JPH09305671A - Electronic medical card system and electronic medical card display method - Google Patents

Abstract

PROBLEM TO BE SOLVED: To treat only required information while grasping the whole configuration of medical examination information when a large quantity of preserved medical card information is displayed in an electronic medical card system. SOLUTION: A binder where first hierarchy in medical information is defined is stored in a database. Tree structure is constituted in a client based on the binder and display is executed in a window 10. In display, an item having hierarchy below is called node and expressed by mark of '+' inside a square frame. It is changed into the mark of '-' at the time of extension like the item of a patient attribute. The item where actual data is displayed without having hierarchy below is called leaf and indicated by an icon where documents are made into a design. The node extended in this way is displayed by being inserted into the tree configuration of an extension source so that a user grasps the whole image of information while viewing required information.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an electronic device capable of rationally displaying a large amount of electronic file-formatted medical record information and easily handling only necessary information while grasping the overall structure of medical care information. Regarding the medical record system.

[0002]

2. Description of the Related Art Medical institutions such as hospitals are obliged to record medical information of patients as medical records and store them. This chart is filled out on paper and saved. Also, in some cases, a method of inputting a medical record into a word processor and saving it as a file is also adopted. This chart is treated as a group for each patient.

[0003]

[Problems to be Solved by the Invention] If you want to obtain the necessary information from these medical records, look at the compiled medical records one by one from the end and write the information. There was a problem that I had to find a medical record.

Further, even when a medical record is input to a word processor and converted into an electronic file for storage, in the past, since the information was simply stored as a file without being classified, it is necessary to search for necessary information. Had the problem of having to check the contents of each file.

Therefore, the object of the present invention is to rationally classify a large amount of medical record information stored as an electronic file, to grasp the entire structure of medical information, and to handle only necessary information. An object of the present invention is to provide such an electronic medical record system and an electronic medical record display method.

[0006]

In order to solve the above-mentioned problems, the present invention comprises a database server in which classified medical information is stored, and a client which receives medical information from the database server. It is an electronic medical record system characterized by displaying medical information received from a database server in a tree structure.

Further, in order to solve the above-mentioned problems, the present invention has a step of receiving medical care information from a database server storing classified medical care information, and a structure of the medical care information received from the database server in a tree structure. And a step of displaying the medical care information in a tree structure, the electronic medical record display method.

As described above, according to the present invention, since the medical information classified and stored in the database server is displayed as it is in the tree structure of the client, when a large amount of medical information is viewed, You can obtain necessary information while grasping the overall structure.

[0009]

Embodiments of the present invention will be described below with reference to the drawings. According to the present invention, medical information of patients is classified by a predetermined method and stored in the database server, and when the stored medical information is displayed on the client side, it is displayed as a tree structure based on the classification. FIG. 1 shows an example of the configuration of an electronic medical record system according to the present invention. A plurality of client computers 1 and 2 installed in an examination room or reception of a hospital and a database server 3 are connected to a LAN (L
oCar Area Network) 4. Client computer (hereinafter abbreviated as client) 1,
2 has a display and an input device such as a keyboard and a mouse.

Although two clients are connected to the LAN in the figure, a larger number of clients may be connected depending on the need and system capability. Also, only one client may be connected to the system. Furthermore, the database server (hereinafter abbreviated as server) 3 may be provided with a client function, and the server 3 may be used alone.

The medical information for each patient is stored in the external storage device 5 which is connected to the server 3 and is composed of, for example, a hard disk. The medical information for each patient is classified and stored based on a predetermined method. This classification is based on, for example, the POS (Problem Oriented Syst) proposed in the United States.
em) based on the medical information such as patient attributes,
It is categorized and stored in items consisting of problems, basic data, observation records, progress records, letters of introduction, and summaries.

