JP6953270B2 - Hospital information system and drug proposal selection program - Google Patents

Description

Embodiments of the present invention relate to hospital information systems and drug proposal selection programs.

A technique has been proposed in which information on a disease name and a corresponding drug entered by a doctor is searched by referring to medical examination results such as medical receipts and electronic medical records. This type of technology can help doctors prescribe the right medication. However, the information provided is standard drug for the patient's disease and is likely already used in treatment. It is assumed that doctors and patients seek new treatment information when standard treatment is continued but no improvement is seen. Therefore, the information provided by conventional techniques may not be sufficient.

When a patient intends to receive treatment with an investigational drug or a domestic unapproved drug, it is common for the patient to search for clinical trial / unapproved drug disclosure information under the jurisdiction of an incorporated administrative agency or to be referred by a medical institution. Is. Therefore, whether a patient can receive treatment with an investigational drug or a domestic unapproved drug according to his / her wishes largely depends on the information gathering ability of the patient and the medical institution.

Japanese Unexamined Patent Publication No. 2010-128718

Therefore, the purpose is to enable doctors to provide patients with new treatment information suitable for patients at the time of medical treatment.

According to the embodiment, the hospital information system includes a processing device and a terminal device. The processing device is based on the personal information and patient medical information about the patient stored in the first database and the information on the investigational drug and the unapproved drug stored in the second database, and the investigational drug and the investigation drug suitable for the patient. / Or select unapproved drugs. The terminal device is connected to the processing device by an in-hospital network, and when a doctor examines a patient, the investigational drug and / or an unapproved drug selected by the processing device is referred to the patient for introduction. Display to the doctor.

FIG. 1 is a block diagram showing an environment in which the hospital information system according to the first embodiment is utilized. FIG. 2 is a block diagram showing a functional configuration of a processing server of the electronic medical record system shown in FIG. FIG. 3 is a flowchart showing an operation when the processing circuit of the processing server shown in FIG. 2 creates proposal information. FIG. 4 is a flowchart showing a subroutine for determining physical condition conformity shown in FIG. FIG. 5 is a flowchart showing a subroutine for determining conformity with social conditions shown in FIG. FIG. 6 is a diagram showing a display example of the terminal device of the electronic medical record system shown in FIG. FIG. 7 is a diagram showing summary information about the investigational drug displayed on the terminal device of the electronic medical record system shown in FIG. FIG. 8 is a diagram showing detailed information about the investigational drug displayed on the terminal device of the electronic medical record system shown in FIG. FIG. 9 is a diagram showing a form for inputting a reason for non-introduction, which is displayed on the terminal device of the electronic medical record system shown in FIG. FIG. 10 is a diagram showing an example of utilization of referral history information. FIG. 11 is a diagram showing another example of utilization of referral history information. FIG. 12 is a block diagram showing another configuration example of the hospital information system shown in FIG.

Hereinafter, embodiments will be described with reference to the drawings.

(First Embodiment)
FIG. 1 is a block diagram showing an example of an environment in which the hospital information system 10 according to the first embodiment is utilized. In FIG. 1, a hospital information system 10, an investigational drug / unapproved drug information management server 20, a domestic health institution 30, a pharmaceutical company 40, an overseas health institution 50, a medical institution 60, and an overseas pharmaceutical company 70 are connected by an IP network. There is.

The hospital information system 10 shown in FIG. 1 is, for example, a system constructed on an in-hospital network. The hospital information system 10 includes, for example, an electronic chart system 11, a medical information management server 12, a medical accounting system 13, a radiation department system 14, a clinical examination department system 15, a medical image management system 16, and an image examination device 17. .. The hospital information system 10, the electronic chart system 11, the medical information management server 12, the medical accounting system 13, the radiation department system 14, the clinical examination department system 15, the medical image management system 16, and the image examination device 17 are LANs (Local Area Network). ) Etc. are connected so that data communication is possible via the in-hospital network.

The connection to the hospital network may be a wired connection or a wireless connection. Moreover, as long as security is ensured, the connected line is not limited to the in-hospital network. For example, it may be connected to a public communication line such as the Internet via a VPN (Virtual Private Network) or the like. Further, the system connected to the in-hospital network is not limited to the above. The in-hospital network may include systems other than the above.

The electronic medical record system 11 is a system for managing information related to the electronic medical record. The information regarding the electronic medical record includes, for example, patient information, medical care information, nursing information, and the like. Patient information includes, for example, patient ID, patient name, address, age, gender, height, weight, contraindication information, transportation used at the time of hospital visit, financial status, and the like. The medical information includes, for example, a first recorded information, a second recorded information, and the like. In the present embodiment, the first recorded information records information generated at the time of medical treatment, such as, for example, a disease, a symptom, a medical history, a finding, a diagnosis, and a plan. Further, in the present embodiment, the second recorded information records information generated in conjunction with the order, such as prescription, examination, injection, and treatment. Nursing information includes, for example, nursing implementation record information and the like.

The medical accounting system 13 is a system that manages information related to billing of medical fees. The information related to the billing of medical fees includes, for example, the status of non-payment of medical expenses at a medical institution.

The radiation department system 14 is a system that manages information such as examination orders and examination appointments in the radiation department, which is one of the medical treatment departments.

The clinical laboratory department system 15 is a system that manages order information for testing samples collected by various methods, information on reports created based on diagnostic results, and the like.

The medical image management system 16 is a so-called PACS (Picture Archiving and Communication System) that manages medical images such as radiological examination images, ultrasonic images, MRI (Magnetic Resonance Imaging) images, and endoscopy images. .. In the medical image management system 16, medical image data is managed according to, for example, a DICOM (Digital Imaging and Communication Medicine) standard. The medical image management system 16 also manages an image diagnosis report created based on the medical image.

The image inspection device 17 is a device for generating medical image data regarding a patient. The image inspection device 17 includes, for example, an X-ray diagnostic device, an X-ray CT (Computed Tomography) device, an ultrasonic diagnostic device, an MRI device, a SPECT (Single Photon Emission Computed Tomography) device, a PET (Positron Emission computed Tomography) device, and the like. Is. The image inspection device 17 performs the inspection based on the inspection order managed by the radiation department system 14, for example, and generates medical image data.

The medical information management server 12 acquires predetermined information from the electronic chart system 11, the medical accounting system 13, the radiation department system 14, the clinical examination department system 15, the medical image management system 16, and the image examination device 17, and the acquired information. It acts as a database for accumulating information.

Specifically, for example, the medical information management server 12 periodically visits the electronic medical record system 11, the medical accounting system 13, the radiation department system 14, the clinical examination department system 15, the medical image management system 16, and the image examination device 17. to access. The medical information management server 12 uses, for example, personal information about the patient (gender, height, weight, contraindication information, age, address, transportation used at the time of hospital visit, and financial status (medical expenses unpaid) from the accessed system and device. (Including the situation), etc.), and patient medical information (disease name, detailed symptom, etc., nursing record, medical history, drug history, test results, diagnostic imaging report, etc.). The medical information management server 12 stores the acquired patient information and patient medical information in a built-in storage circuit. At this time, the medical information management server 12 stores, for example, the acquired patient information and the patient medical information in association with each patient.

