JP7213501B2 - Genetic counseling support system - Google Patents

Description

The present invention relates to a system for supporting the work of genetic counselors.

Genetic factors and environmental factors are involved in the onset of cancer, and tumors caused by genetic factors are called hereditary tumors and are diagnosed by genetic testing. Genetic counseling, which selects eligible patients for this genetic test and assists in decision-making, is performed by professionally qualified and certified genetic counselors in collaboration with specialist physicians.

However, the number of certified genetic counselors is currently about 250, and due to their high level of expertise, it is practically difficult to dramatically increase the number of certified genetic counselors. In addition, certified genetic counselors are subdivided into each specialized genetic field within their qualifications, and the number of counselors specializing in hereditary tumors is less than half of the number of qualified persons (about 100). Therefore, the actual situation is that the number of patients with hereditary tumors who can receive the necessary genetic medical treatment is not increasing.

Japanese Unexamined Patent Application Publication No. 2015-201092

Due to these circumstances, the number of patients who can receive genetic counseling has been limited, and as a result, the number of patients who can receive genetic medical treatment has been limited. In addition, many hospitals do not have certified genetic counselors, which limits the number of patients who can receive genetic treatment.

SUMMARY OF THE INVENTION An object of the present invention is to provide a genetic counseling support system that performs, on behalf of a certified genetic counselor, work that is highly compatible with standardization among the services of a certified genetic counselor.

[1]
a patient information input reception unit for displaying a UI for prompting input of patient information including information on whether the patient is afflicted with cancer, on a medical institution terminal, which is a terminal installed in a medical institution and used by a patient;
a determination target patient information input reception unit for displaying a UI prompting input of information on a patient to be determined whether or not genetic counseling is necessary, on a terminal used by a medical professional including a certified genetic counselor;
Based on the input information of the patient to be determined whether or not the genetic counseling is necessary, the patient information related to the information is acquired from the storage unit, and the acquired patient information is used to determine whether or not the genetic counseling is necessary. a determination unit that determines whether the patient and the relatives thereof associated with the acquired patient information are subject to the genetic counseling by applying to the determination items related to the determination item information serving as determination criteria;
A determination result information creation unit that creates determination result information about the determined result and sends the determination result information to the medical staff terminal;
A genetic counseling support system comprising
The patient information includes:
First patient information including the patient's answers to interview items asking whether the patient himself/herself is afflicted with cancer;
patient second information including answers by the patient to question items asking whether the patient's relatives are affected by cancer;
A genetic counseling support system characterized by:

According to the present invention, it is possible to provide a genetic counseling support system that performs, on behalf of a certified genetic counselor, work that is highly compatible with standardization among the services of a certified genetic counselor.

It is a figure showing an example of the composition of the whole system including the genetic counseling support system of this embodiment. FIG. 4 is a flow chart showing an example of initial processing by the genetic counseling support system of this embodiment; FIG. 4 is a flow chart showing an example of processing for interviewing a patient's personal history by the genetic counseling support system of the present embodiment; FIG. 4 is a flow chart showing an example of a patient's family history inquiry process by the genetic counseling support system of the present embodiment. FIG. 2 is a flow chart showing an example of processing for determining necessity of genetic counseling by the genetic counseling support system of the present embodiment;

An example of an embodiment of the present invention will be described below with reference to the accompanying drawings.

The genetic counseling support system 1 of this embodiment is composed of one or more computers, and is used by medical institutions to determine the necessity of genetic counseling for individuals suspected of having hereditary tumors and their relatives. It is a thing.

As one embodiment, a medical institution interviews a person suspected of having breast cancer and their relatives, and based on the interview results, a certified genetic counselor who is an expert in genetic counseling provides information to a person suspected of having breast cancer and their relatives. It is a genetic counseling support system used when performing genetic counseling for patients. In the present specification, a person suspected of having a hereditary tumor and a person suspected of having breast cancer are sometimes referred to as a "patient".

Such a genetic counseling support system is a system constructed and managed by a system provider who provides genetic counseling support services to medical institutions using one or more computers.

As one embodiment, it is communicably connected to the terminal used by the above-described medical institution via a communication network, and is communicatively connected to the terminal used by medical professionals including the above-described certified genetic counselor via a communication network. , the genetic counseling support system 1 in a form in which the results of interviews with persons suspected of having breast cancer and their relatives sent from the terminal used by the medical institution are displayed on the terminal used by the medical staff including the certified genetic counselor. can be built.

In the form shown in FIG. 1, a genetic counseling support system 1 is communicably connected to a medical institution terminal 2 and a medical staff terminal 3 via a dedicated communication network.

