractor and a list of storage target information based on the access authority of the requester.

The medical record providing unit 104 provides storage target information (particularly, image data of medical records) regarding a designated patient or contractor (individual) in response to a request from a medical institution or a third-party institution. In this provision process, the medical record providing unit 104 provides the storage target information regarding the designated patient or individual contractor based on the access authority of the requester.

Further, FIG. 2 is a block diagram showing a configuration example of the management node 21. The management node 21 shown in FIG. 2 includes a data reception unit 211, a block generation unit 212, a block sharing unit 213, an information storage unit 214, a block verification unit 215, and a data output unit 216.

The data receiving unit 211 receives information to be added to the blockchain 22 from an external node. In the present embodiment, the data reception unit 211 receives a record management number, a summary of public information, and non-public information as information to be added to the blockchain 22.

The block generation unit 212 generates a block to be added to the blockchain by using the information received by the data reception unit 211. The block generation unit 212 generates a block including information based on the previous block and information received by the data reception unit 211. Further, the block generation unit 212 performs, for example, a nonce search process as a predetermined consensus process for a block generated by itself or a block generated by another management node 21 via the block sharing unit 213 described later. After performing the process of giving a signature, a block is added to the blockchain (corresponding to a copy of the blockchain 22) managed by itself. The block generated by the block generation unit 212 is finally added to the block chain 22 by a plurality of management nodes 21 performing a predetermined consensus process.

The block sharing unit 213 exchanges information between the management nodes 21 belonging to the blockchain management system 2. More specifically, the block sharing unit 213 appropriately receives information received by the data receiving unit 211, blocks generated by the block generating unit 212, blocks received from the other management node 21, and the like, as appropriate. Send to. As a result, all management nodes 21 share this information and the latest blockchain 22 as much as possible.

The information storage unit 214 stores a copy of the blockchain 22. In addition to the copy of the blockchain 22, the information storage unit 214 may store, for example, information required for verification processing by the block verification unit 215, which will be described later.

When adding a block to the blockchain held by the block verification unit 215, the block verification unit 215 verifies the inside of the block. For example, the block verification unit 215 generates information based on the previous block included in the block to be added, whether the block to be added actually meets the rules, the signature matches the node that created the block, or the information is generated from the actual previous block. You may verify whether it matches the information provided.

The data output unit 216 searches for and outputs a block containing desired information from the blockchain 22 held by itself in response to a request from an external node.

The configuration of FIG. 2 is just an example, and the management node 21 can execute a predetermined consensus process for sharing and managing the blockchain 22 which is difficult to be tampered with by a plurality of nodes, and can be executed from an external node. As long as the node can add information to the ledger and refer to the ledger in response to the request of, the specific configuration does not matter.

Further, although FIG. 1 shows the medical record management device 1 and the management node 21 as separate items, the medical record management device 1 may have the function of the management node 21.

FIG. 3 is an explanatory diagram showing an outline of a data flow according to an embodiment of the present invention. Note that FIG. 3 shows the image data of the consent form, patient information, medical institution information, and the like as the consent information, but the consent information is not limited to these.

In the example shown in FIG. 3, a medical institution or the like first registers consent information including patient information and medical period information for which system registration consent has been obtained in this system. The system stores the non-public information in the consent information and the key information of the patient in the registration information DB 3, and also stores the public information in the consent information and the Hash value of the non-public information (Hash X in the figure). ) And the consent information block (block i in the figure) is created and added to the blockchain 22. In addition, the system stores the Hash value (Hash i in the figure) of the added consent information block as block management information in the registration information DB 3 in association with the key information of the patient.

Next, five years after the end of the examination of the patient who has consented to the system registration, the medical institution registers the image data of the medical record of the patient whose storage obligation is no longer required in this system. The system stores the image data of the medical record and the record management number in the medical record DB4 in association with each other, and also includes the record management number and the Hash value (Hash Y in the figure) of the image data of the medical record. A block (block n in the figure) is created and added to the blockchain 22.

In addition, the system stores the Hash value (Hash n in the figure) of the added medical record block as block management information in the registration information DB 3 in association with the key information of the patient. At this time, if there is already stored block management information, new block management information may be added to hold two or more block management information. When overwriting the already stored block management information, the system includes the already stored block management information (block management information before overwriting) in the medical record block.

When new public information is provided from the medical institution together with the image data of the medical record, the system may include the public information in the medical record block and register it in the blockchain 22. In addition, when new non-public information is provided from the medical institution together with the image data of the medical record, the system stores the non-public information in the medical record DB 4 in the same manner as the image data of the medical record, and the non-public information thereof. The Hash value may be included in the medical record block and registered in the blockchain 22.

In addition, the image data of the medical record provided by the medical institution may include the image data of the medical record during the storage obligation period. That is, the image data of medical records to be stored by this system is not limited to those for which storage obligation is no longer required.

As described above, each block is connected in chronological order and holds a value based on the previous block. For example, block n holds block Hash n-1, which is the Hash value of block n-1. Similarly, block n + 1 holds block Hash n, which is the Hash value of block n. Therefore, in order to falsify the contents of the block, it is necessary to recreate all the subsequent blocks, and due to the nature of the blockchain, it is difficult to falsify the data in the blockchain.

Further, FIG. 4 is an explanatory diagram showing an example of a data structure of information stored in the blockchain 22, the registration information DB3, and the medical record DB4. There are two types of blocks used by the medical record management system 10, a consent information block and a medical record block. In this example, the same data structure is used for both blocks.

The block used by the medical record management system 10 may include, for example, a header unit D21 and a data unit D22. The header unit D21 includes the previous block management information D211. Further, the data unit D22 may include the management number D221, the public information D222, and the non-public information management information D223.

The front block management information D211 may be information based on the front block, and may be information that can detect when the data of the front block is falsified. An example of the front block management information D211 is a Hash value of the front block.

The control number D221 is information for identifying the data stored in the block. Examples of the control number D221 include a record management number in the case of a medical record block, and a key information or a second key information generated from the key information in the case of a consent information block. The control number D221 of the consent information block may be omitted.

Public information D222 is public information among the storage target information provided by the medical institution. The public information D222 may be omitted when the storage target information for generating the block is provided and the storage target information does not include the public information.

