JP7430912B2 - Rehabilitation support system, rehabilitation support server, method of controlling a medical terminal device, and method of controlling a patient terminal device - Google Patents

Description

The present invention relates to a rehabilitation support system and the like that support rehabilitation.

Suppressing the readmission rate of discharged patients by implementing appropriate rehabilitation may be one measure for reducing medical costs. Continuous rehabilitation is effective in reducing this readmission rate. However, outpatient rehabilitation places a heavy burden on patients and has a low continuation rate.

Therefore, telerehabilitation has been proposed that allows a person to undergo rehabilitation while staying at home (Patent Document 1).

Japanese Patent Application Publication No. 2002-191718

Exercise therapy through cardiac rehabilitation is carried out under the guidance of medical personnel such as doctors, and medical personnel are required to monitor the patient's condition. If a situation that satisfies the discontinuation criteria occurs on the patient's side (for example, sudden symptoms such as arrhythmia), emergency measures such as immediately discontinuing cardiac rehabilitation are required.

This also applies when remote cardiac rehabilitation is performed. Therefore, in a network system that realizes remote cardiac rehabilitation, stable real-time communication is required in both communication networks for medical personnel and patients. This is because if the communication condition deteriorates in any of these communication networks, there is a high possibility that medical personnel will be unable to monitor patients. Therefore, during remote cardiac rehabilitation, constant monitoring of the communication status in both communication networks becomes a problem, but Patent Document 1 does not disclose this problem or means for solving the problem.

The present invention has been made in view of the above-mentioned problems, and an object of the present invention is to monitor the communication state in a network system that implements rehabilitation.

In order to solve the above problems, a rehabilitation support system according to one aspect of the present invention is a rehabilitation support system that supports rehabilitation, and includes a server device for performing the rehabilitation support work, and a server device used by medical personnel. a medical terminal device that communicates with the server device via a first communication network; and a second communication device that is different from the first communication network and that is used by a patient undergoing the rehabilitation and who is a person to be monitored by the medical personnel. A patient terminal device that communicates with the server device via a network and is connected to a device that provides load to the patient, and the server device communicates with the medical terminal device and the patient terminal device during the rehabilitation. The apparatus includes a keep-alive signal transmitting/receiving section that receives each of the keep-alive signals from the transmission source and transmits a response signal in response to the reception to all of the transmission sources.

In order to solve the above-mentioned problems, a rehabilitation support server according to one aspect of the present invention is a rehabilitation support server for performing rehabilitation support work, and includes a medical terminal device used by medical personnel and a first communication network. a first communication control unit that communicates via a first communication control unit, a patient terminal device that is used by a patient undergoing rehabilitation who is a subject of monitoring by the medical personnel, and is connected to a device that provides load to the patient; a second communication control unit that communicates via a second communication network different from the first communication network, and receives each of the keep-alive signals from the medical terminal device and the patient terminal device during the rehabilitation; The device includes a keep-alive signal transmitting/receiving unit that transmits a response signal in response to the reception to all of the transmission sources.

In order to solve the above problems, a method for controlling a medical terminal device according to one aspect of the present invention is a method for controlling a medical terminal device used by medical personnel, wherein the medical terminal device is connected to a first communication network. The server device communicates with a server device for performing rehabilitation support work via the server device, and the server device is used by a patient receiving the rehabilitation who is a person to be monitored by the medical personnel during the implementation of the rehabilitation. and a keep-alive signal transmitting/receiving unit that receives each of the keep-alive signals from the medical terminal device as a transmission source and transmits a response signal in response to the reception to all of the transmission sources. The patient terminal device communicates with the server device via a second communication network different from the first communication network and is connected to a device that provides a load to the patient, and the medical terminal device , receiving the response signal from the keep-alive signal transmitting/receiving unit, and outputting a first predetermined message when the response signal is not received for a first predetermined period.

In order to solve the above-mentioned problems, a method for controlling a patient terminal device according to one aspect of the present invention is a method for controlling a patient terminal device used by a patient undergoing rehabilitation who is a subject to be monitored by a medical professional. , the patient terminal device communicates with the server device via a second communication network different from a first communication network through which the server device for performing rehabilitation support work and the medical terminal device used by medical personnel communicate. The server device is connected to a device that communicates and provides a load to the patient, and the server device transmits each of keep-alive signals transmitted from the medical terminal device and the patient terminal device during the rehabilitation. and a keep-alive signal transmitting/receiving unit that transmits a response signal in response to the reception to all of the transmission sources, and the patient terminal device receives the response signal from the keep-alive signal transmitting/receiving unit. , and instructing the device to stop providing load when the response signal is not received for a predetermined upper limit period.

Each of the server device, medical terminal device, patient terminal device, and rehabilitation support server according to each aspect of the present invention may be realized by a computer, and in this case, the computer may be replaced with each unit ( Each control program that realizes each device on a computer by operating as a software element) and a computer-readable recording medium on which the program is recorded also fall within the scope of the present invention.

According to one aspect of the present invention, it is possible to monitor the communication state in a network system that implements rehabilitation.

FIG. 2 is a block diagram showing the configuration of main parts of a support server. FIG. 1 is a diagram showing a schematic configuration of a rehabilitation support system. FIG. 2 is a block diagram showing the configuration of main parts of a PC used by medical personnel. FIG. 2 is a block diagram showing the main configuration of a tablet used by a patient. FIG. 3 is a diagram showing an example of a data structure of a user management table. It is a figure showing an example of the data structure of a rehabilitation management database. FIG. 2 is a sequence diagram showing the flow of processing executed in the support system. FIG. 2 is a sequence diagram showing the flow of processing executed in the support system. It is a figure which shows an example of a patient viewing screen displayed on the display part of a tablet. It is a figure which shows an example of the viewing screen of a medical person displayed on the display part of PC. FIG. 7 is a diagram illustrating an example of a communication interruption notification displayed on a patient viewing screen. It is a figure which shows an example of the communication interruption warning displayed on a doctor viewing screen. It is a figure which shows an example of the communication interruption notification displayed on a doctor viewing screen. It is a figure which shows an example of the interruption resolution notification displayed on a patient viewing screen. It is a figure which shows an example of the interruption resolution notification displayed on a doctor viewing screen.

<Overview of rehabilitation support system>
Hereinafter, one embodiment of the present invention will be described in detail. FIG. 2 is a diagram showing a schematic configuration of the rehabilitation support system. Rehabilitation support system 100 (hereinafter simply referred to as support system 100) includes a support server 1, a personal computer (PC) 2, and a tablet 3.

The support server 1 is a server device used by an operating company that operates the support system 100, and performs rehabilitation support work (hereinafter referred to as rehabilitation). Specifically, the support work is to relay communication between the PC (Personal Computer) 2 and the tablet 3, and to constantly monitor the communication status of both. The support server 1 may be a cloud server, for example. As another example, the support server 1 may be a server device installed by an operating company and belonging to the operating company.

PC2 is a medical terminal device used by medical personnel. The PC 2 is used by medical personnel to monitor the condition of a patient undergoing rehabilitation, provide dialogic guidance to the patient, and instruct the load of equipment that provides load to the patient. Furthermore, in this embodiment, the PC 2 has a function (keep-alive function) of establishing a keep-alive session with the support server 1 in order to enable the support server 1 to constantly monitor the communication state. The keep-alive function will be explained in detail later.

Note that the medical personnel are assumed to be, for example, a doctor, a physical therapist, or an occupational therapist. The medical terminal device may be any device as long as it has a function of communicating with the tablet 3 via the support server 1 and is configured so that medical personnel can smoothly communicate with patients. For example, the medical terminal device may be an information processing device equipped with any OS (Operating System), such as a notebook computer, a tablet, a smartphone, or a television.

The tablet 3 is a patient terminal device used by the patient. In addition to the keep-alive function, the tablet 3 has the following rehabilitation support function to enable patients to undergo rehabilitation at home. Specifically, the tablet 3 performs short-range communication with peripheral devices such as a device that provides a load to a patient and a device that senses the patient's condition. The tablet 3 has, for example, a camera, a microphone, a speaker, etc., through which the patient can interact with medical personnel. The tablet 3 provides a user interface (hereinafter referred to as UI) necessary for the patient to use the support system 100. For example, the tablet 3 is an input support component for displaying various information to be provided to the patient during rehabilitation on a display unit, and for facilitating the patient's work of inputting various information into the support system 100. displayed on the display. The tablet 3 communicates with the PC 2 via the support server 1. For example, the tablet 3 transmits patient-related information acquired from a peripheral device to the support server 1, or receives from the support server 1 a control command indicating control details for the peripheral device. The patient terminal device is not limited to a tablet, but may be an information processing device equipped with any OS, such as a PC, a notebook computer, a smartphone, or a television.

In this embodiment, communication between the support server 1 and the PC 2 is performed via the first communication network 7. The first communication network 7 is any communication network that communicably connects the support server 1 and the PC 2, but it is assumed that the first communication network 7 is constructed by wire. The first communication network 7 may include one or more of the Internet and a closed network. When the first communication network 7 includes any of the above-mentioned public line communication networks, it is preferable to provide a VPN (Virtual Private Network) between the support server 1 and the PC 2. Alternatively, the first communication network 7 may be configured with a dedicated line that directly connects the support server 1 and the PC 2. The first communication network 7 may include a communication network such as WiFi (registered trademark) or a mobile phone line network such as LTE (Long Term Evolution).

In this embodiment, communication between the support server 1 and the tablet 3 is performed via the second communication network 8. The second communication network 8 may be composed of one or more arbitrary communication networks described above, but is composed of a different communication network from the first communication network 7. The second communication network 8 may be, for example, a communication network using an optical line provided by a communication carrier.

In this embodiment, the tablet 3 is further connected to the support server 1 via a third communication network 9. The third communication network 9 may be composed of one or more arbitrary communication networks mentioned above, but it is composed of a communication network that is different from both the first communication network 7 and the second communication network 8. As the third communication network 9, for example, a mobile phone network such as LTE can be assumed. In this embodiment, the third communication network 9 is used as an alternative line for maintaining a communicable state between the tablet 3 and the support server 1 in case a failure occurs in the second communication network 8.

(Support server 1)
The support server 1 includes a control section 10, a communication section 11, and a storage section 12. The control unit 10 centrally controls each block in the support server 1 based on programs and data stored in the storage unit 12, programs and data received from external devices, and the like.

The control unit 10 may be configured by, for example, a control device such as a CPU (central processing unit) or a dedicated processor. Each part of the control unit 10, which will be described later with reference to FIG. This can be achieved by reading the data into a memory (such as access memory) and executing it.

The communication unit 11 transmits and receives signals and data to and from external devices via the network. Specifically, the communication unit 11 transmits and receives signals and data to and from the PC 2 via the first communication network 7 . The communication unit 11 transmits and receives signals and data to and from the tablet 3 via the second communication network 8 or the third communication network 9.

The storage unit 12 stores various data used by the control unit 10, and includes a ROM, a RAM, and the like. In the present embodiment, as an example, as shown in FIG. DB122) is stored in a non-volatile manner. The user table 121 is a table for managing information related to users, and the rehabilitation DB 122 is a database for managing information related to rehabilitation. The storage unit 12 may be provided as an external storage device that the support server 1 can access.

The support server 1 may include a display section (not shown). For example, the display section displays the state of communication between the PC 2 and the tablet 3 that are monitored by the support server 1. When a communication failure occurs, a notification to that effect may be displayed on the display unit. Thereby, the operator of the support server 1 can detect the occurrence of a communication failure without delay and can immediately respond to emergency measures such as answering telephone calls from patients or medical personnel.

(PC2)
The PC 2 includes a control section 20, a communication section 21, a display section 22, an operation section 23, and an imaging section 24. The PC 2 may include a microphone and a speaker (not shown). The control unit 20 centrally controls each block in the PC 2 based on programs and data stored in a storage device (not shown) included in the PC 2, programs and data received from an external device, and the like.

The control unit 20 may be configured by, for example, a control device such as a CPU or a dedicated processor. Each part of the control unit 20, which will be described later with reference to FIG. 3, can be realized by a control device such as a CPU reading a program stored in a storage device such as a ROM into a RAM or the like and executing the program.

The communication unit 21 transmits and receives signals and data to and from external devices via a network. Specifically, the communication unit 21 transmits and receives signals and data to and from the support server 1 via the first communication network 7 .

The display unit 22 is an output device that visually presents information processed by the control unit 20 to medical personnel. For example, the display unit 22 is configured with a liquid crystal display (LCD), an organic EL (Electro-Luminescence) display, or the like.

The operation unit 23 is an input device for receiving operations from medical personnel. The operation unit 23 inputs an instruction signal corresponding to the received operation to the control unit 20. For example, the operation unit 23 includes a keyboard, a mouse, and the like.

The imaging unit 24 is a camera that photographs a medical person as a subject and generates a moving image. Specifically, the imaging unit 24 uses an imaging device such as a CCD (Charge Coupled Device) or a CMOS (Complementary Metal-oxide Semiconductor) that converts light from a subject into an electrical signal, and converts the electrical signal from the imaging device into each color. and a video processing circuit that converts it into digital data. The moving image captured by the imaging unit 24 is stored in a storage device (not shown) via the control unit 20. Hereinafter, the video generated by the imaging unit 24 and depicting medical personnel will be referred to as a medical video. The medical video is transmitted to the support server 1 via the communication unit 21.

(Home system configuration)
At the patient's home, a home system is constructed to directly support the patient during rehabilitation. The home system includes a central control device that controls the entire home system and enables remote communication between the patient and medical personnel, a load providing device that provides load to the patient, and a condition detector that detects the patient's condition. including equipment. As an example, the central control device is the tablet 3, the load providing device is the ergometer 5, and the state detection device is the electrocardiograph 4. The central control device and other peripheral devices included in the home system are communicably connected to each other via short-range communication technology. For example, as a short-range communication technology for connecting the tablet 3 and each peripheral device, a short-range wireless communication technology such as Bluetooth (registered trademark) can be cited. In another example, the tablet 3 and each peripheral device may be connected by wire via a connection terminal such as a USB (Universal Serial Bus).

