JP7456041B2 - Telemedicine support device, method and program - Google Patents

Description

The present disclosure relates to a remote medical treatment support device, system, method, and program, and particularly relates to a remote medical treatment support device, system, method, and program for supporting remote medical treatment.

Patent Document 1 discloses a technology related to a home care support system for sharing information and providing work support among medical workers, welfare workers, etc. in the community comprehensive care field centered on home medical treatment. . The home care support system includes a mobile home care support terminal, a home care support viewer terminal, and a home care support server. Here, a mobile home care support terminal is a terminal carried by a medical worker such as a nurse who visits a patient's home, etc., and a home care support viewer terminal is a terminal carried by a medical worker such as a doctor at a medical institution. It is a terminal. The home care support server communicably connects the mobile home care support terminal and the home care support viewer terminal, and controls communication between the terminals via the bulletin board.

Japanese Patent Application Publication No. 2016-51365

In the field of telemedicine, including home medical treatment, communication between doctors and other medical personnel at medical institutions and patients and other medical personnel at bases (outside the medical institution), including patients' homes, is important. Real-time interaction is beneficial. However, the technique disclosed in Patent Document 1 involves only exchanging text information on a bulletin board or the like, and there is a problem in that it is insufficient for smoothly conducting remote medical treatment.

The present disclosure has been made to solve these problems, and provides a remote medical care support device, system, method, and program that combine a patient information sharing screen between medical professionals and two-way video communication. The purpose is to provide

The remote medical care support device according to the first aspect of the present disclosure includes:
a connection management unit that controls establishment of a direct communication connection between the first and second terminals;
A medical management department that manages medical information regarding patients receiving remote medical treatment;
Equipped with
The medical management department is
generating display information for displaying the medical information on a screen of the first terminal in response to a request from the first terminal with which the connection has been established with the second terminal;
embedded in the display information a process for transmitting a photographed image of a user using the first terminal to the second terminal through the direct communication;
The embedded display information is sent back to the first terminal.

The remote medical care support system according to the second aspect of the present disclosure includes:
first and second terminals;
a remote medical care support device connected to the first and second terminals via a network;
Equipped with
The remote medical treatment support device includes:
a connection management unit that controls establishment of a direct communication connection between the plurality of terminals;
A medical management department that manages medical information regarding patients receiving remote medical treatment;
Equipped with
The medical management department is
generating display information for displaying the medical information on a screen of the first terminal in response to a request from the first terminal with which the connection has been established with the second terminal;
embedded in the display information a process for transmitting a photographed image of a user using the first terminal to the second terminal through the direct communication;
The embedded display information is sent back to the first terminal.

The remote medical treatment support method according to the third aspect of the present disclosure includes:
The computer is
controlling the establishment of a direct communication connection between the first and second terminals;
generating display information for displaying medical information regarding a patient undergoing remote medical treatment on the screen of the first terminal in response to a request from the first terminal that has established a connection with the second terminal;
embedded in the display information a process for transmitting a photographed image of a user using the first terminal to the second terminal through the direct communication;
The embedded display information is sent back to the first terminal.

The remote medical treatment support program according to the fourth aspect of the present disclosure includes:
A process for controlling the establishment of a direct communication connection between the first and second terminals;
A process of generating display information for displaying medical information regarding a patient undergoing remote medical treatment on the screen of the first terminal in response to a request from the first terminal that has established a connection with the second terminal. and,
embedding in the display information a process of transmitting a photographed image of a user using the first terminal to the second terminal through the direct communication;
a process of replying the embedded display information to the first terminal;
have the computer execute it.

According to the present disclosure, it is possible to provide a remote medical care support device, system, method, and program that combine a patient information sharing screen between medical professionals and two-way communication using video.

FIG. 1 is a block diagram showing the configuration of a remote medical treatment support system according to the first embodiment. 1 is a flowchart showing the flow of a remote medical treatment support method according to the first embodiment. 1 is a flowchart showing the flow of a remote medical treatment support method according to the first embodiment. FIG. 2 is a block diagram showing the configuration of a remote medical treatment support system according to a second embodiment. 3 is a block diagram showing the configuration of each DB in the shared storage device according to the second embodiment. FIG. FIG. 2 is a block diagram showing the configuration of a server device according to a second embodiment. 12 is a flowchart illustrating the flow of login and authentication processing according to the second embodiment. FIG. 7 is a sequence diagram illustrating the flow of terminal-to-terminal connection processing when two terminals of ICE according to the second embodiment are registered in the same server. FIG. 7 is a sequence diagram illustrating the flow of terminal-to-terminal connection processing when two terminals of ICE according to the second embodiment are registered in the same server. FIG. 7 is a sequence diagram illustrating the flow of terminal-to-terminal connection processing when two terminals of ICE according to the second embodiment are registered in different servers. FIG. 7 is a sequence diagram illustrating the flow of terminal-to-terminal connection processing when two terminals of ICE according to the second embodiment are registered in different servers. FIG. 3 is a block diagram showing the configuration of a remote medical treatment support system according to the third embodiment. 12 is a flowchart showing the flow of a remote medical treatment support method according to the third embodiment. FIG. 3 is a block diagram showing the configuration of a remote medical treatment support system according to the fourth embodiment. 12 is a flowchart showing the flow of a remote medical treatment support method according to the fourth embodiment.

Embodiments of the present disclosure will be described in detail below with reference to the drawings. In each drawing, the same or corresponding elements are denoted by the same reference numerals, and for clarity of explanation, redundant explanation will be omitted as necessary.

<Embodiment 1>
First, the problem to be solved by the first embodiment will be explained. As mentioned above, in the field of telemedicine, real-time communication between doctors and other medical professionals at a medical institution and patients, visiting nurses, visiting caregivers, etc. located at locations other than the medical institution (remote areas) It is beneficial to have such exchanges. Therefore, two-way communication using audio and video is required, but the client-server type shown in Patent Document 1 requires a high network load for real-time communication such as video, and is likely to rapidly expand in the future. It is difficult to apply it to the field of remote medical treatment including medical treatment.

In recent years, WebRTC (Web Real-Time Communication) has become popular as a technology for directly connecting devices via P2P (Peer to Peer) without using a server to achieve high-speed real-time communication such as video communication. It is being done.

Therefore, in remote medical treatment, it is conceivable to use real-time communication such as two-way video between terminals using the above-mentioned P2P communication. For example, in WebRTC, by establishing direct communication between terminals via a signaling server, after establishment, it is possible to realize faster two-way video communication between terminals without going through a server, with a lower communication load. can.

Furthermore, in the field of telemedicine, it is not enough just to be able to communicate between terminals; it is also necessary to maintain a connection with a web system in order to share and update various medical information managed by a server. be. Therefore, in the field of remote medical treatment, it is necessary to use both client-server type communication and P2P communication. Further, as described above, in order to meet the increasing needs for remote medical treatment, it is necessary to make the server side redundant, especially the signaling server.

However, since the current signaling server does not have sufficient redundancy, there is a problem that it is difficult to directly apply P2P communication to the field of remote medical treatment. The reason for this is that the signaling server retains pre-registered connection management information (ICE (Interactive Connectivity Establishment), etc.), which is information used to establish a P2P communication connection, only in its built-in memory. . Therefore, even if the signaling server is made redundant, if the first terminal requests establishment of a P2P communication connection, the server does not hold the ICE, etc. for the second terminal to which the connection is requested. cannot establish a direct communication connection.

Therefore, in the first embodiment described below, a redundant connection control server performs connection processing for direct communication between arbitrary terminals among a large number of terminals that share information with a server for remote medical treatment. The purpose is to do so.

FIG. 1 is a block diagram showing the configuration of a remote medical care support system 1000 according to the first embodiment. The remote medical treatment support system 1000 is an information system for supporting home medical treatment (remote medical treatment, online medical treatment) in which a patient receives various medical treatments from a medical professional while remaining at home in a place other than a medical institution. Here, medical personnel include doctors, nurses, physical therapists, caregivers, pharmacists, and the like. In addition, home medical treatment includes medical treatment in a narrow sense, such as treatment and treatment performed by a doctor or a nurse under the direction of a doctor, as well as rehabilitation in a broader sense, such as rehabilitation performed by a physical therapist, health management performed by a caregiver, and medication management. This also includes medical procedures.

The remote medical care support system 1000 includes a storage system 1, remote medical care support devices 21, 22, etc., terminals 31, 32, etc. The storage system 1 is a storage device group composed of one or more storage devices. Therefore, the storage system 1 may be realized by dispersion or redundancy using two or more storage devices. The storage system 1 stores usage management information 11 and connection management information 12. Note that each of the usage management information 11 and the connection management information 12 is two or more. The usage management information 11 is management information for the terminal to use various information services provided by the remote medical care support system 1000. In the usage management information 11, at least a usage status 111 and a terminal ID 112 are associated with each other. The usage status 111 is information indicating a status such as whether or not a specific terminal is activated and is being used by logging in to various information services provided by the remote medical care support system 1000. The terminal ID 112 is associated with the usage state 111 and is identification information of a specific terminal. The connection management information 12 is information used by the terminal indicated by the terminal ID 122 to establish a connection for direct communication with another terminal. In the connection management information 12, at least destination information 121 and terminal ID 122 are associated. The destination information 121 is address information given to the terminal indicated by the terminal ID 122, and is, for example, an IP (Internet Protocol) address.

The remote medical care support devices 21 and 22 are redundant computer devices, and both are connected to the storage system 1. In other words, it can be said that the storage system 1 is used as a shared disk between the remote medical care support devices 21 and 22. Further, the remote medical care support devices 21 and 22 can be connected to terminals 31 and 32, etc. via the network N. In other words, it can be said that the remote medical care support devices 21 and 22 distribute the load with respect to accesses from the terminal 31 and the like via the network N. Hereinafter, the remote medical care support device 21 will be described as a representative, and since the internal configuration of the remote medical care support device 22 is equivalent to the remote medical care support device 21, illustration and explanation will be omitted.