The non-public information management information D223 is information based on the non-public information among the storage target information provided by the medical institution, and is information that can detect the falsification of the non-public information. Good. An example of the non-public information management information D223 is a Hash value of the target non-public information. The non-public information management information D223 may be omitted in the provision of the storage target information that is to generate the block if the storage target information does not include the non-public information.

Although not shown, the data unit D22 may further include block management information of a block in which information about the patient is stored, which is registered in the blockchain 22 before the block.

Further, as shown in FIG. 4, the registration information DB 3 includes, for example, key information D31, non-public information D32, and block management information D33 as patient management information for each patient whose medical record is provided by the medical institution. May be memorized.

The key information D31 is the above-mentioned patient key information.

The non-public information D32 is non-public information of the patient other than the image data of the medical record. The non-public information D32 may be omitted. The image data of the medical record is stored in the medical record DB 4 as described later.

The block management information D33 is block management information of the block including a summary of public and / or non-public information of the patient.

Further, as shown in FIG. 4, the medical record DB 4 stores, for example, a record management number D41 and a medical record image data D42 as medical record information each time the medical institution provides image data of the medical record. You may.

The record management number D41 is the above-mentioned record management number.

The medical record image data D42 is the image data of the provided medical record.

Although not shown, the medical record DB 4 may further store non-public information of the patient as medical record information in combination with the medical record image data D42 or in place of the medical record image data D42. ..

Next, an example of the flow of each stage of patient registration, medical record registration, registration information inquiry, and medical record reference of the medical record management system 10 will be described with reference to FIG. FIG. 5A is an example of a flow of a phase in which a patient is registered in the medical record management system 10. In the example shown in FIG. 5A, the medical institution registers the consent information including the patient information, the medical institution information, and the image data of the consent form of the patient who has consented to the system registration of the medical record in the medical record management system 10. .. As a result, for example, the consent information block including the public information and the summary of the non-public information among the consent information is registered in the blockchain 22, and the key information of the patient and the consent information generated from the patient information and the like are registered. The non-public information of the above and the Hash value (block management information) of the consent information block are associated and stored in the registration information DB3.

FIG. 5B is an example of a flow of a phase of registering image data of medical records of a patient who has obtained consent in the medical record management system 10. In the example shown in FIG. 5B, the medical institution registers the image data of the medical records of the patient who has accepted the system registration of the medical records in the medical record management system 10. At this time, the medical institution inputs the information for identifying the patient and its own medical institution information into the medical record management system 10 together with the image data of the medical record, inquires about the information registered about the patient, and then performs medical treatment. Register the recorded image data. As a result, for example, the image data of the medical record of the patient who has obtained the consent is registered in the medical record DB 4 together with the record management number assigned to the image data. In addition, a medical record block including a summary of the image data and a record management number is registered in the blockchain 22, and the key information of the patient is associated with the Hash value (block management information) of the medical record block. It is stored (added) in the registration information DB3.

FIG. 5C is an example of a flow of a registration information inquiry phase for inquiring information registered in the medical record management system 10. In the example shown in FIG. 5C, a medical institution or a third-party institution such as an insurance company that has obtained consent from the contractor or the like obtains information registered regarding the authorized patient or contractor in the medical record management system 10. Inquire at. A medical institution or a third-party institution specifies, for example, information that can identify a patient (individual) and makes an inquiry request to the medical record management system 10. The medical record management system 10 identifies a patient based on the designated information, inquires with the patient management information of the registration information DB3, and then includes information included in the patient management information and information that can be acquired based on the information. To the extent permitted to the requesting agency. As a result, the medical institution or a third-party institution can know whether or not the medical record of the designated individual is registered in the system within the range permitted by itself. Examples of information that can identify a patient (individual) include a set of patient's date of birth and name, a set of medical institution identification information and patient identification information at the medical institution, and a patient assigned by the medical record management system 10. Key information, personally identifiable information (insurance certificate number) assigned by other systems (administration, etc.), etc. can be mentioned.

FIG. 5D is an example of a flow of the phase of referring to the medical records registered in the medical records management system 10. In the example shown in FIG. 5D, a third-party institution such as an insurance company that has obtained consent from a medical institution or a contractor, etc., selects from the image data of the medical care memory registered in the medical care record management system 10. Refer to the image data of the medical records of the authorized patient or contractor. The medical institution or a third-party institution specifies, for example, information that can identify the patient (individual) and information that can identify the medical record to be referred to, and requests the medical record management system 10 for reference. The medical record management system 10 identifies the patient and the medical record based on the designated information, and provides the information to the requesting institution within the permitted range. As a result, the medical institution or a third-party institution can refer to the image data of the medical record of the designated individual within the range permitted by itself. An example of information that can identify a medical record is a record management number obtained in the registration information inquiry phase. It is also possible to specify narrowing conditions such as the date and time of medical treatment and the period of medical treatment instead of the information that can identify the medical treatment record.

Next, the operation of the medical record management system 10 will be described. 6 to 9 are sequence diagrams showing an example of the operation of the medical record management system 10. In each figure, the patient registration function, the medical record registration function, the inquiry function, and the providing function are the patient registration unit 101, the medical record registration unit 102, the registration information inquiry unit 103, and the medical record providing unit 104 of the medical record management device 1, respectively. Represent. Further, the user in the figure represents a user terminal operated by each user.

First, the patient registration operation in the medical record management system 10 will be described with reference to FIG. The user in the operation is assumed to be a consultation destination of the patient to be registered, that is, a medical institution that creates a medical record of the patient. In the example shown in FIG. 6, first, a consent registration request including patient information and medical institution information as consent information is transmitted to the patient registration unit 101 of the medical record management device 1 (step S101). For example, the user first transmits a consent registration record request requesting patient registration to the medical record management device 1 via a Web page or the like provided by the medical record management device 1, and according to an information input request received as a reply thereof. Patient information and medical institution information, and if present, image data of the consent form, consent contents, etc. may be input.

The patient registration unit 101 that has received the consent information generates key information of the patient based on the received information (step S102). In addition, the patient registration unit 101 calculates the Hash value of the non-public information to be stored included in the received information (step S103). Then, the patient registration unit 101 creates the content to be registered in the blockchain 22 (data unit D22 of the consent information block) (step S104). In step S104, the patient registration unit 101 creates a data unit D22 including at least a control number D221, public information D222, or non-public information management information D223. Then, the block addition request including the created data unit D22 is transmitted to any management node 21 of the blockchain management system 2 (step S105).