The patient attribute is attribute data relating to the patient. For example, a patient number which is an ID given to the patient, a name and a pseudonym of the name, sex, date of birth, current address and telephone number, and jurisdiction ( Information such as insurance). The problem is a list of problems the patient has. The basic data also includes chief complaint, current medical history, patient's life picture, family history, system review, and Physic.
It is classified and memorized in the item consisting of al Examination. The main complaint is the symptom that the patient first complains when he or she visits the hospital, and it is desirable to write the words as expressed by the patient. The current medical history is a summary of the progress up to the point when the above-mentioned problem was found and is written at the time of admission. The life style of the patient is the way of life and environment of the patient. The family calendar describes whether there is a person in the patient's bloodline who has an illness related to a genetic disorder or constitution. The system review is filled in from the patient's perspective as to how the body parts were like before they were hospitalized. Also, this is Phys based on the examination performed on each part of the body, for example, from the doctor's point of view.
ical examination. The progress record is filled with the progress of the problem. The referral is filled in with the content of the referral when the patient is transferred from another hospital or transferred to another hospital. The summary summarizes the progress up to now, such as discharge and transfer.

In the present invention, this classification is organized hierarchically. For example, basic data has a lower hierarchy,
In the lower hierarchy, chief complaint, current medical history, patient's life style,
Family calendar, system review, and Physical Examinati
Classified into items consisting of on. Furthermore, for example Phys
The ical examination has a layer below it, which is classified according to each part of the body, and further below, there is a hierarchy classified according to the examination item in the body part.

It should be noted that this classification is an example, and the present invention is not limited to this example. Various classifications are possible depending on the actual conditions of the hospital where this system is introduced. Further, the classification does not necessarily have to be based on the above-mentioned POS.

In the present invention, the classification of the medical care information is managed in the server 3 by a file called a binder. This binder is created for each patient. FIG. 2 shows an example of the structure of this binder. The data is shown in the part between "/ *" and "* /" in the figure. Further, the numbers attached to the heads of the lines are for explanation. Except for the 1st and 21st rows, each row contains data in 5 columns, the 1st column is the attribute of that row, the 2nd column is the data name, and the 3rd column is the data type. And the fourth column indicates whether the row is a key. The fifth line is a comment for explaining each item.

In the electronic medical record system described above, the data is organized in a table format called such a relation. The data shown in one relation means that they are all in the same hierarchy. There are two types of attributes that make up this relation: an element (Element) attribute and a role (Role) attribute.

The element attribute is an attribute that takes only one data of a simple data type as its value. That is,
The data having this element attribute takes an actual value. Therefore, the data type of the data having the element attribute is uniquely indicated, for example, INT (Integer: integer).

The role attribute is an attribute having one or more other lines (line numbers) as an attribute value. That is, the data having the roll attribute can be used as a pointer to refer to another line (line number) having the attribute value. In this case, since there is no single data type, the data type is given a unique name such as PatientAttr. In the case of the role attribute, the row (row number) held as the attribute value may be another relation or its own relation. Further, the pointer can have a plurality of pointer values for one pointer item. By thus providing a plurality of pointer values for one item, it is possible to allow a plurality of data having the same item but different contents to exist in the same layer.

In FIG. 2, the first line shows that this relation is a binder. 2nd to 5th lines
Up to the line, the attributes of the report (chart) represented by this binder are shown. These have element attributes. In addition, the 6th to 20th lines are data based on the above classification. This binder is composed of data of the same layer, and data having a lower layer has a role attribute and refers to the row in which the lower layer is shown.

FIG. 3 shows an example of a patient attribute schema (file format) referred to by patientAttr on the 8th line. This patient attribute schema is also composed of data in the same hierarchy, as in the binder described above. Second
The line from the 10th line has an element attribute, and an actual value is shown according to the data type shown in the 3rd column. On the other hand, the eleventh and twelfth lines have the role attribute, and it is shown that there is a lower hierarchy. For example, in the 11th row, the Charge in the 3rd column
With the pointer as a pointer, the schema of the supervisor is referenced.

FIG. 4 shows an example of the schema of the patient problem referred to as problem in the 15th line. A problem that shows the symptoms of a patient is added, for example, when a new symptom is discovered due to the visit of the patient,
The number may increase. Therefore, the problem number is attached to the problem as shown in the fifth line of this example. Corresponding to this problem number, nextProblemN and nextProblemN2 are provided on the sixth and seventh lines of the binder described above. The nextProblemN and nextProblemN2 are count values that are incremented by 1, for example, each time a new problem is newly added, and the new problem that is added is given a problem number based on the nextProblemN and nextProblemN2.