The tablet 3 is a central control device, and controls the home system in an integrated manner while communicating with the support server 1. The tablet 3 includes a control section 30, a short range communication section 31, a wide area communication section 32, an imaging section 33, a display section 34, and an operation section 35. The tablet 3 may include a microphone and a speaker (not shown). The control unit 30 centrally controls each block in the tablet 3 based on programs and data stored in a storage device (not shown) included in the tablet 3, programs and data received from an external device, and the like.

The short-range communication unit 31 transmits and receives signals and data to and from each peripheral device using the above-described wired or wireless short-range communication technology.

The wide area communication unit 32 transmits and receives signals and data to and from external devices via a network. Specifically, the wide area communication unit 32 transmits and receives signals and data to and from the support server 1 via the second communication network 8 . Alternatively, the wide area communication unit 32 transmits and receives signals and data to and from the support server 1 via the third communication network 9. The wide area communication unit 32 selects either the second communication network 8 or the third communication network 9 according to instructions from the control unit 30 and communicates with the support server 1 .

The imaging unit 33 is a camera that photographs a patient as a subject and generates a moving image. Specifically, the imaging unit 33 includes an imaging device such as a CCD or CMOS that converts light from a subject into an electrical signal, and a video processing circuit that converts the electrical signal from the imaging device into digital data of each color. The moving image captured by the imaging unit 33 is stored in a storage device (not shown) via the control unit 30. Hereinafter, the video that depicts the patient generated by the imaging unit 33 will be referred to as a patient-side video. The patient-side video is transmitted to the support server 1 via the wide area communication unit 32.

The display unit 34 is an output device that visually presents information processed by the control unit 30 to the patient. For example, the display section 34 is configured with a liquid crystal display device, an organic EL display, or the like.

The operation unit 35 is an input device for receiving operations from a patient. The operation unit 35 inputs an instruction signal corresponding to the received operation to the control unit 30. As an example, the operation section 35 may constitute a touch panel together with the display section 34. The operating unit 35 includes a device capable of detecting contact (including approach) of a patient's finger or an indicator such as a touch pen on the input surface of the operating unit 35, which is also the display surface of the display unit 34. Ru. In other examples, the operation unit 35 may be configured with a keyboard, a mouse, and the like.

The wearable electrocardiograph 4 (hereinafter referred to as the electrocardiograph 4) is a state detection device among peripheral devices that detects the state of a patient. The electrocardiograph 4 includes, as an example, a waveform transmitter 40 and a waveform detector 41. The waveform transmitter 40 generates an electrocardiographic waveform based on the electrical signal detected by the waveform detector 41 and transmits it to the tablet 3. The waveform transmitter 40 is composed of, for example, a telemetry type electrocardiogram transmitter.

The waveform detection unit 41 is brought into close contact with the patient's body and detects an electrical signal based on electricity flowing through the patient's body. The waveform detection section 41 feeds back the detected electrical signal to the waveform transmission section 40. The waveform detection unit 41 is composed of, for example, a single-use electrocardiogram electrode.

In addition to the electrocardiograph 4, the home system includes other condition detection devices for detecting vital data other than electrocardiogram waveforms, such as respiratory rate, arterial oxygen saturation, blood pressure, heart rate, and pulse. Good too. Alternatively, the electrocardiograph 4 may have a function of acquiring the other vital data described above. In this case, the electrocardiograph 4 includes, in addition to the waveform detection section 41, a detection section for detecting other vital data. Vital data such as electrocardiographic waveforms transmitted from the condition detection device in this manner are transmitted to the tablet 3 via short-range communication technology.

Examples of state detection devices other than the electrocardiograph 4 include the following. Specifically, the products include a blood pressure monitor that can communicate via Bluetooth (registered trademark), a real-time blood pressure monitor that can be worn on the ear and uses photoplethysmography (PPG) as an independent method for estimating blood pressure, and a leg A near-infrared spectroscopy (NIRS) device for measuring blood flow in the body or the like may be employed as the condition detection device.

The ergometer 5 is a load providing device among peripheral devices that provides a load to the patient. The ergometer 5 is, for example, a bicycle ergometer, and includes an activity amount transmitter 50 and a load adjuster 51.

The activity amount transmitting unit 50 transmits information regarding the patient's activities using the ergometer 5 to the tablet 3. The activity amount transmitting unit 50 transmits, for example, the cumulative number of pedal rotations, rotation speed, load, exercise intensity (METs) from the start of rehabilitation, the cumulative exercise time from the start of rehabilitation, and the patient's own perceived exercise intensity. Examples include indexes. In this embodiment, the load means the weight of the pedal, and is expressed, for example, in Watts. Note that the Borg index may be directly input into the tablet 3 by the patient.

The load adjustment section 51 adjusts the weight of the pedal so that a load corresponding to the wattage specified by the tablet 3 is applied.

As described above, the home system generates various information related to patients undergoing rehabilitation. Hereinafter, various information related to patients will be collectively referred to as patient information.

The patient information includes, for example, information about the patient himself that is input directly by the patient into a central control device such as the tablet 3. More specifically, the patient information inputted into the tablet 3 is assumed to include response information to an interview, Borg index, and the like. Further, the patient information includes the above-mentioned various vital data acquired from a condition detection device such as the electrocardiograph 4. Further, the patient information includes the above-mentioned various types of information regarding the patient's activities, which is obtained from load providing equipment such as the ergometer 5.

In the support system 100, the transmission of information from the patient side to the medical personnel side is referred to as up-transfer, and the transmission of information from the medical personnel side to the patient side is referred to as down-transfer. During uplink transfer, patient information and patient-side video are transmitted from the tablet 3 to the PC 2 via the support server 1 . This transmission is continuously executed in real time while the communication between the tablet 3 and the support server 1 and the communication between the support server 1 and the PC 2 are established. This allows medical personnel to grasp the health status of patients undergoing rehabilitation in real time.

The patient-side video may be sent to the medical personnel's PC 2 at all times, other than during the video call between the patient and the medical personnel. In addition to the patient-side video, patient information may also be sent to the PC 2 at all times. The patient information that is constantly transmitted is, for example, vital data such as an electrocardiogram waveform, information indicating whether or not an arrhythmia has occurred, and rehabilitation status information indicating the stage of rehabilitation. In another example, management information for each peripheral device may be constantly transmitted to the PC 2. The peripheral device management information includes, for example, the connection status and remaining battery level of the tablet 3, electrocardiograph 4, ergometer 5, and the like. In addition, the rotational speed of the ergometer 5, the load status, the operating status of the motor, and the like may be constantly transmitted to the PC 2 as peripheral device management information.

During downlink transfer, load instructions (for example, wattage) and medical video are transmitted from the PC 2 to the tablet 3 via the support server 1 . Unlike the patient-side video, the medical-side video may be transmitted from the PC 2 to the tablet 3 via the support server 1 only during a video call between the patient and the medical personnel. Moreover, the above-mentioned load instruction does not need to be sent all the time, and may be sent only when a medical person operates the PC 2 to change the load. The tablet 3 transfers the received load instruction to the ergometer 5, and the ergometer 5 adjusts the weight of the pedals to achieve the specified load.

To give a specific example, during upstream transfer, the current load (wattage) of the ergometer 5 is periodically transmitted (for example, once every 0.2 seconds) from the ergometer 5 to the tablet 3. being sent. This load amount is further transmitted to the support server 1 and also to the PC 2 via the support server 1. This makes it possible to constantly confirm from the tablet 3, support server 1, and PC 2 that the intended load amount specified by the medical personnel is achieved. On the other hand, in the downlink transfer, the load instruction output from the medical personnel's PC 2 is sent from the PC 2 to the tablet 3 via the support server 1 when the load amount is changed, and from the tablet 3 to the ergometer. Sent to 5.

The wattage specified by the tablet 3 is specified by the medical personnel operating the PC 2. In other words, the load placed on the patient is appropriately determined and controlled by medical personnel with specialized knowledge, taking into account the patient's current health condition. This allows patients to undergo rehabilitation at home with peace of mind, even if a medical professional is not around to instruct them.

<Functional explanation>
(PC2)
FIG. 3 is a block diagram showing the main configuration of the PC 2 used by medical personnel. The control unit 20 includes, for example, a signal transmitting unit 71, a response receiving unit 72, a timer unit 73, and a notification unit 74 (output unit).

The signal transmitter 71 controls the transmission of signals related to the keep-alive function. Specifically, the signal transmitter 71 transmits a keep-alive start signal requesting the support server 1 to establish a keep-alive session. The keepalive start signal is, for example, an "Echo Request" of an ICMP (Internet Control Message Protocol) packet. For example, in response to a medical person performing an input operation instructing to start a connection with the support server 1 in order to start monitoring rehabilitation, the signal transmitter 71 transmits a keep-alive start signal to the support server 1. It may be sent to 1.

Further, the signal transmitter 71 periodically transmits a keep-alive signal to the support server 1, for example, at every 5 seconds while the keep-alive session is established. By periodically transmitting keepalive signals, the PC 2 can notify the support server 1 that its own communication status is good.

Further, the signal transmitter 71 transmits a keep-alive end signal that notifies the support server 1 of the end of the keep-alive session. For example, the signal transmitter 71 supports a keep-alive end signal in response to a medical personnel performing an input operation instructing to end the connection with the support server 1 in order to end rehabilitation monitoring. It may also be sent to server 1.

For example, communication between the PC 2 and the support server 1 may be established when a medical personnel operates a UI displayed on the display unit 22 of the PC 2. More specifically, it is assumed that the operation screen displayed on the display unit 22 includes information about the patient who is the subject of guidance, as well as a start button for starting rehabilitation guidance for that patient. In response to the medical personnel pressing the start button associated with the patient they wish to instruct, communication is established, and accordingly, a keep-alive session between the PC 2 and the support server 1 is started.

Further, it is assumed that the monitoring screen displayed on the display unit 22 during rehabilitation includes a close button in addition to the patient's electrocardiogram and the like. In response to the medical personnel pressing the close button on the monitoring screen of the patient being monitored, the keep-alive session between the PC 2 and the support server 1 ends.

Note that an application for making a video call between a patient and a medical professional (hereinafter referred to as a video call application) may be installed in each terminal, that is, the tablet 3 and the PC 2.

In the support system 100, the video call using the video call application does not need to be carried out all the time during the rehabilitation period, but only when necessary (for example, during one rehabilitation period, the (e.g., about two times, for a total of less than 10 minutes, etc.) to enable conversation. During the non-conversation period during rehabilitation, the patient performs rehabilitation, specifically resistance training and bike exercise. During this time, the medical personnel can adjust the load while monitoring the patient's electrocardiogram constantly sent from the support server 1, the patient's facial expression seen from the patient-side video, the rotational speed of the ergometer 5, etc. During periods when conversations are not taking place, patient information and load instructions are transmitted and received between the tablet 3 and the support server 1, and between the support server 1 and the PC 2, rather than in the form of a virtual talk room. This is done via a communication path (Websocket).

The response receiving unit 72 controls reception of signals related to the keep-alive function. Specifically, the response receiving unit 72 receives a start acceptance signal from the support server 1 as a response to the keepalive start signal. This establishes a keepalive session. The start acceptance signal is, for example, an "Echo Reply" of an ICMP packet.

Further, the response receiving unit 72 receives a response signal from the support server 1 as a response to the keep-alive signal while the keep-alive session is established. By regularly receiving the response signal, the PC 2 can recognize that the communication state between the support server 1 and the PC 2 is good. The response receiving unit 72 also receives a termination acceptance signal from the support server 1 as a response to the keepalive termination signal.

The timer section 73 measures the elapsed time from the time when the response receiving section 72 receives the response signal. When the response receiving section 72 receives the response signal again, the timer section 73 resets the elapsed time that was being measured and measures the elapsed time from the latest reception time. In one embodiment, each section within the control section 20 may have a function of monitoring the elapsed time measured by the timer section 73 in addition to its own original function. Each of these units may perform its own original function based on the elapsed time measured by the timer unit 73 reaching a predetermined threshold. In other embodiments, the timer section 73 may hold a threshold value for the elapsed time, and may have a function of transmitting the fact that the elapsed time has reached the threshold value to each necessary section in the control section 20. Good too.

The notification unit 74 outputs and informs the medical personnel of various information regarding the communication status between the patient's tablet 3 and the medical personnel's PC 2 with which communication has been established during rehabilitation. As an example, the notification unit 74 outputs a communication interruption warning (first predetermined message) when the signal transmitter 71 does not receive a response signal for a first predetermined period. Here, the first predetermined period is, for example, 10 seconds. The communication interruption warning may be, for example, a warning display that calls attention to the fact that the communication state between the support server 1 and the PC 2 is poor. Further, the communication interruption warning may be a warning display that shows the remaining time until rehabilitation is stopped in a countdown format.

Thereby, it is possible to notify medical personnel that the communication state between the support server 1 and the PC 2 is poor. As a result, medical personnel can take action to continue or discontinue rehabilitation. For example, medical personnel can take action to restore communication status (such as restarting communication equipment). Alternatively, the medical personnel can instruct the patient to discontinue rehabilitation using any communication means (telephone, SNS, etc.) different from the communication means employed by the support system 100.

Note that the first predetermined period is set to be relatively short, such as the above-mentioned "10 seconds". As a result, the notification unit 74 can quickly warn medical personnel of poor communication of the PC 2, and as a result, it is possible to prompt medical personnel to take immediate action without delay after communication is interrupted. becomes.

The most important thing to avoid is a situation where each patient continues rehabilitation even though the PC 2 of a medical person in charge of multiple patients is in a state of poor communication. By setting the first predetermined period that is referred to by the notification unit 74 as a threshold value to be relatively short, it becomes possible to have medical personnel immediately take measures to resolve the communication failure.

