JP6910617B2 - Management methods, management devices and programs for disclosure of electronic medical records - Google Patents

Description

The present invention relates to information processing technology.

A system for managing medical information handled by electronic medical records and regional medical cooperation is known. Patent Document 1 discloses a data linkage system that associates medical records of a plurality of insurers with each insured person.

Japanese Unexamined Patent Publication No. 2011-233110

With the growing health consciousness of people in recent years, it is expected that individuals will often request disclosure of information about themselves among the information registered in electronic medical records and regional medical cooperation. Therefore, there is a need for technology that effectively manages the disclosure of requested medical information.

The present invention has been made in view of the above, and an object of the present invention is to provide a technique for effectively managing the disclosure of medical information.

In the electronic medical record disclosure management method according to the present invention, the first terminal sends a request for disclosure of the electronic medical record to the server in response to the input by the first user, and the server responds to the request for disclosure. , Sending a notification to the second terminal of the second user associated with the first user, and the second terminal responding to the notification and input by the second user. Displaying the electronic medical record of one user, the second terminal selects the mode of disclosure of the displayed electronic medical record in response to the input by the second user, and the information of the selection is transmitted to the above. It includes transmitting to a server and setting the electronic medical record of the first user so that it can be disclosed to the first user in a manner corresponding to the information of the selection.

The electronic medical record management device according to the present invention is associated with a function of receiving an electronic medical record disclosure request from a first terminal in response to an input by a first user and the first user in response to the disclosure request. A function of transmitting a notification to the second terminal of the second user, and a function of receiving information on selection of the disclosure mode of the electronic medical record from the second terminal in response to an input by the second user. It has a function of setting the electronic medical record of the first user so that it can be disclosed to the first user in a manner corresponding to the information of the selection.

The program according to the present invention is associated with a function of receiving a request for disclosure of an electronic medical record from a first terminal in response to an input by a first user to a computer and the first user in response to the request for disclosure. A function of transmitting a notification to a second terminal of the second user, and a function of receiving information on selection of a mode of disclosure of the electronic medical record from the second terminal in response to an input by the second user. , The function of setting the electronic medical record of the first user so that it can be disclosed to the first user is realized in an manner corresponding to the information of the selection.

According to the present invention, it is possible to provide a technique for effectively managing the disclosure of medical information.

It is a conceptual diagram which shows the hardware structure of the electronic medical record disclosure management system in one Embodiment. It is a figure which shows the functional structure example of the server apparatus in one Embodiment. It is a figure which shows the functional structure example of the patient terminal in one Embodiment. It is a figure which shows the functional structure example of the doctor terminal in one Embodiment. It is a conceptual diagram of the screen example displayed on the display part in one Embodiment. It is a flowchart which shows the example of the process executed by the electronic medical record disclosure management system in one Embodiment.

Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings. However, the scope of the invention is not limited to these.

[Hardware configuration]
An example of the hardware configuration of the electronic medical record disclosure management system according to the embodiment will be described with reference to FIG. The electronic medical record disclosure management system 1 is a system for managing the disclosure of electronic medical records in response to requests from patients and the like. The electronic medical record disclosure management system 1 mainly includes a server device 10, a patient terminal 20, and a doctor terminal 30. The patient terminal 20 and the doctor terminal 30 can communicate with each other with the server device 10 via the network N.

The network N is a communication line for transmitting and receiving information between a plurality of devices including a server device 10, a patient terminal 20, and a doctor's terminal 30. The network N may be, for example, the Internet, LAN (Local Area Network), leased line, packet communication network, telephone line, corporate network, other communication line, a combination thereof, or any of them, and is it wired? It doesn't matter if it's wireless (or a combination of these).

The server device 10 functions as an electronic medical record management device. The server device 10 is composed of a dedicated or general-purpose information processing device. The server device 10 may be composed of a single information processing device, or may be composed of a plurality of information processing devices distributed on a network such as cloud computing. good.