The management node 21 that has received the block addition request generates a block that includes at least the received data unit D22 and the header unit D21 created based on the information of the blockchain 22 that it manages (step S106). .. Then, each of the management nodes 21 of the blockchain management system 2 executes a predetermined consensus process and adds the generated blocks to the ledger (step S107). In addition, the management node 21 that has received the block addition request requests the block Hash, which is the Hash value of the added block, as the request source in response to the fact that the block in which the requested data unit D22 is recorded is normally added. Is transmitted to the patient registration unit 101 (step S108).

When the patient registration unit 101 receives the block Hash, the block Hash is used as the block management information, and the patient key information generated in step S102 is associated with the block management information and the non-public information included in the consent information. Then, it is recorded in the registration information DB3 (step S109). If the consent information does not include the non-public information to be retained, the above non-public information is omitted.

Specifically, the patient registration unit 101 registers a DB registration request including the patient's key information, the block Hash as the block management information, and the non-public information to be retained in the consent information, if any. It is transmitted to the information DB3. The registration information DB 3 creates and stores a new record in which the information included in the received DB registration request is recorded (step S110).

When the patient registration unit 101 receives from the registration information DB 3 that the registration is completed (step S111), the patient registration unit 101 notifies the requesting user of the completion of the registration and ends the process (step S112).

Next, the registration information inquiry operation in the medical record management system 10 will be described with reference to FIG. 7. The user in the operation is assumed to be a medical institution from which the medical record of the patient to be referred is created, a medical institution other than the source of the medical record, or a third-party institution.

In the example shown in FIG. 7, the user first transmits a registration information inquiry request including institution information indicating his / her own institution as user information and information for identifying a patient to the registration information inquiry unit 103 of the medical record management device 1. (Step S201). The user transmits a registration information inquiry request requesting a patient inquiry to the medical record management device 1 via, for example, a Web page provided by the medical record management device 1, and the user follows an information input request received as a reply thereof. Information (institutional information) and information that identifies the patient may be entered.

Examples of information that identifies a patient include information included in consent information such as a patient's name, date of birth, and patient's identifier at a medical institution, and key information generated from the information. For example, when a medical institution that is a user identifies his / her own patient, a set of medical institution information and patient identification information at the medical institution may be input as information for identifying the patient. In addition, when a medical institution that is a user identifies a patient at a medical institution other than itself, as information for identifying the patient, a set of medical institution information of the patient's consultation destination and patient identification information at the medical institution, and the patient Information that can identify the patient as an individual (name and date of birth, insurance certificate number, etc.) may be entered. In addition, when a third-party institution that is a user identifies a patient (contractor), as information that identifies the patient, information that can identify the patient as an individual (name and date of birth set, insurance certificate number, etc.) ) May be entered.

The registration information inquiry unit 103 that has received the user information and the information for identifying the patient performs an authority check for determining whether or not the user can access the registration information of the patient based on the received information (step S202). .. The details of the authority check will be described later.

As a result of the authority check, when it is determined that the user cannot access the registration information of the patient, the registration information inquiry unit 103 returns to that effect to the requesting user and ends the process (step S203).

On the other hand, when it is determined as a result of the authority check that the user can access the registration information of the patient, the registration information inquiry unit 103 acquires the key information of the patient, and based on the acquired key information of the patient, Refer to (search) the registration information DB3 (steps S204 to S207). More specifically, the registration information inquiry unit 103 acquires the patient key information based on the received information, and then transmits a DB search request including the patient key information to the registration information DB 3 (step S204, step). S205). The registration information DB 3 searches the data recorded on the recording medium based on the information included in the DB search request (step S206).

In this example, patient management information including the designated key information is registered in the registration information DB3, and the record is returned from the registration information DB3 to the registration information inquiry unit 103 (step S207). If the record corresponding to the registration information DB 3 is not registered, the registration information inquiry unit 103 returns to that effect to the requesting user (step S208).

When the registration information inquiry unit 103 receives the corresponding record from the registration information DB 3, the registration information inquiry unit 103 acquires the block management information included in the record (step S209). Then, the registration information inquiry unit 103 searches for the consent information block and the medical record block of the patient based on the acquired block management information. More specifically, the registration information inquiry unit 103 transmits a block data request including the block management information acquired in step S209 to any management node 21 of the blockchain management system 2 (step S210).

The management node 21 that has received the block data request searches for the corresponding block from the blockchain 22 that it manages, and returns the data unit of the block (step S211 and step S212).

The registration information inquiry unit 103 that has received the data unit of the corresponding block checks the user's access authority to the data recorded in the received data unit (step S213), and acquires the data within the range permitted by the requesting user. The information is provided (step S214).

In the registration information inquiry unit 103, when a plurality of patient management information records exist, such as when a designated patient visits a plurality of medical institutions, or when a plurality of blocks of block management information are contained in one record. When registered, the information may be provided after performing the operations of steps S209 to S213 for a few minutes of the block management information.

Examples of the information provided in step S214 include the presence / absence of system registration, a list of control numbers D221 and public information D222 included in the data section of the medical record block if present. Further, depending on the user, patient information used for generating the non-public information D32, the key information D31, and the key information D31 stored in the registration information DB3 may be mentioned.

Next, the medical record registration operation in the medical record management system 10 will be described with reference to FIG. The user in this operation is assumed to be the medical institution that created the medical record to be registered.

In the example shown in FIG. 8, the user first transmits a registration information inquiry request including information indicating his / her own institution as user information and information for identifying a patient to the registration information inquiry unit 103 of the medical record management device 1. (Step S301). The information that identifies the patient may be omitted. In that case, the system may operate as if all the patients for whom the user has previously registered for consent have been designated.

The registration information inquiry unit 103 that has received the user information and the information that identifies the patient performs the registration information inquiry process (step S302). The registration information inquiry process may be the same as the operation of steps S202 to S213 shown in FIG. In the registration information inquiry process, the registration information inquiry unit 103 generates or acquires the key information of the designated patient based on the received information, and the designated patient is registered in the registration information DB3. At least the patient management information and the data part of the consent information block registered in the blockchain 22 are acquired.

If the information that identifies the patient is omitted, the registration information inquiry unit 103 specifies user information as medical institution information instead of the patient's key information, makes a DB search request to the registration information DB3, and makes a DB search request to the medical institution information. All you have to do is get the records that match. Then, for each of the acquired records, the data part of the consent information block may be acquired based on the block management information included in the record.