(Tablet 3)
FIG. 4 is a block diagram showing the main configuration of the tablet 3 used by the patient. The control unit 30 includes, for example, a main communication control unit 81, a sub-communication control unit 82, a signal transmission unit 83, a response reception unit 84 (patient-side response reception unit), a timer unit 85, a communication switching unit 86, and a communication restart unit. 87, and a device control section 88 (terminal side cancellation instruction section).

The main communication control unit 81 controls the wide area communication unit 32 to connect the tablet 3 to the second communication network 8 . The sub communication control unit 82 controls the wide area communication unit 32 to connect the tablet 3 to the third communication network 9.

This enables the tablet 3 to establish a keep-alive session with the support server 1 and exchange data with the PC 2 via the support server 1. Furthermore, by including both the main communication control unit 81 and the sub-communication control unit 82, even if a failure occurs in one communication network, communication with the support server 1 can be maintained via the other communication network. be able to. Therefore, it becomes possible to safely exchange data with the PC 2.

The signal transmitter 83 controls the transmission of signals related to the keep-alive function. Specifically, the signal transmitter 83 transmits a keep-alive start signal requesting the support server 1 to establish a keep-alive session. For example, the signal transmitter 83 transmits a keep-alive start signal to the support server 1 in response to a patient inputting an instruction to start connection with the support server 1 in order to start rehabilitation. Good too. The keepalive start signal is, for example, an "Echo Request" ICMP packet.

Further, the signal transmitter 83 periodically transmits a keep-alive signal to the support server 1, for example, at 5-second intervals while the keep-alive session is established. By periodically transmitting keep-alive signals, the tablet 3 can notify the support server 1 that its own communication status is good.

Further, the signal transmitter 83 transmits a keep-alive end signal that notifies the support server 1 of the end of the keep-alive session. For example, the signal transmitter 83 transmits a keep-alive termination signal to the support server 1 in response to the patient performing an input operation instructing to terminate the connection with the support server 1 in order to complete rehabilitation. You may.

For example, communication between the tablet 3 and the support server 1 may be established when the patient operates the UI displayed on the display unit 34 of the tablet 3. More specifically, it is assumed that a start button for instructing the start of rehabilitation is arranged on the top screen for rehabilitation operations displayed on the display unit 34. In response to the patient pressing this start button, communication is established, and accordingly, a keep-alive session between the tablet 3 and the support server 1 may be started.

Further, an end button for instructing to end the rehabilitation may be arranged on the operation screen displayed on the display unit 34 during rehabilitation. In response to the patient pressing this end button, the above-mentioned keep-alive session ends until the rehabilitation ends and the screen transitions to the above-mentioned top screen.

The response receiving unit 84 controls reception of signals related to the keep-alive function. Specifically, the response receiving unit 84 receives a start acceptance signal from the support server 1 as a response to the keepalive start signal. This establishes a keepalive session. The start acceptance signal is, for example, an "Echo Reply" of an ICMP packet.

Further, the response receiving unit 84 receives a response signal from the support server 1 as a response to the keep-alive signal while the keep-alive session is established. By periodically receiving the response signal, the tablet 3 can recognize that the communication state between the support server 1 and the tablet 3 is good. The response receiving unit 84 also receives a termination acceptance signal from the support server 1 as a response to the keepalive termination signal.

In another example, in order to carry out safer rehabilitation of the patient, the quality of the communication state may be further determined based on whether the patient's electrocardiogram data can be successfully transmitted. Specifically, the tablet 3 first monitors whether the electrocardiogram data is being transmitted properly, detects a communication failure based on the fact that the electrocardiogram data cannot be transmitted for 9 seconds, and takes this as a safety measure. (For example, it may be a trigger for implementing line switching, rehabilitation cancellation, etc.). The tablet 3 may then use the keep-alive signal to check whether the communication path itself has been disrupted. In this way, patient safety can be further ensured by doubly monitoring communication interruption between the tablet 3 and the support server 1.

Regarding communication between the PC 2 operated by medical personnel and the support server 1, a wide bandwidth is generally guaranteed between the communication equipment at the medical institution and the highly secure cloud server. It is expected that there will be many. Therefore, if the keep-alive signal passes, it is considered that the communication path is secured and that the communication path has sufficient bandwidth in most cases.

On the other hand, the communication path between the tablet 3 used by the patient at home and the support server 1 may actually use a mobile network. In that case, even if a communication channel is secured, there is a possibility that it is not guaranteed to have sufficient bandwidth for the amount of data to be transmitted. Since the keep-alive signal is a signal with a small capacity, it can be transmitted even if the band is narrow. However, the most important data that the tablet 3 should send to the support server 1 is electrocardiogram data regarding the patient's heart condition. The next important piece of information to be transmitted is an image of the patient's face, particularly an image of the patient's facial expression. Preferably, the patient's facial image is transmitted, for example, once every two seconds. Electrocardiogram data and facial images each have a capacity of several kilobytes to more than ten kilobytes. If this most important electrocardiogram data is not transmitted, medical personnel will not be able to monitor the patient's heart condition, and it should be determined that rehabilitation should be discontinued for the patient's safety.

From the above, according to the above-mentioned configuration, a relatively large capacity and indispensable important information can be transmitted without any defects even though the bandwidth is relatively narrow during the period when rehabilitation is being performed. I can guarantee that.

The timer section 85 measures the elapsed time from the time when the response receiving section 84 receives the response signal. When the response receiving section 84 receives the response signal again, the timer section 85 resets the elapsed time that was being measured and measures the elapsed time from the latest reception time. In one embodiment, each section within the control section 30 may have a function of monitoring the elapsed time measured by the timer section 85 in addition to its own original function. Each of these units may perform its own original function based on the elapsed time measured by the timer unit 85 reaching a predetermined threshold. In other embodiments, the timer section 85 may hold a threshold value for the elapsed time, and may have a function of transmitting the fact that the elapsed time has reached the threshold value to each necessary section in the control section 30. Good too.

The communication switching unit 86 switches the communication network for communicating with the support server 1 to the second communication network 8 or the third communication network 9. For example, when the response receiving section 84 does not receive a response signal for a third predetermined period before the period during which the response receiving section 84 does not receive a response signal reaches a predetermined upper limit period, the communication switching section 86 The second communication network 8 is switched to the third communication network 9.

A typical example of the second communication network 8 is a network including a wireless LAN such as WiFi (registered trademark), and a typical example of the third communication network 9 is a network including a communication network such as LTE.

Under the control of the communication switching unit 86, the sub communication control unit 82 connects the wide area communication unit 32 to the third communication network 9 instead of the main communication control unit 81, and attempts to resolve the communication failure. In this way, the communication network is automatically switched depending on the quality of the communication state, and an attempt is made to recover the communication state. Here, if the communication state is restored by switching, the rehabilitation is not canceled and continues. Thereby, even if a communication interruption occurs temporarily between the tablet 3 and the support server 1, it is possible to prevent the patient from being deprived of the opportunity to undergo rehabilitation. Moreover, since the communication network is automatically switched, even if the patient's IT literacy is low, the communication state between the support server 1 and the tablet 3 can be restored.

Furthermore, when the poor communication state in the second communication network 8 is resolved, the communication switching unit 86 switches the communication network for communicating with the support server 1 from the third communication network 9 back to the second communication network 8. Good too.

For example, if communication via the second communication network 8 is more advantageous in terms of cost or speed than the third communication network 9, the more advantageous communication network is used as much as possible. A tablet 3 can be configured. Patients do not need to be aware or concerned about which communication network is currently being used or which communication network is advantageous to use. This allows patients to benefit from the superiority of the second communication network 8 even if they have low IT literacy and do not have the knowledge to timely select an optimal communication network.

The communication restart unit 87 restarts the second communication network 8 when the response reception unit 84 does not receive the response signal for a fourth predetermined period before the period in which the response reception unit 84 does not receive the response signal reaches the above-mentioned upper limit period. Restart the function for communication using . Under the control of the communication restart unit 87, the main communication control unit 81 restarts a function for performing communication using the second communication network 8, such as a router.

As a result, the tablet 3 automatically restarts the function for communicating using the second communication network 8, so that it is possible to attempt to restore the communication state with the support server 1. As a result, if the communication state is restored, rehabilitation can be continued. Further, since the restart is performed automatically, the communication state between the support server 1 and the tablet 3 can be restored even if the patient's IT literacy is low.

The communication restart unit 87 may first restart the communication function of the second communication network 8 before the communication switching unit 86 switches the second communication network 8 to the third communication network 9. The communication restart unit 87 may execute the restart when the communication network is not successfully switched after the switching operation of the communication switching unit 86. The communication restart unit 87 may perform the restart even after rehabilitation is forced to be canceled due to unresolved communication interruption.

The device control unit 88 controls each peripheral device in the home system via the short-range communication unit 31. As an example, the device control unit 88 controls the operation of the ergometer 5, particularly the load adjusted by the load adjustment unit 51. Furthermore, the device control unit 88 instructs the tablet 3 to stop providing the load by the ergometer 5 when the response receiving unit 84 does not receive a response signal for a predetermined upper limit period. This prevents patients from continuing to exercise without being able to contact medical personnel beyond the upper limit period, thereby ensuring patient safety.

For example, the control unit 30 of the tablet 3 causes the display unit 34 to display a message “Rehabilitation is canceled.” The device control unit 88 then controls each peripheral device to stop the rehabilitation. As an example, the device control unit 88 lowers the load on the ergometer 5 to a minimum of 10 watts and causes the patient to perform a cool-down exercise for 3 minutes. After that, the control unit 30 causes the display unit 34 to display a rehabilitation completion screen. Here, the rehabilitation end screen displayed on the display unit 34 may include a UI that prompts the patient to measure their blood pressure at the end of rehabilitation and allows the patient to input the measurement results, and a UI that allows the patient to input the interview results. good. The UI for inputting the interview results may be, for example, one that displays questions on the screen and allows the patient to input answers from two choices. When the blood pressure measurement result and the interview result are input on the rehabilitation end screen, the support system 100 recognizes that the rehabilitation has ended. Note that when the rehabilitation is completed, the device control unit 88 may control the ergometer 5 so that the pedals of the ergometer 5 are locked so that they do not rotate. This prevents the ergometer 5 from being used for purposes other than medical treatment, prevents mischief by children living together, and prevents unexpected accidents.

The above-mentioned third predetermined period referred to by the communication switching unit 86 may be set relatively short, for example, 10 seconds. Thereby, the communication switching unit 86 can immediately switch to another communication network after communication is interrupted. As a result, the period during which the tablet 3 cannot communicate with the support server 1 can be made as short as possible to ensure patient safety.

The communication restart unit 87 may attempt to restart the communication at any timing during a period in which the elapsed time since the response reception unit 84 stopped receiving a response signal is greater than or equal to the third predetermined period and less than the upper limit period. For example, the restart may be performed when the communication switching unit 86 switches the communication network from the second communication network 8 to the third communication network 9, or after the communication network is switched to the third communication network 9.

As a result, the communication switching unit 86 can switch the communication network, and while the communication failure with the support server 1 is immediately resolved, the communication restart unit 87 can attempt to restore the second communication network 8. . After the second communication network 8 is restored, it is also possible to return the connection to the more superior second communication network 8.

As described above, both the switching of the communication network by the communication switching unit 86 and the restarting of the communication function by the communication restarting unit 87 can be performed by the device control unit 88 before the upper limit period during which rehabilitation is stopped expires. For example, the third predetermined period may be 10 seconds, the fourth predetermined period may be 40 seconds, and the upper limit period may be 60 seconds.

In another example, since it is assumed that it may take several minutes to restart a communication function such as a router, the upper limit period may be set longer than 60 seconds (for example, to about several minutes). In another example, the communication restart unit 87 may further restart the router or restart the tablet 3 after the rehabilitation is stopped.

According to the above configuration, first, the communication switching section 86 immediately switches the communication network, and on the other hand, the communication restarting section 87 restarts the router and the like. If this still does not resolve the poor communication condition, in consideration of the patient's safety, rehabilitation will be stopped when the period of communication interruption has exceeded the upper limit period.

In this way, various measures are automatically taken to resolve communication failures up to the point of discontinuing rehabilitation, thereby ensuring patient safety while avoiding the patient's opportunity to undergo rehabilitation as much as possible. can be secured.

Monitoring of communication loss and recovery operation after communication loss is detected may be performed in the following steps. Specifically, as an example, the following recovery operation is performed when electrocardiogram data is not transmitted for 9 seconds as a trigger. First, the communication restart section 87 restarts the main communication control section 81 itself. As an example, the communication restart unit 87 turns WiFi (registered trademark) off and on. Next, the communication switching section 86 causes the sub communication control section 82 to attempt connection to the third communication network 9 instead of the main communication control section 81 . As an example, the communication switching unit 86 instructs the sub-communication control unit 82 to switch to LTE. Each time each recovery operation is executed, the main communication control section 81 or the sub communication control section 82 attempts to retransmit the electrocardiogram data. At this point, if it becomes possible to transmit electrocardiogram data, rehabilitation is restarted. On the other hand, if electrocardiogram data cannot be transmitted by any of the above recovery operations, the device control unit 88 cancels rehabilitation.

After the rehabilitation is stopped, each part of the control unit 30 may further perform line restoration work for the next rehabilitation according to the following procedure. First, the control unit 30 restarts the tablet 3 itself. After restarting, the main communication control unit 81 may try to transmit the electrocardiogram data again. If the electrocardiogram data cannot be transmitted here as well, next, the communication restart unit 87 restarts the communication function of the router or the like. After restarting the router, the main communication control unit 81 may try to transmit the electrocardiogram data again. If the electrocardiogram data cannot be transmitted here as well, the control unit 30 reports to the support server 1 that the state cannot be restored to a state where the electrocardiogram data can be transmitted even after rehabilitation.