Further, the server device 10 mainly includes a control unit 11, a communication unit 12, and a storage unit 13. The control unit 11 mainly includes a CPU (Central Processing Unit) 11a and a memory 11b. A description of each configuration will be described later.

The patient terminal 20 (first terminal) is operated by a user who requests disclosure of the contents of the electronic medical record managed by the electronic medical record disclosure management system 1. The patient terminal 20 is composed of, for example, an information processing device such as a mobile phone (including a smartphone), a tablet terminal, or a personal computer. The patient terminal 20 mainly includes a control unit 21, a communication unit 22, a storage unit 23, an operation unit 24, and a display unit 25. The control unit 21 mainly includes a CPU 21a and a memory 21b.

The doctor terminal 30 (second terminal) is operated by a doctor or the like who manages records of electronic medical records managed by the electronic medical record disclosure management system 1 at a medical institution. The doctor terminal 30 is composed of an information processing device such as a personal computer, for example. The doctor terminal 30 may be a portable information processing device such as a mobile phone (including a smartphone) or a tablet terminal. The doctor terminal 30 mainly includes a control unit 31, a communication unit 32, a storage unit 33, an operation unit 34, and a display unit 35. The control unit 31 mainly includes a CPU 31a and a memory 31b. A description of each configuration will be described later.

The control units 11, 21, and 31 control the operation of various configurations of each information processing apparatus including these, and also control the execution of various processes. Details of the processing executed by the control units 11, 1, 21 and 31 will be described later. The communication units 12, 22, and 32 are communication interfaces for communicating with other information processing devices. The storage units 13, 23, and 33 are composed of a storage device such as a hard disk. The storage units 13, 23, and 33 store various programs and various information necessary for executing processing in each information processing device. The operation units 24 and 34 are user interfaces for receiving operation instructions from the user. The display units 25 and 35 are user interfaces for displaying the processing results of each information processing device.

Note that FIG. 1 only shows the main configurations of the server device 10, the patient terminal 20, and the doctor terminal 30, and the server device 10, the patient terminal 20, and the doctor terminal 30 are generally used. It also has other configurations that a typical information processing device has.

As described above, in the present embodiment, the electronic medical record disclosure management system 1 includes, but is not limited to, the server device 10, the patient terminal 20, and the doctor's terminal 30, and can include any device. Further, the electronic medical record disclosure management system 1 includes a number of patient terminals 20 according to the number of patients who use the system, and a number of doctor terminals 30 required by a medical institution for use by a doctor or the like. Can be included.

[Functional configuration]
First, the functional configuration in one embodiment of the server device 10 will be described with reference to FIG. The server device 10 includes an electronic medical record registration unit 110, a disclosure request transmission / reception unit 111, a disclosure content setting unit 112, and a database 120 as main functional configurations. The server device 10 realizes each functional configuration shown in FIG. 2, for example, when the CPU 11a executes a predetermined program stored in the memory 11b or the like and cooperates with the hardware of the server device 10. The details of each functional configuration will be described below.

The database 120 stores various information such as information required for processing executed by the server device 10 and information generated by the processing. The database 120 stores, for example, patient information, doctor information, and electronic medical record information. Electronic medical record information includes, for example, medical record patient information, doctor in charge information, consultation date, sample test information, imaging test information, other test information (for example, electrocardiogram), prescription information, treatment information, injection information, and calculation information (for example). Includes medical record fee calculation information).

The electronic medical record registration unit 110 stores, updates, and deletes medical records for each patient as electronic medical record information in the database 120 according to the information received from the doctor terminal 30. In addition, the electronic medical record registration unit 110 also stores the history of updating and deleting the electronic medical record information in the database 120.

The disclosure request transmission / reception unit 111 receives the disclosure request of the electronic medical record transmitted from the first user who is the patient via the patient terminal 20. In addition, the disclosure request transmission / reception unit 111 notifies the doctor in charge associated with the patient that the request for disclosure of the electronic medical record of the patient related to the request has been received in response to the request for disclosure via the doctor terminal 30. do.