The investigational drug / unapproved drug information management server 20 serves as a database for accumulating information on clinical trials and information on unapproved drugs. Information on clinical trials is collected from information on clinical trial protocol 31, clinical trial recruitment information 41, investigational drug information 42, and the like.

The clinical trial protocol 31 is delivered to the Ministry of Health, Labor and Welfare in order to obtain approval for the clinical trial, and the medical institution conducting the clinical trial and the pharmaceutical company requesting the clinical trial must comply with it when conducting the clinical trial. Is described. The study protocol 31 describes, for example, the purpose of the study, the subject of the study such as disease and symptoms, the selection criteria of the subject, the exclusion criteria of the subject, the name of the investigational drug, the dose and administration method, the administration period, the side effects, and the like. The cost burden, clinical trial schedule, and the results of the first and second phases of the trial are described. Information on the clinical trial protocol 31 will be made public by public institutions such as the National Health Organization 30.

The clinical trial recruitment information 41 is information for recruiting clinical trial subjects. The clinical trial recruitment information 41 includes, for example, the planned usage / dose of the investigational drug, the name of the target disease and the name of the symptom, the selection criteria of the subject, the purpose of the clinical trial, the content of the clinical trial, the name of the medical institution conducting the clinical trial, the recruitment period, and the like. included. The investigational drug information 42 is pharmaceutical information about the investigational drug used in the clinical trial. The clinical trial recruitment information 41 and the investigational drug information 42 are disclosed by the pharmaceutical company 40 requesting the clinical trial.

Information on unapproved drugs is collected from new drug approval information 32, 51, administration information 61, drug information 71, and the like. The new drug approval information 32 is information on a new drug newly approved in Japan, and is disclosed by a public institution such as the National Health Organization 30. The new drug approval information 51 is information on a new drug newly approved overseas, and is disclosed by a public institution such as the Overseas Health Organization 50. The new drug approval information 32, 51 includes, for example, the name of the active ingredient, the company name, the effect / efficacy, the date of approval, the date of investigation, and the like. In the present embodiment, for example, a drug approved overseas and not approved in Japan is treated as an unapproved drug based on the new drug approval information 32, 51. Further, for example, a drug that has been approved for a predetermined disease but has not been approved for a disease other than the target disease is treated as an unapproved drug. Specifically, for example, it is a drug that has been approved for gastric cancer but not for lung cancer. The administration information 61 is information about a drug administered at the medical institution 60. The administration information 61 includes a drug name, a dose and an administration method, a medical facility name, an administration period, and the like. The drug information 71 is disclosed by the overseas pharmaceutical company 70. The drug information 71 includes pharmaceutical information about the unapproved drug according to the present embodiment.

The investigational drug / unapproved drug information management server 20 accesses the domestic health institution 30, the pharmaceutical company 40, the overseas health institution 50, and the medical institution 60. The investigational drug / unapproved drug information management server 20 provides basic drug information (ingredients, diseases, symptoms, contraindications, usage, etc.) for each drug from the access destination institution and company, for example, for the investigational drug and the unapproved drug. , Read clinical trial recruitment information (target criteria, name of medical institution conducting clinical trial, recruitment period, presence / absence / frequency of hospital visits, cost sharing / total amount, etc.), administration information of unapproved drugs (medical facilities handled, drug costs, etc.). The investigational drug / unapproved drug information management server 20 stores the read information. The investigational drug / unapproved drug information management server 20 transmits the stored information upon request. In addition, the investigational drug / unapproved drug information management server 20 may transmit a notification signal to the effect that the information has been updated when new information is accumulated.

The electronic medical record system 11 shown in FIG. 1 includes a processing server 111 and a terminal device 112. The processing server 111 and the terminal device 112 are connected to each other so as to be capable of data communication via, for example, an in-hospital network. Note that FIG. 1 shows an example in which one processing server 111 and one terminal device 112 are provided in the electronic medical record system 11, but the present invention is not limited to this. A plurality of processing servers 111 and terminal devices 112 may be provided as necessary.

The terminal device 112 is a terminal for displaying information required by a doctor or the like and for the doctor or the like to input an instruction to the processing server 111. Specifically, for example, the terminal device 112 includes a display and an input interface. The terminal device 112 reads information about the electronic medical record from the processing server 111 when the doctor examines the patient, and displays the electronic medical record based on the read information on the display. Further, when the doctor examines the patient, the terminal device 112 reads the proposal information regarding the investigational drug and the unapproved drug selected as the target to be proposed to the patient from the processing server 111, and displays the read proposal information on the display. .. The doctor examines the patient by referring to the electronic medical record displayed on the terminal device 112. The doctor uses the input interface of the terminal device 112 to input findings and the like into the electronic medical record based on the diagnosis result, and inputs an instruction to update the electronic medical record. The updated electronic medical record information is transmitted to the processing server 111 and stored in the processing server 111. In addition, the doctor uses the input interface of the terminal device 112 to input order information and the like from the electronic medical record.

The processing server 111 is an example of a processing device, and is a server that manages information on electronic medical records, proposal information on investigational drugs and unapproved drugs, and the like. The processing server 111 outputs necessary information to the terminal device 112 in response to an input from a doctor via the terminal device 112. Further, the processing server 111 adds the information added by the doctor to the information related to the electronic medical record in response to the update instruction input from the terminal device 112.

FIG. 2 is a block diagram showing an example of the functional configuration of the processing server 111 shown in FIG. The processing server 111 shown in FIG. 2 has a processing circuit 1111, a communication interface 1112, and a storage circuit 1113. The processing circuit 1111, the communication interface 1112, and the storage circuit 1113 are connected to each other so as to be able to communicate with each other via, for example, a bus.

The processing circuit 1111 is a processor that functions as the center of the processing server 111. The processing circuit 1111 realizes a function corresponding to the drug proposal selection program stored in the storage circuit 1113 or the like.

The communication interface 1112 performs data communication with the medical information management server 12, the medical accounting system 13, the radiation department system 14, the clinical examination department system 15, and the medical image management system 16 connected via the hospital network. .. Communication with the medical information management server 12, the medical accounting system 13, the radiation department system 14, the clinical examination department system 15, and the medical image management system 16 is performed in accordance with a known preset standard.

The storage circuit 1113 is a storage device such as an HDD (hard disk drive), an SSD (solid state drive), and an integrated circuit storage device that stores various information. Further, the storage circuit 1113 may be a drive device or the like that reads and writes various information between a CD-ROM drive, a DVD drive, and a portable storage medium such as a flash memory. The storage circuit 1113 does not necessarily have to be realized by a single storage device. For example, the storage circuit 1113 may be realized by a plurality of storage devices.

