JPH1021301A - Area health and medical care information system and portable recording medium used for the system - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an area health and medical care information system capable of easily executing service provider's operation. SOLUTION: The system is composed of operation terminals 31, 32 enabling respective service providers to input and display information, information storing terminals 33 to 35 for service providing organizations, IC card drives 41 to 43 connected to the terminals 33 to 35, database 44 to 46, network 37 connecting respective terminals and a management terminal 36 capable of issuing as IC card 21 to be carried by each service provider and monitoring the execution of each agent. A portable storage medium 21 provided with a function for suppressing the intrusion of a third person is utilized. The management terminal 36 is arranged on a public organization or the like for managing the whole system and stores agents in respective IC cards. The terminal 31 is arranged in a patient home and a portable terminal 47 transmits data to another terminal through a base station 48. Information to be charged by respective service providing organizations is recorded in the terminals 44 to 46. Consequently information necessary for each service provider can be collected from the information storing terminals and referred to.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a community health service for a service provider dispatched from a service providing organization such as a home-visit nursing station or a home care support center to perform nursing and nursing services at a patient's home or the like. The present invention relates to a medical information system and a portable storage medium used therein.

[0002]

2. Description of the Related Art As an example of the prior art, "Health and Medical Card System Standardization Manual First Edition" (Medical Information System Development Center, pp. 14-17),
The privacy protection measures in the healthcare card system are described. For privacy protection measures, prepare an operation card with access rights to healthcare information for each occupation and region and use readable and writable healthcare information. Are restricted by occupation type or region.
As an operation card, use of an IC card is under study. As another example of the prior art, the mechanism of the elderly nursing home nursing system is described in the “Nursing home station opening, operation, and evaluation manual” (Japan Nursing Association Press, p. 15). A plurality of organizations, such as hospitals, clinics, visiting nursing stations, and home care support centers, provide nursing care to home patients, such as home nursing and bathing services. Health and medical information (hereinafter referred to as patient information) about home patients includes medical records (medical records, audit records, doctor's guides, etc.), nursing records (vital signs, nursing content, etc.), consultation records (family status, income, Emergency contact). Each organization that provides services to home patients manages necessary patient information for each organization.

As another example of the prior art, "To the Age of Agents Beyond Objects" (Nikkei Computer, May 30, 1994, pp. 48-62).
Describes a multimedia communication service using an information portable terminal. When the user's terminal asks the agent "I want dentist information", the agent moves to another terminal, collects the dentist's name and telephone number from the address book database, and retrieves the original terminal (user's information). Terminal)
Come back to. The agent is a program module that works as a user's agent and performs desired work (for example, collection of the dentist's name and telephone number), and moves like a human being voluntarily and autonomously. (For example,
Work around the other device over the network). In other words, the agent does not operate passively due to an external event, but performs its own work based on the knowledge of the agent itself and information collected by the agent from other terminals. An information system constituted by agents is called an agent type system. Since each agent works spontaneously and autonomously, dependence on data and processing between terminals can be reduced, and a distributed system can be easily constructed.

In the following description, the terms “patient” and “health and medical information (patient information)” are used in the following sense. For the sake of simplicity, people who receive various services are referred to as "patients." However, the number of people who receive services is not limited to those who are generally hospitalized or going to hospitals. Includes people who need some nursing care, 24 hours nursing care, etc., people who are healthy but elderly and who live alone at home, people with disabilities who live at home, etc. . Further, “health and medical information (patient information)” includes medical records, including medical records, audit records, doctor's guides, etc., vital signs (body temperature, blood pressure, pulse, etc.), nursing content, date and time of nursing care concerning “patient”. Nursing records, family status, income,
It shall represent all information and data related to "patients", such as consultation records with the social welfare section staff on living conditions including emergency contact information, etc.

[0005]

In the above-mentioned prior art, the access right of patient information can be set for each occupation type and each region using an operation card. However, sufficient consideration has not been given to accessing the necessary patient information and providing services efficiently. In the above-described conventional technology, patient information managed for each organization that performs service operations can be collected and managed using an agent.
If the agent is not properly managed, there is a fear that a third party may impersonate the service provider and falsify the patient information data, causing a fatal failure to the entire system. SUMMARY OF THE INVENTION It is an object of the present invention to solve the above-mentioned conventional problems and to efficiently perform a service operation performed by a service provider according to a patient who receives a service, manage patient information in detail, and provide a service providing organization. It is an object of the present invention to provide a community health care information system capable of collecting and managing patient information managed for each data while maintaining data security, and a portable storage medium used for the system.