This embodiment includes a computer program for causing a computer to function as the genetic counseling support system 1 described in this embodiment.

The medical institution terminal 2 is a terminal deployed in a medical institution, and is a terminal such as a personal computer, a smart phone, or a tablet. The medical institution terminal 2 of the present embodiment cooperates with the genetic counseling support system 1 and is equipped with a web browser that displays interview information for interviewing persons suspected of having hereditary tumors and their relatives. Alternatively, the medical institution terminal 2 has an application program downloaded and installed for performing such an inquiry.

Although not shown, the medical institution terminal 2 includes an arithmetic processing unit configured by a CPU or the like to process and calculate various data, a main memory such as a main memory for storing various data, and an auxiliary memory such as a built-in storage. It includes a device, an information display unit such as a liquid crystal display, an information input unit such as a keyboard, mouse, touch panel, etc., and a communication unit for transmitting and receiving various types of information.

The medical staff terminal 3 is a terminal used by medical staff such as doctors, nurses, certified genetic counselors, and medical clerks under the direction and supervision of these persons in medical institutions, and is a personal computer. , smartphones, tablets, etc. The medical staff terminal 3 of the present embodiment cooperates with the genetic counseling support system 1 to analyze the results of interviews with suspected hereditary tumors and their relatives transmitted from the medical institution terminal 2, and analyze the analysis results. It is equipped with a web browser that displays the judgment result of the necessity of genetic counseling adaptation based on the results. Alternatively, an application program is downloaded and installed in the medical staff terminal 3 to obtain such determination results as to whether or not genetic counseling is necessary.

Although not shown, the medical staff terminal 3 includes a CPU or the like and includes an arithmetic processing unit that processes and calculates various data, a main storage unit that stores various data such as a main memory, and an auxiliary storage such as a built-in storage. It includes a storage device, an information display unit such as a liquid crystal display, an information input unit such as a keyboard, mouse, touch panel, etc., and a communication unit for transmitting and receiving various types of information.

The genetic counseling support system 1 is composed of one or more servers. In this embodiment, the system is constructed and managed by the system provider who provides the genetic counseling support service described above. As shown in FIG. 6. A first patient information input reception unit 10, a second patient information input reception unit 11, a determination target patient information input reception unit 12, a determination unit 13, and a determination result information creation unit 14 are provided.

Although not shown, the server that constitutes the genetic counseling support system 1 includes an arithmetic processing unit configured by a CPU or the like for processing various data and performing calculations, a main storage unit for storing various data such as a main memory, and a liquid crystal display. An information display unit such as a display and an information input unit such as a keyboard, mouse, and touch panel are provided.

Since the genetic counseling support system 1 is composed of one or a plurality of computers as described above, it can be composed of servers, devices, and apparatuses corresponding to the respective processing units. Also, the server may be composed of a plurality of devices, or may be a server realized on the cloud.

The information transmitting/receiving unit 4 transmits/receives information to/from the medical institution terminal 2 and the medical staff terminal 3, respectively.

The control unit 5 controls information processing by each processing unit included in the genetic counseling support system 1 .

The storage unit 6 is an auxiliary storage device such as a built-in storage. As shown in FIG. 1, the storage unit 6 stores inquiry information 7, patient information 8, and judgment item information 9. FIG.

The inquiry information 7 is information asking about the presence or absence of a medical history of a person suspected of having a hereditary tumor and his/her relatives. The inquiry information 7 includes inquiry items such as "age", "gender", "presence or absence of cancer", "type of cancer", and "age at cancer" of the patient and his relatives as shown in Table 1. is

The patient information 8 is information input by the patient by operating the medical institution terminal 2 in response to the medical inquiry related to the medical inquiry information 7 . In this embodiment, the patient information 8 consists of first patient information 8a and second patient information 8b, as shown in FIG.

The first patient information 8a is information including information on whether or not the patient has cancer, which is linked to the patient ID. This is the answer information entered by operation.

The second patient information 8b is information including information on whether or not the patient's relatives who are associated with the patient ID are affected with cancer. This is the answer information input by operating 2.

The judgment item information 9 is information used when the later-described judging unit 13 performs processing (criteria judging processing) for judging whether or not the patient or his relatives are targets of genetic counseling. In this embodiment, when the cancer is breast cancer, the storage unit 6 stores determination item information 9 as shown in Table 2 as an example.

The patient first information input receiving unit 10 performs processing for displaying a UI prompting the patient to input the first patient information 8a on the medical institution terminal 2 used by the patient.

The patient second information input receiving unit 11 performs processing for displaying a UI prompting the patient to input the second patient information 8b on the medical institution terminal 2 used by the patient.