The storage circuit 1113 stores the drug proposal selection program and the like according to the present embodiment. In addition, the storage circuit 1113 stores information regarding the electronic medical record. In addition, the storage circuit 1113 stores proposal information regarding the investigational drug and the unapproved drug selected by the processing circuit 1111 by executing the drug proposal selection program.

The processing server 111 may have an input interface. The input interface is realized by, for example, a mouse, a keyboard, a touch panel on which instructions are input by touching the operation surface, and the like. The input interface converts an input instruction from the operator into an electric signal and outputs the electric signal to the processing circuit 1111. The input interface is not limited to those provided with physical operating parts such as a mouse and a keyboard. For example, an example of an input interface includes a circuit that receives an electric signal corresponding to an instruction input from an external input device provided separately from the processing server 111 and outputs the electric signal to the processing circuit 1111.

Further, the processing server 111 may have an output interface. The output interface is realized by, for example, a display device, a printing device, or the like. As the display device, for example, any display such as a CRT display, a liquid crystal display, an organic EL display, an LED display, and a plasma display can be appropriately used. The display device displays image data about the display target. The printing device is, for example, a printer. The printing device prints image data about the printing target on a predetermined sheet of paper. The output interface is not limited to those provided with physical output components such as display devices and printing devices. For example, an example of the output interface includes a circuit for transmitting image data to an external output device provided separately from the processing server 111.

The processing circuit 1111 shown in FIG. 2 realizes a function corresponding to the drug proposal selection program stored in the storage circuit 1113. For example, the processing circuit 1111 realizes the drug extraction function 1111a, the conformity determination function 1111b, the proposal information creation function 1111c, the proposal function 1111d, and the referral information creation function 1111e by executing the drug proposal selection program. In this embodiment, the case where the drug extraction function 1111a, the conformity determination function 1111b, the proposal information creation function 1111c, the proposal function 1111d, and the referral information creation function 1111e are realized by a single processor will be described. Not limited. For example, a processing circuit is configured by combining a plurality of independent processors, and each processor executes a drug proposal selection program to execute a drug extraction function 1111a, a conformity determination function 1111b, a proposal information creation function 1111c, a proposal function 1111d, and an introduction. The information creation function 1111e may be realized.

The drug extraction function 1111a is a function of extracting an investigational drug and / or an unapproved drug suitable for a patient whose information is stored in the medical information management server 12 from the investigational drug / unapproved drug information management server 20. Specifically, for example, the processing circuit 1111 executes the drug extraction function 1111a at a preset timing. When the drug extraction function 1111a is executed, the processing circuit 1111 accesses the medical information management server 12, associates it with a predetermined patient, and stores it in the medical information management server 12, for example, a disease name and / or a symptom name. read out. The processing circuit 1111 displays, for example, a list of investigational drugs and / or unapproved drugs that are expected to be effective against the read-out patient's disease name and / or symptom name from the investigational drug / unapproved drug information management server 20. Extract.

The timing at which the processing circuit 1111 executes the drug extraction function 1111a includes, for example, a preset time, a preset cycle, and the like, but is not limited thereto. Further, the processing circuit 1111 may execute the drug extraction function 1111a when receiving a notification signal indicating that the information has been updated, which is transmitted from the investigational drug / unapproved drug information management server 20.

The conformity determination function 1111b is a function for determining whether or not the investigational drug and / or the unapproved drug extracted by the drug extraction function 1111a matches the patient's condition and course. Specifically, for example, the processing circuit 1111 executes the conformity determination function 1111b when the drug list is extracted by the drug extraction function 1111a. When the conformity determination function 1111b is executed, the processing circuit 1111 executes the physical condition conformity determination and the social condition conformity determination for each of the drugs included in the drug list.

In the physical condition conformity determination, the processing circuit 1111 is the investigational drug / unapproved drug information management server 20 for the investigational drug and / or the unapproved drug from which the patient's physical information stored in the medical information management server 12 is extracted. Determine if the various requirements stored in are met. In the present embodiment, the physical information of the patient includes age, gender, height, weight, contraindication information and the like.

Further, in the social condition conformity determination, in the processing circuit 1111, the clinical information of the patient stored in the medical information management server 12 is extracted, and / or the investigational drug / unapproved drug information for the unapproved drug. It is determined whether the various requirements stored in the management server 20 are satisfied. In the present embodiment, the social information of the patient includes an address, transportation used at the time of hospital visit, financial situation, and the like.

The processing circuit 1111 selects an investigational drug and / or an unapproved drug determined to be suitable for the patient by the physical condition conformity determination and the social condition conformity determination as a target to be proposed to the patient.

The proposal information creation function 1111c is a function for creating proposal information based on the selected investigational drug and / or the unapproved drug. Specifically, for example, the processing circuit 1111 executes the proposal information creation function 1111c when the investigational drug and / or the unapproved drug is selected. When the proposal information creation function 1111c is executed, the processing circuit 1111 reads detailed information on the selected investigational drug and / or the unapproved drug from the investigational drug / unapproved drug information management server 20, and propose information based on the read information. To create. The processing circuit 1111 stores the created proposal information in the storage circuit 1113.

The proposal function 1111d is a function that proposes to the doctor the referral of the selected investigational drug and / or the unapproved drug to the patient at the start of the examination of the patient. Specifically, for example, the processing circuit 1111 executes the proposed function 1111d when the doctor notifies the start of the patient's examination via the terminal device 112. When the proposed function 1111d is executed, the processing circuit 1111 transmits the proposed information regarding the selected investigational drug and / or the unapproved drug to the terminal device 112.

The referral information creation function 1111e is a function for creating referral information including the presence / absence of referral and the reason for not referral. Specifically, for example, the processing circuit 1111 executes the referral information creation function 1111e when the presence or absence of referral of a drug is input from the doctor via the terminal device 112. When the referral information creation function 1111e is executed, the processing circuit 1111 includes the presence or absence of referral and the reason for not referral based on whether or not the investigational drug and / or the unapproved drug included in the proposed information has been referred to the patient. Create referral information. The processing circuit 1111 transmits the created referral information to the medical information management server 12. The medical information management server 12 stores referral information as referral history information. The referral history information includes, for example, the presence / absence of referral to a predetermined patient, the referral date or non-referral date, the non-referral reason, and the like for each drug. Further, the processing circuit 1111 deletes the information that can identify the patient from the created referral information, anonymizes it, and then transmits the referral information to the investigational drug / unapproved drug information management server 20. In the investigational drug / unapproved drug information management server 20, referral information is stored as referral history information.

Next, the operation when the processing server 111 configured as described above proposes the investigational drug and / or the unapproved drug to the doctor will be described in detail.

FIG. 3 is a flowchart showing an example of the operation when the processing circuit 1111 of the processing server 111 shown in FIG. 2 creates the proposal information.