When at least the data unit of the patient management information and the consent information block is acquired, the registration information inquiry unit 103 provides the acquired information within the range permitted by the requesting user (step S303). In this example, for a legitimate user (medical institution to be examined) who registers medical records with the consent of the patient, the registration status of the medical records of the designated patient, key information D31, and the key information D31. Patient information used for generation, attribute information of registered medical records (medical institution, medical treatment date, record management number), etc. are provided.

Next, the user requests the medical record registration including the key information, the patient information, and the like acquired in step S303 as the information for identifying the patient, and the image data of the medical record, in the medical record registration unit 102 of the medical record management device 1. (Step S304). For example, after acquiring the result of the registration information inquiry request on the Web page accessed when inquiring the registration information, the user specifies a patient from the information acquired on the Web page and registers the medical record. The image data of the medical record may be input according to the information input request received as a reply to the request.

In this example, the inquiry data reference list, which is a list for referring to the data inquired by the registration information inquiry unit 103, is provided from the registration information inquiry unit 103 to the medical record registration unit 102 via the same Web page or the like. It shall be done. The inquiry data reference list includes, for example, user information (institutional information) that is information at the time of inquiry request, information that identifies a patient, key information that is information provided for the user information (institutional information), and / or patient information, if any. The information may include a record management number of a patient's medical record and a block hash of a block containing the record management number. The inquiry data reference list includes information for the user to specify the patient and medical record (patient information and record management number) and information for accessing the specified patient and medical record information (key information and block). Hash etc.) is preferably included. In addition to these pieces of information, information provided to the user (public information in the block, etc.) may be included.

The medical record registration unit 102, which has received the information for identifying the patient from the user and the image data of the medical record, performs a consent check based on the received information and the user information (step S305). In the consent check, for example, whether the consent information block of the patient specified in association with the medical institution that is the requesting user is registered in the blockchain 22, and the Hash value is set in the consent information block and the consent information block. Check if the stored non-public information has been tampered with. When the medical record registration unit 102 determines, for example, that the consent information block is registered in the blockchain 22, and the consent information block and the non-public information storing the Hash value in the consent information block have not been tampered with. Judges that consent has been given.

If consent is given, the medical record registration unit 102 adopts a record management number assigned to the image data of the received medical record (step S306). In addition, the medical record registration unit 102 calculates the Hash value of the received image data (non-public information) of the medical record (step S307). When the medical record registration unit 102 receives the non-public information in addition to the image data of the medical record, the Hash value may be calculated for the non-public information as well.

Then, the medical record registration unit 102 creates the content to be registered in the blockchain 22 (data unit D22 of the medical record block) (step S308). In step S308, the medical record registration unit 102 creates a data unit D22 including at least a record management number as the control number D221 and a Hash value of the image data of the medical record as the non-public information management information D223. When the information received in step S304 includes non-public information other than the painting data of the medical record, the medical record registration unit 102 includes the non-public information Hash in the non-public information management information D223. Also include the value.

Next, the medical record registration unit 102 performs a block addition process for adding the medical record block including the created data unit D22 to the blockchain 22 (step S309). The block addition process may be the same as the operation of steps S105 to S108 shown in FIG.

As a result of the block addition process, when the medical record registration unit 102 receives the block hash from the management node 21, the received block hash is registered as block management information in the registration information DB3 in association with the patient's key information. More specifically, the medical record registration unit 102 transmits a DB update request including the key information and the acquired block Hash to the registration information DB 3, and the key information among the patient management information of the registration information DB 3 matches. The block management information D33 in the record is updated (added) (step S310, step S311).

When the medical record registration unit 102 receives from the registration information DB 3 that the update is completed (step S312), the medical record DB 4 stores the record management number acquired in step S306 and the image data of the medical record received from the user. Register in association. At this time, if the received information includes other non-public information, the non-public information is also registered. The medical record registration unit 102 transmits a DB registration request including at least a record management number and image data of the medical record to the medical record DB 4, and registers a new record (medical record information) in the medical record DB 4 (step). S313, step S314).

Finally, when the medical record registration unit 102 receives from the medical record DB 4 that the registration is completed (step S315), the medical record registration unit 102 notifies the requesting user of the registration completion and ends the process (step S315).

In the example of FIG. 8, the medical record registration unit 102 registers the image data of the medical record in the medical record DB 4 after adding the medical record block to the blockchain 22, but for example, the medical record DB 4 has the medical treatment. After registering the image data of the record, the medical record block may be added to the blockchain 22.

On the other hand, if the consent is not obtained as a result of the consent check, the medical record registration unit 102 returns to the requesting user that the registration of the medical record is not accepted, and ends the process.

Next, the medical record reference operation in the medical record management system 10 will be described with reference to FIG. The user in the operation is assumed to be a medical institution from which the medical record to be referred is created, a medical institution other than the medical institution from which the medical record is created, or a third-party institution.

In the example shown in FIG. 9, the user first transmits a registration information inquiry request including user information and patient-identifying information to the registration information inquiry unit 103 of the medical record management device 1 (step S401).

The registration information inquiry unit 103 that has received the user information and the information that identifies the patient performs a registration information inquiry process that inquires the registration information of the designated patient (step S402). The registration information inquiry process may be the same as the operation of step S302 in FIG. 8, that is, the operation of steps S202 to S213 in FIG. The same applies when the information for identifying the patient is omitted.

When at least the patient management information of the specified patient and the data part of the consent information block are acquired in the registration information inquiry process, the registration information inquiry unit 103 provides the acquired information within the range permitted by the requesting user. (Step S403). In this example, a legitimate user who refers to medical records with the consent of the patient or contractor (medical institution to be examined, other medical institution with reference authority, third-party institution with consent for disclosure, etc.) On the other hand, the registration status of the medical record of the designated patient, the key information D31, the patient information used to generate the key information D31, the attribute information of the registered medical record (medical institution, medical treatment date, record management number), etc. Is provided.

Next, the user transmits a medical record reference request including the record management number acquired in step S403 as information for identifying the image data of the medical record to be referred to to the medical record providing unit 104 of the medical record management device 1 ( Step S404). For example, after acquiring the result of the registration information inquiry request on the Web page accessed when inquiring the registration information, the user specifies the medical record to be referred to from the information acquired on the Web page and performs medical treatment. A request for reference to the record may be sent.