The remote medical treatment support device 21 includes a medical treatment management section 211, a connection management section 212, and a memory 213. The memory 213 is a volatile storage device, such as a RAM (Random Access Memory). The medical care management unit 211 inputs and outputs medical information regarding patients undergoing remote medical treatment to and from the terminal. For example, the medical care management unit 211 is realized by a WEB application, and in response to a WEB access from a terminal, generates a display page by referring to the storage system 1, etc., and sends it back, and displays the display page on the screen of the requesting terminal. Display. Further, the medical care management unit 211 receives data input via a display page on the terminal, and stores the data in the storage system 1 or the like. The medical care management unit 211 obtains a list of terminal IDs 112 whose usage status 111 is in use from the usage management information 11 of the storage system 1 in response to a terminal list request from at least the first terminal, and stores the list as the first terminal. Reply to terminal 1. The above-mentioned medical information includes the patient's own personal information, biological information, text information indicating records of medical examinations, prescriptions, nursing care, rehabilitation, etc., image data, audio data, etc., and the dates and times of updates thereof. Further, the list of terminal IDs may include the own terminal ID.

The connection management unit 212 controls the establishment of a connection for direct communication between terminals. When the connection management unit 212 receives a request to register connection management information on a predetermined terminal, the connection management unit 212 holds the connection management information (as connection management information 214) in the memory 213 of the remote medical care support device 21. At the same time, the connection management unit 212 registers the connection management information (as connection management information 12) in the storage system 1. Furthermore, when the connection management unit 212 receives a connection management information request (an example of a connection establishment request) including a second terminal ID of a second terminal selected from the list at the first terminal, , searches the memory 213 for the second terminal ID. The connection management unit 212 searches the storage system 1 for the second terminal ID when the second terminal ID does not exist in the memory 213 (the search results in a mishit). The connection management unit 212 acquires second connection management information associated with the second terminal ID from the memory 213 or the storage system 1 where the second terminal ID exists (the search hits). and sends a reply to the first terminal. In response to receiving a terminal-to-terminal connection request in which second connection management information is specified from the first terminal, the connection management unit 212 transmits the first connection to the second terminal based on the second connection management information. Inquires whether direct communication with the terminal is possible. Then, in response to the connection permission response from the second terminal, the connection management unit 212 responds to the first terminal requesting connection permission for direct communication with the second terminal.

The remote medical care support devices 21 and 22 each include a processor and a storage device (not shown). Further, the storage device stores a remote medical treatment support program, which is a computer program in which the remote medical treatment support method according to the present embodiment is implemented. Then, the processor reads the remote medical care support program from the storage device into the memory 213 and executes the remote medical care support program. Thereby, the processor realizes the functions of the medical treatment management section 211 and the connection management section 212.

The network N is a communication network such as the Internet or a leased line.

The terminals 31 and 32 are information processing terminal devices that can access the remote medical care support device 21 or 22 or the like via the network N and use various information services provided by the remote medical care support system 1000. The terminals 31 and 32 are, for example, information processing terminals capable of wireless communication, such as tablet terminals. Then, the terminal 31 and the terminal 32 establish a connection for direct communication via the remote medical care support device 21 or the like, and perform real-time communication regarding video and audio through direct communication. The terminal 31 stores the terminal ID 311 and connection management information 312 in an internal storage device (not shown). The terminal ID 311 is identification information for identifying the terminal 31, and may use a value equivalent to a telephone number. The connection management information 312 has the same configuration as the connection management information 12 described above, and is information necessary for the terminal 31 to establish a direct communication connection with another terminal, and information provided to the connection destination during direct communication. . In addition, since a publicly known configuration of the terminal 31 can be used, illustration and explanation of other configurations will be omitted. Further, the terminal 32 has the same configuration as the terminal 31. However, the terminal ID 321 is identification information for identifying the terminal 32. Further, the connection management information 322 is information necessary for the terminal 32 to establish a connection for direct communication with another terminal, and information provided to the connection destination during direct communication.

2 and 3 are flowcharts showing the flow of the remote medical treatment support method according to the first embodiment. First, the connection management unit 212 of the remote medical care support device 21 receives a request from a predetermined terminal (for example, the terminal 31) to register connection management information (for example, the connection management information 312) in the terminal (S101). At this time, the connection management unit 212 holds the connection management information in the memory 214 of its own device (S102). At the same time, the connection management unit 212 registers the connection management information in the storage system 1 (S103).

Note that the remote medical care support device 21 may separately receive registration of the connection management information 322 from the terminal 32 as well. In that case, steps S102 and S103 are similarly executed. That is, in this case, the remote medical care support device 21 will hold both the connection management information 312 and 322 in the memory 213. Alternatively, the remote medical care support device 21 may accept registration of the connection management information 312 from the terminal 31, but may not accept registration of the connection management information 322 from the terminal 32. In this case, the remote medical care support device 21 will hold only the connection management information 312 in the memory 213. The same applies to the case where the remote medical care support device 21 receives registration of the connection management information 322 only from the terminal 32.

Subsequently, the medical care management unit 211 of the remote medical care support device 21 receives a terminal list request from the first terminal (for example, the terminal 31) (S104). In response, the medical treatment management unit 211 obtains a list of terminal IDs 112 whose usage status 111 is in use from the usage management information 11 of the storage system 1 (S105). For example, the medical care management unit 211 obtains a list including the terminal ID of the terminal 32. The medical care management unit 211 then returns the list to the terminal 31 (S106).

Thereafter, the connection management unit 212 receives a connection management information request including the second terminal ID of the second terminal (for example, terminal 32) selected from the list returned in step S106 in the terminal 31 (S107). ). In response, the connection management unit 212 searches the memory 213 for the second terminal ID (S108).

The connection management unit 212 determines whether the second terminal ID exists in the memory 213 through the search in step S108 (S109). For example, if the remote medical care support device 21 receives a registration request for the connection management information 322 from the terminal 32 in step S101, since the connection management information 322 is held in the memory 213, the second terminal ID is stored in the memory 213. It is determined that it exists (YES in S109). The connection management unit 212 then acquires second connection management information associated with the second terminal ID from the memory 213 (S110).

On the other hand, if the remote medical care support device 21 does not receive a registration request for the connection management information 322 from the terminal 32 in step S101, the connection management information 322 is not held in the memory 213, and therefore the second terminal ID is stored in the memory 213. It is determined that it does not exist (NO in S109). In that case, the connection management unit 212 searches the storage system 1 for the second terminal ID (S111). Then, the connection management unit 212 determines whether the second terminal ID exists in the terminal ID 122 in the connection management information 12 of the storage system 1 through the search in step S111 (S112). Note that if the determination in step S112 is NO, it means that the second connection management information cannot be acquired due to some kind of system fraud. Therefore, in that case, the connection management unit 212 returns a message to the terminal 31 that the connection is not possible (S114).

On the other hand, if it is determined in step S112 that the second terminal ID exists in the storage system 1, the connection management unit 212 acquires the second connection management information associated with the second terminal ID from the storage system 1. (S113). After step S110 or S113, the connection management unit 212 returns the acquired second connection management information (for example, the connection management information 322 of the terminal 32) to the first terminal (terminal 31) (S115).

Then, the connection management unit 212 receives an inter-terminal connection request in which the second connection management information is specified from the first terminal (S116). In response, the connection management unit 212 sends an inquiry to the second terminal based on the second connection management information as to whether direct communication with the first terminal is possible (S117). Then, the connection management unit 212 receives a connection permission response from the second terminal (S118), and in response, responds to the first terminal with connection permission for direct communication with the second terminal. (S119).

As a result, after this, the terminal 31 establishes a direct communication connection with the terminal 32 using the connection management information 322 of the terminal 32, and performs real-time communication of video, audio, etc. The terminals 31 and 32 are also connected to a medical care management section 211 such as the remote medical care support device 21, and can also maintain input and output of medical information using a web application or the like. Therefore, according to the first embodiment, a redundant connection control server realizes connection processing for direct communication between arbitrary terminals among a large number of terminals that share information with a server for remote medical treatment. be able to.

<Embodiment 2>
The second embodiment is a specific example of the first embodiment described above. FIG. 4 is a block diagram showing the configuration of a remote medical care support system 2000 according to the second embodiment. The remote medical care support system 2000 includes a shared storage device 4, server devices 51, 52, etc., a load balancing device 6, and tablet terminals 710, 720, and 730.

The shared storage device 4 is a storage device group composed of one or more storage devices, and may be distributed or made redundant by two or more storage devices. The shared storage device 4 is connected to server devices 51, 52, etc., and is shared between the server devices 51, 52, etc. The shared storage device 4 runs a DBMS (DataBase Management System) and includes a plurality of DB instances, such as a usage management DB 41, a connection management DB 42, a medical personnel DB 43, a medical history DB 44, and an authority definition DB 45.

FIG. 5 is a block diagram showing the configuration of each DB in the shared storage device 4 according to the second embodiment. The usage management DB 41 is a database that manages a plurality of pieces of usage management information 11 described above. One record managed by the usage management DB 41 is, for example, information in which a user ID 411, a user attribute 412, a terminal ID 413, a usage status 414, a password 415, and a face image 416 are associated with each other. Here, the user ID 411 is identification information of a user of a predetermined terminal. The user attributes 412 are information indicating attributes of users who are related parties in telemedicine, such as doctors, nurses, caregivers, pharmacists, patients, and the like. The terminal ID 413 is identification information of a terminal that the user can use (operate, log in, etc.). The usage status 414 is an example of the usage status 111 described above, and is information indicating whether or not the user corresponding to the user ID 411 is currently using the terminal corresponding to the terminal ID 413. Password 415 is a password used for password authentication when user ID 411 logs in. The face image 416 is the user's face image data used for face authentication when the user ID 411 logs in.

The connection management DB 42 is a database that manages the ICEs 421, 422, and the like. Here, the ICE 421 and the like are an example of the connection management information 12 described above. For example, the ICE 421 is associated with a terminal ID 4211, a dynamic IP address 4212, and route information 4213. The dynamic IP address 4212 is an example of the destination information 121 described above, and is an address dynamically assigned when the terminal is started. The route information 4213 is information regarding a communication route that may reach a connection destination for P2P communication. Note that the route information 4213 is also a candidate for route information in the network N through which direct communication takes place. Note that the connection management DB 42 may further include SDP (Session Description Protocol) as connection management information.

The medical care personnel DB 43 is a database that manages persons involved in remote medical treatment for each patient. One record of the medical personnel DB 43 is one in which, for example, a patient ID 431, a doctor ID 432, a nurse ID 433, and a caregiver ID 434 are associated with each other. Here, the user ID 411 described above may be used as the patient ID 431, doctor ID 432, nurse ID 433, and caregiver ID 434. The same applies to the subsequent explanation.