The disclosure content setting unit 112 requests disclosure in a manner corresponding to the information of selection of the disclosure mode (designation of the disclosure range of the electronic medical record information and approval / disapproval of disclosure) of the electronic medical record information received from the doctor terminal 30. The electronic medical record of the patient (first user) is set so that it can be disclosed to the patient.

That is, the disclosure content setting unit 112 sets the disclosure range of the electronic medical record and the disclosure range of the electronic medical record according to the setting information specified for the electronic medical record information for each patient received from the doctor terminal 30 and the information on whether or not the disclosure of the electronic medical record is approved. Set whether to approve disclosure. Whether or not to disclose the setting information for each item included in the electronic medical record information (for example, items such as consultation date, sample test information, image test information, prescription information, and change history of the contents of these medical records). Information is included. When the disclosure range of the electronic medical record and the approval / disapproval of disclosure are set, the notification of the contents of the setting is transmitted to the patient terminal 20.

Further, the disclosure content setting unit 112 stores the information set as the disclosing range among the information included in the electronic medical record information in another storage area. That is, the disclosure content setting unit 112 sets the information set as the disclosing range among the information included in the electronic medical record information stored in the first storage area of the database 120 to be different from the first storage area. Store in the storage area of. The second storage area may be provided on hardware different from that of the first storage area, or may be provided on the same hardware but in a different virtual area. The disclosure of the electronic medical record information is performed on the information stored in the second storage area, and the electronic medical record information stored in the first storage area is not disclosed. By storing the electronic medical record information set as the disclosing range in different storage areas in this way, it is possible to enhance the safety against leakage of the electronic medical record information not set to be disclosed.

Next, with reference to FIG. 3, the functional configuration in one embodiment of the patient terminal 20 will be described. The patient terminal 20 includes a disclosure request transmission unit 210, an electronic medical record receiving unit 211, and a display control unit 212 as main functional configurations. The patient terminal 20 realizes each functional configuration shown in FIG. 3, for example, by the CPU 21a executing a predetermined program stored in the memory 21b or the like and cooperating with the hardware of the patient terminal 20. The details of each functional configuration will be described below.

The disclosure request transmission unit 210 transmits a disclosure request for an electronic medical record with the user as a patient to the server device 10 in response to an input by the user (first user) of the patient terminal 20. Specifically, first, the user operates the patient terminal 20, specifies the scope of disclosure of his / her electronic medical record, and requests disclosure. The disclosure request transmission unit 210 transmits a request for disclosure of the electronic medical record to the server device 10 together with the information in the specified disclosure range according to the operation by the user. The scope of disclosure of the electronic medical record that can be specified (the scope of request for disclosure) includes, for example, the date of consultation, "all", "specimen test result", "prescription", "treatment", and the like.

The electronic medical record receiving unit 211 receives the approval notification of the disclosure of the electronic medical record from the server device 10 (for example, received by the push notification), then accesses the server device 10 in response to the user input, and approves from the server device 10. Receives electronic medical record information within the range according to.

The display control unit 212 controls the display of the electronic medical record information received via the electronic medical record receiving unit 211 on the display unit 25 in response to user input.

Next, with reference to FIG. 4, the functional configuration in one embodiment of the doctor's terminal 30 will be described. The doctor terminal 30 includes an electronic medical record editing unit 310, a disclosure request receiving unit 311 and a disclosure range indicating unit 312 as main functional configurations. The doctor terminal 30 realizes each functional configuration shown in FIG. 4, for example, by the CPU 31a executing a predetermined program stored in the memory 31b or the like and cooperating with the hardware of the doctor terminal 30. The details of each functional configuration will be described below.

The electronic medical record editing unit 310 edits the electronic medical record information of the patient in charge of the doctor as a doctor (registration of medical records) in response to the input by the user (second user) of the doctor terminal 30 and the input from the external device. , Modify and delete). The electronic medical record editing unit 310 transmits the edited electronic medical record information to the server device 10, and the server device 10 stores the received electronic medical record information. The history information of correction (change) and deletion of medical records is also transmitted to and stored in the server device 10. In addition, the user can input the operation for editing to the doctor terminal 30 while referring to the screen for editing the electronic medical record information displayed on the display unit 35.