In this way, since the problems are accumulated for one patient, the binder is
It is called a lifetime problem list.

In the schema of the problem, the userType in the third line is for determining whether this problem is created by a doctor or a medical worker other than a doctor, such as a nurse or a pharmacist. Is the flag of. The status on the 4th line is a flag indicating whether this problem is currently a problem (active) or, for example, has been cured and is no longer a problem (inactive). For example, if this flag is set to "1", it indicates inactive. 14th line re
laterProblem is a pointer for referring to another problem related to this problem. Line 15
Charge is a pointer for referring to information such as insurance related to this problem.

Next, a case where the user views the chart information of a patient with the client 1 or 2 will be described. The server 3 is configured with a database that associates information for identifying a patient such as first and last name with a report number that is a key in the binder. The user first identifies the patient, for example, by first and last name in the client 1, and searches for the report number by a predetermined method. When the report number of the target patient is obtained, the binder of the target patient is referred to in the server 3 based on this report number. Based on the referenced binder, an initial screen for displaying patient information is displayed on the display of the client 1.

FIG. 5 shows an example of the window 10 displayed as an initial display screen of this patient information. In this way, the information display of the patient is made in the tree structure based on the hierarchy shown in the binder. As mentioned above,
In the binder, patient attributes, family history, chief complaint, current medical history,
Lifestyle of patient, system review, Physical Examinati
Each item of on, lifelong problem list, progress record, observation record, surgery record, summary, and referral letter is shown as the same layer, but this layer is reflected on this screen display.

In this example, family calendar, chief complaint,
Current medical history, patient lifestyle, system review, and Phys
Although the ical examinations are summarized as basic data for the convenience of use, they actually belong to the same hierarchy as the other data shown in FIG. As described above, in this system, the display form can be changed to another form depending on the specifications.

In the figure, at the top of window 10 is shown that this window is for patient A. In the window 10, an icon indicating the state of each item is displayed for each item. In this example, a pattern of a closed folder is used as an icon. Further, an item to which a role attribute is added in the binder and which is referred to another relation is called a node. By referring to the role attribute, the hierarchy further below is expanded from this node.

In this example, this node is represented by a "+" or "-" sign in a square frame. Nodes with a "+" sign indicate that they are not referenced based on the role attribute and are closed, while nodes with a "-" sign are referenced and further down the screen. Indicates that the hierarchy is expanded.

The closed node can be arbitrarily expanded by an instruction given to the client 1 by the user. For this instruction, for example, by operating the mouse connected to the client 1 as an input device, the mouse cursor displayed on the screen is moved, and the square frame or icon representing the node for the target item or the place of the item name is displayed. Made by double-clicking.

FIG. 6 shows a state where the patient attribute node in the window 10 is expanded in this way. In this way, when a node is expanded, the icon indicating the status of the expanded item changes to the corresponding status. In this example, a design in which the folder is opened is used. At the same time, the symbol inside the square frame is set to "-", which indicates that the node is expanded.

The expanded hierarchy is displayed based on the patient attribute schema shown in FIG. In this patient attribute schema, there is an item that has an element attribute whose actual value is shown. An icon representing that this item shows an actual value is displayed in the item having this element attribute. In this example, a stylized document is used for that purpose. Then, actual data is displayed following this icon. In addition, since the item of management has a role attribute, it is expressed as a node.

The hierarchy in which the node is expanded is displayed in a tree structure for the node, and the row of the hierarchy is displayed so as to be inserted in the row of the original hierarchy in which the node is expanded. It By doing so, the user can always see the display centered on the information that he / she wants to see (expanded).

The window 10 shown in FIG. 6 is used.
Then, since the amount of information is larger than that in FIG. 5 described above, the display is off the screen. In such a case, it is preferable to arrange a scroll bar in the window 10 as shown on the right end of the figure so that the whole can be seen by operating the scroll bar. Further, when the information extends laterally, a scroll bar as shown at the lower end of the window 10 may be arranged.