[0006]

According to the present invention, there is provided a community health care information system in which a service provider dispatched from a predetermined medical or nursing care organization performs a medical or nursing care service at a visiting place. Recording medium distributed to the service provider, a management terminal for recording the contents of the service work approved by the administrator of the predetermined organization to the service provider on the portable recording medium, and a recording medium recorded on the portable recording medium. Based on the information, the service provider and the service recipient who receives the service operation are identified, and an operation terminal installed at the place of visit for reading the contents of the service operation recorded on the portable recording medium, and a medical or nursing care A network device that connects the information storage device that records the community health care information for performing service operations and the operation terminal and transmits predetermined information from the community health care information It is characterized by the regional healthcare information system with a door. The operation terminal collects, from the information storage device, information necessary for executing the service task read from the portable recording medium. Information collected from the information storage device
It is information on a program module that supports the execution of a service operation and a service recipient. The portable recording medium used in the above regional health information system,
The storage contents of the portable recording medium can be changed by the administrator, and the service provider has a management recording area that allows only reading of the storage contents of the portable recording medium, except for the administrator and the service provider. Reading and writing by three parties is prohibited. Further, the portable recording medium has an area for storing a flag indicating whether information recorded in the management recording area is valid or invalid. The contents of the service business authorized by the service provider are recorded in the management recording area. After the information necessary for the service operation is read out by the service provider, the flag in the management recording area for the service operation is changed to invalid, and the flag in the management recording area for the service operation is enabled after the execution of the read service operation is completed. Is changed to Further, the portable recording medium has an area for storing a service agent which is a program module for supporting a service operation, and the service agent stores information necessary for executing the service operation via a network to which an information storage device is connected. Includes an information collection agent that collects information while moving. An IC card is used as a portable recording medium.

[0007] In the community health information system of the present invention,
Various services (home help service (home-based service) that provides home care and housework assistance by visiting homes where there is a need for nursing care such as the elderly, bedridden sick people, and the disabled, For example, go to a health care facility for the aged, rehabilitation center, take a meal, take a bath, receive physical function training (rehabilitation), etc. ) Participation, short-stay service to provide care on behalf of caregivers, home-visit nursing service to visit people who need care to live at home and check their health status, 24 hours home for those who need care Patrols early in the morning and late at night to provide support for daily life, patrol services to check health status, and visit people who need nursing care to take a bath. Visiting bathing services, specialists, family doctors, dentists, etc. visit the homes of those who need nursing care and receive medical care services. Visit rehabilitation services to help rehabilitation at home, etc. can be provided efficiently to the elderly and those who need care.

The above-mentioned various services are provided by service providers belonging to organizations (organizations) that provide different services, and health care information (patient information) is managed for each service providing organization. The service providers belonging to each service providing organization are accredited by a public organization (organization) or the service providing organization (eg, a legal entity authorized by a public organization, a private business entity entrusted by a public organization). Healthcare information (patient information) necessary to perform a range of service operations can be accessed, and service providers provide services based on the comprehensive information accessed. Therefore, a more suitable and safe service can be received in a timely manner. In the specification of the present invention, providing the above-mentioned various services is referred to as “providing a service business”, and an organization or an organization that provides the “service business” is referred to as a “service providing organization”.

[0009]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Embodiments of the present invention will be described below in detail with reference to the drawings, taking as an example a home service in which a patient living at home receives various services at home.

(Embodiment 1) FIG. 1 is a flowchart showing a procedure of a service providing process in a community health information system according to the present invention. The processing steps are roughly divided into the steps of developing and creating a program module for supporting the execution of service work and recording the program module on the portable recording medium 13, and for each patient, (patient name: service work content received by the patient:
A service recording step 11 comprising a step of creating a service item table represented by a correspondence of program module numbers (a plurality of program modules may be provided) supporting the execution of the service task; Bring it to the home or place of stay where the patient lives, read the program module that supports the execution of service work from the portable recording medium 13 there, and the service item table, and allow the service provider to actually provide the service. The task execution step 12 is performed. The business record step 11 is
A module creating step 14 for developing and creating a program module for supporting the execution of a service business authorized by the service providing organization to which the service provider belongs; and a module recording step 15 for recording the created program module on the portable storage medium 13. The name of the patient in charge of the service provider: the content of the service operation received by the patient: a step 171 of creating a service item table represented by the correspondence of the program module number (there may be a plurality) which supports the execution of this service operation. And a service item recording step 172 of recording the created service item table in the portable storage medium 13. The program module is developed and created by a service providing organization to which the service provider belongs. This program module is a program module that works as an agent of a service provider and supports a desired service operation, and is more specifically an agent.

The service item table is represented by the correspondence between the name of the patient in charge of the service provider, the contents of the service work received by the patient, and the program module (agent) number (sometimes plural) supporting the execution of this service work. You. The service business contents in the service item table are the service business contents approved by the service provider from the service provider organization (normally, display of nursing care records, display of test results, recording of vital signs, display of a visit schedule, etc. Multiple)
Is selected from A specific example of the service item table will be described later in FIG.
1, 12, 13, and 15 will be described in detail.

The business execution step 12 includes a medium reading step 16 for reading out the program module (agent) and the service item table recorded in the business recording step 11 from the portable storage medium 13, and a portable recording medium 13.
Service erasing step 17 (hereinafter simply referred to as erasing step) for invalidating the agent recorded in the medium, a service executing step 18 for executing the agent read in the medium reading step 16, and the portable recording means 1.
3 includes a service restoration step 19 (hereinafter, simply referred to as a restoration step) for validating the agent recorded in 3. The portable recording medium 13 used in the community health care information system of the present invention has a mechanism for inhibiting reading and writing of the record information by a third party. One example is the IC card shown in FIG. The IC card 21 is inserted into an IC card insertion slot 23 of an IC card drive 22 for reading and writing information recorded on the IC card, and data is input / output through contacts 24 of the IC card. The IC card 21 has a security circuit (confirmation (authentication) as to whether or not the service provider is the principal, and encryption and decryption of various data (including program modules and agents) recorded in the IC card 21 ( For example, it is composed of a circuit for performing data scramble for changing the order of data arrangement) 25, and a memory 2 for recording the above various data
6.