Also in this example, the inquiry data reference list, which is a list for referring to the data inquired by the registration information inquiry unit 103, is provided from the registration information inquiry unit 103 to the medical record providing unit 104 via the same Web page or the like. It shall be done.

The medical care record providing unit 104, which has received information for identifying the medical care record such as the record management number and the block Hash of the medical care record block from the user, performs an authority check based on the received information and the user information (step S405).

When it is determined as a result of the authority check that the user can access the registration information of the patient, the medical record providing unit 104 transmits a DB search request including the record management number to the medical record DB 4 (step S406). At this time, when the medical record providing unit 104 receives the block Hash of the medical record block from the user as the information for identifying the medical record, the medical record providing unit 104 refers to the request or inquiry data list to the blockchain management system 2 and refers to the corresponding block. The record management number included in the data section may be acquired.

The record management DB 4 searches the data recorded on the recording medium based on the information included in the DB search request (step S407).

In this example, medical record information including the designated record management number is registered in the medical record DB 4, and the record is returned from the medical record DB 4 to the medical record providing unit 104 (step S408).

Further, if the data unit of the medical record block including the record management number of the designated medical record has not been acquired, the medical record providing unit 104 acquires the data unit of the medical record block (step S409). The block data acquisition process may be the same as the operation of steps S210 to S212 shown in FIG. 7.

Next, the medical record providing unit 104 sets the Hash value indicated by the non-public information management information D223 included in the data unit including the record management number of the medical record designated by the user, and the non-public included in the record received in step S408. The Hash value generated from the information (image data of the medical record) is collated (step S410). When the Hash values match, it is assumed that the non-public information has not been tampered with, and the non-public information is transmitted to the requesting user (step S411).

When there are a plurality of medical records designated by the user, the medical record providing unit 104 may perform the operations of steps S405 to S411 for the number of the designated medical records.

Note that FIGS. 8 and 9 show an example in which the user makes a registration information inquiry request and then makes a medical record registration request and a medical record reference request based on the information obtained as a result. It is also possible to register medical records and refer to medical records with a single request.

For example, the user may send a medical record registration request including user information, patient-identifying information, and medical record image data to the medical record registration unit 102. In that case, the medical record registration unit 102 requests the registration information inquiry unit 103 to inquire about the registration information based on the received information, obtains the registration information of the designated patient, and then performs the above-mentioned medical record registration process. You just have to do.

Further, for example, the user may send a medical record reference request including user information, information identifying a patient, and an acquisition range (date and time, conditions, etc.) to the medical record providing unit 104. In that case, the medical record providing unit 104 requests the registration information inquiry unit 103 to inquire about the registration information based on the received information, obtains the registration information of the designated patient, and then provides the information based on the acquisition range. The medical record may be specified and the above-mentioned medical record providing process may be performed.

Further, FIG. 10 is an explanatory diagram showing an example of authority check in the medical record management system 10. The medical record management system 10 (particularly, the registration information inquiry unit 103 and the medical record providing unit 104) may confirm the access authority of the requesting user according to the conditions shown in FIG. That is, the medical record management system 10 first determines whether or not the requesting user is a service subscriber. If you are not a service subscriber, the user does not have access to the inquired information. On the other hand, if it is a service subscriber, it is further determined whether the user's institution is a medical institution or another (third-party institution).

If the user's institution is a medical institution, it is further determined whether the reference information is the user's (medical institution) patient or medical record. If the reference information is the patient information or medical record of the user (medical institution), the user shall have access to the reference information.

On the other hand, if the reference information is not the patient or medical record of the user (medical institution), it is further determined whether or not the reference authority is set for the user. The reference authority is, for example, the medical institution from which the medical institution designated as the reference destination or the medical institution that creates the medical record designated as the reference destination, the user (medical institution) who wants to refer to the patient, or the patient himself / herself, as the disclosure destination. It can be set by registering a letter of introduction or a written consent that specifies (institution) in this system (registration information DB3). When such reference authority is set for the user, it is assumed that the user has access authority to the information of the inquiry destination. On the other hand, if the reference authority is not set, the user does not have the access right to the information of the reference destination.

Further, if the user's institution is a third-party institution other than the medical institution, it is further determined whether or not the reference information is the contractor's information and there is a disclosure agreement. If the information of the inquiry destination is the information of the contractor of the user (third party organization) and there is a disclosure agreement, the user shall have access rights to the information of the inquiry destination. Whether or not the reference information is the contractor's information and whether or not there is a disclosure agreement can be determined, for example, by making it possible to set the contractor's setting and reference authority that specify an individual for this system. , It can be determined by associating those settings with the patient management information.

On the other hand, if the information of the inquiry destination is not the information of the contractor of the user (third party organization) or there is no disclosure agreement, the user shall not have access right to the information of the inquiry destination.

As described above, according to the present embodiment, the third-party institution can inquire the medical records registered by the medical institution within the range permitted by the patient, so that it seems that they have been discarded until now. You can also get medical records. It is also possible to contact a medical institution using the obtained information. Therefore, if the third-party institution is an insurance company, it is possible to obtain benefits such as reduction of investigation cost, improvement of accuracy, and suppression of fraudulent payment of benefits.

In addition, the medical institution can reduce the burden of storing medical records. For this reason, for example, it is not necessary to destroy medical records that had to be destroyed due to cost reasons. In addition, if the medical records are stored for a long period of time, it is possible to respond to a request from the patient to inquire about old medical records. For example, it is possible to prepare for medical proceedings after the hospital is closed.

In addition, by connecting third-party institutions and medical institutions, it is possible to improve the quality of services and reduce risks at each institution.

Note that FIG. 11 is a block diagram showing another example of the medical record management device 1 of the present embodiment. As shown in FIG. 11, the medical record management device 1 may further include a billing unit 105. When the user uses this system, the billing unit 105 charges the user according to the user and the content of use.

If the user is a medical institution, the billing unit 105 may charge only for the registration of medical records and the reference of medical records registered by other medical institutions. In this case, reference to the medical records registered by oneself is free of charge. Further, if the user is a third-party institution, the billing unit 105 may perform pay-as-you-go billing as a usage fee for inquiries about registration information and reference to medical records, in addition to a certain annual membership fee. For example, you may charge according to the usage amount of this system such as the amount of information provided by this system, the number of times of provision, and the number of inquiries. In addition, the billing unit 105 can also charge according to the period in which the information is stored.