The medical history DB 44 is a database that manages medical information and access rights for each patient. One record of the medical history DB 44 is one in which, for example, a patient ID 441, medical information 442, access authority 443, and user ID 444 are associated with each other. Here, the patient ID 441 is the same as the patient ID 431 described above. As mentioned above, the medical information 442 includes the patient's own personal information, biological information, text information, image, audio data, etc. indicating records of examinations, prescriptions, nursing care, rehabilitation, etc., as well as their update dates and times, and the type of medical information. is included. The access authority 443 is information indicating the type of authority such as viewing authority and update authority. The user ID 444 is identification information of a user who has been granted access authority 443 to the set of patient ID 431 and medical information 442.

The authority definition DB 45 is a database that defines users to whom access authority is granted based on the type of medical information for each patient. One record of the authority definition DB 45 is, for example, a record in which a patient ID 451, a medical information type 452, and a user ID 453 are associated with each other. Here, the patient ID 451 is the same as the patient ID 431 described above. The medical information type 452 is, for example, information that identifies whether the content of the medical information is the patient's own personal information, biological information, medical examination progress, or the like. The user ID 453 is identification information of a user who has been granted access authority 443 to the set of patient ID 451 and medical information type 452.

Returning to FIG. 4, the explanation will be continued. The server devices 51 and 52 are two or more redundant computer devices, both connected to the shared storage device 4, and load distributed by the load distribution device 6 to receive access requests. The server device 51 has the functions of a Web/AP server 511 and a P2P connection control server 513. The Web/AP server 511 has the function of a medical care management section 512. The P2P connection control server 513 has the functions of a Stun server 514 and a PeerJS server 515. Note that the Stun server 514 may be replaced with a TURN server. Further, the P2P connection control server 513 or the PeerJS server 515 may be called a signaling server. Note that the Stun server 514 can be considered to hold the ICE 5141 for convenience. Further, the server device 52 has the functions of a Web/AP server 521 and a P2P connection control server 523. The P2P connection control server 523 has the functions of a Stun server 524 and a PeerJS server 525. Note that the server device 52 also has the same configuration as the server device 51, and some illustrations are omitted.

FIG. 6 is a block diagram showing the configuration of the server device 51 according to the second embodiment. The server device 51 includes a storage device 81, a memory 82, a communication IF section 83, and a control section 84. The storage device 81 is, for example, a nonvolatile storage device such as a hard disk or a flash memory. The storage device 81 stores an OS (Operating System) 811, a Web server program 812, an AP (Application) server program 813, a Web application program 814, a Stun server program 815, and a PeerJS server program 816. The OS 811 is basic software that controls the overall operation of the server device 51. The Web server program 812 is an HTTP (Hypertext Transfer Protocol) server program. The AP server program 813 is middleware for executing the Web application program 814. The web application program 814 is a program implemented with processing that refers to a DB in response to a request from a client, generates a dynamic web page, sends a response as a response, and updates the DB in accordance with input to the web page. It is. The Stun server program 815 is a program implemented with processes such as notifying an IP address to a terminal in order to establish a connection for P2P communication, and replying in response to an inquiry for connection management information such as ICE. Note that the Stun server program 815 may be an improved version of a known Stun server program. The PeerJS server program 816 is a program in which processing is implemented to inquire of a connection destination requested for establishment of a connection for P2P communication as to whether or not a connection for direct communication with a request source can be established. Note that the PeerJS server program 816 may be an improved version of a known PeerJS server program.

The memory 82 is an example of the memory 213 described above, and stores the ICE 5141, for example. The communication IF section 83 is an interface that performs input/output between the server device 51 and the outside.

The control unit 84 is a processor such as a CPU (Central Processing Unit) that controls each component of the server device 51. The control unit 84 reads the OS 811, the Web server program 812, the AP server program 813, the Web application program 814, the Stun server program 815, and the PeerJS server program 816 from the storage device 81 into the memory 82, and executes these programs. Thereby, the control unit 84 realizes the functions of a medical care management unit 841, a terminal information processing unit 842, and a connection processing unit 843, which will be described later. Note that the medical care management section 841 corresponds to the medical care management section 512 described above, and is an example of the medical care management section 211. Further, the medical care management section 841 is mainly realized by a Web server program 812, an AP server program 813, and a Web application program 814. The terminal information processing unit 842 and the connection processing unit 843 are examples of the connection management unit 212 described above. Note that the terminal information processing unit 842 is mainly realized by the Stun server program 815. The connection processing unit 843 is mainly realized by the PeerJS server program 816.

Returning to FIG. 4, the explanation will be continued. The load distribution device 6 distributes accesses from the tablet terminals 710, 720, 730, etc. via the network N to the server devices 51, 52, etc., thereby making the connection control servers (P2P connection control servers 513, 523, etc.) redundant. This is a device that realizes this. Therefore, the actual access destination of the tablet terminal 710 may switch to the server device 51 or 52 each time.

The tablet terminals 710, 720, and 730 are examples of the above-described terminals 31 and 32, and are capable of input/output using a touch panel (screen). It is also assumed that the tablet terminal 710 and the like are also equipped with a photographing means such as a camera. However, these terminals are not limited to tablets, and may be personal computers or the like. The tablet terminal 710 is a terminal located in the medical institution 71. It is assumed that the medical institution 71 is a clinic or the like, where a doctor 713 and a nurse 714 who remotely perform telemedicine work. It is assumed that the doctor 713 and the nurse 714 use the tablet terminal 710. The tablet terminal 710 includes a terminal application 711 and an ICE 712. The terminal application 711 is application software on the terminal side of the remote medical care support system 2000. The terminal application 711 makes a terminal list request to the medical treatment management section 512 via the network N, and displays the returned list on the screen. The terminal application 711 transmits a connection management information registration request and a connection management information request including the terminal ID to the Stun server 514 via the network N, receives a response, and displays it on the screen. In addition, the terminal application 711 transmits a terminal-to-terminal connection request specifying connection management information to the PeerJS server 515 via the network N, and in response to a connection permission response, connects the terminal to the PeerJS server 515 based on the route information indicated by the connection management information. Establish a connection with the destination of direct communication via N. The terminal application 711 then performs real-time communication of video, audio, etc. through direct communication. The ICE 712 is connection management information on the tablet terminal 710.

The tablet terminal 720 is a terminal located at the patient's home 72. The patient's home 72 is a home or the like where a patient 723 resides. The caregiver 724 is a visiting caregiver dispatched from the nursing care office 73 or the like, and supports remote medical treatment of the patient 723. However, the caregiver 724 is not essential for remote medical treatment. In other words, the patient 723 may operate the tablet terminal 720 alone to undergo remote medical treatment. Alternatively, in addition to the caregiver 724, for example, a family member, a visiting nurse, or the like may support remote medical treatment of the patient 723. The tablet terminal 720 includes a terminal application 721 and an ICE 722. The terminal application 721 has the same functions as the terminal application 711. The ICE 722 is connection management information on the tablet terminal 720.

The tablet terminal 730 is a terminal located at the nursing care office 73. It is assumed that a care worker 733 and a care worker 724 work in the care office 73. It is assumed that the caregiver 733 uses the tablet terminal 730. The tablet terminal 730 includes a terminal application 731 and an ICE 732. The terminal application 731 has the same functions as the terminal application 711. The ICE 732 is connection management information on the tablet terminal 730.

Therefore, for example, the doctor 713 or the nurse 714 can perform remote medical treatment for the patient 723 by operating the tablet terminal 710 and establishing a P2P communication connection with the tablet terminal 720. Further, the caregiver 733 can perform remote medical treatment (health management, etc.) for the patient 723 by operating the tablet terminal 730 and establishing a P2P communication connection with the tablet terminal 720. It goes without saying that the tablet terminals 710 and 730 can establish a P2P communication connection.

It is also assumed that the tablet terminal 710 or the like transmits its own ICE registration request to the Stun server 514 or the like via the network N at the time of startup and every 10 minutes during startup.

Further, it is assumed that user IDs 411 and the like for the doctor 713, nurse 714, patient 723, caregiver 724, and caregiver 733 are registered in advance in the usage management DB 41.

FIG. 7 is a flowchart illustrating the flow of login and authentication processing according to the second embodiment. Here, the explanation will be given assuming that the tablet terminal 710 is taken as an example and that the access destination from the tablet terminal 710 is the server device 51. First, the tablet terminal 710 is activated by a user's operation (the doctor 713 or the nurse 714), and the terminal application 711 starts operating. The terminal application 711 transmits a request for a login screen to the medical treatment management section 512 via the network N. In response, the medical treatment management unit 512 generates a login screen in response to the request, and transmits the login screen to the terminal application 711 via the network N (S201).

Then, the terminal application 711 displays the received login screen, accepts the input of the user ID by the user's operation, and reads out the terminal ID set in the tablet terminal 710. Furthermore, the terminal application 711 uses the camera function to photograph the vicinity of the user's face and obtains a facial image. Then, the terminal application 711 transmits the user ID, terminal ID, and facial image to the medical treatment management section 512 via the network N. In response, the medical care management unit 512 receives the user ID, terminal ID, and facial image (S202).

The medical care management unit 512 then refers to the shared storage device 4 and determines whether the received set of user ID and terminal ID has been registered in the usage management DB 41 (S203). If it is determined that the registration has been completed, the medical treatment management unit 512 performs face authentication. That is, the medical care management unit 512 reads the facial image 416 associated with the set of user ID and terminal ID received from the usage management DB 41 of the shared storage device 4, and compares it with the received facial image. The medical treatment management unit 512 then determines whether face authentication has been successful (S204). Note that a known technique can be applied to the face recognition process.

If face authentication is successful in step S204, the medical treatment management unit 512 determines whether the user attribute is other than a doctor (S205). That is, the medical treatment management unit 512 identifies the user attribute 412 associated with the received user ID from the usage management DB 41 of the shared storage device 4, and determines whether the identified user attribute 412 is a person other than a doctor. . For example, in the case of nurse 714 (YES in S205), the process advances to steps S208 and S209. On the other hand, in the case of the doctor 713 (NO in S205), the medical treatment management unit 512 requests the tablet terminal 710 to input a password (S206).

The tablet terminal 710 accepts the input of a password through the operation of the doctor 713 who is the user, and transmits it to the medical treatment management section 512 via the network N. The medical care management unit 512 then compares the received password with the password 415 in the usage management DB 41 and determines whether password authentication has been successful (S207). If the password authentication is successful, the process advances to steps S208 and S209.

That is, the medical care management unit 512 updates the usage management DB 41 by setting the usage status 414 associated with the received user ID to "in use" (S208). At the same time, the medical care management unit 512 transmits the initial screen after login to the tablet terminal 710 (S209). Thereby, the terminal application 711 displays the received initial screen on the screen.