In the module recording step 15, after the security circuit 25 authenticates the service provider using a password or the like, the agent to be recorded is encrypted and recorded in the recording area 27 of the memory 26. Similarly,
In the service item table recording step 172, the service circuit table is authenticated by the security circuit 25 using a password or the like, and then the service item table is encrypted and recorded in the recording area 30 of the memory 26. Medium reading step 16
Then, after authenticating the service provider, the recording area 27
And the service item table recorded in the recording area 30 are read and decrypted, and the agent is executed in the service execution step 18. When a third party tries to steal the agent and the service item table, reading and writing are prohibited during authentication by the security circuit 25. Further, even if the IC card itself is disassembled to read the agent and service item table recorded in the memory 26, the agent and service item table are encrypted and recorded unless the encryption is decrypted. (Decryption) cannot be performed. The erasing step 17 includes:
In the step of disabling (unusable) the agent recorded on the IC card 21, for example, a storage area 29 (FIG. 2) for storing a flag for disabling the recording of the IC card itself or disabling the agent is provided. Storage area 2
9 is flagged to invalidate the agent (make it unusable). When there are a plurality of agents, a storage area for storing a flag for each agent is provided in the memory 26 of the IC card. The resurrection step 19 is a step of validating (making available) the agent invalidated in the erasing step 17.
The flag set in (FIG. 2) is turned off, and the agent that has been disabled earlier is enabled (made available).

An erasing step 17 and a resuming step 19
During the service execution step 18,
The agent recorded on the IC card 21 cannot be used. That is, during the execution of the agent, the IC card is removed from the IC card drive currently used, and another IC card is
This prevents the card drive from reading out and executing the agent recorded on the IC card 21. In the medium reading step 16, reading of an agent with a flag for disabling the agent is prohibited,
In the service execution step 18, this agent cannot be executed. Therefore, the execution of a new agent by the same service provider can be prevented, and an overload that may occur when there are a plurality of the same agents, for example, an overload due to accessing the same data by the agents, processing by the agents Overload and the like due to repetition of the above are reduced, and the management of the entire system becomes easy. The patient's care record is stored in the storage area 28 of the IC card 21. Next, an example of a local healthcare information system composed of an agent type system for executing the procedure of the processing for performing the service shown in FIG. 1 will be described with reference to FIG.
FIG. 3 is a diagram showing a configuration of a community health care information system in which service providing organizations are connected via a network. The community health care information system includes operating terminals 31 and 32 for inputting and displaying necessary information for medical workers such as doctors and nurses and service providers such as care helpers, and information storage installed in the service providing organization. Terminals 33, 34, 35, IC card drives 41, 42, 43, and databases 44, 4 connected to the information storage terminals 33, 34, 35, respectively.
5 and 46, a network 37 connecting the terminals, and a management terminal 36 for issuing the IC card 21 carried by the service provider and monitoring the status of other terminals and the execution of agents. You. In this system, an IC card 21 is used as an example of a portable storage medium. The management terminal 36 is disposed, for example, in a public organization or the like that manages the entire system. The IC card 21 is connected to an IC card drive 38 for writing an agent.

The operation terminal 31 is a stationary terminal, for example, installed in a patient's home or a service provider's home.
An IC card drive 39 is connected (in FIG. 3,
Although only one operation terminal 31 is shown for simplicity, it is generally installed at each home of a plurality of patients and each home of a plurality of service providers. The operation terminal 32 is a portable portable terminal 4.
7 and the base station 4 connected to the network 37
8 to perform data transmission with another terminal. The portable portable terminal 47 is carried by a service provider,
An IC card drive is built in and has an IC card insertion slot 40. The operation terminal 31 (usually, for example, installed at each patient's home) or the portable portable terminal 47 transmits information and data necessary for providing a service when the service provider executes a service operation at the patient's home. Used to obtain. Information storage terminal 3 installed in service providing organization
3, 34 and 35 record information to be managed by each service providing organization with responsibility. In the example shown in FIG. 3, the information storage terminal 33 is a hospital where a doctor who regularly visits a patient works, the information storage terminal 34 is a nursing care support center which provides a helper dispatch service and a bathing service, and the management terminal 36 is a social terminal. The information storage terminal 35 is installed in the city hall welfare section, which provides care consultation services by workers, and the like, respectively. The management terminal 36 may be installed in a health center, a nursing care service, or the like. The database 44 of the information storage terminal 33 installed in the hospital records information and data (FIG. 7 and FIG. 10) of home visits and nursing care services performed by doctors working in the hospital.
3 manages data necessary for providing medical services. The patient's medical record shown in FIG. 7 is updated each time a doctor makes a home visit, and the patient's nursing record shown in FIG. 10 is updated each time a nurse performs a nursing care service. Information and data (FIGS. 8 and 10) of the bathing service provided by the care support center are recorded in the database 45 of the information storage terminal 34 installed at the care support center.
Manages the data needed to provide care services. The bathing instructions referred to in the bathing service shown in FIG. 8 are regularly issued by the attending physician of the hospital, and the nursing record of the patient shown in FIG. 10 indicates that the nurse provides bathing service (bathing service is a kind of nursing). Updated each time you do. Database 4 of information storage terminal 35 installed in city hall welfare section
5 stores information and data (FIG. 9) of the nursing consultation service provided by the city office welfare section, and the information storage terminal 35 manages data necessary for providing services for nursing care planning. The consultation record of the patient shown in FIG. 9 includes information and data on the patient himself and the living environment of the patient, and is updated every time the social worker provides a consultation service.