After receiving the report, the support server 1 notifies the PC 2 of the communication interruption between the tablet 3 and the support server 1. In response to receiving such a notification, the PC 2 causes the display unit 22 to display a message for medical personnel to "contact the operating company of the support server 1." In this way, a series of rehabilitation processes are completed. If the electrocardiogram data is successfully transmitted during any of the steps in the above-mentioned line restoration work after rehabilitation is stopped, the control unit 30 displays a message on the display unit 34 of the tablet 3 saying “Communication has been restored. The next rehabilitation will be normal.” "This can be done" message is displayed and the device enters sleep mode. The notification that the line has been restored and that the next rehabilitation can be performed is similarly reported from the tablet 3 to the support server 1, and from the support server 1 to the PC 2. A similar message may also be displayed on the display unit 22 of the PC 2.

(Support server 1)
FIG. 1 is a block diagram showing the main configuration of the support server 1. As shown in FIG. The control unit 10 includes, for example, a medical communication control unit 61 (first communication control unit), a patient communication control unit 62 (second communication control unit), a relay processing unit 63, and a signal transmission/reception unit 64 (keep-alive signal transmission/reception). ), a timer section 65, a remote cancellation instruction section 66 (server-side cancellation instruction section), and a notification transmission section 67 (transmission section). The storage unit 12 stores a user table 121 and a rehabilitation DB 122.

The medical communication control unit 61 controls the communication unit 11 to connect the support server 1 to the first communication network 7 . This allows the support server 1 to establish a keep-alive session with the PC 2 and exchange data with the PC 2 while constantly monitoring the communication status of the PC 2.

The patient-side communication control unit 62 controls the communication unit 11 to connect the support server 1 to the second communication network 8 or the third communication network 9. This enables the support server 1 to establish a keep-alive session with the tablet 3 and exchange data with the tablet 3 while constantly monitoring the communication status of the tablet 3.

The relay processing unit 63 supervises information exchange between patients and medical personnel during rehabilitation. To relay data so that the data transmitted and received during uplink transfer or downlink transfer is transferred to an appropriate party. For example, the relay processing unit 63 relays a patient-side video and a medical-side video that are exchanged during a video call between a patient and a medical professional. In addition, while rehabilitation is being performed, the relay processing unit 63 constantly processes the patient's vital data (for example, facial images showing the patient's condition, electrocardiogram data, heart rate, blood pressure, etc.) even when video calls are not being performed. etc.) is relayed from the tablet 3 to the PC 2. During rehabilitation, if the patient operates the tablet 3 and inputs an answer to the medical interview, the relay processing unit 63 may relay the answer information to the PC 2.

The user table 121 stores correspondence relationships indicating which medical personnel are in charge of which patients. The relay processing unit 63 can refer to the user table 121 and relay transmitted/received data to an appropriate party. The data structure of the user table 121 will be described in detail later with reference to FIG. 5.

In other examples, the correspondence between medical personnel and patients is not fixed and may be changed each time rehabilitation is performed. In such an example, the user table 121 may be created by being divided into two tables, a medical personnel master and a patient master, and the correspondence may be managed for each rehabilitation session. .

The relay processing unit 63 also manages information on each participant in the rehabilitation, such as patient information, for each rehabilitation session stored in the rehabilitation DB 122. The data structure of the rehabilitation DB 122 will be described in detail later with reference to FIG. 6.

Note that participants are medical personnel and patients. In this embodiment, as an example, one or more patients to undergo rehabilitation are assigned to one medical professional who instructs rehabilitation. Therefore, one medical personnel is associated with one or more patients for each rehabilitation session. Specifically, in the rehabilitation DB 122, the relay processing unit 63 registers the correspondence between medical personnel and patients in the record for one rehabilitation scheduled to be performed. Medical personnel can have one-on-one online interactions with all patients participating in rehabilitation, if necessary. The support server 1 may provide the PC 2 and the tablet 3 with a virtual web conference room for implementing the rehabilitation every time the rehabilitation is performed. At this time, the patient may be prohibited from participating in dialogue with medical personnel and other patients in the room. Further, conversations between patients in the same room may be prohibited. Medical personnel may be able to interact one-on-many online with all patients who enter the web conference room. Medical personnel may have the authority to allow patients to interact with each other, or to allow other patients to interact with themselves, as appropriate.

In other examples, multiple medical personnel may participate in one rehabilitation session. In this case, the second and subsequent medical personnel are connected to the support server 1 via a PC 2 different from the PC 2 operated by the first person. In this way, a plurality of medical personnel may enter the same web conference room and monitor and instruct the same patients at the same time. Each medical professional can make a video call with the patient as needed. For example, while there is a medical professional who is dedicated to monitoring the condition of patients, another medical professional who is temporarily free can make video calls with the patients.

The signal transmission/reception unit 64 controls transmission and reception of signals related to the keep-alive function. Specifically, during rehabilitation in the support system 100, the signal transmitting/receiving unit 64 receives each of the keep-alive signals sent from the PC 2 and the tablet 3, and transmits a response signal to all the sending devices. Send to. More specifically, upon receiving a keep-alive start signal requesting the establishment of a keep-alive session from a participant's terminal (PC 2 or tablet 3), the signal transmitting/receiving unit 64 sends a start acceptance signal to the transmitting terminal. Reply to establish a keepalive session. Further, upon receiving a keep-alive termination signal requesting termination of the keep-alive session from a participant's terminal, the signal transmitting/receiving unit 64 returns a termination acceptance signal to the transmitting terminal and terminates the keep-alive session. do. While the keep-alive session is being established, when the signal transmitting/receiving unit 64 receives a keep-alive signal from a participant's terminal, it sends a response signal back to the terminal that sent the keep-alive signal. This signaling is performed periodically, for example every 5 seconds, while the keep-alive session is being established. Thereby, the support server 1 can understand that the communication state of the terminal that is the source of the keep-alive signal is good because the signal transmitting/receiving unit 64 regularly receives the keep-alive signal. On the other hand, based on the fact that the reception of the keep-alive signal has stopped, the support server 1 can recognize that the communication state of the transmission source terminal is poor.

The timer section 65 measures the elapsed time from the time when the signal transmitting/receiving section 64 receives the keep-alive signal for each participant's terminal. When the signal transmitting/receiving section 64 receives the keep-alive signal again from the same terminal, the timer section 65 resets the elapsed time that was being measured and measures the elapsed time from the latest reception time. In one embodiment, each section within the control section 10 may have, in addition to its own original function, a function of monitoring the elapsed time of each participant's terminal as measured by the timer section 65. Each of these units may perform its own original function based on the elapsed time measured by the timer unit 65 reaching a predetermined threshold. In other embodiments, the timer section 65 may hold a threshold value for the elapsed time, and may have a function of transmitting the fact that the elapsed time has reached the threshold value to each necessary section in the control section 10. Good too.

When the signal transmitting/receiving unit 64 does not receive a keep-alive signal from the PC 2 for a second predetermined period that is longer than the first predetermined period, the remote stop instruction unit 66 instructs each of the tablets 3 associated with the PC 2 to reduce the load caused by the load providing device. Instruct to discontinue provision.

As described above, during the first predetermined period, the PC 2 notifies the medical person who is the user of a communication failure in its own device regarding the elapsed time from the time when the medical person's PC 2 receives the response signal from the support server 1. This is the period that becomes the threshold value. The first predetermined period is, for example, 10 seconds. That is, when 10 seconds have elapsed since the last response signal was received from the support server 1, the PC 2 warns the medical personnel and informs them that there is a communication failure. On the other hand, the second predetermined period is a period longer than the first predetermined period, and is, for example, 90 seconds. In other words, when 90 seconds have elapsed since no keep-alive signals were received from the PC 2, the remote cancellation instruction unit 66 sends the tablets 3 of all patients assigned to the medical personnel using the PC 2 with poor communication. In response, the government sends instructions to discontinue rehabilitation.

The most important thing to avoid is a situation where each patient continues rehabilitation even though the PC 2 of a medical person in charge of multiple patients is in a state of poor communication. On the other hand, it is also desirable to avoid, as much as possible, the loss of opportunities for rehabilitation for all participating patients, even if the PC 2 suffers from a temporary communication failure for a very short period of, for example, around one minute.

Therefore, the first predetermined period is set to be relatively short, thereby promptly notifying medical personnel of the communication failure of their own PC 2 and prompting them to take corrective action. On the other hand, the second predetermined period, which is used as a guideline for the remote cancellation instruction unit 66 to determine cancellation, is set longer than that. As an example, the second predetermined period is set to be short enough to ensure the time required for the communication failure in the PC 2 to be resolved by medical personnel, and to the extent that patient safety is not compromised. It is preferable that Such a period is, for example, 90 seconds.

If the remote cancellation instruction unit 66 is configured in this way, even if the PC 2 temporarily falls into a communication failure state, if the communication failure is resolved before the second predetermined period elapses, rehabilitation can be restarted. It becomes possible. In this way, patients are not deprived of the opportunity to undergo rehabilitation. However, if the second predetermined period is set unnecessarily long with emphasis on resuming rehabilitation, this will lead to an avoidable situation in which many patients continue to exercise while communication with medical personnel is interrupted. will continue for a long time. Therefore, the second predetermined period is set to a short period so as not to become unnecessarily long. The remote discontinuation instruction unit 66 instructs each patient's tablet 3 to discontinue rehabilitation when the second predetermined period has elapsed. This makes it possible to ensure the safety of the patient while avoiding the patient's opportunity to undergo rehabilitation as much as possible.

The notification transmitter 67 transmits a communication interruption notification (second predetermined message) to the PC 2 when the signal transmitter/receiver 64 does not receive the keep-alive signal from the tablet 3 for a fifth predetermined period. The fifth predetermined period is, for example, 60 seconds. More specifically, the communication loss notification may include a notification that the communication status between the support server 1 and the tablet 3 is poor, or a notification that indicates the remaining time until rehabilitation is stopped in a countdown format. It may be.

Thereby, it is possible to notify the medical personnel in charge of the patient who uses the tablet 3 that the communication state between the support server 1 and the tablet 3 is poor. As a result, medical personnel can take action to continue or discontinue rehabilitation. For example, medical personnel can instruct a patient with poor communication status to stop rehabilitation using any communication means (such as a telephone or SNS) that is different from the rehabilitation support system. In this way, even if communication is interrupted, it is possible to avoid a situation where a patient continues exercising for a long period of time without being able to contact medical personnel, and it is possible to ensure patient safety.

<Data structure>
(User management table)
FIG. 5 is a diagram showing an example of the data structure of the user table 121. The user table 121 is stored in the storage unit 12 and is used by the support server 1 to refer to the correspondence between the medical personnel's PC 2 and the patient's tablet 3. Specifically, information on the medical personnel and the PC 2 used by the medical personnel and information on the patient and the tablet 3 used by the patient are stored in association with each other. The user table 121 may be stored in a storage device external to the support server 1 so that the support server 1 can access it.

The user table 121 includes, for example, columns of doctor ID, doctor name, doctor address, patient ID, patient name, and patient address. The following information is stored in each column.

The doctor ID is identification information for uniquely identifying on the support system 100 a medical person who provides rehabilitation guidance. Physician name refers to the name of a medical professional. The doctor's name is set so that the medical personnel and the patient can recognize the medical personnel as referring to the medical personnel. Therefore, it is preferable that the doctor's name is composed of readable characters such as kana characters and alphabetic characters, for example. The doctor's name does not have to be his real name; it can also be a nickname. In this embodiment, a medical person himself/herself may set his/her own doctor name. Therefore, although it may happen that the same doctor name is given to different medical personnel, whether or not to allow this in the support system 100 may be determined as appropriate. For example, the doctor's name is displayed on the terminal of each participant participating in rehabilitation as information indicating the medical personnel concerned.

The doctor address is destination information of the PC 2 on the communication network, which is necessary for communicating with the PC 2 used by medical personnel. When a plurality of medical personnel share one PC 2, the same doctor address may be associated with the plurality of medical personnel. Note that the doctor address for identifying each PC 2 is not limited to an IP address, and may be any information unique to the PC 2 that can uniquely identify the PC 2 .

In the user table 121, one or more patients are associated with one medical professional. The patient ID is identification information for uniquely identifying a patient undergoing rehabilitation on the support system 100. Patient name refers to the patient's full name. It is preferable that the patient name is composed of readable characters like the doctor's name. Furthermore, it is preferable that patient names be set without allowing duplication so that medical personnel who are in charge of multiple patients do not confuse patients.

The patient address is destination information of the tablet 3 on the communication network, which is necessary for communicating with the tablet 3 used by the patient.

By referring to the user table 121 having the above data structure by each section of the control section 10, each section of the control section 10 can grasp which medical personnel is in charge of which patient. . As an example, the relay processing unit 63 can appropriately transfer patient information and patient-side video of a certain patient to the PC 2 of a medical personnel associated with the patient. In another example, when a communication failure occurs with the PC 2 of a certain medical professional, the remote discontinuation instruction unit 66 appropriately sends messages to tablets 3 of all patients associated with the medical professional to perform rehabilitation. Cancellation instructions can be sent.

In other examples, it is also assumed that the correspondence between medical personnel and patients is not fixed and may change each time rehabilitation is performed. In such an example, the user table 121 may be created by being divided into two tables: a medical personnel master and a patient master.

In this case, columns related to medical personnel such as doctor ID, doctor name, and doctor address shown in Figure 5 are included in the medical personnel master, and columns related to patients such as patient ID, patient name, and patient address are included in the patient master. Included. The correspondence between medical personnel and patients may be managed in the rehabilitation DB 122 for each rehabilitation session.

(Rehabilitation management database)
FIG. 6 is a diagram showing an example of the data structure of the rehabilitation DB 122. The rehabilitation DB 122 is stored in the storage unit 12. The rehabilitation DB 122 is used by the support server 1 to manage the web conference room where rehabilitation is being performed or scheduled to be performed, and to appropriately relay various uploaded data. It is also used to store records regarding rehabilitation after implementation. The rehabilitation DB 122 includes, for example, rehabilitation basic information 221 and participating patient information 222. Both basic rehabilitation information 221 and participating patient information 222 are generated in the support system 100 for each rehabilitation session. For example, as shown in the figure, one rehabilitation session is identified by a "reservation number" that is uniquely assigned to one rehabilitation session.