FIG. 7 shows a flow chart when this node expansion and screen display based on the node expansion are performed. When the operation is started and an instruction is given from the user, it is determined in the first step S1 whether or not to expand the node. For example, when the user double-clicks a certain position on the screen by operating the mouse, this position corresponds to the closed node, that is, a square frame showing the node, a closed folder icon, or the It is determined whether it is an item name. If it is determined that the position corresponding to the closed node is designated, the node is expanded, and the process proceeds to step S3.

On the other hand, if it is determined in step S1 that the position does not correspond to the closed node, the process proceeds to step S2, and the node in which the designated position is expanded is expanded by the same method as in step S1. It is determined whether or not the position corresponds to. If it is determined to be the position corresponding to the node to be expanded, this node will be closed,
The process proceeds to step S10. On the other hand, if it is determined that the position is not the corresponding position, this instruction is ignored and the process returns to step S1.

In step S3, it is determined based on the user's instruction what the item indicated by the expanded node is. Based on this judgment, the process branches for each node to be expanded. For example, when the user designates a folder, a node, or an item name indicating a patient attribute, the process proceeds to step S4, and the patient attribute node is expanded. Similarly, if the user gives an instruction to manage, the process proceeds to step S4 ′, and if the user gives a lifetime problem list, the process proceeds to step S4 ″. Then, from step S4 ′ or step S4 ″. A process similar to the process from step S4 described below is performed.

If it is determined in step S4 that the patient attributes are to be developed, the process proceeds to step S5. In this step S5, the client 1 issues an instruction to the server 3 to refer to the relation indicating the corresponding patient attribute. Based on this instruction, the server 3 retrieves the data to be displayed from the data of the corresponding binder from the database configured in the external storage device 4. In this example, patient number, name, pseudonym name, gender,
The current address, telephone number, and data of the supervisor are retrieved. These retrieved data are sent to the client 1.

In the next step S6, the client 1 creates a text sentence for displaying the data having the element attribute displayed as a leaf among the data fetched and sent from the server 3 for each data. It Then, in the next step S7, the display position of each data is determined in order to insert these data into the original node display to be expanded.
That is, in the row direction, the display row position is lowered by one row from the row in which the original node to be expanded is displayed, and in the column direction,
The display start position is indented by a predetermined interval so that one layer below can be displayed. The second and subsequent data to be displayed are only line-indented line by line with respect to the first data. In this way, line indentation and indentation are performed on the data, and the display position is determined.

When the display position of the leaf is determined in this way, for the data having the roll attribute displayed as a node, in the next step S8, the above-mentioned step S is performed.
A text sentence for display is created in the same way as in 7.
Further, the display position is determined.

When the text sentence to be displayed and the display position are thus determined, the display screen is updated to display them (step S9). At this time, icons corresponding to the respective data and symbols indicating the states of the nodes are also displayed. That is, for data represented as leaves, a stylized icon of a document is displayed with the data, and for data represented as a node, a stylized icon of a closed folder is displayed with the data. . Then, the tree structure is displayed so that it can be seen from the expansion source node that these leaves and nodes have been expanded, and the display is as shown in FIG.

On the other hand, when it is determined that the node is closed in step S10 described above, it is checked how the leaf or node is expanded in this designated node. Then, based on the result, the next step S1
In 1, the leaves and nodes expanded below the designated node are closed. That is, the line displaying the expanded leaf or node is deleted and packed. Then, in the expansion source node, the symbol of the square frame is changed from "-" to "+", and the icon of the opened folder is changed to the icon of the closed folder. And
In step S9, the display screen is updated based on these changes.

The screen display of the patient information in the window 10 described above is an example, and other display forms are possible depending on the contents of the displayed data and the like. For example, an item of a problem (lifetime problem list) in the binder can have a plurality of pointers for one item, as described above. Furthermore, in the relation referred to by the pointer of this problem, FIG.
As shown in, a plurality of flags are provided, and the problem displayed by these flags is selected.

FIG. 8A shows an example of the first screen when the problem is developed on the initial screen of the medical information of the patient A in the window 10. When this problem is developed, the relations of the problems referred to in the binder are retrieved from the database and sent to the client 1. Among these sent problems, the value of userType in the second line and st in the third line in the schema of the problem shown in FIG.
These problems are classified based on the value of atus. Then, nodes for doctors and for co-medical are generated, and nodes for problems are expanded. Furthermore, when an instruction for a doctor, for example, is given from among the generated nodes, an active problem which is a currently valid problem and an inactive problem which is not so are generated.