(Embodiment 2) Next, an example of a procedure for collecting patient information in the community health information system of FIG. 3 will be described according to the procedure shown in FIG. Here, for one patient, a home visit by a hospital doctor, a nursing service such as changing positions and putting on and taking off clothes by a hospital nurse, a bathing service by a nurse at a nursing support center, and a nursing consultation by a social worker at the city hall welfare section Take the case of providing a service as an example. The service provider is a doctor at a hospital, a nurse at a nursing support center, and a social worker at the welfare section of the city hall. Patients receive three types of services. An example is given in which service providers from three service providing organizations (organizations) use the operation terminal 31 installed at the patient's home to display a nursing record, display a bathing instruction, and create a visit schedule. This will be described in detail below. The collection of patient information in the community health information system shown in FIG. 3 is performed by the system administrator by issuing a smart card for each service provider at the management terminal 36 and by the service provider using the IC card. The procedure can be broadly divided into First, a procedure in which a system administrator issues an IC card for each service provider will be described.

(Example 2-1) An example of an agent working as an agent of a doctor at a hospital: A nursing care record of a patient is displayed on the operation terminal 31. First, at the management terminal 36,
The module creation step 14 is executed, and an agent that has a work procedure as shown in FIG. 4 and displays a patient's care record on the operation terminal 31 is developed and created. The agent for displaying the patient's care record on the operation terminal 31 includes three types of agents (a care record display agent 51, a care record reference agent 52, and a care record collection agent 53, 54). The care record display agent 51 sets the care record collection conditions and activates the care record inquiry agent 52 (calls an agent prepared in advance), and the care record collection agent 5
Agents 3 and 54 rearrange the care records collected from the information storage terminals 33 and 34 in chronological order and display them on the operation terminal 31. The care record inquiry agent 52 is an agent that finds a record location of a care record. The nursing care record collection agents 53 and 54 are agents that read out nursing care records from an information storage device in which patient information is recorded and transmit the nursing care record display agents 51.
Each of the agents (51 to 54) moves to another terminal via the network and is executed at the terminal of the movement destination. A broken line with an arrow (for example, 69) shown in FIG. 4 indicates that each agent moves through the network. Next, the module recording step 15 is executed in the management terminal 36. The IC card 21 is set in the IC card drive 38, and the agent shown in FIG. 4 is recorded in the memory 26 of the IC card 21 of the doctor. At the time of this recording, authentication of the service provider (here, a doctor) and encryption of the agent shown in FIG. 4 are performed as described above. FIG.
Are described later (Example 3).
This will be described in detail in 1). A broken line with an arrow shown in FIG. 4 indicates that each agent moves through the network.

Next, a service item table creation step 171 is executed in the management terminal 36, and a service item table as shown in FIG. 11 is created. In the service item table shown in FIG. 11, a patient ID column 181 and a patient name column 182, which are patient-specific numbers, are information for a doctor to specify a patient who provides a medical service. The service operation column 183 is information for specifying the service operation performed by the doctor, and specifically, is a pointer or a unique number assigned in advance that points to the agent recorded in the module recording step 15. In the service item table, correspondence between patients and service operations provided to the patients is shown for each patient. In the example of FIG. 11, the doctor performs four service operations for Taro Yamada whose patient ID is 0123-4567: display of a care record, display of an examination result, recording of a vital sign, and a visit schedule. Note that the display of the nursing record shown in FIG.
11 are stored in the memory 26 of the IC card 21 in advance, and each service task is executed by a doctor with the assistance of the agent. You.

Finally, in the management terminal 36, a service item table recording step 172 is executed. IC card 21
Is set in the IC card drive 38, and the service item table shown in FIG. 11 is recorded in the memory 26 of the IC card 21. At the time of this recording, authentication of the service provider and encryption of the agent are performed as described above.