The determination target patient information input reception unit 12 displays a UI prompting input of information on a patient to be determined whether or not genetic counseling is necessary, on the medical staff terminal 3 used by medical staff including certified genetic counselors. process to cause

The determination unit 13 acquires the patient information 8 related to the input information of the patient to be determined whether or not genetic counseling is necessary from the storage unit 6, and stores the acquired patient information 8. The patient or his/her relatives associated with the acquired patient information 8 are subjected to the genetic counseling by applying to the determination items related to the determination item information 9 that serves as the determination criteria for the necessity of genetic counseling stored in the unit 6. Perform processing to determine whether or not

The determination result information creation unit 14 creates determination result information about the result determined by the determination unit 13 and performs processing for sending the determination result information to the medical staff terminal 3 .

The determination result information is information about the result of determining whether or not the patient or his/her relative is a target of genetic counseling. Although not shown, the created judgment result information may be processed so as to be stored in the storage unit 6 .

As an example, the information processing regarding the necessity of adaptation of genetic counseling for breast cancer by the genetic counseling support system 1 will be described below with reference to FIGS. 2 to 5. FIG.

[Initial processing]
(S101) The first patient information input receiving unit 10 displays a chatbot window on the UI of the medical institution terminal 2. FIG.

(S102) The first patient information input reception unit 10 prompts the person suspected of having breast cancer or the breast cancer patient to input an anonymous code or patient ID in the chatbot window.

(S103) A person suspected of having breast cancer or a breast cancer patient operates the medical institution terminal 2 to enter an anonymous code or patient ID issued by the medical institution.

[Interviewing process of the personal history of the patient]
(S201 to S206) The first patient information input reception unit 10 asks a person suspected of having breast cancer or a patient with breast cancer in the chatbot window an interview item "Age ”, “sex”, and “presence or absence of cancer”.
A person suspected of having breast cancer or a breast cancer patient operates the medical institution terminal 2 to input answers to the inquiry items "age", "sex", and "presence or absence of cancer".
When the answer "no cancer affliction" is input to the inquiry item "cancer affliction", the process proceeds to the process of interviewing the patient's family history, which will be described later.

(S207-S210) When the answer "having cancer" is input to the inquiry item "presence or absence of cancer", the first patient information input reception unit 10 asks the person suspected of having breast cancer or the breast cancer patient in the chatbot window. On the other hand, it prompts the patient to input answers to the inquiry items "type of cancer suffered" and "age of cancer at diagnosis" related to inquiry information 7 shown in Table 1. FIG.
A person suspected of having breast cancer or a breast cancer patient operates the medical institution terminal 2 to input answers to the inquiry items "Type of cancer suffered" and "Age of cancer."

(S211-S212) The first patient information input receiving unit 10 prompts the person suspected of having breast cancer or the patient with breast cancer to input an answer as to whether or not they are suffering from other cancers in the chatbot window.
If an answer is input that there is no other cancer, the process proceeds to the process of interviewing the patient's family history, which will be described later.
If a reply that the patient has other cancers is input, the first patient information input reception unit 10 repeats the processes of S207 to S212.
The input answer to the interview with the person suspected of having breast cancer or the patient with breast cancer is stored in the storage unit 6 as first patient information 8a.

[Interviewing process of patient's family history]
(S301-S302) The patient second information input receiving unit 11 prompts the person suspected of having breast cancer or the breast cancer patient to input an answer about whether or not they have relatives in the chatbot window. In the present embodiment, as an example, a reply about the presence or absence of blood relatives up to the fourth degree who are related to the patient is entered.
A person suspected of having breast cancer or a patient with breast cancer operates the medical institution terminal 2 to input the presence or absence of relatives.
If the answer "no relatives" is entered, the interview ends.

(S303 to S308) When a response that there are relatives is input, the patient second information input reception unit 11 asks the person suspected of having breast cancer or the breast cancer patient in the chatbot window the interview information shown in Table 1. 7. Prompts the patient to enter answers to the question items "age", "sex", and "presence or absence of cancer" for the patient's relatives.
A person suspected of having breast cancer or a patient with breast cancer operates the medical institution terminal 2 to input answers to questions about "age", "sex", and "presence or absence of cancer" for relatives.
When the patient's second information input reception unit 11 repeats the processes of S301 to S308 when the answer "No cancer" is input to the inquiry item "cancer cancer" for relatives.

(S309-S312) When a response of having cancer is input to the inquiry item "presence or absence of cancer" for relatives, the patient second information input reception unit 11 displays a person suspected of having breast cancer in the chatbot window. The breast cancer patient is prompted to enter responses to the inquiry items "kind of cancer suffered" and "age of cancer affliction" for the patient's relatives related to inquiry information 7 shown in Table 1.
A person suspected of having breast cancer or a breast cancer patient operates the medical institution terminal 2 to input answers to the question items "type of cancer suffered" and "age of cancer at diagnosis" for relatives.