Here, when the node of Active Problem is designated, this node is expanded, and the corresponding problem is expanded as a node based on the classification by the above-mentioned flag (FIG. 8B). Next, when a desired problem is selected from these expanded problems and designated, the problem is expanded, the item having the element attribute is expanded as a leaf, and the actual value is displayed, as shown in FIG. . Like this problem, it is possible to construct a hierarchical structure based on the information shown in the relation.

In the binder, the pointer Progress
The progress record, observation record, operation record, etc. referred to in Note, ObservationRecord, and OperationRecord have not only textual data but also information such as photographs and graphs. Even in such a case, another display form suitable for displaying information other than these text sentences is adopted.

FIG. 10 shows an example in which the progress record node is expanded in the window 10. The progress log node is
First, in this way, it is developed based on the date when the record was taken. This progress record has image data such as photographs as data. Therefore, based on the expanded node, a new window 11 for displaying a progress record is opened as shown in FIG. And this window 11
The corresponding image data is displayed in the data display frame 12 inside.

At this time, for example, by opening the progress record node and expanding the node indicating the desired year, predetermined data such as the latest data or the first data in the specified year can be displayed. it can.
In this case, it is advisable to display the previous date data or the next date data by operating a button or the like arranged on the operation unit 13 of the window 11 with a mouse or the like. Further, the node expansion in the window 10 can be automatically controlled in conjunction with the operation in the window 11.

[0048]

As described above, according to the present invention, in a system for treating medical information of patients, a large amount of medical information can be compacted by classifying the information in a tree structure and displaying the information as it is. There is an effect that can be expressed in.

Further, according to the present invention, it is possible to handle only the necessary information when necessary while grasping the type and overall structure of the medical care information handled by the system.

[Brief description of drawings]

FIG. 1 is a schematic diagram showing an example of a configuration of an electronic medical chart system according to the present invention.

FIG. 2 is a schematic diagram illustrating an example of a binder configuration.

FIG. 3 is a schematic diagram showing an example of a schema of patient attributes.

FIG. 4 is a schematic diagram showing an example of a schema of a problem.

FIG. 5 is a schematic diagram showing an example of a window of an initial display screen of patient information.

FIG. 6 is a schematic diagram showing a state in which a patient attribute node is expanded.

FIG. 7 is a flowchart when expanding a node and displaying a screen based on the expansion of the node.

FIG. 8 is a schematic diagram for explaining development of a problem.

FIG. 9 is a schematic diagram for explaining development of a problem.

FIG. 10 is a schematic diagram for explaining development of a progress record.

FIG. 11 is a schematic diagram for explaining development of a progress record.

[Explanation of symbols]

1, 2 ... Client computer, 3 ... Database server, 5 ... External storage device, 10, 11 ...
..Window, 12 ... display frame

Claims (4)

[Claims] 1. An electronic medical record system for treating medical information of a patient as an electronic file, comprising: a database server storing classified medical information; and a client receiving the medical information from the database server. An electronic medical record system displaying the medical care information received from the database server in a tree structure. 2. An electronic medical record display method for displaying medical information of a patient in an electronic file, the step of receiving the medical information from a database server in which the classified medical information is stored, and the step of receiving the medical information from the database server. An electronic medical record display method comprising: a step of forming medical information in a tree structure; and a step of displaying the medical information in the tree structure. 3. The electronic medical record system or the electronic medical record display method according to claim 1, wherein the tree structure represents a node indicating that the tree structure further has a layer below, and an end of the layer. An electronic medical record system or an electronic medical record display method, characterized in that the display comprises a leaf, and the display is performed by expanding the designated node by designating the node. 4. The method according to claim 1, 2 or 3.
In the electronic medical chart system or the electronic medical chart display method described above, the tree structure is defined based on a binder in which information of the node and the leaf in the first layer of the tree structure is written, and the display is the binder. An electronic medical record system or an electronic medical record display method characterized by being performed based on the above.