Note that if the determination in step S203, S204, or S207 is NO, the medical care management unit 512 transmits a notification that the login has failed to the tablet terminal 710 (S210).

In this way, in the login and authentication processing according to this embodiment, if the user operating the terminal is a doctor (an example of a first medical worker), not only face authentication but also password authentication can be added. request. As a result, the use of functions for doctors with large responsibilities in telemedicine can be checked more strictly than other attributes, and highly reliable telemedicine can be achieved.

Next, the flow of establishing a connection for direct communication between the terminals after the two terminals log in will be described. First, the flow of the terminal-to-terminal connection process when two terminals of ICE are registered in the same server will be explained using the sequence diagrams of FIGS. 8 and 9. Here, it is assumed that the tablet terminal 710 and the tablet terminal 720 establish a connection for P2P communication. Further, it is assumed that the tablet terminals 710 and 720 have already undergone the above-mentioned login and authentication processing, and have been set to be in use in the usage status 414 of the usage management DB 41.

First, the tablet terminal 710 (terminal A) transmits a registration request for the ICE 712 (ICE_A), which is its own connection management information, to the Stun server via the network N (S221). At this time, it is assumed that the load balancing device 6 transfers the registration request to the Stun server 514 in the server device 51. Therefore, the Stun server 514 accepts the registration request from the tablet terminal 710, and stores ICE_A included in the registration request in the memory 82 (S222). Furthermore, the Stun server 514 registers ICE_A in the connection management DB 42 of the shared storage device 4 (S223).

Further, the tablet terminal 720 (terminal B) transmits a registration request for the ICE 722 (ICE_B), which is its own connection management information, to the Stun server via the network N (S224). Also at this time, the load distribution device 6 shall transfer the registration request to the Stun server 514 in the server device 51. Therefore, the Stun server 514 accepts the registration request from the tablet terminal 720 and stores ICE_B included in the registration request in the memory 82 (S225). Furthermore, the Stun server 514 registers ICE_B in the connection management DB 42 of the shared storage device 4 (S226).

After that, the tablet terminal 710 transmits a terminal list request to the medical care management department via the network N (S227). At this time, it is assumed that the load balancing device 6 transfers the terminal list request to the medical care management section 512 in the server device 51. Therefore, in response to receiving the terminal list request, the medical care management unit 512 searches the usage management DB 41 of the shared storage device 4 for the terminal ID whose usage status 414 is in use (S228). Here, a list including at least the terminal ID of terminal B is searched, and the medical care management unit 512 acquires the list from the usage management DB 41 of the shared storage device 4 (S229). The medical treatment management unit 512 then returns the acquired terminal list to the tablet terminal 710 (S230). Therefore, the tablet terminal 710 displays the received terminal list on the screen (S231).

Then, the tablet terminal 710 accepts the user's selection of terminal B (S232), and transmits an ICE acquisition request for terminal B to the Stun server via network N (S233). At this time, it is assumed that the load distribution device 6 transfers the ICE acquisition request to the Stun server 514 in the server device 51. Therefore, the Stun server 514 searches its own memory 82 for the terminal ID corresponding to the terminal B specified in the received ICE acquisition request. Here, since ICE_B is held in the memory in step S225, the Stun server 514 acquires ICE_B from the memory 82 (S234), and returns the acquired ICE_B to the tablet terminal 710 (S235).

In response, the tablet terminal 710 transmits the received P2P connection request specifying ICE_B to the PeerJS server via the network N (S236). At this time, it is assumed that the load balancing device 6 transfers the P2P connection request to the PeerJS server 515 in the server device 51. Therefore, in response to the received P2P connection request, the PeerJS server 515 makes an inquiry to terminal B about whether P2P connection with terminal A is possible based on ICE_B (S237). At this time, the PeerJS server 515 may transmit ICE_A of terminal A to terminal B.

If there is no problem with the inquiry as to whether P2P connection with terminal A is possible, tablet terminal 720 responds to PeerJS server 515 to permit connection with terminal A (S238). Note that the tablet terminal 720 may also internally hold ICE_A. Then, in response to the connection permission response, the PeerJS server 515 transmits a P2P connection permission response with terminal B to terminal A (S239). In response to the P2P connection permission response with terminal B, the tablet terminal 710 establishes a P2P connection with the tablet terminal 720 based on the dynamic IP address 4212 and route information 4213 of ICE_B (S240). Thereafter, the tablet terminal 710 and the tablet terminal 720 can perform real-time communication of video and audio through direct communication.

Next, the flow of the terminal-to-terminal connection process when the ICEs of two terminals are registered in different servers will be explained using the sequence diagrams of FIGS. 10 and 11. Note that the difference from FIGS. 8 and 9 described above is the access allocation destination in the load distribution device 6, and the following description will focus on the differences, and will omit descriptions of similar processing as appropriate.

First, steps S221 to S223 are similar to those in FIG. 8. Then, the tablet terminal 720 (terminal B) transmits a registration request for the ICE 722 (ICE_B), which is its own connection management information, to the Stun server via the network N (S224a). Here, it is assumed that the load balancing device 6 transfers the registration request to the Stun server 524 in the server device 52. Therefore, the Stun server 524 accepts the registration request from the tablet terminal 720 and holds ICE_B included in the registration request in its own memory (S225a). The Stun server 524 also registers ICE_B in the connection management DB 42 of the shared storage device 4 (S226a). As a result, ICE_A is held in the memory of the Stun server 514 on the server device 51 side, and ICE_B is held in the memory of the Stun server 524 on the server device 52 side. Then, both ICE_A and ICE_B are registered in the connection management DB 42 of the shared storage device 4.

Subsequently, steps S227 to S232 are similar to those in FIG. 8. Then, the tablet terminal 710 transmits the ICE acquisition request of the terminal B to the Stun server via the network N (S233). At this time, it is assumed that the load distribution device 6 transfers the ICE acquisition request to the Stun server 514 in the server device 51. Therefore, the Stun server 514 searches its own memory 82 for the terminal ID corresponding to the terminal B specified in the received ICE acquisition request. However, here, the search for ICE_B in the memory results in a miss (S234a). Therefore, the Stun server 514 issues a search request for ICE_B to the connection management DB 42 of the shared storage device 4 (S234b). As described above, since ICE_B is already registered in the connection management DB 42, the Stun server 514 acquires ICE_B from the connection management DB 42 as a search result (S234c). The Stun server 514 then returns the acquired ICE_B to the tablet terminal 710 (S235). Thereafter, steps S236 to S240 are the same as those in FIG. 9.

In this way, according to the second embodiment, two terminals that are scheduled to communicate directly between the terminals actually have their own ICEs registered in the Stun server, and the registration destinations are distributed to different redundant servers. Even if you accidentally do this, you can reliably share the ICE. The reason for this is that each Stun server not only holds the ICE in its own memory, but also registers the ICE in the shared storage device 4 of both servers. In addition, by first referring to the memory for the ICE of the terminal specified in the ICE acquisition request, each Stun server can reply the ICE more quickly if the search results in a hit in the memory. Even if there is a mismatch in the memory search, the desired ICE can be quickly acquired by searching the shared storage device 4.

Subsequently, it is desirable to perform the following processing in order to support remote medical treatment more effectively. First, it is assumed that the medical care management unit 512 receives a registration request for the user ID of a second medical worker involved in remote medical treatment of a specific patient from any terminal used by the first medical worker. In this case, the medical care management unit 512 associates and registers the user IDs of the first medical worker, the second medical worker, and the specific patient in the storage system. For example, the medical care management unit 512 receives a request to register the user ID of a nurse 714 or a caregiver 724 involved in remote medical treatment of a patient 723 from a tablet terminal 710 used by a doctor 713. In this case, the medical care management unit 512 associates the user IDs of the doctor 713, nurse 714, caregiver 724, and patient 723 and registers them in the medical care personnel DB 43 of the shared storage device 4.

Then, in response to a terminal list request from the tablet terminal 710 used by the nurse 714, the medical care management unit 512 selects other user IDs associated with the user ID of the nurse 714 from the medical care personnel DB 43. (caregiver 724, patient 723). In this case, the medical care management unit 512 acquires a list of terminal IDs 413 in the usage management DB 41 that are associated with the other specified user ID 411 and whose usage status 414 is in use, and transfers the list to the tablet terminal 710. Reply to That is, in this case, the terminal ID list does not include the terminal ID of the tablet terminal 730 that can be used by the caregiver 733 who is not a person involved in the remote medical treatment of the patient 723. Therefore, terminal IDs that do not require P2P connection can be excluded, and terminal IDs of other patients for whom the nurse 714 is not in charge are also excluded. This also applies when the patient 723 performs the operation, and information on other patients and medical personnel is excluded. Therefore, patient privacy can be protected and troubles caused by unnecessary connections between medical personnel and patients can be avoided. In addition, these can be controlled by the authority of doctors with greater responsibility, rather than all medical personnel.

Furthermore, it is desirable for physicians to be able to control access privileges to medical information. To this end, the medical care management unit 512 receives a registration request for the medical information of the specific patient and a user ID that allows access to the medical information from the arbitrary terminal used by the first medical worker. do. In that case, the medical care management unit 512 associates the user ID of the specific patient with the medical information, grants access authority to the medical information to the user ID for which access is permitted, and stores the medical information in the storage system. register. For example, the medical care management unit 512 receives a request to register a doctor's memo for the patient 723 and a user ID of a nurse 714 who is permitted to view the memo from the tablet terminal 710 used by the doctor 713. In that case, the medical care management unit 512 associates the patient ID 441 of the patient 723 with the medical information 442, assigns the user ID 444 of the nurse 714 to the access authority 443 "view", and registers the access authority 443 in the medical history DB 44.

It is assumed that the medical care management unit 512 receives a request for access to the medical information of the specific patient from the first terminal or the second terminal. In this case, the medical care management unit 512 obtains, from the storage system, the medical information of the specific patient in which the access authority is granted to the user ID currently using the request source of the access request; The obtained medical information is returned to the requester. For example, it is assumed that the medical care management unit 512 receives a request for access to medical information for itself from the tablet terminal 720 that the patient 723 is using. For example, it is assumed that the medical care management unit 512 receives a request from the terminal application 721 in the tablet terminal 720 to refer to the patient's 723's medical history. In this case, the medical care management unit 512 reads out of the medical information 442 associated with the patient ID 441 of the patient 723 from the medical history DB 44, only the information to which the user ID 444 of the patient 723 has been assigned as the access authority 443 "view". The medical care management unit 512 then returns the read medical information to the tablet terminal 720. That is, in this case, the doctor's note described above is not disclosed to the patient 723. In this way, access authority to medical information registered by a doctor can be controlled. For example, depending on the content of the information, it may be desirable not to disclose the medical information of a specific patient even to a second medical worker rather than the patient. Therefore, the doctor can finely control disclosure according to the patient's condition.