Rehabilitation basic information 221 indicates basic information regarding rehabilitation that is scheduled to be implemented or that has been implemented. The rehabilitation basic information 221 includes, for example, a reservation number, a doctor ID, a scheduled start time, and a scheduled end time. The reservation number is information that uniquely identifies one session of rehabilitation to be performed. For example, when a medical person who has planned to hold a rehabilitation session performs an operation to reserve the rehabilitation session via the PC 2, the control unit 10 of the support server 1 that has accepted the reservation The rehabilitation basic information 221 of the rehabilitation is registered in the rehabilitation DB 122. A medical person who plans to hold rehabilitation inputs his/her doctor ID, scheduled start time, and scheduled end time of the rehabilitation via the PC 2.

Patients who participate in this rehabilitation may be designated by the medical personnel who planned the rehabilitation. In this case, the medical personnel, via the PC 2, determine which patients will participate in rehabilitation. Alternatively, the patient may decide whether to participate or not after receiving an invitation from a medical professional. In accordance with the above-described determination, the control unit 10 of the support server 1 registers participating patient information 222 in the rehabilitation DB 122 for linking the times of rehabilitation and participating patients.

Participating patient information 222 indicates information on each patient participating in the corresponding rehabilitation. As an example, the participating patient information 222 includes a reservation number, a patient ID, a performance start time, a performance end time, pre-exercise patient information, post-exercise patient information, and the like.

The patient ID column stores the patient ID of the patient participating in the rehabilitation indicated by the reservation number. The actual start time column stores the time when the patient indicated by the patient ID actually started rehabilitation. At the time when a rehabilitation reservation is registered, the column is blank until the rehabilitation actually starts. The actual end time column stores the actual time when the rehabilitation that the patient was performing was completed. The column is empty until the rehabilitation actually ends. The pre-exercise patient information column stores various vital data of the patient that was measured before the patient started exercising during this rehabilitation. Vital data may include electrocardiogram waveforms, blood pressure, heart rate, and the like. The post-exercise patient information column stores various vital data of the patient that was measured immediately after the patient exercised during this rehabilitation session.

Participating patient information 222 may further include a column for storing medical-side videos or patient-side videos for each patient transmitted and received between the PC 2 and the tablet 3 via video call during rehabilitation. good.

By referring to the rehabilitation basic information 221 and the participating patient information 222 based on the reservation number, the relay processing unit 63 identifies the participants of the rehabilitation being implemented, specifically, the medical personnel who are the attending physicians. It is possible to understand the correspondence relationship with patients.

Note that the support server 1 may include a display section (not shown). The display unit may present the information stored in the user table 121 and the rehabilitation DB 122 with good visibility to an operator engaged in rehabilitation monitoring work at the operating company.

<Processing flow>
(Case 1: When a failure occurs in the communication path between the medical personnel's PC 2 and the support server 1)
FIG. 7 is a sequence diagram showing the flow of processing executed in the support system 100. In particular, the sequence diagram shown in FIG. 7 includes the processing of the support system 100 when a communication failure occurs between the medical personnel's PC 2 and the support server 1.

In step S1, a keep-alive start signal is transmitted to the support server 1 from the terminal of each participant in the rehabilitation.

In step S2, the signal transmitting/receiving unit 64 of the support server 1 responds to the keep-alive start signal and sends a start acceptance signal back to each terminal that is the source.

In step S3, a start acceptance signal is received at the terminal, thereby establishing a keep-alive session between the terminal and the support server 1.

As shown in step S4, after the keep-alive session is established, the signal transmitting unit (signal transmitting unit 71 and signal transmitting unit 83) of each terminal supports keep-alive signals at predetermined intervals (for example, 5 seconds). Send to server 1. On the other hand, the signal transmitting/receiving unit 64 of the support server 1 receives each of the keep-alive signals from each terminal as a transmission source, and transmits a response signal in response to the reception to all the transmission sources.

Here, if a failure occurs in the communication path between the support server 1 and the PC 2, even if the signal transmitting unit 71 of the PC 2 transmits a keep-alive signal to the support server 1, the response receiving unit 72 does not respond from the support server 1. This results in a situation where the signal cannot be received. Alternatively, the signal transmitting/receiving section 64 of the support server 1 cannot receive the keep-alive signal transmitted by the signal transmitting section 71, and as a result, the response signal is not transmitted to the response receiving section 72.

In step S5, when the response receiving section 72 does not receive a response signal for a first predetermined period, the notification section 74 sends a communication interruption warning to the user that the communication between the PC 2 and the support server 1 has been interrupted. Output to medical personnel. The first predetermined period is, for example, 10 seconds. The notification unit 74 outputs a communication interruption warning at a time t2 when 10 seconds have passed since the time t1 when the response receiving unit 72 last received a response signal.

The notification unit 74 may display the communication interruption warning in the form of text, pictures, etc. on the display unit 22. The notification unit 74 may output the communication interruption warning in the form of voice, sound effects, etc. from an audio output unit such as a speaker (not shown). As a result, medical personnel using the PC 2 can immediately take measures to resolve poor communication or contact the management company that monitors rehabilitation.

In step S6, when the signal transmitting/receiving section 64 does not receive a keep live signal from the PC 2 for a second predetermined period that is longer than the first predetermined period, the remote stop instruction section 66 of the support server 1 controls each of the tablets 3 associated with the PC 2. instructs the device to stop providing load. The second predetermined period is, for example, 90 seconds. The remote stop instructing unit 66 instructs each patient's tablet 3 to stop providing the load at a time t4 when 90 seconds have elapsed from the time t3 when the signal transmitting/receiving unit 64 last received the keep-alive signal from the PC 2. send instructions to. The device control unit 88 of the tablet 3 receives the above-mentioned load provision stop instruction via the main communication control unit 81.

In step S7, the device control unit 88 of each patient's tablet 3 controls the ergometer 5 in accordance with the above-mentioned stop instruction to stop providing the load to the patient. As a result, rehabilitation is discontinued.

In this embodiment, if rehabilitation is once canceled due to a communication failure of the PC 2, it may be arranged that the rehabilitation will not be restarted on that day in consideration of the safety of the patients. Alternative rehabilitation dates will be rescheduled. After the communication environment between the support server 1 and the PC 2 is re-established, rehabilitation may be performed on the alternative schedule.

In step S8, the tablet 3 may, for example, confirm that the operation of the ergometer 5 has been safely stopped, and proceed with the procedure for leaving the room. Specifically, the signal transmitter 83 of the tablet 3 transmits a keep-alive end signal to the support server 1.

In step S9, the signal transmitting/receiving unit 64 of the support server 1 returns a termination acceptance signal to the tablet 3 as the transmission source in response to the keepalive termination signal transmitted from the tablet 3.

In step S10, the end acceptance signal is received at the tablet 3, thereby ending the keep-alive session between the tablet 3 and the support server 1.

Note that when the communication function is restored and the keep-alive session with the support server 1 is restarted, the PC 2 that has lost communication with the support server 1 will send a keep-alive end signal in the same way as other tablets 3. You can. When the signal transmitting/receiving unit 64 of the support server 1 returns an end acceptance signal in response to the keep-alive end signal from the PC 2, the keep-alive session between the PC 2 and the support server 1 is also ended.

(Case 2: When a failure occurs in the communication path between the support server 1 and the patient's tablet 3)
FIG. 8 is a sequence diagram showing the flow of processing executed in the support system 100. In particular, the sequence diagram shown in FIG. 8 includes the processing of the support system 100 when a communication failure occurs between the patient's tablet 3 and the support server 1.

Although not shown in FIG. 8, first, as described with reference to FIG. 7, steps S1 to S4 are executed to perform rehabilitation.

Here, if a failure occurs in the communication path between the support server 1 and the tablet 3, even if the signal transmitter 83 of the tablet 3 transmits a keep-alive signal to the support server 1, the response receiver 84 This results in a situation where a response signal cannot be received from the Alternatively, the signal transmitting/receiving section 64 of the support server 1 cannot receive the keep-alive signal transmitted by the signal transmitting section 83, and as a result, the response signal is not transmitted to the response receiving section 84.

In step S21, when the response receiving unit 84 does not receive a response signal for the third predetermined period, the communication switching unit 86 changes the communication network for communicating with the support server 1 from the second communication network 8 to the third communication network 9. Switch. Switching of the communication network by the communication switching unit 86 is attempted before the period in which the response receiving unit 84 of the tablet 3 does not receive a response signal reaches a predetermined upper limit period. As will be described later, rehabilitation is canceled when the period in which no response signal is received reaches the upper limit period, so it is preferable to switch the communication network before the upper limit period is reached in order to avoid canceling the rehabilitation.

In the illustrated example, the communication switching unit 86 switches the communication network at a time t6 when a third predetermined period (for example, 10 seconds) has elapsed from the time t5 when the response receiving unit 84 last received the response signal.

If the switching to the third communication network 9 is successful (YES in S22), the signal transmitting unit 83 and the response receiving unit 84, as shown in S4 of FIG. Repeat sending the alive signal and receiving the response signal. This repetition may be continued, for example, until reaching step S27, which will be described later.

In step S23, when the response receiving section 84 does not receive the response signal for a fourth predetermined period, the communication restarting section 87 may restart the function for communicating using the second communication network 8. In the illustrated example, it is written that if switching of the communication network by the communication switching unit 86 fails, restarting is executed. However, even if the switching of the communication network is successful, the communication restart unit 87 restarts the function related to the second communication network 8 while communication via the third communication network 9 continues. You can. The restart by the communication restart unit 87 is preferably performed before the period in which the response receiving unit 84 does not receive a response signal reaches an upper limit period.

In the illustrated example, the communication restart unit 87 restarts the second communication network 8 at a time t7 when a fourth predetermined period (for example, 40 seconds) has elapsed from the time t5 when the response reception unit 84 last received the response signal. Restart the router, etc. that supports this. In this way, even if network switching to the third communication network 9 fails, there is a possibility that communication via the second communication network 8 can be restored before reaching the upper limit period. In this way, it is possible to avoid discontinuation of rehabilitation and increase the possibility of returning to rehabilitation.

In step S24, the device control unit 88 instructs the ergometer 5 to stop providing load when the response receiving unit 84 does not receive a response signal for a predetermined upper limit period. This makes it possible to avoid a situation where a patient continues to exercise for a long period of time in a situation where they are unable to communicate with medical personnel.

In the illustrated example, the device control unit 88 starts providing load to the ergometer 5 at time t8 when an upper limit period (for example, 60 seconds) has elapsed from time t5 when the response receiving unit 84 last received the response signal. Instruct to cancel.

After rehabilitation is stopped, the support server 1 may automatically treat the tablet 3 with which communication has been interrupted as having completed rehabilitation. Note that the support server 1 and the tablets 3 of other patients continue a keep-alive session for rehabilitation.

Even after rehabilitation is stopped, switching of the communication network by the communication switching section 86 or restarting by the communication restarting section 87 may be executed. If the communication failure between the tablet 3 and the support server 1 is resolved after such attempts to restore communication, the patient may resume rehabilitation under the guidance of medical personnel. .

On the other hand, in step S25, when the signal transmitter/receiver 64 does not receive the keep-alive signal from the tablet 3 for a fifth predetermined period, the notification transmitter 67 of the support server 1 notifies the PC 2 associated with the tablet 3 of communication loss. (second predetermined message).

In the illustrated example, the notification transmitter 67 transmits the above-mentioned information at time t10 when a fifth predetermined period (for example, 60 seconds) has elapsed from time t9 when the signal transmitter/receiver 64 last received the keep-alive signal from the tablet 3. A communication interruption notification regarding the tablet 3 is sent to the PC 2.

In step S26, the notification unit 74 of the PC 2 notifies the medical personnel that there is a patient for whom guidance cannot be given due to the communication interruption when the communication interruption notification is received via the communication unit 21. This allows healthcare professionals to deal with communication disruptions by directly contacting the patient through another communication method (e.g., by phone) or by reporting the situation to the operating company. can.

In step S27, the communication switching section 86 of the tablet 3 may detect that the poor communication state in the second communication network 8 has been resolved by restarting the communication restarting section 87 or the like.

In step S28, the communication switching unit 86 switches the communication network for communicating with the support server 1 from the third communication network 9 to the second communication network 8 when the poor communication state in the second communication network 8 is resolved. You may switch. In this way, the keep-alive session is restarted between the tablet 3 and the support server 1 via the second communication network 8.

In step S29, the signal transmitter 83 resumes transmitting the keep-alive signal via the main communication controller 81. In step S30, the signal transmitting/receiving unit 64 of the support server 1 returns a response signal to the tablet 3 in response to the keep-alive signal. In step S31, the notification sending unit 67 may send to the PC 2 a disruption resolution notification indicating that communication with the tablet 3 that was notified of the communication disruption in S25 has been resumed. In step S32, the notification unit 74 of the PC 2 may notify the medical personnel that the communication interruption has been resolved for the patient who was previously notified that communication is not possible. Although not shown in FIG. 8, finally, as described with reference to FIG. 7, steps S8 to S10 are executed to complete the rehabilitation.

In the illustrated example, a case is described in which, after the communication switching unit 86 attempts to switch the communication network, if the switching is not successful, the communication restart unit 87 attempts to restart the communication network. However, the tablet 3 is not limited to such a configuration. The communication restart unit 87 may first try to restart the function related to the second communication network 8, and if the communication still does not recover, the communication switching unit 86 may attempt to switch the communication network. Furthermore, switching of the communication network by the communication switching section 86 and restarting by the communication restarting section 87 may be attempted at the same time. Therefore, the third predetermined period and the fourth predetermined period described above may be set to the same length or may be set to different lengths. Either period may be set longer.

<Screen example>
FIG. 9 is a diagram showing an example of a patient viewing screen displayed on the display unit 34 of the tablet 3 during a period when rehabilitation is being performed in the support system 100. The control unit 30 generates a patient viewing screen 300 based on various information acquired through the short-range communication unit 31, wide-area communication unit 32, imaging unit 33, and operation unit 35, and displays the patient viewing screen 300 on the display unit 34. Display.