FIG. 5 shows an example of an electronic medical record screen displayed on the display unit 35 for reference and editing of electronic medical record information. FIG. 5 shows the screen 50 of the electronic medical record. Screen 50 shows an electronic medical record for a patient. The screen 50 includes a reference area 51 and an editing area 52. The reference area 51 is an area for displaying the medical records of the patient on a certain consultation date (in this example, August 14, 2017). The reference region 51 includes a region 51a to a region 51g. The region 51a displays the information of the sample test. The area 51b displays the information of the image inspection. The region 51c displays information on tests other than the sample test and the image test, such as an electrocardiogram. Region 51d displays prescription information. Area 51e displays treatment information. Region 51f displays injection information. The area 51g displays information on calculation (for example, calculation of medical certificate fee). Area 52 is an area for inputting, modifying and deleting medical records.

Returning to the description of FIG. The disclosure request receiving unit 311 receives a disclosure request for electronic medical record information from a user of the patient terminal 20 with the user as a patient via the disclosure request receiving unit 311 of the server device 10. The disclosure request includes information on the scope of the request for disclosure of electronic medical record information designated by the user of the patient terminal 20. After receiving the disclosure request for electronic medical record information, the disclosure request receiving unit 311 notifies the user of the doctor terminal 30 that the disclosure request has been received. As the method of the notification, for example, any one of notification by a message, display of an icon on the display unit 35, and output of voice, or at least a part of a combination thereof can be adopted.

The disclosure range instruction unit 312 specifies the disclosure range of the electronic medical record information and approves the disclosure in response to the input by the user of the doctor terminal 30. The information of the designated disclosure range and the information of approval of disclosure are transmitted to the server device 10. The server device 10 sets the disclosure range of the electronic medical record information according to the received disclosure range information and the disclosure approval information, and sets the disclosure request of the electronic medical record information to the approved state.

In order to specify the disclosure range of the electronic medical record information and approve the disclosure, the disclosure range instruction unit 312 first receives, for example, the disclosure request of the first user's electronic medical record after being notified by the disclosure request receiving unit 311. In response to the user operation of the doctor terminal 30, electronic medical record information with the first user who requested disclosure as a patient is displayed on the display unit 35. After that, the disclosure range instruction unit 312 responds to the user operation to disclose the electronic medical record information of the first user displayed on the display unit 35 (designation of the disclosure range of the electronic medical record information and approval / disapproval of disclosure). Is selected, and the information of the selection is transmitted to the server device 10. The server device 10 sets the electronic medical record information of the first user so that it can be disclosed to the first user in a manner corresponding to the selection information received from the disclosure range indicating unit 312.

An example of the electronic medical record information displayed on the display unit 35 according to the user operation is as shown in FIG. Further, although not shown, the range of claims from the patient for disclosure of electronic medical record information may be highlighted on the screen. The highlighting method includes, for example, tagging, enclosing, and coloring information items in the disclosure request range. The user can approve the disclosure request by clicking the approval button or the like. In addition, the user can specify the disclosure range by selecting the items to be disclosed.

Further, the disclosure range instruction unit 312 receives a comment in response to an input by the user of the doctor terminal 30. The comment is information separate from the information contained in the electronic medical record information. Further, the disclosure range instruction unit 312 indicates whether the comment is disclosed according to the input by the user of the doctor terminal 30 (for example, for a patient, a doctor in charge, or a staff member of a medical institution). Disclosure range) can be set. The disclosure range instruction unit 312 can transmit the above comment and the disclosure mode to the server device 10 together with the information on selecting the disclosure mode of the electronic medical record information. The server device 10 can be set so that the comment can be disclosed to the first user together with the electronic medical record information of the first user in a manner corresponding to the selection information received from the disclosure range indicating unit 312.