Furthermore, since the above-mentioned access authority settings are individually set for each piece of medical information, the burden of setting operations on the doctor is heavy. Therefore, it is possible to automate the setting of access privileges as follows. That is, the medical care management unit 512 receives a registration request for a user ID that permits access from the arbitrary terminal used by the first medical worker according to the type of the medical information of the specific patient. In that case, the medical care management unit 512 associates the user ID of the specific patient, the type of medical information, and the user ID to which access is permitted, and registers them in the storage system. For example, if the type of medical information of the patient 723 from the tablet terminal 710 used by the doctor 713 is a caregiver's memo, the medical care management unit 512 limits viewing permission to the doctor 713, nurse 714, and caregiver 724. We accept registration requests for these user IDs. In this case, the medical care management unit 512 associates the patient ID 451 of the patient 723, the medical information type 452, and the user IDs 453 of the doctor 713, nurse 714, and caregiver 724 and registers them in the authority definition DB 45.

Thereafter, it is assumed that the medical care management unit 512 receives a request to register a memo regarding the condition of the patient 723 from the tablet terminal 720 used by the caregiver 724. In this case, the medical care management unit 512 associates the patient ID 441 of the patient 723 with the medical information 442 that is a memo of the patient's condition, and the doctor 713 and nurse 714 who are the user IDs 453 associated with the medical information type 452 of the patient 723. And the user ID 453 of the caregiver 724 is registered in the medical history DB 44 as the user ID 444 and the access authority 443 as viewing.

When the medical care management unit 512 receives a request to view the medical information of the patient 723 from the tablet terminal 710 used by the nurse 714, the medical care management unit 512 allows the nurse 714 to view the medical information 442 of the patient 723 from the medical history DB 44. Get what you are entitled to. The medical care management unit 512 then returns the acquired medical information to the tablet terminal 710. On the other hand, when the medical care management unit 512 receives a request to view the patient's own medical information from the tablet terminal 720 used by the patient 723, the medical care management unit 512 retrieves medical information from the medical history DB 44 to which the user ID of the patient 723 has not been granted access authority. is not acquired.

In this way, when a doctor registers in advance the definition of access authority according to the type of medical information, it is possible to automatically set access restrictions to medical information input by users other than the doctor. In addition, since access privileges are granted for each type of medical information, doctors can reduce the hassle of granting access privileges for all individual medical information.In other words, the granting of access privileges is automated, making it easier to manage access privileges. Become.

<Embodiment 3>
Embodiment 3 describes the present disclosure from a different perspective from Embodiment 1 described above. Here, the problem to be solved in the third embodiment is to combine a screen for sharing patient information between medical professionals and two-way communication using video.

FIG. 12 is a block diagram showing the configuration of a remote medical care support system 3000 according to the third embodiment. The remote medical care support system 3000 includes at least a remote medical care support device 21a, terminals 31, 32, and the like. Further, the remote medical treatment support device 21a and the terminals 31, . . . , 32 are connected via a network N. It should be noted that the terminals 31 and 32 and the network N are the same as those in the first embodiment described above, and therefore their explanations will be omitted.

The remote medical treatment support device 21a includes a medical treatment management section 211a and a connection management section 212a. The medical care management unit 211a manages medical information regarding patients receiving remote medical treatment. The connection management unit 212a controls the establishment of a connection for direct communication between terminals. Note that as a method for establishing a direct communication connection between terminals, a known technique may be used, or the technique of Embodiment 1 or 2 described above may be used.

The medical care management unit 211a generates display information for displaying medical information on the screen of the terminal 31 in response to a request from the terminal 31 (first terminal) that has established a connection with the terminal 32 (second terminal). do. At this time, the medical care management unit 211a embeds in the display information a process for transmitting a captured image of the user (using the terminal 31) via direct communication to the terminal 32 (the other party to establish the connection). Here, the "process of transmitting a photographed image to the terminal 32 through direct communication" includes, for example, a code written using WebRTC. Alternatively, a two-way video communication technology between terminals using P2P communication may be used, but the present invention is not limited thereto. The medical care management unit 211a then returns the embedded display information to the first terminal.

The remote medical care support device 21a includes a processor, a memory, and a storage device (not shown). Further, the storage device stores a remote medical treatment support program, which is a computer program in which the remote medical treatment support method according to the present embodiment is implemented. Then, the processor reads the remote medical care support program from the storage device into the memory and executes the remote medical care support program. Thereby, the processor realizes the functions of the medical treatment management section 211a and the connection management section 212a.

FIG. 13 is a flowchart showing the flow of the remote medical treatment support method according to the third embodiment. First, the connection management unit 212a controls the establishment of a direct communication connection between the first and second terminals (S31). Thereby, for example, the terminal 31 and the terminal 32 can communicate directly without going through the remote medical care support device 21a.

Next, in response to a request from the first terminal (which has established a connection with the second terminal), the medical care management unit 211a displays medical information regarding the patient undergoing remote medical treatment on the screen of the first terminal. display information is generated (S32). Then, the medical care management unit 211a embeds in the display information a process for transmitting the captured image of the user to the second terminal through direct communication (S33). Here, the photographed image is an image taken by a user using the first terminal using a photographing device such as a camera installed in the first terminal which is the source of the request in S32.

Thereafter, the medical care management unit 211a returns the embedded display information to the first terminal (S34). Thereby, by displaying the display information received by the first terminal on the screen, the first user of the first terminal can view the medical information displayed on the screen. Further, the first terminal can transmit a photographed image of the first user using a built-in camera to the second terminal through direct communication by means of a "transmission process" embedded in the display information. Therefore, the second terminal can display the photographed image received from the first terminal on the screen, and the second user of the second terminal can visually recognize the first user from the screen.

Similarly, the remote medical care support device 21a performs steps S32 to S34 in response to an access request from the second terminal, so that the second terminal can display the received display information on the screen. Therefore, the second user of the second terminal can also view the medical information displayed on the screen. That is, medical information including patient information can be shared between the first and second users.

In addition, the second terminal can transmit a captured image of the second user using a built-in camera to the first terminal through direct communication, using the "transmission process" embedded in the display information. Therefore, the first terminal can display the photographed image received from the second terminal on the screen, and the first user of the first terminal can visually recognize the second user from the screen. In other words, the first and second terminals can perform two-way communication using moving images through direct communication. Therefore, for example, two-way real-time video communication is possible between doctors and other medical professionals at a medical institution and patients and other medical professionals located at locations remote from the medical institution. Become.

In this way, according to the third embodiment, it is possible to smoothly combine a patient information sharing screen between medical professionals and two-way communication using video.

Note that this third embodiment may further include some or all of the configurations of the first or second embodiment described above. For example, the remote medical care support device 21a does not necessarily need to be redundant.

<Embodiment 4>
Embodiment 4 describes the present disclosure from a different perspective from Embodiments 1 and 3 described above. Here, the problem to be solved in the fourth embodiment is to control access authority to medical information regarding a specific patient by a specific medical professional such as a doctor.

FIG. 14 is a block diagram showing the configuration of a remote medical care support system 4000 according to the fourth embodiment. The remote medical care support system 4000 includes at least a storage device 4a, a remote medical care support device 21b, terminals 31, 32, and the like. Further, the storage device 4a and the remote medical care support device 21b are connected. The remote medical care support device 21b and the terminals 31, . . . , 32 are connected via a network N. It should be noted that the terminals 31 and 32 and the network N are the same as those in the first embodiment described above, and therefore their explanations will be omitted.

The storage device 4a is a storage system composed of one or more storage devices, and the shared storage device 4 described above may be used. The storage device 4a includes a usage management DB41, a medical care personnel DB43a, and a medical history DB44a. The usage management DB 41 is the same as that shown in FIG. In the medical care personnel DB 43a, a patient ID 431, a related person attribute 435, and a user list 436 are associated with each other. The related party attribute 435 is information indicating the type of group of related parties related to the medical treatment of the specific patient corresponding to the patient ID 431. Examples of related person attributes 435 include: medical personnel representing a group of medical personnel such as doctors and nurses belonging to a medical institution; care team representing a group of medical personnel such as caregivers belonging to a care provider; Examples include patient families, which group patients and their families. The user list 436 is a collection of individual user IDs 437 belonging to each of the above-mentioned related party attributes. In other words, the user list 436 is an example of a user list belonging to the attribute 435 of related parties involved in the medical treatment of a specific patient (patient ID 431).

In the medical history DB 44a, a patient ID 441a, medical information 442a, and related person attributes 443a are associated with each other. The patient ID 441a and medical information 442a are the same as the patient ID 441 and medical information 442 described above. The related party attribute 443a is similar to the related party attribute 435 described above.

The remote medical treatment support device 21b includes at least a medical treatment management section 211b. The medical care management unit 211b provides first medical information regarding a specific patient and a second medical information that allows access to the first medical information from a terminal used by a first medical worker belonging to a first stakeholder attribute. Receive a registration request with stakeholder attributes. Then, the medical treatment management unit 211b associates the first medical information with at least the second related person attribute and registers the first medical information in the storage device 4a. The medical care management unit 211b also receives a request for access to medical information of a specific patient from a predetermined terminal used by the user 437. Then, the medical care management unit 211b refers to the medical care personnel DB 43a, identifies the related person attribute 435 to which the user list 436 including the user 437 belongs, and sets one or more pieces of medical information 422a to which the identified related person attribute 435 is associated. is acquired from the medical history DB 44a. The medical care management unit 211b sends the acquired one or more pieces of medical information 442a back to a predetermined terminal in order to display it on the screen of the predetermined terminal.

The remote medical care support device 21b includes a processor, a memory, and a storage device (not shown). Further, the storage device stores a remote medical treatment support program, which is a computer program in which the remote medical treatment support method according to the present embodiment is implemented. Then, the processor reads the remote medical care support program from the storage device into the memory and executes the remote medical care support program. Thereby, the processor realizes the function of the medical care management section 211b.

FIG. 15 is a flowchart showing the flow of the remote medical treatment support method according to the fourth embodiment. First, the medical care management unit 211b, for example, from a terminal used by a doctor belonging to a medical professional, first medical information regarding a specific patient and related person attribute 443a "care team" that allows access to the first medical information. ” (S41).