First, the processing circuit 1111 reads, for example, a drug proposal selection program from the storage circuit 1113 at a predetermined time at night, and executes the read drug proposal selection program. By executing the drug proposal selection program, the drug extraction function 1111a is first executed. When the drug extraction function 1111a is executed, the processing circuit 1111 accesses the medical information management server 12, and selects, for example, one patient A from a plurality of patients examined during the day. This selection may be made according to either the order of examination, the order of ID, or the like. In addition, it may be selected from patients who have been examined in the past, not limited to the daytime. The processing circuit 1111 reads out, for example, a disease name stored in the medical information management server 12 in association with the selected patient A (step S31). If the disease name has not been diagnosed, the symptom name may be read out.

The processing circuit 1111 accesses the investigational drug / unapproved drug information management server 20, and selects the unapproved drug whose effect / efficacy includes the disease name read from the medical information management server 12 in the investigational drug / unapproved drug information management server 20. Extract from. In addition, the processing circuit 1111 extracts the investigational drug whose disease name read from the medical information management server 12 is included in the investigation target from the investigational drug / unapproved drug information management server 20 (step S32).

The processing circuit 1111 executes the conformity determination function 1111b when the investigational drug and / or the drug list including the unapproved drug is extracted from the investigational drug / unapproved drug information management server 20 (step S33). When the conformity determination function 1111b is executed, the processing circuit 1111 executes the physical condition conformity determination (step S34) and the social condition conformity determination (step S35) for each of the drugs included in the drug list. In the following description, for example, in step S32, one investigational drug and one unapproved drug are extracted, first, conformity determination for the investigational drug is performed, and then conformity determination for the unapproved drug is performed. Will be described as an example.

FIG. 4 is a flowchart showing an example of a subroutine for determining physical condition conformity shown in FIG. First, the processing circuit 1111 accesses the investigational drug / unapproved drug information management server 20, and conducts clinical trial recruitment information for the investigational drug listed in the drug list, for example, information on the selection criteria of the subject, and the test. The information and the like regarding the exclusion criteria of the person are read out (step S41).

The processing circuit 1111 accesses the medical information management server 12, and from the personal information stored in association with the patient A, the medical information management server 12 obtains physical information such as gender, height, weight, age, and contraindication information. Read from (step S42).

The processing circuit 1111 determines whether or not the physical information of the patient A read from the medical information management server 12 satisfies the selection criteria of the subject read from the investigational drug / unapproved drug information management server 20 (step). S43). When the physical information of patient A satisfies the selection criteria (Yes in step S43), the processing circuit 1111 reads the physical information of patient A read from the medical information management server 12 from the investigational drug / unapproved drug information management server 20. It is determined whether or not the subject's exclusion criteria are violated (step S44). If the physical information of patient A does not meet the selection criteria (No in step S43), the processing circuit 1111 determines that the investigational drug is incompatible with patient A (step S45), and uses a subroutine for determining physical condition conformity. To finish.

In step S44, if the physical information of patient A does not conflict with the exclusion criteria (Yes in step S44), the processing circuit 1111 accesses the medical information management server 12 and has a medical history from the patient medical information about patient A. (Medical history) and various test values (liver function, renal function, etc.) are read out (step S46). If the physical information of patient A violates the exclusion criteria (No in step S44), the processing circuit 1111 determines that the investigational drug is incompatible with patient A (step S45).

Whether or not the medical history and various test values read from the medical information management server 12 in step S46 satisfy the selection criteria of the subject read from the investigational drug / unapproved drug information management server 20 in the processing circuit 1111. Is determined (step S47). When the medical history of patient A and various test values satisfy the selection criteria (Yes in step S47), the processing circuit 1111 has a medical history read from the medical information management server 12 and various test values are investigational drug / unapproved. It is determined whether or not the exclusion criteria of the subject read from the drug information management server 20 is violated (step S48). If the medical history of patient A and various test values do not meet the selection criteria (No in step S47), the processing circuit 1111 determines that the investigational drug is incompatible with patient A (step S45).

In step S48, if the medical history of patient A and various test values do not conflict with the exclusion criteria (Yes in step S48), the processing circuit 1111 determines that the investigational drug is compatible with the physical condition of patient A and conforms to the physical condition. End the judgment subroutine. If the medical history of patient A and various test values conflict with the exclusion criteria (No in step S48), the processing circuit 1111 determines that the investigational drug is incompatible with patient A (step S45).

Returning to the description of FIG. 3, when the processing circuit 1111 determines that the investigational drug is suitable for the patient A in the physical condition conformity determination shown in step S34, the processing circuit 1111 executes the social condition conformity determination (step S35). On the other hand, when the processing circuit 1111 determines that the investigational drug is incompatible with patient A in the physical condition conformity determination shown in step S34, the next drug included in the drug list, in this description, an unapproved drug is set ( Step S36), the conformity determination process is carried out for the unapproved drug set through the determination shown in step S37.

FIG. 5 is a flowchart showing an example of a subroutine for determining conformity with social conditions shown in FIG. First, the processing circuit 1111 accesses the investigational drug / unapproved drug information management server 20, and names the investigational drug / unapproved drug in which the clinical trial is conducted using the investigational drug listed in the drug list. Read from the information management server 20 (step S51).

The processing circuit 1111 accesses the medical information management server 12 and reads out social information such as an address and transportation used at the time of hospital visit from the medical information management server 12 from the personal information stored in association with the patient A. (Step S52). The processing circuit 1111 determines whether or not the social information of the patient A read from the medical information management server 12 conforms to the social conditions (step S53). Specifically, in the processing circuit 1111 the allowable distance is the distance between the address of patient A read from the medical information management server 12 and the clinical trial site read from the investigational drug / unapproved drug information management server 20. Determine if it fits. The permissible distance is defined in advance for each means of transportation mainly used. The permissible distance for patient A is calculated based on the transportation system used at the time of hospital reading read from the medical information management server 12.

When the social information meets the social conditions, that is, when the distance between the patient A's address and the study site is within the permissible distance (Yes in step S53), the processing circuit 1111 is the investigational drug. Terminates the social condition conformity determination subroutine as being compatible with the social information of patient A. If the social information does not meet the social conditions, that is, if the distance between the patient A's address and the study site is not within the permissible distance (No in step S53), the processing circuit 1111 will perform this clinical trial. It is determined that the drug is incompatible with patient A (step S54), and the subroutine for determining physical condition conformity is terminated.

Returning to the description of FIG. 3, when the processing circuit 1111 determines that the investigational drug is suitable for the patient A in the social condition conformity determination shown in step S35, the processing circuit 1111 refers to the referral history information stored in the medical information management server 12 and refers to the referral history information. It is determined whether or not this investigational drug has not been referred to patient A (step S38). On the other hand, when the processing circuit 1111 determines that the investigational drug is incompatible with patient A in the social condition conformity determination shown in step S35, the next drug included in the drug list, in this description, an unapproved drug is set ( Step S36), the conformity determination process is carried out for the unapproved drug set through the determination shown in step S37.