(Example 2-2) Agent acting as a nurse's agent of a care support center: An agent displaying a bathing instruction of a home patient on the operation terminal 31 is recorded on the nurse's IC card. This procedure replaces the agent shown in FIG. 4 with the agent shown in FIG.
The procedure described in (Example 2-1) is the same as that described in (Example 2-1) except that the service item table shown in FIG. 12 is recorded on the nurse's IC card instead of the doctor's IC card instead of the service item table shown in FIG. is there. The agent for displaying the home patient's bathing instruction on the operation terminal 31 shown in FIG. 5 includes two types of agents (bathing instruction display agent 71 and bathing instruction collection agents 72 and 73). The bathing instruction display agent 71 activates the bathing instruction collection agents 72 and 73 (calls an agent prepared in advance), and the latest one from the bathing instruction collected by the bathing instruction collection agent 71 from the information storage terminals 33 and 34. Is an agent that selects and displays on the operation terminal 31. The bathing instruction collection agents 72 and 73 are agents that read a bathing instruction from an information storage device that records patient information and transmit the instruction to the bathing instruction display agent 71. In addition, each step described in FIG.
This will be described in detail later (Example 3-2). In FIG. 5, a broken line with an arrow indicates that each agent moves through a network. The service item table recorded on the nurse's IC card shown in FIG.
Similarly to the service item table shown in FIG.
1. The patient has a patient name column 192 and a service operation column 193, and the nurse asks Taro Yamada of the patient ID 0123-4567.
We perform four service duties: display of care records, display of bathing instructions, recording of vital signs, and display of a visit schedule.
The display of the bathing instruction is executed by the above-described agent shown in FIG.

(Embodiment 2-3) Agents acting as agents of social workers in the welfare section of the city hall: An agent that collects the scheduled visit dates and times that the service providing organizations have and creates a visit schedule for home patients is called a social agent. Record on worker's IC card. In this procedure, the agent shown in FIG. 6 is used instead of the agent shown in FIG. 4, the service item table shown in FIG. 13 is used instead of the service item table shown in FIG. 11, and the IC card of the social worker is used instead of the IC card of the doctor. Except to record
This is the same as the procedure described in (Example 2-1). As shown in FIG. 6, two types of agents (schedule display agent 9) create an at-home patient visit schedule.
1. Schedule collection agents 92, 93, 94). The schedule display agent 91 activates the schedule collection agents 92, 93 and 94 (calls an agent prepared in advance), and the schedule collection agents 92, 93 and 94 operate the information storage terminals 33, 34,
35. Is an agent that displays the scheduled visit date and time collected from the operation terminal 31 in the form of, for example, a table. The schedule collection agents 92, 93, and 94 read the scheduled visit date and time from the information storage device that records the patient information,
This is an agent to be transmitted to the schedule display agent 91. In addition, each step described in FIG. 6 will be described in detail later (Example 3-3). In FIG. 6, a broken line with an arrow indicates that each agent moves via a network. The service item table recorded on the social worker's IC card shown in FIG.
Similarly to the service item table shown in FIG.
1. In the example shown in FIG. 13, the social worker has a patient name column 202 and a service operation column 203, and displays a facility use history on Taro Yamada whose patient ID is 0123-4567,
It performs four service tasks: displaying mental and physical conditions, recording comments, and displaying a visit schedule. The display of the visit schedule is executed by the agent (the agent that creates the visit schedule) illustrated in FIG. 6 described above. The procedure in which the system administrator issues an IC card for each service provider has been described.

(Third Embodiment) Description of Procedure for Service Provider to Collect Necessary Information Using IC Card: Next, procedure for a service provider to collect necessary information using an IC card will be described. I do. In the present embodiment, the operation terminal 3
1 is located at the patient's home. Each service provider (a doctor at a hospital, a nurse at a nursing support center, and a social worker at the welfare section of the city hall) visits a patient's home with their respective IC cards, and inserts the IC card into the IC card drive 38 of the operation terminal 31. To collect the information needed to perform the service offering.

(Embodiment 3-1) When a doctor at a hospital makes a home visit to a patient (Taro Yamada), he operates a nursing record that shows a numerical value such as a vital sign, a condition, and nursing contents from the previous home visit. Procedure to be displayed on the terminal 31: The doctor's IC card 21 stores the patient's (Taro Yamada's) nursing care record collected by the doctor at the time of the past visit together with the agent supporting the service work performed by the doctor. I do.
First, when the IC card 21 is set in the IC card drive 39 of the operation terminal 31, the medium reading step 16 is executed, and the agent shown in FIG. Upon reading, authentication of the service provider and decryption of the agent are performed as described above. The agent to be read in the medium reading step 16 is an agent corresponding to a service operation performed on a patient (Taro Yamada) in the service item table. The service item table stored in the recording area 30 of the memory 26 is read, and the agent corresponding to the service operation column 183 is read from the recording area 27 of the memory. Next, an erasing step 17 is executed, and a service executing step 18 is executed. In this embodiment, in the service execution step 18, the agent shown in FIG. 4 is executed. Hereinafter, the execution example will be specifically described.
First, the care record display agent 51 is executed on the operation terminal 31. The care record display agent 51 determines whether or not the care record of the patient has been recorded on the IC card (5).
5) If the record has been made, the collection condition is set to the care record generated after the date and time of the last record on the IC card (5).
6). If there is no record, the collection condition is set for all care records (57). Finally, the care record inquiry agent 52 that performs a task of “checking the location of the information storage terminal that records the care record that satisfies the collection condition and collecting the care record from the corresponding information storage terminal” is started ( Call an agent prepared in advance) (58).