Next, the medical care management unit 211b associates the first medical information 442a with at least the related person attribute 443a "care team" and registers it in the medical history DB 44a (S42). At this time, the medical care management unit 211b may also associate the first medical information 442a with the related person attribute 443a "medical personnel" and register it in the medical history DB 44a. However, in this case, the medical care management unit 211b does not associate the related party attribute 443a "patient family" with the first medical information 442a.

Further, in step S41, if "patient family" is associated with the related party attribute 443a that allows access to the first medical information, in step S42, the medical care management unit 211b 442a is associated with the related person attribute 443a "patient family" and registered in the medical history DB 44a.

Subsequently, the medical care management unit 211b receives a request for access to medical information of a specific patient from a predetermined terminal used by a predetermined user (S43). For example, assume that the medical care management unit 211b receives a request for access to the patient's medical information from a terminal used by a caregiver.

At this time, the medical care management unit 211b refers to the medical care personnel DB 43a and specifies the related person attribute 435 to which the user list 436 including the user ID 437 of the caregiver belongs (S44). If the user list 436 including the user ID 437 of the caregiver in the medical care personnel DB 43a is not associated with the related person attribute 435 of the patient ID 431 of the patient, it will not be identified and a message to that effect will be sent to the terminal. do.

Here, it is assumed that the information was identified in step S44, and then the medical care management unit 211b acquires one or more pieces of medical information 442a associated with the identified related person attribute 443a from the medical history DB 44a (S45). In other words, if multiple pieces of medical information 442a associated with the patient ID 441a of the patient have been registered in the past, and the identified related person attribute 443a is associated with multiple pieces of medical information 442a, 2 The above medical information 442a is acquired.

Then, the medical care management unit 211b sends back the acquired one or more pieces of medical information 442a to a predetermined terminal in order to display it on the screen of the predetermined terminal (S46). As a result, medical information is disclosed to users who have been registered in advance in the related party attributes and user list by the patient's doctor, that is, to users who belong to the group that has been granted access rights to the patient's medical information. . On the other hand, for users who are not registered by the doctor in charge, that is, users who are not granted access authority to the patient's medical information, the medical information will not be obtained and will not be disclosed. For example, it is possible to safely and easily record comments that a doctor cannot disclose to a patient's family and share them only with medical personnel and the care team. Furthermore, even if users are medical professionals, access to the patient's medical information can be restricted to users who are not related to the patient, thereby protecting privacy.

The fourth embodiment may further include some or all of the configurations of the first to third embodiments described above. For example, the remote medical care support device 21b does not necessarily need to be made redundant. Furthermore, the remote medical care support device 21b does not necessarily need to control the establishment of a direct communication connection between terminals.

<Other embodiments>
Note that although the above embodiment has been described as a hardware configuration, the present invention is not limited to this. The present disclosure can also realize arbitrary processing by causing a CPU (Central Processing Unit) to execute a computer program.

In the examples above, the program may be stored and provided to the computer using various types of non-transitory computer readable media. Non-transitory computer-readable media includes various types of tangible storage media. Examples of non-transitory computer-readable media include magnetic recording media (e.g., flexible disks, magnetic tapes, hard disk drives), magneto-optical recording media (e.g., magneto-optical disks), CD-ROMs (Read Only Memory), CD-Rs, Includes CD-R/W, DVD (Digital Versatile Disc), and semiconductor memory (for example, mask ROM, PROM (Programmable ROM), EPROM (Erasable PROM), flash ROM, and RAM (Random Access Memory)). The program may also be provided to the computer on various types of transitory computer readable media. Examples of transitory computer-readable media include electrical signals, optical signals, and electromagnetic waves. The temporary computer-readable medium can provide the program to the computer via wired communication channels, such as electrical wires and fiber optics, or wireless communication channels.

Note that the present disclosure is not limited to the above embodiments, and can be modified as appropriate without departing from the spirit. Further, the present disclosure may be implemented by appropriately combining the respective embodiments.