If the investigational drug has not been referred to patient A in step S38 (Yes in step S38), the processing circuit 1111 selects the investigational drug and includes the next drug in the drug list, this description. Now, the conformity determination process will be carried out for unapproved drugs. If this investigational drug has been unreferred to patient A (No in step S38), the processing circuit 1111 sets the next drug on the drug list, an unapproved drug in this description (No). Step S36), the conformity determination process is carried out for the unapproved drug set through the determination shown in step S37.

When the conformity determination process for the investigational drug listed in the drug list is completed, the processing circuit 1111 executes a subroutine for determining physical condition conformity for the unapproved drug listed in the drug list (step S34).

First, the processing circuit 1111 accesses the investigational drug / unapproved drug information management server 20 and reads out usage information, contraindication information, and the like about the unapproved drug listed in the drug list (step S41). The processing circuit 1111 accesses the medical information management server 12, and from the personal information stored in association with the patient A, the medical information management server 12 obtains physical information such as gender, height, weight, age, and contraindication information. Read from (step S42).

The processing circuit 1111 determines whether or not the physical information of the patient A read from the medical information management server 12 satisfies the conditions based on the usage information read from the investigational drug / unapproved drug information management server 20 (step S43). ). When the physical information of patient A satisfies the condition based on the usage information (Yes in step S43), in the processing circuit 1111, the physical information of patient A read from the medical information management server 12 is the investigational drug / unapproved drug information management server. It is determined whether or not the condition based on the contraindication information read from No. 20 is violated (step S44). If the physical information of patient A does not meet the conditions based on the usage information (No in step S43), the processing circuit 1111 determines that this unapproved drug is incompatible with patient A (step S45) and conforms to the physical conditions. End the judgment subroutine.

In step S44, when the physical information of patient A does not conflict with the condition based on the contraindication information (Yes in step S44), the processing circuit 1111 accesses the medical information management server 12 and obtains the patient medical information about patient A. , History, various inspection values, etc. are read out (step S46). If the physical information of patient A conflicts with the conditions based on the contraindicated information (No in step S44), the processing circuit 1111 determines that the investigational drug is incompatible with patient A (step S45).

The processing circuit 1111 determines whether or not the medical history read from the medical information management server 12 and various test values in step S46 satisfy the conditions based on the usage information read from the investigational drug / unapproved drug information management server 20. Judgment (step S47). When the medical history of patient A and various test values satisfy the conditions based on the usage information (Yes in step S47), the processing circuit 1111 has a medical history read from the medical information management server 12 and various test values are the investigational drug. / It is determined whether or not the condition based on the contraindication information read from the unapproved drug information management server 20 is violated (step S48). If the medical history of patient A and various test values do not meet the conditions based on the usage information (No in step S47), the processing circuit 1111 determines that this unapproved drug is incompatible with patient A (step S45). ).

In step S48, if the medical history of patient A and various test values do not conflict with the conditions based on the contraindication information (Yes in step S48), the processing circuit 1111 matches the unapproved drug with the physical condition of patient A. To end the subroutine of physical condition conformity determination. If the medical history of patient A and various test values conflict with conditions based on contraindication information (No in step S48), the processing circuit 1111 determines that this unapproved drug is incompatible with patient A (No). Step S45).

Returning to the description of FIG. 3, when the processing circuit 1111 determines that the unapproved drug is suitable for the patient A in the physical condition conformity determination shown in step S34, the processing circuit 1111 executes the social condition conformity determination (step S35). On the other hand, when the processing circuit 1111 determines that the unapproved drug is incompatible with the patient A in the physical condition conformity determination shown in step S34, the processing circuit 1111 sets the next drug included in the drug list (step S36). When the next drug is not present in the drug list (No in step S37), the conformity determination for patient A is terminated (step S39).

The processing circuit 1111 accesses the investigational drug / unapproved drug information management server 20 in the social condition conformity determination shown in FIG. 5, and handles medical facilities to which the unapproved drug listed in the drug list has been administered. Is read from the investigational drug / unapproved drug information management server 20 (step S51).

The processing circuit 1111 accesses the medical information management server 12, and manages social information such as an address, transportation used at the time of hospital visit, financial situation, etc. from personal information stored in association with patient A. Read from the server 12 (step S52). The processing circuit 1111 determines whether or not the social information of the patient A read from the medical information management server 12 conforms to the social conditions (step S53). Specifically, in the processing circuit 1111, the distance between the address of patient A read from the medical information management server 12 and the handling medical facility read from the investigational drug / unapproved drug information management server 20 becomes an allowable distance. Determine if it fits. Further, the processing circuit 1111 determines whether or not there is a record of non-payment of medical expenses in the economic situation read from the medical information management server 12. Patients who have not paid their medical expenses are more likely to be unable to tolerate the heavy out-of-pocket costs of unapproved drugs.

When the social information meets the social conditions, that is, when the distance between the patient A's address and the medical facility handled is within the permissible distance, and there is no record of unpaid medical expenses in the financial situation. (Yes in step S53), the processing circuit 1111 terminates the subroutine of determining conformity with social conditions, assuming that the investigational drug matches the social information of patient A. If the social information does not meet the social conditions, that is, the distance between the patient A's address and the medical facility handled is not within the permissible distance, or there is a record of non-payment of medical expenses in the financial situation. In the case (No in step S53), the processing circuit 1111 determines that the unapproved drug is incompatible with patient A (step S54), and terminates the subroutine of determining physical condition conformity.

Returning to the description of FIG. 3, when the processing circuit 1111 determines that the unapproved drug is suitable for the patient A in the social condition conformity determination shown in step S35, the processing circuit 1111 refers to the referral history information stored in the medical information management server 12. , It is determined whether or not this unapproved drug has not been referred to patient A (step S38). On the other hand, when the processing circuit 1111 determines that the unapproved drug is incompatible with the patient A in the social condition conformity determination shown in step S35, the conformity determination for the patient A is completed through steps S36 and S37 (step S39). ).

If there is no record of this unapproved drug being unintroduced to patient A in step S38 (Yes in step S38), the processing circuit 1111 selects this unapproved drug. Then, the processing circuit 1111 ends the conformity determination for the patient A when there is no next drug included in the drug list (step S39).

The processing circuit 1111 executes the proposal information creation function 1111c when the conformity determination process is completed and the investigational drug and / or the unapproved drug is selected in this process. When the proposal information creation function 1111c is executed, the processing circuit 1111 reads out detailed information about the selected investigational drug and / or the unapproved drug from the investigational drug / unapproved drug information management server 20. Detailed information on the investigational drug includes, for example, information on the name of the investigational drug, the generic name of the investigational drug, the subject of the study, side effects, the results of the previous phase, the name of the medical institution conducting the study, the dosage and administration, and the mechanism of action. Is included. Detailed information on unapproved drugs includes, for example, information on the active ingredient name, company name, efficacy / efficacy, approved country, and medical facility handled. The processing circuit 1111 creates the proposal information based on the read information (step S310).