(S313-S314) The second patient information input receiving unit 11 prompts the person suspected of having breast cancer or the patient with breast cancer to input whether or not any of their relatives have other cancers in the chatbot window.
When a response is input that the relative does not have other cancers, the patient second information input reception unit 11 repeats the processing of S301 to S314.
When the response that the relative has other cancers is input, the patient second information input reception unit 11 repeats the processing of S309 to S314.
The input answer to the interview with the person suspected of having breast cancer or the relatives of the patient with breast cancer is stored in the storage unit 6 as second patient information 8b.

[Determining whether or not genetic counseling is necessary]
(S401) Medical staff including certified genetic counselors access the genetic counseling support system 1 using the medical staff terminal 3 in order to grasp the necessity of genetic counseling for any given patient.
The determination target patient information input reception unit 12 causes the medical staff terminal 3 to display a criteria determination operation screen configured with a predetermined input form.

(S402) The determination target patient information input reception unit 12 prompts the medical staff including the certified genetic counselor to input the patient ID of the patient for whom genetic counseling is necessary or not on the criteria determination operation screen.

(S403) The medical staff including the certified genetic counselor inputs the patient ID described in the electronic medical record or the like for the patient for whom genetic counseling is required or not.

(S404) Based on the input patient ID, the determination unit 13 acquires the patient first information 8a and the patient second information 8b related to the patient ID from the storage unit 6.

(S405) The determination unit 13 stores the answer information to the inquiry items related to the acquired first patient information 8a and second patient information 8b to the determination item information 9 as shown in Table 2 stored in the storage unit 6. Applying to the determination items, processing is performed to determine whether a person suspected of having breast cancer or relatives of a breast cancer patient according to the acquired first patient information 8a and second patient information 8b is subject to genetic counseling.

( S<b>406 ) The determination result information creation unit 14 creates determination result information about the result determined by the determination unit 13 in a predetermined form, and performs processing for sending the determination result information to the medical staff terminal 3 .
Medical professionals, including certified genetic counselors, can grasp the necessity of genetic counseling for target patients from the judgment result information.

In this way, the genetic counseling support system 1 of the present embodiment carries out the work of a certified genetic counselor, from interviews to support in determining whether or not genetic counseling is necessary. of information can be collected.

In addition, the genetic counseling support system 1 of the present embodiment carries out the work of the certified genetic counselor, from interviews to determination of the necessity of genetic counseling, so that the certified genetic counselor can carry out the work after the determination of the necessity of genetic counseling. As a result, the burden of work will be reduced, and more patients and their relatives will be able to receive genetic counseling, which will lead to more testing and treatment of hereditary tumors. can be provided to the patient.

1 genetic counseling support system 2 medical institution terminal 3 medical staff terminal 4 information transmission/reception unit 5 control unit 6 storage unit 7 interview information 8 patient information 8a patient first information 8b patient second information 9 judgment item information 10 patient first information input Reception unit 11 Patient second information input reception unit 12 Determination target patient information input reception unit 13 Determination unit 14 Determination result information creation unit

Claims (3)

a patient information input reception unit for displaying a UI for prompting input of patient information including information on whether the patient is afflicted with cancer, on a medical institution terminal, which is a terminal installed in a medical institution and used by a patient;
a determination target patient information input reception unit for displaying a UI prompting input of information on a patient to be determined whether or not genetic counseling is necessary, on a terminal used by a medical professional including a certified genetic counselor;
Based on the input information of the patient to be determined whether or not the genetic counseling is necessary, the patient information related to the information is acquired from the storage unit, and the acquired patient information is used to determine whether or not the genetic counseling is necessary. a determination unit that determines whether the patient and the relatives thereof associated with the acquired patient information are subject to the genetic counseling by applying to the determination items related to the determination item information serving as determination criteria;
A determination result information creation unit that creates determination result information about the determined result and sends the determination result information to the medical staff terminal;
A genetic counseling support system comprising
The patient information includes:
First patient information including the patient's answers to interview items asking whether the patient himself/herself is afflicted with cancer;
patient second information including answers by the patient to question items asking whether the patient's relatives are affected by cancer;
A genetic counseling support system characterized by: The patient information input reception unit displays a chatbot window on the UI and prompts the medical institution terminal to input the patient information in the chatbot window.
The genetic counseling support system according to claim 1. A computer program for causing a computer to function as the genetic counseling support system according to claim 1 or 2.

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