The care record inquiry agent 52 is transmitted to the management terminal 36 via the network 37 and is executed by the management terminal. The management terminal 36 monitors the operation of each agent in the system and grasps information managed by each information storage device. Care record reference agent 52
Queries the information storage device that records the patient's care record (FIG. 10) to obtain its location (63). Based on the result, a care record collection agent that performs a task of “collecting care records satisfying the collection conditions from the information storage terminal” is started (call an agent prepared in advance) 64). The care record collection agent generates a plurality of care record records corresponding to the number of locations of the information storage terminals that record the care records. In the present embodiment, the nursing care records (numerical values such as vital signs, condition, and nursing contents) are recorded in the information storage terminals 33 and 34 of the hospital and the nursing care support center. Assume to generate 54. Care record collection agents 53, 54
Is transmitted via the network 37 to the information storage devices 33 and 34 in which patient care records are recorded, and is executed by the information storage terminal. The nursing care records of the corresponding patients are collected from the respective databases 44 and 45 (65, 67), and are moved to the nursing care record display agent 51 together with the collected nursing care records (66, 68). Care record display agent 51
Receives the care record from the care record collection agents 53 and 54 (59), and additionally records the care record in the recording area 28 of the IC card 21 (60). Further, after sorting the collected nursing records in chronological order (61), the operation terminal 3
1 (62). After the display of the nursing record, the nursing record display agent 51 repeats the collection and display of the nursing information spontaneously and autonomously after a certain waiting time. This repetition is performed to update the display contents when the nursing care record is updated in the information storage device, and is performed until a service provider (physician) instructs to end. The agent shown in FIG. 4 can display, on a screen of the operation terminal 31, the nursing record by the hospital nurse and the nursing record by the nurse at the nursing support center in chronological order. , Can be referenced in an organized manner without omission.

The agents available to the doctor are:
The management terminal is limited to only the agent recorded on the IC card, and the doctor cannot refer to information that is not directly related to medical treatment. That is, only by performing an agent to be recorded on the IC card for each service provider, the work content can be managed in detail, accurately, and easily for each service provider such as a doctor, a nurse, and a social worker. Here, the information that is not directly related to medical care is, for example, the information on the nursing care consultation service recorded in the database 46 of the information storage device 35 of the city office welfare section (FIG. 9), the income situation 138 and tax-dependent support. 13
Items such as 9 regarding the privacy of patients. After the end of the display of the care record, a resurrection step 19 is executed. After performing other necessary work during a house call, the doctor
Take out the card 21 from the IC card drive 39,
Go to another patient's home or hospital. As described above, the procedure has been described by taking an example in which a nursing record is displayed after a previous visit, which is performed when a doctor at a hospital visits a patient's home.

(Embodiment 3-2) Procedure for displaying a bathing instruction when a nurse at a care support center visits a patient's home and provides a bathing service: A bathing instruction is necessary for a bathing service. This is a bathing instruction that is issued periodically by the attending physician of the hospital. The bathing instruction is, for example, as shown in FIG.
The items shown in are included. The procedure of this embodiment is the same as the procedure described in (Embodiment 3-1), except that the agent shown in FIG. 5 is read out and executed using the nurse's IC card. Hereinafter, only a specific description of the execution example of the agent shown in FIG. 5 will be given. The bathing instruction is recorded at a hospital to which a doctor visiting a patient belongs or a nursing care support center to which a nurse belongs. In this embodiment, it is assumed that these recording locations are known in advance. First, the bathing instruction display agent 71 is executed on the operation terminal 31, and then, the bathing instruction collection agents 72 and 73 for performing a task of "collecting a bathing instruction from the information storage terminal" are started (prepared in advance). Called agent).
A plurality of bathing instruction collection agents are generated corresponding to the number of information storage terminals. Here, it is assumed that two bathing instruction collection agents 72 and 73 are recorded and recorded in the information storage terminals 33 and 34 of the hospital and the care support center. The bathing instruction collecting agents 72 and 73 are transmitted via the network 37 to the information storage devices 33 and 34 which record the patient's bathing instruction, and are executed by the information storage devices. Then, bathing instructions are collected from the respective databases 44 and 45 (78, 80). In the hospital database 44, a medical record of the patient including the items shown in FIG. 7 is recorded, and a bathing instruction is collected from various doctor instructions 115 among the items shown in FIG. Database 4 of care support center
5 records a patient bathing instruction including the items shown in FIG. 8 and collects it. Finally, it moves to the bathing instruction display agent together with the collected bathing instruction (7).
9, 81). The bathing instruction display agent 71 receives the bathing instruction from the bathing instruction collection agent (7).
5) The latest one is selected from the received bathing instructions (76) and displayed on the screen of the operation terminal 31 (77). The latest bathing instruction is selected by using the item 164 of the designated date of the bathing instruction (FIG. 8). After displaying the bathing instruction, the bathing instruction display agent repeats the collection and display of the bathing instruction spontaneously and autonomously after a certain waiting time. This repetition is performed in order to update the display content when the information storage device updates the bathing instruction, and is performed until the service provider (nurse) gives an instruction to end. The agent shown in FIG. 5 can display the latest bathing instruction recorded by the hospital and the care support center on the screen of the operation terminal 31, and the nurse who provides the bathing service can always refer to the latest information. .