Part or all of the above embodiments may be described as in the following additional notes, but are not limited to the following.
(Appendix A1)
a connection management unit that controls establishment of a direct communication connection between the first and second terminals;
A medical management department that manages medical information regarding patients receiving remote medical treatment;
Equipped with
The medical management department is
generating display information for displaying the medical information on a screen of the first terminal in response to a request from the first terminal with which the connection has been established with the second terminal;
embedded in the display information a process for transmitting a photographed image of a user using the first terminal to the second terminal through the direct communication;
A remote medical care support device that returns the embedded display information to the first terminal.
(Appendix A2)
The connection management section includes:
When receiving connection management information that associates the terminal ID of a predetermined terminal with destination information assigned to the terminal, retaining the connection management information in the memory of the own device;
In response to the request from the first terminal to establish the connection with the second terminal, return second connection management information of the second terminal to the first terminal; The remote medical treatment support device according to appendix A1, wherein the connection is established between the first and second terminals by inquiring the terminal as to whether or not the connection with the first terminal can be established.
(Appendix A3)
The connection management section includes:
When the connection management information is received, retaining the connection management information in the memory, and registering the connection management information in a storage system connected with the self device and other redundant devices;
searching the memory for the second connection management information in response to the connection establishment request;
searching for the second connection management information for the storage system if the search results in a mishit;
The remote medical care support device according to appendix A2, wherein the second connection management information is acquired from the memory or the storage system on which the search hits, and is sent back to the first terminal.
(Appendix A4)
The storage system further stores usage management information that associates the usage status of the terminal with the terminal ID,
The medical management department is
In response to a terminal list request from the first terminal, obtain a list of the terminal IDs whose usage status is in use from the usage management information of the storage system, and send the list to the first terminal. Reply and
The connection management section includes:
When the first terminal receives a connection management information request including the second terminal ID of the second terminal selected from the list as the connection establishment request, the first terminal stores the second terminal ID in the memory. Search for the terminal ID of 2,
searching the storage system for the second terminal ID if the search results in a mishit;
Acquire the second connection management information associated with the second terminal ID from the side of the memory or storage system where the search hits, and send it back to the first terminal. remote medical care support device.
(Appendix A5)
The connection management section includes:
In response to a terminal-to-terminal connection request in which the second connection management information is specified from the first terminal, the second terminal is connected to the first terminal based on the second connection management information. Inquire whether the connection can be established,
The remote medical care support device according to appendix A4, wherein the remote medical care support device responds to the first terminal to establish the connection with the second terminal in response to the connection establishment permission response from the second terminal.
(Appendix A6)
The remote medical treatment support device according to any one of Supplementary Notes A2 to A5, wherein the connection management information includes candidates for route information in a network to be passed during the direct communication.
(Appendix A7)
The remote medical care support device is connected to a first storage device that stores a user list belonging to attributes of parties involved in medical treatment of a specific patient,
The medical management department is
first medical information regarding the specific patient received from a terminal used by a first medical worker belonging to a first stakeholder attribute; and a second stakeholder attribute that permits access to the first medical information; registering the first medical information in association with at least the second stakeholder attribute in the first storage device in response to a registration request;
In response to a request for access to the specific patient's medical information received from a predetermined terminal used by a predetermined user, the relationship to which the user list including the predetermined user belongs is determined by referring to the first storage device. identify the attributes of the person,
acquiring one or more pieces of medical information associated with the identified stakeholder attributes from the first storage device;
The remote medical care support device according to any one of Supplementary Notes A1 to A6, wherein the remote medical care support device generates first display information for displaying the acquired one or more pieces of medical information on the screen of the predetermined terminal.
(Appendix A8)
The remote medical treatment support device is connected to a second storage device that stores in advance a user ID and password of a user who can use a specific terminal, an attribute of the user ID, and a face image of the user ID in association with each other,
The medical management department is
At the time of login processing of a predetermined terminal, accepting a face image and user ID of a user of the terminal taken by the predetermined terminal,
acquiring a facial image associated with the accepted user ID from the second storage device; performing face authentication between the accepted facial image and the acquired facial image;
If the attribute of the received user ID is that of a specific medical worker, after the face authentication is successful, password authentication is requested from the predetermined terminal, and if the password authentication is successful, login is permitted. ,
If the attribute of the user ID included in the accepted user ID is other than the specific medical worker, login is permitted after the face authentication is successful. The remote medical care support device according to any one of appendices A1 to A7. .
(Appendix A9)
The usage management information is further associated with a user ID that can use the terminal,
The medical management department is
When a request for registration of the user ID of a second medical worker involved in remote medical treatment of a specific patient is received from any terminal used by a first medical worker, the first medical worker, the second registering the respective user IDs of the medical worker and the specific patient in the storage system in association with each other;
In response to the terminal list request from the first terminal, identifying another user ID associated with the user ID of the user currently using the first terminal from the storage system;
obtaining a list of the terminal IDs of the usage management information that are associated with the identified other user ID and whose usage status is in use;
The remote medical care support device according to appendix A4 or A5, which sends the list back to the first terminal.
(Appendix A10)
The medical management department is
When a request for registration of a user ID that permits access according to the type of the medical information of the specific patient is received from the arbitrary terminal used by the first medical worker, the user ID of the specific patient and registering the type of medical information and the user ID to which access is permitted in the storage system;
When a request to register the medical information of the specific patient is received from the first terminal or the second terminal, the user ID of the specific patient is associated with the medical information, and the type of medical information is Grant access authority to the medical information to the associated user ID and register it in the storage system;
When a request for access to the medical information of the specific patient is received from the first terminal or the second terminal, the request source of the access request is sent from the storage system to the medical information of the specific patient. The remote medical care support device according to appendix A9, wherein the access authority is granted to the user ID currently using the remote medical care support device, and the obtained medical information is returned to the request source.
(Appendix A11)
The remote medical care support device according to any one of appendices A1 to A10, wherein the medical information includes biological information of the patient.
(Appendix B1)
first and second terminals;
a remote medical care support device connected to the first and second terminals via a network;
Equipped with
The remote medical treatment support device includes:
a connection management unit that controls establishment of a direct communication connection between the first and second terminals;
A medical management department that manages medical information regarding patients receiving remote medical treatment;
Equipped with
The medical management department is
generating display information for displaying the medical information on a screen of the first terminal in response to a request from the first terminal with which the connection has been established with the second terminal;
embedded in the display information a process for transmitting a photographed image of a user using the first terminal to the second terminal through the direct communication;
A remote medical care support system that returns the embedded display information to the first terminal.
(Appendix B2)
The connection management section includes:
When receiving connection management information that associates the terminal ID of a predetermined terminal with destination information assigned to the terminal, retaining the connection management information in the memory of the own device;
In response to the request from the first terminal to establish the connection with the second terminal, return second connection management information of the second terminal to the first terminal; The remote medical care support system according to appendix B1, wherein the connection is established between the first and second terminals by inquiring the terminal as to whether or not the connection with the first terminal can be established.
(Appendix C1)
The computer is
controlling the establishment of a direct communication connection between the first and second terminals;
generating display information for displaying medical information regarding a patient undergoing remote medical treatment on the screen of the first terminal in response to a request from the first terminal with which the connection has been established with the second terminal;
embedding in the display information a process for transmitting an image taken by the first terminal of a user using the first terminal to the second terminal through the direct communication;
A remote medical treatment support method, wherein the embedded display information is returned to the first terminal.
(Appendix D1)
A process for controlling the establishment of a direct communication connection between the first and second terminals;
A process of generating display information for displaying medical information regarding a patient undergoing remote medical treatment on the screen of the first terminal in response to a request from the first terminal that has established a connection with the second terminal. and,
embedding in the display information a process of transmitting a photographed image of a user using the first terminal to the second terminal through the direct communication;
a process of replying the embedded display information to the first terminal;
A remote medical treatment support program that allows a computer to execute the following.
(Appendix E1)
connected to a storage device that stores a user list belonging to attributes of parties involved in the medical treatment of a specific patient;
first medical information regarding the specific patient received from a terminal used by a first medical worker belonging to a first stakeholder attribute; and a second stakeholder attribute that permits access to the first medical information; registering the first medical information in association with at least the second stakeholder attribute in the storage device in response to a registration request;
In response to a request for access to the medical information of the specific patient received from a predetermined terminal used by a predetermined user, the related party attribute to which the user list including the predetermined user belongs is determined by referring to the storage device. identify,
acquiring one or more pieces of medical information associated with the identified stakeholder attributes from the storage device;
A remote medical care support device comprising a medical care management unit that sends back the acquired one or more pieces of medical information to the predetermined terminal in order to display it on the screen of the predetermined terminal.
(Appendix E2)
The storage device stores in advance a user ID and a password of a user who can use the terminal, an attribute of the user ID, and a face image of the user ID in association with each other,
The medical management department is
At the time of login processing of the predetermined terminal, receiving a face image and user ID of the user of the terminal taken by the predetermined terminal;
acquiring a facial image associated with the accepted user ID from the storage device; performing face authentication on the accepted facial image and the acquired facial image;
If the attribute of the received user ID is the first medical worker, after the face authentication is successful, password authentication is requested from the predetermined terminal, and if the password authentication is successful, login is performed. allow,
The remote medical care support device according to appendix E1, wherein if the attribute of the user ID included in the accepted user ID is other than the first medical worker, login is permitted after the face authentication is successful.
(Appendix E3)
The remote medical care support device according to appendix E1 or E2, wherein the medical information includes biological information of the patient.
(Appendix E4)
further comprising a connection management unit that controls establishment of a direct communication connection between the first and second terminals,
The medical management department is
generating display information for displaying the acquired one or more pieces of medical information on a screen of the first terminal in response to the access request from the first terminal that has established a connection with the second terminal; ,
embedding in the generated display information a process for transmitting an image of the user of the first terminal taken by the first terminal to the second terminal through the direct communication;
The remote medical care support device according to any one of appendices E1 to E3, wherein the embedded display information is returned to the first terminal.
(Appendix E5)
The connection management section includes:
When receiving connection management information in which the terminal ID of an arbitrary terminal is associated with destination information assigned to the terminal, retaining the connection management information in the memory of the own device,
In response to the request from the first terminal to establish the connection with the second terminal, return second connection management information of the second terminal to the first terminal; The remote medical care support device according to appendix E4, wherein the connection is established between the first and second terminals by inquiring the terminal as to whether or not the connection can be established with the first terminal.
(Appendix E6)
The storage device is connected to the remote medical care support device and other devices made redundant with the remote medical care support device,
The connection management section includes:
When receiving the connection management information, retaining the connection management information in the memory and registering the connection management information in the storage device;
searching the memory for the second connection management information in response to the connection establishment request;
searching the storage device for the second connection management information if the search results in a mishit;
The remote medical care support device according to appendix E5, wherein the second connection management information is acquired from the side of the memory or the storage device on which the search hits, and is sent back to the first terminal.
(Appendix F1)
A computer connected to a storage device that stores a user list belonging to attributes of parties involved in medical treatment of a specific patient,
From a terminal used by a first medical worker belonging to a first stakeholder attribute, first medical information regarding the specific patient and a second stakeholder attribute that allows access to the first medical information are displayed. receive a registration request;
registering at least the second stakeholder attribute in association with the first medical information in the storage device;
receiving a request for access to medical information of the specific patient from a predetermined terminal used by a predetermined user;
identifying the related party attribute to which the user list including the predetermined user belongs by referring to the storage device;
acquiring one or more pieces of medical information associated with the identified stakeholder attributes from the storage device;
A remote medical treatment support method, comprising: sending the acquired one or more pieces of medical information back to the predetermined terminal in order to display it on the screen of the predetermined terminal.
(Appendix G1)
A computer connected to a storage device that stores a list of users belonging to the attributes of people involved in the medical treatment of a specific patient;
From a terminal used by a first medical worker belonging to a first stakeholder attribute, first medical information regarding the specific patient and a second stakeholder attribute that allows access to the first medical information are displayed. a process for receiving a registration request;
a process of associating at least the second stakeholder attribute with the first medical information and registering it in the storage device;
A process of receiving an access request to the medical information of the specific patient from a predetermined terminal used by a predetermined user;
a process of identifying the related person attribute to which the user list including the predetermined user belongs by referring to the storage device;
a process of acquiring one or more pieces of medical information associated with the identified stakeholder attributes from the storage device;
a process of sending the acquired one or more pieces of medical information back to the predetermined terminal in order to display it on the screen of the predetermined terminal;
A telemedicine support program that allows you to carry out.
(Appendix H1)
The self-device and Connected with other redundant devices,
a medical care management unit that inputs and outputs medical information regarding patients undergoing remote medical treatment to and from the terminal;
a connection management unit that controls the establishment of a connection for direct communication between terminals;
Equipped with
The connection management section includes:
When a request for registration of the connection management information from a predetermined terminal is received, retaining the connection management information in the memory of the own device, and registering the connection management information in the storage system;
The medical management department is
In response to a terminal list request from the first terminal, obtain a list of the terminal IDs whose usage status is in use from the usage management information of the storage system, and send the list to the first terminal. death,
The connection management section includes:
When the first terminal receives a connection management information request that includes a second terminal ID of a second terminal selected from the list, searches the memory for the second terminal ID. ,
searching the storage system for the second terminal ID if the second terminal ID does not exist in the memory;
acquiring second connection management information associated with the second terminal ID from the memory or storage system where the second terminal ID existed, and sending it back to the first terminal;
In response to receiving a terminal-to-terminal connection request in which the second connection management information is specified from the first terminal, the first terminal is sent to the second terminal based on the second connection management information. Inquires whether direct communication with the terminal is possible,
A remote medical treatment support device that responds to the first terminal with connection permission for direct communication with the second terminal in response to a connection permission response from the second terminal.
(Appendix H2)
The remote medical care support device according to appendix H1, wherein the connection management information includes candidates for route information in a network through which the direct communication takes place.
(Appendix H3)
The remote medical treatment support device according to appendix H1 or H2, wherein the medical information includes biological information of the patient.
(Appendix H4)
The usage management information is further associated with a user ID that can use the terminal,
The medical management department is
When a request for registration of the user ID of a second medical worker involved in remote medical treatment of a specific patient is received from any terminal used by a first medical worker, the first medical worker, the second registering the respective user IDs of the medical worker and the specific patient in the storage system in association with each other;
In response to the terminal list request from the first terminal, identifying another user ID associated with the user ID currently using the first terminal from the storage system;
obtaining a list of the terminal IDs of the usage management information that are associated with the identified other user ID and whose usage status is in use;
The remote medical care support device according to any one of appendices H1 to H3, which returns the list to the first terminal.
(Appendix H5)
The medical management department is
When a request for registration of the medical information of the specific patient and a user ID that allows access to the medical information is received from the arbitrary terminal used by the first medical worker, the user ID of the specific patient and and registering the medical information in the storage system by associating the medical information with the medical information, granting the access authority to the user ID to which the access is permitted, and registering the medical information in the storage system;
When a request for access to the medical information of the specific patient is received from the first terminal or the second terminal, the request source of the access request is sent from the storage system to the medical information of the specific patient. The remote medical care support device according to appendix H4, wherein the access authority is granted to the user ID currently in use, and the obtained medical information is returned to the requester.
(Appendix H6)
The medical management department is
When a request for registration of a user ID that permits access according to the type of the medical information of the specific patient is received from the arbitrary terminal used by the first medical worker, the user ID of the specific patient and registering the type of medical information and the user ID to which access is permitted in the storage system;
When a request to register the medical information of the specific patient is received from the first terminal or the second terminal, the user ID of the specific patient is associated with the medical information, and the type of medical information is Grant access authority to the medical information to the associated user ID and register it in the storage system;
When a request for access to the medical information of the specific patient is received from the first terminal or the second terminal, the request source of the access request is sent from the storage system to the medical information of the specific patient. The remote medical care support device according to appendix H4 or H5, wherein the access authority is granted to the user ID currently in use, and the acquired medical information is returned to the requester.
(Appendix H7)
In the storage system, the user ID and password of the user who can use the terminal, the attributes of the user ID, and the face image of the user ID are registered in advance in association with each other,
The medical management department is
At the time of login processing of the predetermined terminal, receiving a face image and user ID of the user of the terminal taken by the predetermined terminal;
acquiring a facial image associated with the accepted user ID from the storage system; performing face authentication on the accepted facial image and the acquired facial image;
If the attribute of the received user ID is a first medical worker, after the face authentication is successful, password authentication is requested from the predetermined terminal, and if the password authentication is successful, login is permitted. death,
If the attribute of the received user ID is other than the first medical worker, login is permitted after the face authentication is successful. The remote medical care support device according to any one of appendices H1 to H6.
(Appendix I1)
The self-device and A remote medical care support device connected with other redundant devices,
When a request for registration of the connection management information from a predetermined terminal is received, retaining the connection management information in the memory of the own device, and registering the connection management information in the storage system;
In response to a terminal list request from the first terminal, obtain a list of the terminal IDs whose usage status is in use from the usage management information of the storage system, and send the list to the first terminal. death,
When the first terminal receives a connection management information request that includes a second terminal ID of a second terminal selected from the list, searches the memory for the second terminal ID. ,
searching the storage system for the second terminal ID if the second terminal ID does not exist in the memory;
acquiring second connection management information associated with the second terminal ID from the memory or storage system where the second terminal ID existed, and sending it back to the first terminal;
In response to receiving a terminal-to-terminal connection request in which the second connection management information is specified from the first terminal, the first terminal is sent to the second terminal based on the second connection management information. Inquires whether direct communication with the terminal is possible,
A remote medical treatment support method, wherein, in response to a connection permission response from the second terminal, a response is sent to the first terminal requesting connection permission for direct communication with the second terminal.
(Appendix J1)
The self-device and to a computer connected with other redundant devices,
When a request for registration of the connection management information from a predetermined terminal is received, a process of retaining the connection management information in the memory of the own device and registering the connection management information in the storage system;
In response to a terminal list request from the first terminal, obtain a list of the terminal IDs whose usage status is in use from the usage management information of the storage system, and send the list to the first terminal. processing and
When the first terminal receives a connection management information request including a second terminal ID of a second terminal selected from the list, the memory is searched for the second terminal ID. processing and
a process of searching the storage system for the second terminal ID when the second terminal ID does not exist in the memory;
A process of acquiring second connection management information associated with the second terminal ID from the memory or the storage system where the second terminal ID exists, and sending it back to the first terminal. and,
In response to receiving a terminal-to-terminal connection request in which the second connection management information is specified from the first terminal, the first terminal is sent to the second terminal based on the second connection management information. A process of inquiring whether direct communication with the terminal is possible;
A process of responding to the first terminal with connection permission for direct communication with the second terminal in response to a connection permission response from the second terminal;
A telemedicine support program that allows you to carry out.