By incorporating such a billing system, it is possible to realize a mechanism that can secure system maintenance costs for a long period of time.

Further, FIG. 12 is a block diagram showing another example of the medical record management device 1 of the present embodiment. As shown in FIG. 12, the medical record management device 1 may further include an authority determination unit 106. The authority determination unit 106 receives a request from the registration information inquiry unit 103 or the medical record providing unit 104, and determines whether or not there is an access right to the information regarding the patient or the medical record designated for the requesting user.

As shown in FIG. 12, the medical record management device 1 includes a registration unit 11, a providing unit 12, and a billing unit 105, and the registration unit 11 includes a patient registration unit 101 and a medical record registration unit 102. The providing unit 12 may include a registration information inquiry unit 103, a medical record providing unit 104, and an authority determination unit 106.

Next, a configuration example of the computer according to the embodiment of the present invention will be shown. FIG. 13 is a schematic block diagram showing a configuration example of a computer according to an embodiment of the present invention. The computer 1000 includes a CPU 1001, a main storage device 1002, an auxiliary storage device 1003, an interface 1004, a display device 1005, and an input device 1006.

Each device (including a node) of the medical record management system described above may be mounted on the computer 1000, for example. In that case, the operation of each device may be stored in the auxiliary storage device 1003 in the form of a program. The CPU 1001 reads a program from the auxiliary storage device 1003, deploys it to the main storage device 1002, and performs a predetermined process in the above embodiment according to the program.

Auxiliary storage 1003 is an example of a non-temporary tangible medium. Other examples of non-temporary tangible media include magnetic disks, magneto-optical disks, CD-ROMs, DVD-ROMs, semiconductor memories, etc., which are connected via interface 1004. Further, when this program is distributed to the computer 1000 by a communication line, the distributed computer may deploy the program to the main storage device 1002 and execute a predetermined process according to the above embodiment.

Further, the program may be for realizing a part of a predetermined process in each embodiment. Further, the program may be a difference program that realizes a predetermined process in the above embodiment in combination with another program already stored in the auxiliary storage device 1003.

Interface 1004 sends and receives information to and from other devices. In addition, the display device 1005 presents information to the user. Further, the input device 1006 accepts the input of information from the user.

Further, depending on the processing content in the embodiment, some elements of the computer 1000 may be omitted. For example, the display device 1005 can be omitted if the device does not present information to the user.

In addition, some or all of each component of each device is implemented by a general-purpose or dedicated circuit (Circuitry), a processor, or a combination thereof. These may be composed of a single chip, or may be composed of a plurality of chips connected via a bus. Further, a part or all of each component of each device may be realized by a combination of the above-mentioned circuit or the like and a program.

When a part or all of each component of each device is realized by a plurality of information processing devices and circuits, the plurality of information processing devices and circuits may be centrally arranged or distributed. May be good. For example, the information processing device, the circuit, and the like may be realized as a form in which each of the client and server system, the cloud computing system, and the like is connected via a communication network.

Next, the outline of the present invention will be described. FIG. 14 is a block diagram showing an outline of the medical record management device of the present invention. As shown in FIG. 14, the medical record management device 6 of the present invention is characterized by including a registration means 601 and a providing means 602.

The registration means 601 (for example, the registration unit 11, particularly the medical record registration unit 102) is a predetermined first storage means (for example, every time the medical institution provides image data of the medical record of the patient of the medical institution). The medical care memory DB4) stores the record identification information (for example, the record management number) that identifies the medical care record in association with the image data, and processes according to a predetermined consensus algorithm in which two or more nodes participate. A medical record block containing record identification information and a summary of image data is added to a predetermined blockchain (for example, blockchain 22) to which a new block is added, and a predetermined second storage means (for example, for example). , Registration information DB3) stores patient identification information (for example, patient key information) that identifies a patient and block specific information that can identify a medical record block in association with each other.

Further, the providing means 602 (for example, the providing unit 12, particularly the medical record providing unit 104) is stored in the first storage means in response to a request from a user including a third-party institution that is an institution other than the medical institution. The image data of the medical record of the designated patient is searched and provided from the image data of the medical record of the designated patient.

Here, the patient identification information includes the first patient identification information (for example, personal identification information) or the first patient identification information which is information that allows an institution other than the medical institution that created the medical record to identify the patient of the medical institution. A second patient-specific information generated from the patient-specific information of the above (for example, a Hash value generated from the information that identifies an individual) may be included. In such a case, the providing means 602 receives a request from the user including the first patient identification information as information for designating the target patient, and receives the patient identification information specified based on the received first patient identification information. It may be used to identify a patient's medical record block and acquire image data of a patient's medical record.

Further, the patient identification information may include a third patient identification information which is a set of the medical institution information which is the information of the medical institution from which the medical record is created and the patient identification information in the medical institution. In such a case, the providing means 602 receives a request from the user including the third patient identification information as information for designating the target patient, and the patient identification information specified based on the received third patient identification information. May be used to identify the patient's medical record block and acquire image data of the patient's medical record.

By having such a configuration, it is possible to realize a service of storing medical records of a plurality of medical institutions and providing services to institutions other than medical institutions, while at least achieving both confidentiality of personal information and accessibility of data. According to the above configuration, since the blockchain is used as the recording destination of the medical record block, it is possible to achieve both confidentiality of personal information, data accessibility, and data integrity of a plurality of medical institutions. It is possible to realize the storage of medical records and the services provided to institutions other than medical institutions.

The above embodiment can also be described as described in the following appendix.

(Appendix 1) A first storage means for storing at least image data of medical records provided by a medical institution, and
A second storage means for storing information that associates the target patient of the medical record with the image data of the medical record, and
Every time the medical institution provides image data of the medical records of the patients of the medical institution, the record identification information for identifying the medical records and the image data are stored in association with each other in the first storage means, and 2 A new block is added through processing according to a predetermined consensus algorithm in which more than one node participates. A medical record block containing record identification information and a summary of image data is added to a predetermined blockchain, and the first The registration means for storing the patient identification information for identifying the patient and the block specific information which is the information that can identify the medical record block in association with the storage means of 2.
In response to a request from a user including a third-party institution that is an institution other than a medical institution, the image data of the medical record of a designated patient is selected from the image data of the medical record stored in the first storage means. A medical record management system characterized by having a means of searching and providing.