The patient viewing screen 300 includes, for example, an electrocardiogram waveform 301, a load 302, a cumulative number of revolutions 303, a Borg index 304, a medical video 305, and a patient video 306.

An electrocardiographic waveform 301 represents a patient's electrocardiographic waveform obtained from the electrocardiograph 4. Load 302 represents the load set on ergometer 5. The cumulative number of rotations 303 represents the cumulative number of rotations of the pedals on the ergometer 5 from the start of rehabilitation to the present.

Borg index 304 represents the perceived exercise intensity felt by the patient. Regarding the Borg index 304, for example, a user interface component (UI component) that can be operated by the patient may be provided on the patient viewing screen 300. Thereby, the patient can input the current difficulty of exercise into the tablet 3 by touching the UI component.

The medical video 305 is a video of the medical personnel who is in charge of the patient, which is shot by the PC 2 of the medical personnel. The medical video 305 is received by the wide area communication unit 32 from the support server 1 via the second communication network 8 or the third communication network 9. The patient-side video 306 is a video of the patient himself photographed by the imaging unit 33. The patient-side video 306 is displayed on the patient viewing screen 300, and is transmitted by the wide area communication unit 32 to the support server 1, and from the support server 1 to the medical personnel's PC 2.

In some embodiments, video calls (interactions through exchanging videos) may be possible as needed during rehabilitation. During rehabilitation, what is constantly exchanged may be limited to patient information during upstream transfer. In this case, the video call may be limited to only the period during which a session for interaction is established depending on a specific operation. For example, a call button 307 may be placed on the patient viewing screen 300. By touching the call button 307, the patient may be able to interact with the attending medical personnel through video and audio. When the task is completed, the patient may, for example, touch the end dialogue button 308 to close the video window 309 and end the dialogue. Real-time patient information continues to be uploaded during the interaction and after the interaction ends. During rehabilitation, a load instruction for downlink transfer may be transmitted from the PC 2 to the tablet 3 as necessary.

FIG. 10 is a diagram showing an example of a viewing screen for medical personnel displayed on the display unit 22 of the PC 2 during a period when rehabilitation is being performed in the support system 100. In the following, the viewing screen for medical personnel is referred to as the doctor viewing screen 320, but this screen is not intended to be viewed only by doctors, but is intended to be viewed by any PC 2 of a medical personnel who is in a position to instruct patient rehabilitation. is also displayed.

The doctor viewing screen 320 includes, for example, a patient information list 321 and one or more video windows 322.

The patient information list 321 is a list for listing patient information of all patients handled by the medical personnel. The support server 1 retrieves, among the information stored in the user table 121 shown in FIG. 5 and the rehabilitation DB 122 shown in FIG. is extracted and provided to the PC 2 of the medical personnel. The control unit 20 generates a patient information list 321 based on the above-mentioned information provided from the support server 1.

In the illustrated example, the patient information list 321 is displayed behind the video window 322 and is partially hidden, but it may be displayed in the forefront according to an operation by a medical personnel. This allows medical personnel to view all patient information for all patients.
The patient information list 321 includes, for example, a patient ID, patient name, communication status, patient information, and a call button 323 for individually calling a patient for each patient that a medical professional is in charge of.

While the rehabilitation is being performed, the medical personnel can check the patient information list 321 and, if they wish to interact with the patient, click on the patient's call button 323. When the communication unit 21 establishes a session for voice communication with the patient in response to a click operation on the call button 323, the control unit 20 moves the video window 322 containing the patient-side video 306 of the patient to the top layer. to be displayed. This allows medical personnel to interact with any patient they care for.

FIG. 11 is a diagram illustrating an example of a communication interruption notification 340 displayed on the patient viewing screen 300. As an example, the communication loss notification 340 may also serve as a cancellation instruction notification that instructs the patient to cancel rehabilitation. The communication interruption notification 340 is displayed on the patient viewing screen 300 at a predetermined timing when a failure occurs in the communication path between the PC 2 and the support server 1. For example, when the device control unit 88 stops providing the load to the ergometer 5 in response to the stop instruction sent from the support server 1 at time t4 shown in FIG. 7, the control unit 30 (S7) The communication interruption notification 340 may be displayed on the display unit 34.

In the communication loss notification 340 presented to the patient, it is not important to indicate which problem is causing the communication failure, the tablet 3 side or the PC 2 side. Patients need only be informed that they are unable to contact medical personnel and that they should not continue exercising under such circumstances. Therefore, the communication loss notification 340 may be displayed on the patient viewing screen 300 at a predetermined timing even when a failure occurs in the communication path between the tablet 3 and the support server 1. For example, the control unit 30 may display the communication loss notification 340 on the display unit 34 when the device control unit 88 stops providing the load to the ergometer 5 at time t8 shown in FIG. good.

This allows the patient to understand that they are unable to contact medical personnel and that they must stop exercising.

Regarding the communication interruption notification 340, unlike the case where it is presented on the medical personnel's PC 2, detailed information such as the cause of the communication interruption does not need to be presented in order to avoid unnecessary worry to the patient. No matter what communication trouble occurs, the message may be a simple message such as "Communication status is poor. Please wait for a moment." The communication loss notification 340 may include a telephone number for inquiries, etc., in order to alleviate the patient's anxiety.

FIG. 12 is a diagram showing an example of a communication interruption warning 350 (first predetermined message) displayed on the doctor viewing screen 320. The communication interruption warning 350 is displayed on the doctor viewing screen 320 at a predetermined timing when a failure occurs in the communication path between the PC 2 and the support server 1. For example, the notification unit 74 causes the display unit 22 to display the communication interruption warning 350 at time t2 (FIG. 7) when 10 seconds have elapsed since the response receiving unit 72 stopped receiving the response signal (S5 in FIG. 7).

The communication interruption warning 350 includes, for example, text data 351 that reports that the communication status between the support server 1 and the PC 2 is poor, and a timer display 352 that indicates the time until rehabilitation is stopped in a countdown format. Good too.

This allows medical personnel to quickly realize that they are unable to contact all of their patients due to a communication problem on their own PC2 side, and take immediate action to deal with the problem. can move to.

FIG. 13 is a diagram illustrating an example of a communication interruption notification 360 (second predetermined message) displayed on the doctor viewing screen 320. Communication interruption notification 360 is displayed on doctor viewing screen 320 at a predetermined timing when a failure occurs in the communication path between tablet 3 and support server 1. At time t10 (FIG. 8), when 60 seconds have elapsed since the support server 1 stopped receiving a keep-alive signal from the patient's tablet 3, the PC 2 receives a communication loss notification 360 from the support server 1 (S25 in FIG. 8). . For example, the notification unit 74 causes the display unit 22 to display the communication interruption notification 360 received from the support server 1 in step S26.

Thereby, it is possible to notify medical personnel that the communication state between the support server 1 and the tablet 3 is poor. As a result, medical personnel can take action to continue or discontinue rehabilitation. For example, medical personnel can instruct a patient with poor communication status to stop rehabilitation using any communication means (such as a telephone or SNS) that is different from the rehabilitation support system.

FIG. 14 is a diagram showing an example of a disruption resolution notification 341 displayed on the patient viewing screen 300. The disruption resolution notification 341 is displayed on the patient viewing screen 300 at a predetermined timing when a failure occurs in the communication path between the tablet 3 and the support server 1, and the failure is removed and the communication path is restored. Ru. For example, the control unit 30 may display the disruption resolution notification 341 on the display unit 34 when the communication network is successfully switched in step S22 shown in FIG. Alternatively, the control unit 30 may display the disruption resolution notification 341 on the display unit 34 after the restart is successful in step S27 and the second communication network 8 is restored.

This allows the patient to know that they are able to contact medical personnel again, and to take action toward resuming rehabilitation.

FIG. 15 is a diagram showing an example of the interruption resolution notification 361 displayed on the doctor viewing screen 320. The disruption resolution notification 361 is displayed on the doctor viewing screen 320 at a predetermined timing when a failure occurs in the communication path between the tablet 3 and the support server 1, and the failure is removed and the communication path is restored. Ru. For example, after receiving the disruption resolution notification 361 from the support server 1 (S31 in FIG. 8), the notification unit 74 may display the disruption resolution notification 361 received from the support server 1 on the display unit 22 (S32).

This allows medical personnel to know that they are able to contact the patient again and take action toward resuming rehabilitation. For example, it is possible to send a load instruction to the patient's tablet 3 via the support server 1, or to interact with the patient to give detailed instructions on the rehabilitation restart procedure.

[Modified example]
(About the configuration for monitoring communication interruption)
The timer unit 85 monitors the operations of the main communication control unit 81 or the sub communication control unit 82, the wide area communication unit 32, and the device control unit 88, and waits until the next electrocardiogram data is transmitted after the latest electrocardiogram data is transmitted. It may also be configured to measure the elapsed time until the end of the process. Alternatively, the control unit 30 includes an operation monitoring unit (not shown), and the operation monitoring unit transmits the electrocardiogram data generated by the device control unit 88 to the wide area communication unit 32 periodically (for example, once every 3 seconds). It may also be possible to monitor whether or not the information is being sent to the support server 1 (at a pace of 100 times). The device control unit 88 may be configured to periodically (for example, once every 3 seconds) generate electrocardiogram data based on numerical information regarding the electrocardiogram waveform received from the electrocardiograph 4. . Further, the device control unit 88 may be configured to acquire one image of the patient's face every 3 seconds from the imaging unit 33 and transmit it to the support server 1 via the wide area communication unit 32.

For example, the timer section 85 or the operation monitoring section may detect that a communication breakdown has occurred between the tablet 3 and the support server 1 based on the fact that electrocardiogram data is not transmitted for 9 seconds. In response to the timer unit 85 or the operation monitoring unit detecting the communication interruption, the communication switching unit 86 and the communication restarting unit 87 may take measures against the communication interruption (steps S21 to S24, etc.). ).

Specifically, the communication restart unit 87 of the tablet 3 turns on/off the WiFi (registered trademark) of the second communication network 8 to eliminate the possibility that the WiFi (registered trademark) is the cause of the communication interruption. You may. The communication switching unit 86 may switch the third communication network 9 to LTE. If the transmission of electrocardiogram data is not restarted by any of the above measures, the device control unit 88 controls each peripheral device (in particular, the ergometer 5) to stop the rehabilitation. At this point, if the electrocardiogram data cannot be transmitted, but the keep-alive signal is still being transmitted and received, it is determined that the problem is the bandwidth and that the communication path itself has been secured, and the main communication control is The unit 81 or the sub-communication control unit 82 reports the status of the tablet 3 to the support server 1 one by one.

Further, the control unit 10 of the support server 1 may detect a communication abnormality, for example, based on the timer unit 65 detecting that the period during which electrocardiogram data is not sent has reached 9 seconds. The control unit 10 of the support server 1 that has detected the communication abnormality immediately sends a communication interruption notification to notify the PC 2 of the abnormality (S25). The notification unit 74 of the PC 2 that has received the communication loss notification from the support server 1 causes the display unit 22 to display a dialog such as a communication loss warning 350. Here, the displayed communication interruption warning 350 may include, for example, a counter that counts 60 seconds.

If the PC 2 is unable to receive electrocardiogram data by the time this counter reaches 0, that is, by the time 60 seconds have elapsed, the support server 1 determines whether or not a keep-alive signal could be sent/received to/from the tablet 3. judge. If the support server 1 determines that the keep-alive signal was not received, it transmits a message to the PC 2 stating that "rehabilitation is presumed to have been automatically canceled."

On the other hand, if the support server 1 determines that the transmission and reception of keep-alive signals is maintained, it receives a report from the tablet 3 operated by the patient that the rehabilitation has started to be stopped, and notifies the patient to that effect. Send the message to PC2.

That is, in any case, if image transmission is delayed, rehabilitation is automatically stopped.

As described above, regarding communication between the support server 1 and the PC 2, the communication path is monitored using a keep-alive signal. On the other hand, regarding communication between the support server 1 and the tablet 3, in addition to monitoring the bandwidth based on the image transmission interval, the communication path is monitored using a keep-alive signal.

(About the configuration to resolve communication interruption)
In FIG. 8, an example has been described in which the communication function of the second communication network 8 is restarted before the rehabilitation is stopped. Here, when the communication restart unit 87 restarts a communication function such as a router, this restart may take a relatively long time of about several minutes. Therefore, in another example, the communication restart unit 87 may restart the communication function of the router or the like after the rehabilitation is stopped. Depending on the type of line failure, there is a possibility that the current line failure will remain even when the next rehabilitation is carried out. Therefore, it is desirable to continue work to restore the line even after this rehabilitation is cancelled. Note that if the line is not restored even after restarting by the communication restart unit 87, the support system 100 allows the operator of the operating company that operates the support server 1 to attempt recovery work by manual remote control. and the tablet 3 may be configured. Furthermore, if recovery cannot be expected even with remote recovery work, the operating company will dispatch an operator to the patient's home to carry out repair work, keeping in mind the possibility of failure of equipment installed at the patient's home. Services such as these may be provided to patients.

[Example of implementation using software]
The control blocks of the support server 1 (in particular, the medical communication control unit 61, the patient communication control unit 62, the relay processing unit 63, the signal transmission/reception unit 64, the timer unit 65, the remote cancellation instruction unit 66, and the notification transmission unit 67) are as follows: It may be realized by a logic circuit (hardware) formed on an integrated circuit (IC chip) or the like, or it may be realized by software.

The control blocks of the PC 2 (in particular, the signal transmitting section 71, response receiving section 72, timer section 73, and notification section 74) may be realized by a logic circuit (hardware) formed in an integrated circuit (IC chip) or the like. However, it may also be realized by software.