1000 Telemedicine support system 1 Storage system 11 Usage management information 111 Usage status 112 Terminal ID
12 Connection management information 121 Destination information 122 Terminal ID
21 Remote medical care support device 211 Medical care management unit 212 Connection management unit 213 Memory 214 Connection management information 22 Remote medical care support device N Network 31 Terminal 311 Terminal ID
312 Connection management information 32 Terminal 321 Terminal ID
322 Connection management information 2000 Remote medical care support system 4 Shared storage device 41 Usage management DB
411 User ID
412 User attribute 413 Terminal ID
414 Usage status 415 Password 416 Face image 42 Connection management DB
421 ICE
4211 Terminal ID
4212 Dynamic IP address 4213 Route information 422 ICE
43 Medical personnel DB
431 Patient ID
432 Doctor ID
433 Nurse ID
434 Caregiver ID
44 Medical history DB
441 Patient ID
442 Medical information 443 Access authority 444 User ID
45 Authority definition DB
451 Patient ID
452 Medical information type 453 User ID
51 Server device 511 Web/AP server 512 Medical care management department 513 P2P connection control server 514 Stun server 5141 ICE
515 PeerJS server 52 Server device 521 Web/AP server 523 P2P connection control server 524 Stun server 525 PeerJS server 6 Load balancing device 71 Medical institution 710 Tablet terminal 711 Terminal application 712 ICE
713 Doctor 714 Nurse 72 Patient's home 720 Tablet terminal 721 Terminal application 722 ICE
723 Patient 724 Caregiver 73 Nursing care office 730 Tablet terminal 731 Terminal application 732 ICE
733 Caregiver 81 Storage device 811 OS
812 Web server program 813 AP server program 814 Web application program 815 Stun server program 816 PeerJS server program 82 Memory 83 Communication IF section 84 Control section 841 Medical treatment management section 842 Terminal information processing section 843 Connection processing section 3000 Remote medical treatment support system 21a Remote medical treatment Support device 211a Medical care management unit 212a Connection management unit 4000 Remote medical care support system 21b Remote medical care support device 211b Medical care management unit 4a Storage device 43a Medical care personnel DB
431 Patient ID
435 Related party attributes 436 User list 437 User ID
44a Medical history DB
441a Patient ID
442a Medical information 443a Related party attributes

Claims (9)

The self-device and Connected with other redundant devices,
a medical care management unit that inputs and outputs medical information regarding patients undergoing remote medical treatment to and from the terminal;
a connection management unit that controls the establishment of a connection for direct communication between terminals;
Equipped with
The connection management section includes:
When a request for registration of the connection management information from a predetermined terminal is received, retaining the connection management information in the memory of the own device, and registering the connection management information in the storage system;
The medical management department is
In response to a terminal list request from the first terminal, obtain a list of the terminal IDs whose usage status is in use from the usage management information of the storage system, and send the list to the first terminal. death,
The connection management section includes:
When the first terminal receives a connection management information request that includes a second terminal ID of a second terminal selected from the list, searches the memory for the second terminal ID. ,
searching the storage system for the second terminal ID if the second terminal ID does not exist in the memory;
acquiring second connection management information associated with the second terminal ID from the memory or storage system where the second terminal ID existed, and sending it back to the first terminal;
In response to receiving a terminal-to-terminal connection request in which the second connection management information is specified from the first terminal, the first terminal is sent to the second terminal based on the second connection management information. Inquires whether direct communication with the terminal is possible,
A remote medical treatment support device that responds to the first terminal with connection permission for direct communication with the second terminal in response to a connection permission response from the second terminal. The remote medical care support device according to claim 1, wherein the connection management information includes candidates for route information in a network via which the direct communication takes place. The remote medical treatment support device according to claim 1 or 2, wherein the medical information includes biological information of the patient. The usage management information is further associated with a user ID that can use the terminal,
The medical management department is
When a request for registration of the user ID of a second medical worker involved in remote medical treatment of a specific patient is received from any terminal used by a first medical worker, the first medical worker, the second registering the respective user IDs of the medical worker and the specific patient in the storage system in association with each other;
In response to the terminal list request from the first terminal, identifying another user ID associated with the user ID currently using the first terminal from the storage system;
obtaining a list of the terminal IDs of the usage management information that are associated with the identified other user ID and whose usage status is in use;
The remote medical care support device according to any one of claims 1 to 3, wherein the list is returned to the first terminal. The medical management department is
When a request for registration of the medical information of the specific patient and a user ID that allows access to the medical information is received from the arbitrary terminal used by the first medical worker, the user ID of the specific patient and and registering the medical information in the storage system by associating the medical information with the medical information, granting the access authority to the user ID to which the access is permitted, and registering the medical information in the storage system;
When a request for access to the medical information of the specific patient is received from the first terminal or the second terminal, the request source of the access request is sent from the storage system to the medical information of the specific patient. 5. The remote medical care support device according to claim 4, wherein the access authority is granted to the user ID currently using the remote medical care support device, and the obtained medical information is returned to the requester. The medical management department is
When a request for registration of a user ID that permits access according to the type of the medical information of the specific patient is received from the arbitrary terminal used by the first medical worker, the user ID of the specific patient and registering the type of medical information and the user ID to which access is permitted in the storage system;
When a request to register the medical information of the specific patient is received from the first terminal or the second terminal, the user ID of the specific patient is associated with the medical information, and the type of medical information is Grant access authority to the medical information to the associated user ID and register it in the storage system;
When a request for access to the medical information of the specific patient is received from the first terminal or the second terminal, the request source of the access request is sent from the storage system to the medical information of the specific patient. 6. The remote medical care support device according to claim 4, further comprising: acquiring the user ID currently using the access authority, and returning the acquired medical information to the requester. In the storage system, the user ID and password of the user who can use the terminal, the attributes of the user ID, and the face image of the user ID are registered in advance in association with each other,
The medical management department is
At the time of login processing of the predetermined terminal, receiving a face image and user ID of the user of the terminal taken by the predetermined terminal;
acquiring a facial image associated with the accepted user ID from the storage system; performing face authentication on the accepted facial image and the acquired facial image;
If the attribute of the received user ID is a first medical worker, after the face authentication is successful, password authentication is requested from the predetermined terminal, and if the password authentication is successful, login is permitted. death,
The remote medical care support device according to any one of claims 1 to 6, wherein if the attribute of the accepted user ID is other than the first medical worker, login is permitted after the face authentication is successful. The self-device and A remote medical care support device connected with other redundant devices,
When a request for registration of the connection management information from a predetermined terminal is received, retaining the connection management information in the memory of the own device, and registering the connection management information in the storage system;
In response to a terminal list request from the first terminal, obtain a list of the terminal IDs whose usage status is in use from the usage management information of the storage system, and send the list to the first terminal. death,
When the first terminal receives a connection management information request that includes a second terminal ID of a second terminal selected from the list, searches the memory for the second terminal ID. ,
searching the storage system for the second terminal ID if the second terminal ID does not exist in the memory;
acquiring second connection management information associated with the second terminal ID from the memory or storage system where the second terminal ID existed, and sending it back to the first terminal;
In response to receiving a terminal-to-terminal connection request in which the second connection management information is specified from the first terminal, the first terminal is sent to the second terminal based on the second connection management information. Inquires whether direct communication with the terminal is possible,
A remote medical treatment support method, wherein, in response to a connection permission response from the second terminal, a response is sent to the first terminal requesting connection permission for direct communication with the second terminal. The self-device and to a computer connected with other redundant devices,
When a request for registration of the connection management information from a predetermined terminal is received, a process of retaining the connection management information in the memory of the own device and registering the connection management information in the storage system;
In response to a terminal list request from the first terminal, obtain a list of the terminal IDs whose usage status is in use from the usage management information of the storage system, and send the list to the first terminal. processing and
When the first terminal receives a connection management information request including a second terminal ID of a second terminal selected from the list, the memory is searched for the second terminal ID. processing and
a process of searching the storage system for the second terminal ID when the second terminal ID does not exist in the memory;
A process of acquiring second connection management information associated with the second terminal ID from the side of the memory or storage system where the second terminal ID existed, and sending it back to the first terminal. and,
In response to receiving a terminal-to-terminal connection request in which the second connection management information is specified from the first terminal, the first terminal is sent to the second terminal based on the second connection management information. A process of inquiring whether direct communication with the terminal is possible,
A process of responding to the first terminal with connection permission for direct communication with the second terminal in response to a connection permission response from the second terminal;
A telemedicine support program that allows you to carry out.

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