(Appendix 2) The image data of the medical record provided by the medical institution is the image data of the medical record whose storage obligation period has been exceeded.
The registration means is the medical record management system described in Appendix 1, which accepts the provision of image data of medical records of its own patients from a plurality of medical institutions.

(Appendix 3) The registration method divides the information provided by the medical institution into public information and non-public information, and then manages the information in the block, and summarizes the public information and non-public information. the block including a registered block chain, and stores private information to the first storage hand stage,
Non-public information includes image data of medical records,
The medical record management system according to Appendix 1 or Appendix 2, which includes record identification information in the management information.

(Appendix 4) The medical record management system described in Appendix 3 in which the non-public information includes patient information that is information about the target patient of the medical record.

(Appendix 5) The patient identification information is generated from the first patient identification information or the first patient identification information, which is information that allows an institution other than the medical institution that created the medical record to identify the patient of the medical institution. Contains a second patient-specific information,
The providing means receives a request from the user including the first patient identification information as information for designating the target patient, and uses the patient identification information specified based on the received first patient identification information to treat the patient. The medical record management system according to any one of Supplements 1 to 4, which identifies a record block and acquires image data of a patient's medical record.

(Appendix 6) The patient identification information includes the medical institution information which is the information of the medical institution that created the medical record and the third patient identification information which is a set of the patient identification information in the medical institution.
The providing means receives a request from the user including the third patient identification information as information for designating the target patient, and uses the patient identification information specified based on the received third patient identification information to treat the patient. The medical record management system according to any one of Supplements 1 to 5, which identifies a record block and acquires image data of a patient's medical record.

(Appendix 7) The providing means is described in any one of Appendix 1 to Appendix 6 for providing the image data after determining whether or not the image data has been tampered with by using the summary of the image data included in the medical record block. Medical record management system.

(Appendix 8) The means of provision is
A referral means that provides registration status of information about a designated patient in a first storage means, blockchain or second storage means in response to a request from a user, including a third party institution other than a medical institution. The medical record management system according to any one of Supplementary notes 1 to 7.

(Appendix 9) The means of provision is
The medical record management system according to any one of Supplements 1 to 8, which includes an authority determining means for determining whether or not the requesting user has access to information on a designated patient or medical record.

(Appendix 10) When the consent information, which is the information about the patient who has received the consent to provide the medical record from the medical institution, is provided, the registration means includes at least the medical institution information, which is the information of the medical institution, in the blockchain. Of Appendix 1 to Appendix 9, the information block is added and the patient identification information for identifying the patient and the block specific information which is the information that can identify the consent information block are stored in association with each other in the second storage means. The medical record management system described in any of.

(Appendix 11) A first storage means for storing at least image data of medical records provided by a medical institution, which is constructed in a secure environment.
A second storage means that is built in a secure environment and stores information that associates the target patient of the medical record with the image data of the medical record.
A third storage means possessed by a node operated by a third-party institution other than a medical institution,
Each time the medical institution provides image data of the medical records of the patients of the medical institution, the first storage means stores the record identification information for identifying the medical records and the image data in association with each other. The medical record block including the record identification information and the summary of the image data is stored in the storage means of 3, and the patient identification information for identifying the patient and the medical record block can be identified in the second storage means. A registration method that stores a certain block specific information in association with it,
In response to a request from a user including a third-party institution that is an institution other than a medical institution, the image data of the medical record of a designated patient is selected from the image data of the medical record stored in the first storage means. A medical record management system characterized by having a means of searching and providing.

(Appendix 12) Each time a medical institution provides image data of medical records of patients at the medical institution, the record identification information that identifies the medical records is associated with the image data in a predetermined first storage means. A medical record block containing record identification information and a summary of image data in a predetermined blockchain in which a new block is added after processing according to a predetermined consensus algorithm in which two or more nodes participate. And a registration means for storing the patient identification information for identifying the patient and the block specific information which is the information that can identify the medical record block in association with the predetermined second storage means.
In response to a request from a user including a third-party institution that is an institution other than a medical institution, the image data of the medical record of a designated patient is selected from the image data of the medical record stored in the first storage means. A medical record management device characterized by having a means of searching and providing.

(Appendix 13) The information processing device
Each time a medical institution provides image data of medical records of patients in the medical institution, record identification information for identifying medical records and image data are stored in association with a predetermined first storage means. In addition, a medical record block containing record identification information and a summary of image data is added to a predetermined blockchain in which a new block is added through processing according to a predetermined consensus algorithm in which two or more nodes participate. In addition, the patient identification information that identifies the patient and the block specific information that can identify the medical record block are stored in association with each other in a predetermined second storage means.
In response to a request from a user including a third-party institution that is an institution other than a medical institution, the image data of the medical record of a designated patient is selected from the image data of the medical record stored in the first storage means. A medical record management method characterized by searching and providing.

(Appendix 14) To the computer
Every time a medical institution provides image data of medical records of patients at the medical institution, record identification information for identifying medical records and image data are stored in association with a predetermined first storage means. In addition, a medical record block containing record identification information and a summary of image data is added to a predetermined blockchain in which a new block is added through processing according to a predetermined consensus algorithm in which two or more nodes participate. In addition, a process of associating patient identification information for identifying a patient with block-specific information that can identify a medical record block in a predetermined second storage means, and an institution other than a medical institution. In response to a request from a user including a tripartite institution, a process of searching and providing the image data of the designated patient's medical record from the image data of the medical record stored in the first storage means is executed. Medical record management program to let you.

Although the present invention has been described above with reference to the present embodiment and examples, the present invention is not limited to the above embodiments and examples. Various changes that can be understood by those skilled in the art can be made within the scope of the present invention in terms of the structure and details of the present invention.

This application claims priority on the basis of Japanese Patent Application 2017-11102, filed June 5, 2017, and incorporates all of its disclosures herein.

The present invention is suitably applicable not only to medical records but also to applications that enable highly confidential information to be provided to an institution other than the institution that created the information.