[Processing flow]
Next, with reference to FIG. 6, an example of a processing flow executed in the server device 10, the patient terminal 20, and the doctor terminal 30 included in the electronic medical record disclosure management system 1 will be described. This process is realized, for example, by the CPU executing a predetermined program stored in a storage means such as a memory in each of the server device 10, the patient terminal 20, and the doctor terminal 30. In addition, each processing step included in the processing flow described below may add another step between each processing step. Further, the steps described as one step for convenience can be executed by being divided into a plurality of steps, while those described as one step can be grasped as one step for convenience.

First, the patient terminal 20 transmits a request for disclosure of an electronic medical record with the first user as a patient to the server device 10 in response to an input by a user (first user) of the patient terminal 20 (step S11). ). The disclosure request includes information on the scope of disclosure of the electronic medical record for which the first user requests disclosure.

In response to the request for disclosure of the electronic medical record received from the patient terminal 20, the server device 10 notifies the doctor terminal 30 that the request for disclosure of the patient's electronic medical record related to the request has been received (step S12). After receiving the notification of the request for disclosure of the electronic medical record information, the doctor terminal 30 notifies the user of the doctor terminal 30 that the request for disclosure has been received.

After that, the doctor terminal 30 displays the electronic medical record information with the first user who requested the disclosure as a patient on the display unit 35 in response to the operation by the user (second user) of the doctor terminal 30 (the display unit 35). Step S13). An example of the electronic medical record information displayed on the display unit 35 is as described with reference to FIG.

Next, the doctor terminal 30 determines the mode of disclosure of the electronic medical record information of the first user displayed on the display unit 35 according to the user operation (for example, designation of the disclosure range of the electronic medical record information and approval / disapproval of disclosure). ) Is selected, and the information of the selection is transmitted to the server device 10 (step S14). Further, when the doctor terminal 30 receives the comment of the second user in response to the user operation, the doctor terminal 30 can transmit the selection information of the disclosure mode of the electronic medical record information to the server device 10 together with the comment.

The server device 10 sets the disclosure range of the electronic medical record information (and comments) of the first user and the approval / disapproval of disclosure in an manner corresponding to the selection information received from the doctor terminal 30 (step S15). In the setting, among the information included in the electronic medical record information stored in the area (first storage area) of the storage unit 13 of the server device 10, the information set as the distributable range is the first storage area. Is stored in a different second storage area.

When the disclosure range of the electronic medical record and the approval / disapproval of disclosure are set, the server device 10 notifies the patient terminal 20 of the contents of the setting (step S16).

After receiving the notification from the server device 10, the patient terminal 20 accesses the server device 10 in response to the user input, and receives the electronic medical record information and the comment from the server device 10 within the range approved by the approval (step S17). ). After that, the patient terminal 20 displays the electronic medical record information and the comment on the display unit 25 in response to the user input (step S18).

As described above, according to the present embodiment, in the electronic medical record disclosure management system 1, the patient can request the disclosure of medical information (for example, the electronic medical record) via the patient terminal 20. The doctor in charge of the patient can set the disclosure range of medical information in a manner specified via the doctor terminal 30 for the request received via the server device 10 and approve the disclosure. As a result, the electronic medical record disclosure management system 1 can effectively manage the disclosure of the medical information in response to the request for disclosure of the medical information from the patient.

[Other Embodiments]
The present invention is not limited to the above-described embodiment, and can be implemented in various other forms without departing from the gist of the present invention. The above embodiments are merely exemplary in all respects and are not to be construed in a limited manner.

For example, in the processing flow shown in FIG. 6, the server device 10 receives the electronic medical record information disclosure request from the patient terminal 20 in step S11, and then transmits the disclosure request notification to the doctor terminal 30. , Conditions for sending the notification may be set. As a specific example, first, a disclosure range of electronic medical record information is set in advance according to an operation by a user such as a doctor or a system administrator, and the setting information is stored in the server device 10. The server device 10 is a doctor's terminal in step S12, provided that the disclosure range requested by the request for disclosure of the electronic medical record information received in step S11 exceeds the disclosure range of the preset electronic medical record information. A notice of disclosure request to 30 may be transmitted.