At this time, the processing circuit 1111 may divide the proposed information into a plurality of types of information. For example, the processing circuit 1111 creates summary information representing the summary of the proposal information and detailed information representing the detailed information of the drug included in the proposal information. The processing circuit 1111 provides outline information such as the name of the investigational drug, the subject of the clinical trial, the phase of the clinical trial, the name of the medical institution conducting the clinical trial, etc. for the investigational drug, and the effect / efficacy, the medical facility handled, etc. for the unapproved drug. And. In addition, the processing circuit 1111 contains, for example, the generic name of the investigational drug, the mechanism of action, the test results in the previous phase, side effects, etc. for the investigational drug, and the active ingredient name, the manufacturing company name, etc. for the unapproved drug. And the approved countries, etc. will be used as detailed information. The created proposal information is stored in the storage circuit 1113.

The processing circuit 1111 performs the processing shown in FIGS. 3 to 5 for the patient stored in the medical information management server 12. The processing circuit 1111 may perform processing on all the patients stored in the medical information management server 12, or may perform processing on a predetermined patient among the patients stored in the medical information management server 12. You may.

The processing circuit 1111 proposes the created proposal information to the doctor as follows, for example. When examining a patient, the doctor accesses the processing server 111 via the terminal device 112. The doctor acquires a patient list in which the patient's name, patient ID, etc. are arranged from the processing server 111. From the patient list, the doctor specifies the patient to be examined next and inputs a request signal for information regarding the electronic medical record. Upon receiving the request signal, the processing circuit 1111 of the processing server 111 reads out information about the electronic medical record for the designated patient from the storage circuit 1113 or the medical information management server 12.

Upon receiving the request signal, the processing circuit 1111 executes the proposed function 1111d. When the proposal function 1111d is executed, the processing circuit 1111 determines whether or not the proposal information about the designated patient is stored in the storage circuit 1113. When the proposal information about the designated patient is stored in the storage circuit 1113, the processing circuit 1111 includes the proposal information in the information regarding the electronic medical record. The processing circuit 1111 transmits electronic medical record information including the proposal information to the terminal device 112.

When the terminal device 112 receives the electronic medical record information from the processing server 111, the terminal device 112 displays the patient information, the medical care information, and the information indicating the existence of the proposed information on the medical care platform screen. FIG. 6 is a schematic view showing a display example of the terminal device 112. According to FIG. 6, when the proposal information exists, the notification button F21 for notifying the existence of the proposal information blinks on the patient information display unit F2 on the medical care platform screen F1 of the electronic medical record system. This allows the doctor to recognize that new information is being proposed.

When the display of the proposal information is requested by, for example, pressing the notification button F21, the terminal device 112 displays the summary information included in the proposal information. In addition, the terminal device 112 displays summary information and also displays an icon for accepting whether or not to introduce the proposed drug to the patient. In addition, the terminal device 112 displays an icon for accepting a request for detailed information on the proposed drug.

FIG. 7 is a schematic diagram showing an example of summary information about the investigational drug displayed on the terminal device 112. According to FIG. 7, on the summary display screen F3, the name of the investigational drug, which is the summary information of the investigational drug: “AAAA drug”, the subject of the study: “○○ disease”, the phase of the clinical trial: “Phase 3 clinical trial in progress”, The bearer: "Corporate cost burden" and the name of the medical institution conducting the clinical trial: "○○ prefecture △△ hospital visit required" are displayed. Further, on the summary display screen F3, an icon F31 for displaying detailed information of the AAAA drug, an icon F32 pressed when introducing the AAAA drug to the patient, and an icon F33 pressed when the AAAA drug is not introduced to the patient. Is displayed.

When the display of the detailed information of the drug is requested by, for example, pressing the icon F31, the terminal device 112 displays the detailed information included in the proposal information. FIG. 8 is a schematic diagram showing an example of detailed information about the investigational drug displayed on the terminal device 112. According to FIG. 8, on the detailed display screen F4, the generic name, the mechanism of action, the results of the first and second phase trials, which are detailed information of the investigational drug, and the information on the side effects are displayed. The physician will refer to the summary and detailed information to determine whether to refer the proposed drug, eg, investigational drug: AAAA drug, to the patient.

When introducing the proposed drug to the patient, the doctor presses the icon F32 displayed on the summary display screen F3. When the icon F32 is pressed, the terminal device 112 transmits to the processing server 111 a notification signal notifying that the displayed drug, for example, the investigational drug: AAAA drug has been introduced to the patient.

When the processing circuit 1111 of the processing server 111 receives the notification signal from the terminal device 112, the processing circuit 1111 executes the referral information creation function 1111e. When the referral information creation function 1111e is executed, the processing circuit 1111 creates referral information indicating that the AAAA drug has been referred to the patient on the date when the patient was examined. The processing circuit 1111 transmits the created referral information to the medical information management server 12 and the investigational drug / unapproved drug information management server 20.

If the proposed drug is not referred to the patient, the doctor presses the icon F33 displayed on the summary display screen F3. When the icon F33 is pressed, the terminal device 112 displays an input form for inputting the reason why the drug was not introduced. The reason for not introducing the drug may be to select at least one from a plurality of predetermined reasons, or to input an arbitrary character. FIG. 9 is a schematic view showing an example of the form F5 for inputting the reason for non-introduction, which is displayed on the terminal device 112. In Fig. 9, the reasons for not introducing the investigational drug: AAAA drug are "patient cost burden is large", "cannot go to the clinical trial due to remote location", "cannot agree to participate in the clinical trial", and "treatment with prescription drug". It is possible to select from "I want". In FIG. 9, “Cannot go to clinical trial because of remote location” is selected. The examples of the reasons that can be selected are not limited to these.

When the reason for not referral of the drug is input, the terminal device 112 notifies the patient of the drug being displayed, for example, the investigational drug: AAAA drug, and the reason why the drug was not referred. The signal is transmitted to the processing server 111.

When the processing circuit 1111 of the processing server 111 receives the notification signal from the terminal device 112, the processing circuit 1111 executes the referral information creation function 1111e. When the referral information creation function 1111e is executed, the processing circuit 1111 creates referral information indicating that the AAAA drug was not referred to the patient for the reason notified on the date when the patient was examined. The processing circuit 1111 transmits the created referral information to the medical information management server 12. The medical information management server 12 stores referral information as referral history information.

The processing circuit 1111 deletes the information that can identify the patient from the created referral information and anonymizes it. The processing circuit 1111 transmits the anonymized referral information to the investigational drug / unapproved drug information management server 20. In the investigational drug / unapproved drug information management server 20, referral information is stored as referral history information.