10 Medical record management system 1 Medical record management device 101 Patient registration department 102 Medical record registration department 103 Registration information inquiry department 104 Medical record provision department 105 Billing department 106 Authority judgment department 11 Registration department 12 Provision department 2 Blockchain management system 21 Management node 211 Data reception unit 212 Block generation unit 213 Block sharing unit 214 Information storage unit 215 Block verification unit 216 Data output unit 22 Blockchain 3 Registration information DB
4 Medical record DB
5 Network 1000 Computer 1001 CPU
1002 Main storage device 1003 Auxiliary storage device 1004 Interface 1005 Display device 1006 Input device 6 Medical record management device 601 Registration means 602 Providing means

Claims (14)

A first storage means for at least storing image data of medical records provided by a medical institution,
A second storage means for storing information that associates the target patient of the medical record with the image data of the medical record, and
Each time the medical institution provides image data of the medical records of the patients of the medical institution, the first storage means stores the record identification information for identifying the medical records and the image data in association with each other. In addition, a medical record block containing the record identification information and the summary of the image data is added to a predetermined block chain in which a new block is added through processing according to a predetermined consensus algorithm in which two or more nodes participate. A registration means for storing the patient identification information for identifying the patient and the block specific information which is the information that can identify the medical record block in association with the second storage means.
Image data of a patient's medical record designated from among the image data of the medical record stored in the first storage means in response to a request from a user including a third-party institution other than the medical institution. A medical record management system characterized by having a means of providing a search and providing a medical record. The image data of the medical record provided by the medical institution is the image data of the medical record whose storage obligation period has been exceeded.
The medical record management system according to claim 1, wherein the registration means receives the provision of image data of medical records of its own patient from a plurality of medical institutions. The registration means divides the information provided by the medical institution into public information and non-public information, and then includes a management information for managing the information in the block, a public information, and a summary of the non-public information. was registered in the block chain, and stores private information in the first storage hand stage,
The non-public information includes image data of the medical record,
The medical record management system according to claim 1 or 2, wherein the management information includes the record identification information. The medical record management system according to claim 3, wherein the non-public information includes patient information which is information about a patient subject to medical records. The patient identification information is generated from the first patient identification information or the first patient identification information, which is information that allows an institution other than the medical institution that created the medical record to identify the patient of the medical institution. Contains 2 patient-specific information,
The providing means receives a request including the first patient identification information from the user as information for designating the target patient, and uses the patient identification information specified based on the received first patient identification information. The medical record management system according to any one of claims 1 to 4, wherein the medical record block of the patient is specified and image data of the medical record of the patient is acquired. The patient identification information includes medical institution information which is information of the medical institution from which the medical record is created and third patient identification information which is a set of patient identification information in the medical institution.
The providing means receives a request including the third patient identification information from the user as information for designating the target patient, and uses the patient identification information specified based on the received third patient identification information. The medical record management system according to any one of claims 1 to 5, wherein the medical record block of the patient is specified and image data of the medical record of the patient is acquired. The providing means is any one of claims 1 to 6 that provides the image data after determining whether or not the image data has been tampered with by using a summary of the image data included in the medical record block. The medical record management system described in. The providing means
In response to a request from a user including a third-party institution that is an institution other than a medical institution, the registration status of information about a designated patient in the first storage means, the blockchain, or the second storage means is provided. The medical record management system according to any one of claims 1 to 7, which includes a means of inquiry. The providing means
The medical record management system according to any one of claims 1 to 8, which includes an authority determining means for determining whether or not the requesting user has access to information on a designated patient or medical record. .. When the registration means is provided with the consent information which is the information about the patient who has received the consent to provide the medical record from the medical institution, the consent information including at least the medical institution information which is the information of the medical institution in the blockchain. Claimed from claim 1 in which a block is added and the patient identification information for identifying the patient and the block identification information which is information that can identify the consent information block are stored in association with the second storage means. The medical record management system according to any one of item 9. A first storage means that is built in a secure environment and stores at least image data of medical records provided by medical institutions.
A second storage means constructed in a secure environment and storing information that associates the target patient of the medical care record with the image data of the medical care record.
A third storage means possessed by a node operated by a third-party institution other than a medical institution,
Each time the medical institution provides image data of the medical records of the patients of the medical institution, the first storage means stores the record identification information for identifying the medical records and the image data in association with each other. A medical record block containing the record identification information and a summary of the image data is stored in the third storage means, and the patient identification information for identifying the patient and the patient identification information are stored in the second storage means. A registration means for storing medical record blocks in association with block-specific information, which is identifiable information,
Image data of a patient's medical record designated from among the image data of the medical record stored in the first storage means in response to a request from a user including a third-party institution other than the medical institution. A medical record management system characterized by having a means of providing a search and providing a medical record. Each time the medical institution provides image data of the medical records of the patients of the medical institution, the record identification information for identifying the medical records and the image data are stored in association with a predetermined first storage means. A medical record block containing the record identification information and a summary of the image data in a predetermined blockchain in which a new block is added through processing according to a predetermined consensus algorithm in which two or more nodes participate. And a registration means for storing the patient identification information for identifying the patient and the block identification information which is the information that can identify the medical record block in association with the predetermined second storage means.
Image data of the medical record of the patient specified from the image data of the medical record stored in the first storage means in response to a request from a user including a third-party institution other than the medical institution. A medical record management device characterized in that it is equipped with a providing means for searching and providing. Information processing device
Each time the medical institution provides image data of the medical records of the patients of the medical institution, the record identification information for identifying the medical records and the image data are stored in association with a predetermined first storage means. A medical record block containing the record identification information and a summary of the image data in a predetermined blockchain in which a new block is added through processing according to a predetermined consensus algorithm in which two or more nodes participate. Is added, and the patient identification information that identifies the patient and the block identification information that can identify the medical record block are stored in association with each other in a predetermined second storage means.
Image data of the medical record of the patient specified from the image data of the medical record stored in the first storage means in response to a request from a user including a third-party institution other than the medical institution. A medical record management method characterized by searching for and providing. On the computer
Each time the medical institution provides image data of the medical record of the patient of the medical institution, the record identification information for identifying the medical record and the image data are stored in association with a predetermined first storage means. A medical record block containing the record identification information and a summary of the image data in a predetermined blockchain in which a new block is added through processing according to a predetermined consensus algorithm in which two or more nodes participate. The process of storing the patient identification information for identifying the patient and the block-specific information which is the information that can identify the medical record block in association with the predetermined second storage means, and the medical institution. In response to a request from a user including a third-party institution other than the institution, the image data of the designated patient's medical record is searched from the image data of the medical record stored in the first storage means. A medical record management program for executing the processing provided by.

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