As another modification, in step S13 of FIG. 6, the doctor terminal 30 displays electronic medical record information for the first user who requested disclosure on the display unit 35 in response to an operation by the user. However, the display method may be changed depending on the conditions. For example, the doctor terminal 30 covers the disclosure range requested by the request for disclosure of electronic medical record information, which exceeds the disclosure range preset according to the operation by a user such as a doctor or a system administrator. It can be highlighted and displayed on the display unit 35. As a specific example, in the electronic medical record information, if the "sample test result" is not included in the preset disclosing range but is included in the disclosure range requested by the disclosure request, the doctor's terminal 30 Can be displayed on the display unit 35 with emphasis on the “sample test result”.

1 Electronic medical record disclosure management system, 10 server device, 20 patient terminal, 30 doctor terminal, 11,21,31 control unit, 11a, 21a, 31a CPU, 11b, 21b, 31b memory, 12, 22, 32 communication unit , 13, 23, 33 Storage unit, 24, 34 operation unit, 25, 35 display unit

Claims (10)

The first terminal sends a request for disclosure of the electronic medical record to the server in response to the input by the first user.
In response to the disclosure request, the server sends a notification to the second terminal of the second user associated with the first user.
The second terminal displays the electronic medical record of the first user in response to the notification and the input by the second user.
The second terminal selects the mode of disclosure of the displayed electronic medical record in response to the input by the second user, and transmits the information of the selection to the server.
The server sets the electronic medical record of the first user so that it can be disclosed to the first user in a manner corresponding to the information of the selection.
Electronic medical record disclosure management method having. Setting the electronic medical record of the first user to be disclosed by the server includes setting whether or not the electronic medical record of the first user can be disclosed for each item included in the electronic medical record according to the information of the selection. Item 1. The electronic medical record disclosure management method according to item 1. Setting the electronic medical record of the first user to be disclosed by the server includes setting whether or not the change history of the contents of the electronic medical record can be disclosed according to the information of the selection. Item 4. The electronic medical record disclosure management method according to Item 1 or 2. The second terminal includes sending a comment in response to an input by the second user to the server together with the information of the selection.
The electronic medical record disclosure management method according to any one of claims 1 to 3, wherein setting the electronic medical record of the first user to be disclosed by the server includes setting the comment to be disclosed. .. The electronic medical record disclosure management method according to claim 4, wherein the second terminal sets a disclosure range of the comment. The server includes storing the information of the electronic medical record in the first storage area.
Setting the electronic medical record of the first user to be disclosing means that the server stores the information of the electronic medical record of the first user in a manner corresponding to the information of the selection. The electronic medical record disclosure management method according to any one of claims 1 to 5, which comprises storing in a second storage area different from the area. The notification to the second terminal of the second user associated with the first user by the server is transmitted when the disclosure range in the disclosure request exceeds a preset range. The electronic medical record disclosure management method according to any one of items 1 to 6. Displaying the electronic medical record of the first user by the second terminal includes highlighting a range exceeding a preset range in the disclosure request. The electronic medical record disclosure management method according to any one of items 1 to 7. A function to receive an electronic medical record disclosure request from a first terminal in response to an input by a first user, and
In response to the disclosure request, a function of transmitting a notification to a second terminal of a second user associated with the first user, and
A function of receiving information on selection of a mode of disclosure of the electronic medical record from the second terminal in response to input by the second user, and
A function of setting the electronic medical record of the first user so that it can be disclosed to the first user in an manner corresponding to the information of the selection.
Electronic medical record management device with. On the computer
A function to receive an electronic medical record disclosure request from a first terminal in response to an input by a first user, and
In response to the disclosure request, a function of transmitting a notification to a second terminal of a second user associated with the first user, and
A function of receiving information on selection of a mode of disclosure of the electronic medical record from the second terminal in response to input by the second user, and
A function of setting the electronic medical record of the first user so that it can be disclosed to the first user in an manner corresponding to the information of the selection.
A program to realize.

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