The anonymized referral history information stored in the investigational drug / unapproved drug information management server 20 can be utilized, for example, in the development of a new drug in a pharmaceutical company. FIG. 10 is a diagram showing an example of utilization of referral history information. FIG. 10 schematically shows the positional relationship between the clinical trial facility, public transportation, and the place of residence of the patient. The figures for each area represent the number of patients who were not referred and the number of patients who were not referred due to the location of the clinical trial site. According to FIG. 10, it is possible to grasp the regional uneven distribution of drug clinical trial needs and use it for improving the clinical trial plan.

FIG. 11 is a diagram showing another example of utilization of referral history information. In FIG. 11, the correlation between the economic situation of the case that was not introduced due to economic circumstances and the cost burden scale of the unapproved drug / investigational drug is plotted in two dimensions. According to FIG. 11, it is possible to formulate an appropriate selling price plan for a drug.

As described above, in the present embodiment, the processing circuit 1111 of the processing server 111 stores the patient's personal information and patient medical information stored in the medical information management server 12 and the investigational drug / unapproved drug information management server 20. Select the patient-appropriate investigational drug and / or unapproved drug based on the memorized information on the investigational drug and the unapproved drug. The terminal device 112 connected to the processing circuit 1111 displays the selected investigational drug and / or the unapproved drug when the doctor examines the patient. As a result, the attending physician can automatically propose information on the investigational drug and the unapproved drug suitable for the patient simply by inputting the daily medical care into the processing server 111 of the electronic medical record system 11.

Therefore, according to the hospital information system according to the present embodiment, the doctor can provide the patient with new treatment information suitable for the patient at the time of medical treatment. In addition, patients will have the opportunity to receive the latest treatments as their doctor will provide them with the latest information about new drugs.

In addition, the processing circuit 1111 of the processing server 111 transmits information on the selected investigational drug and / or the unapproved drug to the terminal device 112 together with the data on the electronic medical record when the medical examination for the patient is started. Then, the terminal device 112 displays an electronic medical record for the patient, and also displays on the electronic medical record that the selected investigational drug and / or the unapproved drug exists. This enables the doctor to examine the patient while recognizing the existence of the selected investigational drug and / or the unapproved drug from the start of the examination.

In addition, the processing circuit 1111 of the processing server 111 determines whether or not the physical information of the patient satisfies the physical conditions for administering the extracted investigational drug and / or the unapproved drug. The processing circuit 1111 also determines whether the patient's social information satisfies the social conditions for continuing administration of the extracted investigational drug and / or the unapproved drug. This makes it possible to select investigational drugs and / or unapproved drugs that can be continuously administered to patients.

Further, the processing circuit 1111 of the processing server 111 transmits to the medical information management server 12 whether or not the selected investigational drug and / or the unapproved drug has actually been introduced. As a result, the medical information management server 12 can store information about the investigational drug introduced to the patient and / or the unapproved drug.

Further, the processing circuit 1111 of the processing server 111 refers to the medical information management server 12 to determine whether or not the selected investigational drug and / or the unapproved drug has a history of being unintroduced in the past. do. Then, the processing circuit 1111 excludes a drug having a history of being unintroduced to the same patient from being referred to this patient. As a result, the referral information becomes feedback for the next and subsequent referrals. That is, the more the electronic medical record system 11 is used, the more appropriate information can be obtained.

In addition, the processing circuit 1111 of the processing server 111 informs the medical information management server 12 whether or not the selected investigational drug and / or the unapproved drug has actually been introduced, and if not, the reason for non-introduction. I try to send it. As a result, the medical information management server 12 can analyze the reason why the investigational drug and / or the unapproved drug is not referred.

In addition, the processing circuit 1111 of the processing server 111 anonymizes the selected investigational drug and / or whether or not the unapproved drug was actually introduced, and if not, the reason for non-introduction. It is sent to the unapproved drug information management server 20. As a result, the investigational drug / unapproved drug information management server 20 can analyze the reason why the investigational drug and / or the unapproved drug is not referred. In other words, it is possible to contribute to the efficient formulation of clinical trial plans in pharmaceutical companies and the like.

Further, in the present embodiment, the medical information management server 12 periodically connects to the electronic medical information management system 11, the medical accounting system 13, the radiation department system 14, the clinical examination department system 15, the medical image management system 16, and the image examination device 17. Access and obtain personal information about the patient and patient medical information from the accessed system and device. Then, the medical information management server 12 associates the acquired information with each patient and stores it. As a result, various information about the patient is accumulated in the medical information management server 12.

Further, in the present embodiment, the investigational drug / unapproved drug information management server 20 accesses the domestic health institution 30, the pharmaceutical company 40, the overseas health institution 50, and the medical institution 60, and is accessed from the access destination institution and company. Obtain information on investigational and unapproved drugs. Then, the investigational drug / unapproved drug information management server 20 associates the acquired information with each drug and stores it. As a result, various information regarding the clinical trial and the unapproved drug will be accumulated in the investigational drug / unapproved drug information management server 20.

In the above embodiment, the case where the investigational drug / unapproved drug information management server 20 is provided outside the hospital information system 10 has been described as an example. However, it is not limited to this. The investigational drug / unapproved drug information management server 20 may be included in the hospital information system 10a as shown in FIG.

The word "processor" used in the description of the embodiment means, for example, a CPU (central processing unit), a GPU (Graphics Processing Unit), an integrated circuit for a specific application (Application Specific Integrated Circuit (ASIC)), or a programmable logic device. (For example, a circuit such as a simple programmable logic device (SPLD), a complex programmable logic device (CPLD), and a field programmable gate array (FPGA)) is meant. The processor realizes the function by reading and executing the drug proposal selection program stored in the storage circuit 1113. Instead of storing the drug proposal selection program in the storage circuit 1113, the drug proposal selection program may be directly incorporated in the circuit of the processor. In this case, the processor realizes the function by reading and executing the drug proposal selection program incorporated in the circuit. The processor described in the above embodiment is not limited to the case where it is configured as a single circuit, and a plurality of independent circuits may be combined to form one processor to realize its function.

Although embodiments of the present invention have been described, these embodiments are presented as examples and are not intended to limit the scope of the invention. This embodiment can be implemented in various other forms, and various omissions, replacements, and changes can be made without departing from the gist of the invention. These embodiments and modifications thereof are included in the scope and gist of the invention, as well as in the scope of the invention described in the claims and the equivalent scope thereof.