(Embodiment 3-3) Procedure for creating a visit schedule when a social worker of the city office welfare section visits a patient's home and provides a care consultation service: A visit schedule is a service providing organization ( 3 is a schedule table in which scheduled visit dates and times for patient support performed by the institution are described. It is assumed that a social worker provides a nursing care consulting service and uses it for schedule adjustment with another service providing organization when determining the next scheduled visit date and time. This procedure is the same as the procedure described in (Example 3-1), except that the agent shown in FIG. 6 is read and executed using the IC card of the social worker. Hereinafter, only a specific description of the execution example of the agent shown in FIG. 6 will be given. Here, it is assumed that the scheduled visit date and time of the service providing organization is recorded in each information storage terminal, and the recording location is known in advance. First, the schedule display agent 91 is operated on the operation terminal 31.
Is executed, and then a schedule collection agent that performs a task of “collecting scheduled visit date and time from the information storage terminal” is started (calling an agent prepared in advance). A plurality of schedule collection agents are generated corresponding to the number of information storage terminals. In this embodiment, the information storage terminal 3 of the hospital, the care support center, and the city hall welfare section
3, 34, 35 and generate three schedule collection agents 92, 93, 94. The schedule collection agents 92, 93, and 94 are connected to the information storage device 3 recording the scheduled visit date and time of the patient via the network 37.
3, 34 and 35 and executed by the information storage terminal. Then, scheduled visit dates and times of the corresponding patients are collected from the respective databases 44, 45 and 46 (99, 10).
1, 103). For example, from the hospital database 44, the scheduled visit date and time 121 from the medical record shown in FIG.
From the nursing record shown in FIG. 0, the planned nursing care date and time 154, from the nursing care support center database 45, the planned nursing care date and time 154 from the nursing care record shown in FIG. The scheduled visit date and time from the records of Finally, it moves to the schedule display agent 91 together with the collected scheduled visit date and time (1
00, 102, 104).

The schedule display agent 91 receives scheduled visit dates and times from the schedule collection agents 92, 93 and 94 (96), organizes the received scheduled visit dates and times into, for example, a table (97), and operates the operation terminal. 31 is displayed on the screen (98). After displaying the scheduled visit date and time, the schedule display agent 91 repeats the collection and display of the scheduled visit date and time spontaneously and autonomously with a certain waiting time. This repetition is performed in order to update the display content when the scheduled visit date and time is updated in the information storage device, and is performed until there is a termination instruction from the service provider (social worker). The agent shown in FIG.
For example, the scheduled visit date and time of the service provider from another service providing organization (institution) can be displayed in a table, and the social worker providing the nursing care consultation service can refer to the scheduled visit date and time of the next visit. The scheduled date and time can be determined. In the present embodiment, the patient's bathing instruction is transmitted to the operation terminal 3.
The agent displayed at 1 (FIG. 5) may record the bathing instruction selected in the latest instruction selecting step 76 in the database 45 of the home support center. In particular, when the bathing instruction in the hospital database 44 is newer than the bathing instruction in the home support center database 45 or when there is no bathing instruction in the home support center database 45, the home support center database 45 is updated to the latest one. Can be updated.
The agent (FIG. 5) that displays the patient's bathing instruction on the operation terminal 31 is similar to the agent (FIG. 4) that displays the patient's care record on the operation terminal 31. It may be recorded and stored.

(Embodiment 4) Description of Modifications of the Above Embodiment (Embodiment 4-1) A system administrator can read and write on a portable storage medium (IC card), and a service provider can only read. A management storage area may be provided, and an agent and a service item table may be stored in the management storage area. FIG. 14 shows an IC card 211 as another example. The IC card 211 is a security circuit that performs authentication of a system administrator and encrypts and decrypts recorded data (for example, changes the order of data arrangement). A security circuit for authenticating the service provider of the IC card (ie, the service provider) and decrypting the recording data; and 214, a service provider authentication and recording data (For example, a circuit for performing data scramble for changing the order of data arrangement) 213 and a management storage area 215 accessible via the security circuits 212 and 213 And a storage area (memory) 2 that can be reached (accessed) via the security circuits 212 and 214 It has a 6. In the task recording step 11 shown in FIG. 1, the agent supporting the service task is stored in the storage area 27 of the management storage area 215 and the service item table is stored in the storage area 30 of the management storage area 215 in accordance with the instruction of the system administrator at the management terminal 36 In the task execution step 12, the agent is stored in the storage area 27 of the management storage area 215 in accordance with the service provider's instruction on the operation terminal 31, and is stored in the storage area 30 of the management storage area 215. From the service item table to the security circuit 213, respectively.
, And then read out the desired service operation. In this embodiment, the storage area 29 for recording a flag for disabling the agent is provided in the management storage area 215. Nursing care records to be read and written during the service operation are stored in the storage area 216 via the security circuit 214.
And the service provider freely reads and writes. In this embodiment, since the service provider cannot record in the management storage area, it is possible to prevent the service provider's agent supporting the service operation and the service item table from being tampered with. Furthermore, even if the IC card and the password are stolen by a third party, for example, the system cannot be entered unless the encryption conditions of the security circuit are solved. Can be prevented from entering the system and damage to the entire system can be minimized.