Control blocks of the tablet 3 (especially main communication control section 81, sub communication control section 82, signal transmission section 83, response reception section 84, timer section 85, communication switching section 86, communication restart section 87, and device control section 88) may be realized by a logic circuit (hardware) formed on an integrated circuit (IC chip) or the like, or may be realized by software.

When implemented by software, the support server 1, PC 2, and tablet 3 are equipped with a computer that executes instructions of a program that is software that implements each function. This computer includes, for example, one or more processors and a computer-readable recording medium storing the program. Then, in the computer, the processor reads the program from the recording medium and executes it, thereby achieving the object of the present invention. As the processor, for example, a CPU (Central Processing Unit) can be used. As the recording medium, in addition to "non-temporary tangible media" such as ROM (Read Only Memory), tapes, disks, cards, semiconductor memories, programmable logic circuits, etc. can be used. Further, the computer may further include a RAM (Random Access Memory) for expanding the program. Further, the program may be supplied to the computer via any transmission medium (communication network, broadcast wave, etc.) that can transmit the program. Note that one aspect of the present invention can also be realized in the form of a data signal embedded in a carrier wave, in which the program is embodied by electronic transmission.

[Additional notes]
A rehabilitation support system (support system 100) according to the present disclosure is a rehabilitation support system that supports rehabilitation, and includes a server device (support server 1) for performing the rehabilitation support work, a server device (support server 1) used by medical personnel, a medical terminal device (PC2) that communicates with the server device via a first communication network 7; a medical terminal device (PC2) that is used by a patient undergoing the rehabilitation who is a person to be monitored by the medical personnel, and is different from the first communication network 7; The server device includes a patient terminal device (tablet 3) that communicates with the server device via a second communication network 8 and is connected to a device (load providing device, ergometer 5) that provides load to the patient. , during the implementation of the rehabilitation, keep-alive signal transmission and reception that receives each of the keep-alive signals from the medical terminal device and the patient terminal device as transmission sources, and transmits a response signal in response to the reception to all of the transmission sources. (signal transmitting/receiving section 64).

According to the above configuration, the rehabilitation support system includes a server device, a medical terminal device, and a patient terminal device. Then, during rehabilitation, the server device receives each of the keep-alive signals sent from the medical terminal device and the patient terminal device. Furthermore, the server device transmits a response signal to the received keep-alive signal to all the transmission sources (that is, the medical terminal device and the patient terminal device). Note that the keep-alive signal is a character string of approximately several tens of bytes that is transmitted and received at relatively short predetermined intervals (for example, every 5 seconds).

This allows the server device to continuously monitor the quality of communication with the medical terminal device and the quality of communication with the patient terminal device during rehabilitation.

The medical terminal device includes a medical response receiving section (response receiving section 72) that receives the response signal from the keep-alive signal transmitting/receiving section, and when the medical response receiving section does not receive the response signal for a first predetermined period. , and an output section (notification section 74) that outputs the first predetermined message.

According to the above configuration, the medical terminal device outputs the first predetermined message when it does not receive a response signal to the keep-alive signal from the server device for the first predetermined period. The first predetermined period is, for example, 10 seconds. The first predetermined message may include, for example, information indicating that the communication state between the server device and the medical terminal device is poor, and timer information that counts down and indicates the remaining time until the rehabilitation is stopped. good.

Thereby, it is possible to notify medical personnel that the communication state between the server device and the patient terminal device is poor. As a result, medical personnel can take action to continue or discontinue rehabilitation. For example, medical personnel may take actions to restore the communication status (such as restarting communication equipment) or may request the patient to discontinue rehabilitation by using any communication means (phone, SNS, etc.) that is different from the rehabilitation support system. It becomes possible to give instructions to

The server device reduces the load caused by the equipment to each of the patient terminal devices when the keep-alive signal transmitting/receiving unit does not receive the keep-alive signal from the medical terminal device for a second predetermined period that is longer than the first predetermined period. A server-side cancellation instruction unit (remote cancellation instruction unit 66) may be provided to instruct cancellation of provision.

According to the above configuration, when the server device does not receive a keep-alive signal from the medical terminal device for the second predetermined period, the server device instructs each of the patient terminal devices to stop providing load by the device. The second predetermined period is, for example, 90 seconds.

As a result, if the communication state between the server device and the medical terminal device continues to be poor, the server device can instruct the device to stop providing the load via the patient terminal device. As a result, it is possible to avoid a situation where rehabilitation is continued in a situation where medical personnel cannot monitor the patient.

The patient terminal device includes a patient-side response reception unit (response reception unit 84) that receives the response signal from the keep-alive signal transmission/reception unit, and a patient-side response reception unit that receives the response signal for a predetermined upper limit period. The device may include a terminal-side stop instruction unit (device control unit 88) that instructs the device to stop providing the load when the device does not provide the load.

According to the above configuration, the patient terminal device instructs the load providing device to stop providing the load when the communication failure is not resolved and the patient terminal device does not receive a response signal from the server device even after the upper limit period has elapsed. . The upper limit period is, for example, 60 seconds.

Thereby, if the communication state between the server device and the patient terminal device is not recovered, the load provision by the load providing device can be automatically stopped after the upper limit period. As a result, it is possible to avoid a situation where rehabilitation is continued in a situation where medical personnel cannot monitor the patient.

The patient terminal device is capable of communicating with the server device via a third communication network different from the first communication network and the second communication network, and there is a period during which the patient-side response receiving unit does not receive the response signal. When the patient-side response receiving unit does not receive the response signal for a third predetermined period before reaching the upper limit period, the communication network for communicating with the server device is changed from the second communication network to the third communication network. A communication switching section for switching to a network may be provided.

According to the above configuration, when the patient terminal device does not receive a response signal from the server device for the third predetermined period, the patient terminal device switches the communication network for communicating with the server device from the second communication network to the third communication network. The third predetermined period is, for example, 10 seconds. A typical example of the second communication network is a network including a wireless LAN such as WiFi (registered trademark), and a typical example of the third communication network is a network including a communication network such as LTE.

Thereby, the patient terminal device automatically switches the communication network, so it is possible to attempt to recover the communication state with the server device. As a result, if the communication state is restored, rehabilitation can be continued. Moreover, since the communication network is automatically switched, even if the patient's IT literacy is low, the communication state between the server device and the patient terminal device can be restored.

Furthermore, switching of the communication network is performed from the time when the response signal is no longer received until the upper limit period elapses. Therefore, if the communication network is successfully switched, cancellation of rehabilitation can be avoided.

The communication switching unit may switch a communication network for communicating with the server device from the third communication network to the second communication network when a poor communication state in the second communication network is resolved. .

According to the above configuration, the communication switching unit switches the communication network to be used to the third communication network in response to a communication failure in the second communication network, and then switches the communication network to the third communication network when the communication failure is resolved. changing the communication network back to the second communication network;

For example, if communication using a second communication network is more advantageous in terms of cost or speed than using a third communication network, use the more advantageous communication network as much as possible. A patient terminal device can be configured. This allows the patient to benefit from the advantageous aspects of the second communication network, even if the patient has low IT literacy and does not have the knowledge to select the most suitable communication network in a timely manner.

The patient terminal device is configured such that when the patient-side response receiving unit does not receive the response signal for a fourth predetermined period before the period in which the patient-side response receiving unit does not receive the response signal reaches the upper limit period, The device may include a communication restart unit that restarts a function for communicating using the second communication network.

According to the above configuration, when the patient terminal device does not receive a response signal from the server device for the fourth predetermined period, the patient terminal device restarts the function for communicating using the second communication network. The fourth predetermined period is, for example, 60 seconds.

As a result, the patient terminal device automatically restarts the function for communicating using the second communication network, so that it is possible to attempt to recover the communication state with the server device. As a result, if the communication state is restored, rehabilitation can be continued. Moreover, since the restart is performed automatically, even if the patient's IT literacy is low, the communication state between the server device and the patient terminal device can be restored.

Further, the restart is performed after the response signal is no longer received until the upper limit period elapses. Therefore, if the communication network is successfully switched, cancellation of rehabilitation can be avoided.

The server device includes a transmitting unit that transmits a second predetermined message to the medical terminal device when the keep-alive signal transmitting and receiving unit does not receive the keep-alive signal from the patient terminal device for a fifth predetermined period. Good too.

According to the above configuration, when the server device does not receive a keep-alive signal from the patient terminal device for the fifth predetermined period, the server device transmits the second predetermined message to the medical terminal device. The fifth predetermined period is, for example, 60 seconds. The second predetermined message may include, for example, information indicating that the communication state between the server device and the patient terminal device is poor, and timer information that counts down and indicates the remaining time until the rehabilitation is stopped. good.

Thereby, it is possible to notify medical personnel that the communication state between the server device and the patient terminal device is poor. As a result, medical personnel can take action to continue or discontinue rehabilitation. For example, medical personnel can instruct a patient with poor communication status to stop rehabilitation using any communication means (such as a telephone or SNS) that is different from the rehabilitation support system.

A rehabilitation support server (support server 1) according to the present disclosure is a rehabilitation support server for performing rehabilitation support work, and communicates with a medical terminal device (PC2) used by medical personnel via a first communication network. A first communication control unit (medical side communication control unit 61) is connected to a device (ergometer 5) used by a patient undergoing rehabilitation who is a person to be monitored by the medical personnel and provides load to the patient. a second communication control unit (patient side communication control unit 62) that communicates with a patient terminal device (tablet 3) to be used via a second communication network 8 different from the first communication network 7; A keep-alive signal transmitting/receiving unit (signal transmitting/receiving unit 64) that receives each of the keep-alive signals transmitted from the medical terminal device and the patient terminal device, and transmits a response signal in response to the reception to all of the transmitting sources. We are prepared. According to the above-described configuration, the same effects as in claim 1 can be achieved.

A method for controlling a medical terminal device according to the present disclosure is a method for controlling a medical terminal device used by medical personnel, wherein the medical terminal device is configured to perform rehabilitation support work via a first communication network. The server device communicates with a patient terminal device used by a patient undergoing the rehabilitation who is a person to be monitored by the medical personnel during the implementation of the rehabilitation, and the medical terminal device. The patient terminal device includes a keep-alive signal transmitting/receiving unit that receives each of the keep-alive signals from the transmission sources and transmits a response signal in response to the reception to all of the transmission sources, and the patient terminal device The medical terminal device communicates with the server device via a second communication network different from the network and is connected to a device that provides a load to the patient, and the medical terminal device receives the response signal from the keep-alive signal transmitting/receiving section. and outputting a first predetermined message when the response signal is not received for a first predetermined period. According to the above-described method, the same effects as in claim 2 can be achieved.

A method for controlling a patient terminal device according to the present disclosure is a method for controlling a patient terminal device used by a patient undergoing rehabilitation who is a person to be monitored by a medical professional, wherein the patient terminal device performs rehabilitation support work. A device that communicates with the server device via a second communication network that is different from a first communication network through which the server device for performing the communication and the medical terminal device used by the medical personnel communicates, and provides a load to the patient. During the rehabilitation, the server device receives each of the keep-alive signals sent from the medical terminal device and the patient terminal device, and transmits a response signal to the sender from the medical terminal device and the patient terminal device. the patient terminal device receives the response signal from the keep-alive signal transmitter/receiver, and transmits the response signal to a predetermined upper limit. This includes instructing the device to stop providing the load at a point in time when no reception is received for a period of time. According to the above-described method, the same effects as in claim 4 can be achieved.

The present invention is not limited to the embodiments described above, and various modifications can be made within the scope of the claims, and embodiments obtained by appropriately combining technical means disclosed in different embodiments. are also included within the technical scope of the present invention.

1 support server, 2 PC, 3 tablet, 4 wearable electrocardiograph, 5 ergometer, 7 first communication network, 8 second communication network, 9 third communication network, 61 medical side communication control unit, 62 patient side communication control unit , 63 Relay processing unit, 64 Signal transmission/reception unit, 66 Remote cancellation instruction unit, 67 Notification transmission unit, 71 Signal transmission unit, 72 Response reception unit, 74 Notification unit, 81 Main communication control unit, 82 Sub communication control unit, 71 Signal Transmitting unit, 72 Response receiving unit, 86 Communication switching unit, 87 Communication restart unit, 88 Equipment control unit, 100 Rehabilitation support system, 350 Communication loss warning (first predetermined message), 360 Communication loss notification (second predetermined message)

Claims (21)