10,10a ... Hospital information system, 11 ... Electronic chart system, 111 ... Processing server, 1111 ... Processing circuit, 1111a ... Drug extraction function, 1111b ... Conformity judgment function, 1111c ... Proposal information creation function, 1111d ... Proposal function, 1111e ... Referral information creation function, 1112 ... communication interface, 1113 ... storage circuit, 112 ... terminal device, 12 ... medical information management server, 13 ... medical accounting system, 14 ... radiation department system, 15 ... clinical examination department system, 16 ... medical image Management system, 17 ... Imaging testing equipment, 20 ... Unapproved drug information management server, 30 ... Domestic health institution, 31 ... Clinical trial implementation plan, 32 ... New drug approval information, 40 ... Pharmaceutical company, 41 ... Clinical trial recruitment information, 42 ... Investigative drug information, 50 ... overseas health institutions, 51 ... new drug approval information, 60 ... medical institutions, 61 ... administration information, 70 ... overseas pharmaceutical companies, 71 ... drug information.

Claims (10)

Based on the personal information and patient medical information about the patient stored in the first database and the information about the investigational drug and the unapproved drug stored in the second database, the investigational drug and / or unapproved drug suitable for the patient. A processing device for selecting drugs and
It is connected to the processing device by an in-hospital network, and when a doctor examines a patient, the investigational drug and / or an unapproved drug selected by the processing device is displayed to the doctor for referral to the patient. ; and a terminal device,
The processing device is
An extraction unit that extracts the investigational drug and / or the unapproved drug corresponding to the patient's disease name or symptom name from the investigational drug and the unapproved drug stored in the second database.
By determining whether or not the patient meets the conditions for administering the extracted investigational drug and / or the unapproved drug, and whether or not the patient meets the conditions for continuing the administration. With a judgment unit that selects investigational drugs and / or unapproved drugs suitable for the patient
With
The condition for continuing the administration is that the distance between the patient's address and the clinical trial facility of the extracted investigational drug and / or the medical facility handling the extracted unapproved drug is within an allowable distance. In addition, the hospital information system is a condition that there is no record of unpaid medical expenses when the unapproved drug is extracted. The processing device receives a referral information creation unit that receives whether or not the selected investigational drug and / or the unapproved drug is actually referred to the patient and transmits the presence or absence of the referral as referral information to the first database. Further prepare
The determination unit refers to the first database and selects an investigational drug and / or an unapproved drug having no history of not being introduced as an investigational drug and / or an unapproved drug suitable for the patient. Item 1. The hospital information system according to item 1. If the selected investigational drug and / or unapproved drug is not referred to the patient, the referral information creation unit accepts the reason, and transmits the presence or absence of the referral and the reason to the first database. The hospital information system according to claim 2. Based on the personal information and patient medical information about the patient stored in the first database and the information about the investigational drug and the unapproved drug stored in the second database, the investigational drug and / or unapproved drug suitable for the patient. A processing device for selecting drugs and
It is connected to the processing device by an in-hospital network, and when a doctor examines a patient, the investigational drug and / or an unapproved drug selected by the processing device is displayed to the doctor for referral to the patient. With terminal equipment
Equipped with
The processing device is
An extraction unit that extracts the investigational drug and / or the unapproved drug corresponding to the patient's disease name or symptom name from the investigational drug and the unapproved drug stored in the second database.
By determining whether or not the patient meets the conditions for administering the extracted investigational drug and / or the unapproved drug, and whether or not the patient meets the conditions for continuing the administration. A judgment unit that selects an investigational drug and / or an unapproved drug suitable for the patient,
With the referral information creation department that accepts whether or not the selected investigational drug and / or unapproved drug has actually been referred to the patient and sends the presence or absence of the referral as referral information to the first database.
With
The determination unit refers to the first database and selects an investigational drug and / or an unapproved drug having no history of not being introduced as an investigational drug and / or an unapproved drug suitable for the patient.
If the selected investigational drug and / or unapproved drug is not referred to the patient, the referral information creation unit accepts the reason, and transmits the presence or absence of the referral and the reason to the first database. , Hospital information system. The hospital information system according to claim 3 or 4, wherein the referral information creation unit anonymizes the presence or absence of the referral and the reason for the referral and transmits it to the second database. When the examination is started, the terminal device displays that the selected investigational drug and / or the unapproved drug exists, and requests the display of the selected investigational drug and / or the unapproved drug. The hospital information system according to any one of claims 1 to 5, which displays the selected investigational drug and / or the unapproved drug according to the above. Further including the first database,
The hospital information system according to any one of claims 1 to 6, wherein the first database collects the personal information and the patient medical information from a plurality of systems in the hospital. Further equipped with the second database,
The hospital information system according to any one of claims 1 to 7, wherein the second database collects information on the investigational drug and the unapproved drug from a pharmaceutical company, a domestic health organization, and an overseas health organization. Based on the personal information and patient medical information about the patient stored in the first database and the information about the investigational drug and the unapproved drug stored in the second database, the investigational drug and / or unapproved drug suitable for the patient. The process of selecting drugs and
When a doctor examines a patient, the processor is made to perform a process of displaying the selected investigational drug and / or an unapproved drug to the doctor for referral to the patient .
The process of selecting is
Extraction processing for extracting the investigational drug and / or the unapproved drug corresponding to the disease name or symptom name of the patient from the investigational drug and the unapproved drug stored in the second database.
By determining whether or not the patient meets the conditions for administering the extracted investigational drug and / or the unapproved drug, and whether or not the patient meets the conditions for continuing the administration. Judgment processing to select an investigational drug and / or an unapproved drug suitable for the patient
With
The condition for continuing the administration is that the distance between the patient's address and the clinical trial facility of the extracted investigational drug and / or the medical facility handling the extracted unapproved drug is within an allowable distance. In addition, a drug proposal selection program is a condition that there is no record of unpaid medical expenses when the unapproved drug is extracted. Based on the personal information and patient medical information about the patient stored in the first database and the information about the investigational drug and the unapproved drug stored in the second database, the investigational drug and / or unapproved drug suitable for the patient. The process of selecting drugs and
When a doctor examines a patient, the processor is made to perform a process of displaying the selected investigational drug and / or an unapproved drug to the doctor for referral to the patient .
The process of selecting is
Extraction processing for extracting the investigational drug and / or the unapproved drug corresponding to the disease name or symptom name of the patient from the investigational drug and the unapproved drug stored in the second database.
By determining whether or not the patient meets the conditions for administering the extracted investigational drug and / or the unapproved drug, and whether or not the patient meets the conditions for continuing the administration. Judgment processing to select an investigational drug and / or an unapproved drug suitable for the patient,
With the referral information creation process, which accepts whether or not the selected investigational drug and / or unapproved drug has actually been referred to the patient, and sends the presence or absence of the referral as referral information to the first database.
With
The determination process refers to the first database and selects an investigational drug and / or an unapproved drug that has not been introduced and has no history as an investigational drug and / or an unapproved drug suitable for the patient. Including
The referral information creation process accepts the reason why the selected investigational drug and / or the unapproved drug is not referred to the patient, and transmits the presence or absence of the referral and the reason to the first database. Drug proposal selection program , including treatment.

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