A rehabilitation support system that supports remote cardiac rehabilitation,
a server device for performing support work for the remote cardiac rehabilitation;
a medical terminal device used by a medical personnel and communicating with the server device via a first communication network;
Used by a patient who is a subject of monitoring by the medical personnel and who undergoes remote cardiac rehabilitation, communicates with the server device via a second communication network different from the first communication network, and provides a load to the patient. Equipped with an ergometer and a patient terminal device connected to it,
During the implementation of the remote cardiac rehabilitation, transmission from the patient terminal device to the medical terminal device via the server device is performed in real time,
During the implementation of the remote cardiac rehabilitation, the server device receives each of the keep-alive signals sent from the medical terminal device and the patient terminal device, and sends a response signal in response to the reception to all of the senders. A rehabilitation support system comprising a keep-alive signal transmitting/receiving unit. A rehabilitation support system that supports rehabilitation,
a server device for performing the rehabilitation support work;
a medical terminal device used by a medical personnel and communicating with the server device via a first communication network;
A device that is used by a patient undergoing rehabilitation who is a person to be monitored by the medical personnel, communicates with the server device via a second communication network different from the first communication network, and provides a load to the patient. Equipped with a patient terminal device to be connected,
During the implementation of the rehabilitation, the server device receives each of the keep-alive signals sent from the medical terminal device and the patient terminal device, and transmits a response signal in response to the reception to all of the senders. Equipped with a keep-alive signal transmitter and receiver ,
The patient terminal device includes:
a patient-side response receiving unit that receives the response signal from the keep-alive signal transmitting and receiving unit;
and a terminal-side stop instructing unit that instructs the device to stop providing a load when the patient-side response receiving unit does not receive the response signal for a predetermined upper limit period after the patient-side response receiving unit last receives the response signal. Rehabilitation support system. A rehabilitation support system that supports rehabilitation,
a server device for performing the rehabilitation support work;
a medical terminal device used by a medical personnel and communicating with the server device via a first communication network;
A device that is used by a patient undergoing rehabilitation who is a person to be monitored by the medical personnel, communicates with the server device via a second communication network different from the first communication network, and provides a load to the patient. Equipped with a patient terminal device to be connected,
During the implementation of the rehabilitation, the server device receives each of the keep-alive signals sent from the medical terminal device and the patient terminal device, and transmits a response signal in response to the reception to all of the senders. Equipped with a keep-alive signal transmitter and receiver,
The medical terminal device includes:
a medical response receiving unit that receives the response signal from the keep-alive signal transmitting and receiving unit;
an output unit that outputs a first predetermined message when the medical side response receiving unit does not receive the response signal for a first predetermined period after last receiving the response signal;
The server device further includes:
When the keep-alive signal transmitting/receiving unit does not receive the keep-alive signal for a second predetermined period longer than the first predetermined period after last receiving the keep-alive signal from the medical terminal device, transmitting a signal to each of the patient terminal devices. A rehabilitation support system, comprising : a server-side stop instruction unit that instructs the device to stop providing load . The medical terminal device includes:
a medical response receiving unit that receives the response signal from the keep-alive signal transmitting and receiving unit;
The rehabilitation support according to claim 1, further comprising an output section that outputs a first predetermined message when the medical response receiving section does not receive the response signal for a first predetermined period after receiving the response signal last. system. The medical terminal device includes:
a medical response receiving unit that receives the response signal from the keep-alive signal transmitting and receiving unit;
Rehabilitation support according to claim 2 , further comprising an output section that outputs a first predetermined message when the medical response receiving section does not receive the response signal for a first predetermined period after the last reception of the response signal. system. The server device includes:
When the keep-alive signal transmitting/receiving unit does not receive the keep-alive signal for a second predetermined period longer than the first predetermined period after last receiving the keep-alive signal from the medical terminal device, transmitting a signal to each of the patient terminal devices. 5. The rehabilitation support system according to claim 4 , further comprising a server-side stop instruction unit that instructs the ergometer to stop providing load. The server device includes:
When the keep-alive signal transmitting/receiving unit does not receive the keep-alive signal for a second predetermined period longer than the first predetermined period after last receiving the keep-alive signal from the medical terminal device, transmitting a signal to each of the patient terminal devices. 6. The rehabilitation support system according to claim 5 , further comprising a server-side stop instruction unit that instructs the device to stop providing load. The patient terminal device includes:
a patient-side response receiving unit that receives the response signal from the keep-alive signal transmitting and receiving unit;
The present invention further comprises: a terminal-side stop instructing unit that instructs the ergometer to stop providing load when the patient-side response receiving unit does not receive the response signal for a predetermined upper limit period after the patient-side response receiving unit last receives the response signal. The rehabilitation support system according to any one of Items 1 , 4, and 6 . The patient terminal device includes:
a patient-side response receiving unit that receives the response signal from the keep-alive signal transmitting and receiving unit;
Claim comprising: a terminal-side stop instructing unit that instructs the device to stop providing load when the patient-side response receiving unit does not receive the response signal for a predetermined upper limit period after last receiving the response signal. The rehabilitation support system according to any one of Items 3, 5, and 7 . The patient terminal device includes:
capable of communicating with the server device via a third communication network different from the first communication network and the second communication network;
Before the period during which the patient side response receiving unit does not receive the response signal reaches the upper limit period, the patient side response receiving unit receives the response signal for a third predetermined period after receiving the response signal last. 10. The communication switching unit according to claim 2, further comprising a communication switching unit that switches a communication network for communicating with the server device from the second communication network to the third communication network when the server device does not communicate with the server device. Rehabilitation support system. The patient terminal device includes:
Before the period during which the patient side response receiving unit does not receive the response signal reaches the upper limit period, the patient side response receiving unit receives the response signal for a fourth predetermined period after receiving the response signal last. 11. The rehabilitation support system according to claim 2 , further comprising a communication restart unit that restarts a function for communicating using the second communication network when the second communication network is not used. The server device includes:
When the keep-alive signal transmitting/receiving unit does not receive the keep-alive signal for a fifth predetermined period after last receiving the keep-alive signal from the patient terminal device, transmits a second predetermined message to the medical terminal device. The rehabilitation support system according to any one of claims 1 to 11 , comprising a transmitter. A rehabilitation support server for performing remote cardiac rehabilitation support operations,
a first communication control unit that communicates with a medical terminal device used by medical personnel via a first communication network;
A patient terminal device connected to an ergometer that is used by a patient who is a subject to be monitored by the medical personnel and who undergoes the remote cardiac rehabilitation and provides load to the patient, and a second communication network different from the first communication network. a second communication control unit that communicates through the
During the implementation of the remote cardiac rehabilitation, a keep-alive signal receives each of the keep-alive signals from the medical terminal device and the patient terminal device, and transmits a response signal in response to the reception to all of the transmission sources. Equipped with a transmitting and receiving section,
A rehabilitation support server that executes transmission from the patient terminal device to the medical terminal device in real time during implementation of the remote cardiac rehabilitation . A rehabilitation support server for performing rehabilitation support operations,
a first communication control unit that communicates with a medical terminal device used by medical personnel via a first communication network;
A patient terminal device that is used by a patient undergoing rehabilitation who is a person to be monitored by the medical personnel and is connected to a device that provides load to the patient, and a second communication network different from the first communication network. a second communication control unit that communicates;
During implementation of the rehabilitation, a keep-alive signal transmitting/receiving unit receives each of the keep-alive signals from the medical terminal device and the patient terminal device, and transmits a response signal in response to the reception to all of the transmission sources. Equipped with
The patient terminal device includes:
a patient-side response receiving unit that receives the response signal from the keep-alive signal transmitting and receiving unit;
and a terminal-side stop instructing unit that instructs the device to stop providing a load when the patient-side response receiving unit does not receive the response signal for a predetermined upper limit period after the patient-side response receiving unit last receives the response signal . Rehabilitation support server. A rehabilitation support server for performing rehabilitation support operations,
a first communication control unit that communicates with a medical terminal device used by medical personnel via a first communication network;
A patient terminal device that is used by a patient undergoing rehabilitation who is a person to be monitored by the medical personnel and is connected to a device that provides load to the patient, and a second communication network different from the first communication network. a second communication control unit that communicates;
During implementation of the rehabilitation, a keep-alive signal transmitting/receiving unit receives each of the keep-alive signals from the medical terminal device and the patient terminal device, and transmits a response signal in response to the reception to all of the transmission sources. and,
When the keep-alive signal transmitting/receiving unit does not receive the keep-alive signal for a second predetermined period longer than the first predetermined period after last receiving the keep-alive signal from the medical terminal device, transmitting a signal to each of the patient terminal devices. a server-side stop instruction unit that instructs the device to stop providing the load ;
The medical terminal device includes:
a medical response receiving unit that receives the response signal from the keep-alive signal transmitting and receiving unit;
and an output section that outputs a first predetermined message when the medical response receiving section does not receive the response signal for a first predetermined period after the last reception of the response signal . A method for controlling a medical terminal device used by medical personnel, the method comprising:
The medical terminal device communicates with a server device for performing remote cardiac rehabilitation support work via a first communication network,
The server device includes a patient terminal device used by a patient receiving the remote cardiac rehabilitation who is a person to be monitored by the medical personnel during the implementation of the remote cardiac rehabilitation, and a keep server device whose transmission source is the medical terminal device. A keep-alive signal transmitting/receiving unit that receives each of the alive signals and transmits a response signal in response to the reception to all of the transmission sources,
The patient terminal device communicates with the server device via a second communication network different from the first communication network, and is connected to an ergometer that provides a load to the patient;
During the implementation of the remote cardiac rehabilitation, transmission from the patient terminal device to the medical terminal device via the server device is performed in real time,
The medical terminal device,
receiving the response signal from the keep-alive signal transmitting/receiving section; and
outputting a first predetermined message when the response signal is not received for a first predetermined period after last receiving the response signal;
A method of controlling a medical terminal device. A method for controlling a medical terminal device used by medical personnel, the method comprising:
The medical terminal device communicates with a server device for performing rehabilitation support work via a first communication network,
During the implementation of the rehabilitation, the server device transmits each of a patient terminal device used by a patient who is monitored by the medical personnel and who undergoes the rehabilitation, and a keep-alive signal whose transmission source is the medical terminal device. and a keep-alive signal transmitting/receiving unit that receives a response signal and transmits a response signal in response to the reception to all of the transmission sources,
The patient terminal device includes:
communicates with the server device via a second communication network different from the first communication network and is connected to a device that provides a load to the patient;
a patient-side response receiving unit that receives the response signal from the keep-alive signal transmitting and receiving unit;
and a terminal-side stop instruction section that instructs the device to stop providing load when the patient-side response receiving section does not receive the response signal for a predetermined upper limit period after last receiving the response signal. and
The medical terminal device,
receiving the response signal from the keep-alive signal transmitting/receiving section; and
outputting a first predetermined message when the response signal is not received for a first predetermined period after last receiving the response signal;
A method of controlling a medical terminal device. A method for controlling a medical terminal device used by medical personnel, the method comprising:
The medical terminal device communicates with a server device for performing rehabilitation support work via a first communication network,
During the implementation of the rehabilitation, the server device transmits each of a patient terminal device used by a patient who is monitored by the medical personnel and who undergoes the rehabilitation, and a keep-alive signal whose transmission source is the medical terminal device. and a keep-alive signal transmitting/receiving unit that receives a response signal and transmits a response signal in response to the reception to all of the transmission sources,
The medical terminal device includes:
a medical response receiving unit that receives the response signal from the keep-alive signal transmitting and receiving unit;
an output section that outputs a first predetermined message when the medical response receiving section does not receive the response signal for a first predetermined period after the last reception of the response signal;
The server device further includes:
When the keep-alive signal transmitting/receiving unit does not receive the keep-alive signal for a second predetermined period longer than the first predetermined period after last receiving the keep-alive signal from the medical terminal device, transmitting a signal to each of the patient terminal devices. In contrast, the device includes a server-side stop instruction unit that instructs the device that provides the load to the patient to stop providing the load,
The patient terminal device includes:
communicates with the server device via a second communication network different from the first communication network and is connected to the device ;
The medical terminal device,
receiving the response signal from the keep-alive signal transmitting/receiving section; and
outputting a first predetermined message when the response signal is not received for a first predetermined period after last receiving the response signal;
A method of controlling a medical terminal device. A method for controlling a patient terminal device used by a patient who is monitored by a medical professional and who undergoes remote cardiac rehabilitation, the method comprising:
The patient terminal device connects to the server via a second communication network different from a first communication network through which the server device for performing the remote cardiac rehabilitation support service and the medical terminal device used by medical personnel communicate. in communication with the device and connected to an ergometer that provides resistance to the patient;
During the implementation of the remote cardiac rehabilitation, the server device receives each of the keep-alive signals sent from the medical terminal device and the patient terminal device, and sends a response signal in response to the reception to all of the senders. It is equipped with a keep-alive signal transmitting/receiving unit to transmit,
During the implementation of the remote cardiac rehabilitation, transmission from the patient terminal device to the medical terminal device via the server device is performed in real time,
The patient terminal device,
receiving the response signal from the keep-alive signal transmitting/receiving section; and
including instructing the ergometer to stop providing load at a time when the response signal is not received for a predetermined upper limit period after the response signal is last received ;
A method of controlling a patient terminal device. A method of controlling a patient terminal device used by a patient undergoing rehabilitation who is a subject of monitoring by a medical professional, the method comprising:
The patient terminal device communicates with the server device via a second communication network different from a first communication network through which a server device for performing rehabilitation support work and a medical terminal device used by medical personnel communicate. and is connected to a device that provides a load to the patient,
During the implementation of the rehabilitation, the server device receives each of the keep-alive signals sent from the medical terminal device and the patient terminal device, and transmits a response signal in response to the reception to all of the senders. It is equipped with a keep-alive signal transmitting and receiving section,
The patient terminal device includes:
a patient-side response receiving unit that receives the response signal from the keep-alive signal transmitting and receiving unit;
and a terminal-side stop instruction section that instructs the device to stop providing the load when the patient-side response receiving section does not receive the response signal for a predetermined upper limit period after last receiving the response signal. and
The patient terminal device,
receiving the response signal from the keep-alive signal transmitting/receiving section; and
including instructing the device to stop providing load when the response signal is not received for a predetermined upper limit period after last receiving the response signal;
A method of controlling a patient terminal device. A method of controlling a patient terminal device used by a patient undergoing rehabilitation who is a subject of monitoring by a medical professional, the method comprising:
The patient terminal device communicates with the server device via a second communication network different from a first communication network through which a server device for performing rehabilitation support work and a medical terminal device used by medical personnel communicate. and is connected to a device that provides a load to the patient,
During the implementation of the rehabilitation, the server device receives each of the keep-alive signals sent from the medical terminal device and the patient terminal device, and transmits a response signal in response to the reception to all of the senders. It is equipped with a keep-alive signal transmitting and receiving section,
The medical terminal device includes:
a medical response receiving unit that receives the response signal from the keep-alive signal transmitting and receiving unit;
an output unit that outputs a first predetermined message when the medical side response receiving unit does not receive the response signal for a first predetermined period after last receiving the response signal;
The server device further includes:
When the keep-alive signal transmitting/receiving unit does not receive the keep-alive signal for a second predetermined period longer than the first predetermined period after last receiving the keep-alive signal from the medical terminal device, transmitting a signal to each of the patient terminal devices. a server-side stop instruction unit that instructs the device to stop providing load to the device;
The patient terminal device,
receiving the response signal from the keep-alive signal transmitting/receiving section; and
including instructing the device to stop providing load when the response signal is not received for a predetermined upper limit period after last receiving the response signal;
A method of controlling a patient terminal device.

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