(Embodiment 4-2) In the above description, the recording of the agent and the service item table on the IC card is as follows.
Although the management is performed by the management terminal 36, a plurality of management terminals may be prepared, and the agent and the service item table may be recorded by different terminals. Alternatively, a plurality of management terminals may record different agents and service item tables on the same IC card under the management of a plurality of managers. For example, the agent records at an organization that performs qualification tests and accreditations for service work or permits and approvals for service business, and the service item table shows the service provider to which the service provider belongs (service provider organization (institution)) May be recorded. For example, the agent may be developed and created by a public health center or a city office welfare section, recorded on an IC card, and the service item list may be recorded on the IC card at a care support center.

(Embodiment 4-3) In the above embodiment, for the sake of simplicity, the case in which the service provider is in charge of only the patient Taro Yamada has been described. It is also possible to record the contents of the service operation corresponding to. FIG. 15 shows another example of the service item table of the nurses at the care support center.
Has a patient ID column 191, a patient name column 192, and a service operation column 193 like the service item table shown in FIG. In this embodiment, two patients (Taro Yamada with patient ID 0123-4567 and Hanako Tanaka with patient ID 0123-8901)
And the service operation for the two patients. When executing a service operation on the operation terminal 31, a sub-step for selecting a patient is provided, and the service operation corresponding to the patient (Taro Yamada or Hanako Tanaka) selected by the service provider is shown in each of the embodiments described above. The procedure is as follows. When the operation terminal is installed at the patient's house, information for specifying the patient (patient ID and patient name) is set in the operation terminal in advance, and when the service provider inserts the IC card, the operation terminal is placed. The service operation may be executed by automatically reading out the service item table in which the contents of the service operation to be performed on the patient at the patient's home are written. Further, as in the example of the service item table shown in FIG. 15, a service date / time column 194 indicating the day (or time) at which the service operation is performed is provided, and the system administrator collectively records the service operations over and over in the service item table. Alternatively, the service provider may perform a service operation on the corresponding service date and time. Alternatively, a timer indicating the current date and time may be prepared in the operation terminal in advance, and when the service provider inserts the IC card, the service operation at the corresponding date and time may be automatically read to execute the service operation.

(Embodiment 4-4) An agent (FIG. 5) which displays a patient's bathing instruction on the operation terminal 31 may request a doctor if only an old bathing instruction can be collected. For example, the bathing instruction is set to be issued once a month, and if one month or more has passed since the latest instruction date, the bathing instruction collection agent 72 prompts the doctor to issue the bathing instruction or obtains permission from the doctor, and An agent that collects necessary information from other items of the medical record shown in FIG. 7 (for example, the medical record 112, etc.) and creates a bathing instruction (by substituting the collected information for each item in FIG. 8) is newly added. It may be developed and prepared in advance.

(Embodiment 4-5) In the above embodiment, the procedure for collecting necessary information by each service provider using the agent has been described. Various agents that work and perform desired tasks may be created and used, for example, based on the result of analyzing the current service task. For example, a social worker not only creates and refers to a visit schedule, but also develops and prepares an agent (schedule management agent) that manages a schedule for each service provider, and prepares a social worker for a desired visit. If another service provider (doctor or nurse) has a scheduled visit at the date and time, request the schedule management agent of the other party (other service provider (doctor or nurse)) to change the scheduled visit date and time. And perform the procedure to secure the desired visit date and time.

(Embodiment 4-6) In the above embodiment, the service provider (a doctor at a hospital, a nurse at a care support center, a social worker at the welfare section of the city hall) brings each IC card to the patient's house. And set the IC card in the IC card drive of the operation terminal installed at the patient's home.
Although the example in which the information necessary for the service work is collected has been described, a similar operation can be performed using an operation terminal installed in a place other than the patient's house. For example, an information storage terminal (FIG. 3) to which IC card drives (41, 42, 43) are connected.
44, 45, and 46) are also used as the operation terminal. Further, the work supported by the agent may be changed according to the terminal into which the IC card is inserted. For example, when collecting bathing instructions, if only the bathing instructions of an old age can be collected, if operating with the information storage terminal of the hospital, the location of the doctor to be issued in the hospital is displayed, You may perform the work of calling with a pager.

(Embodiment 4-7) In the above embodiment,
Although the program module that supports the execution of the service task is an agent that works as a proxy of the service provider and supports a desired service task, a program module that is not an agent may be used. For example, a work procedure of transmitting a bathing instruction from the database 45 of the care support center and displaying the operation instruction on the operation terminal 31 as a service operation on the management terminal 36 is performed by the operation terminal 31.
In an executable format (for example, a script, a command sequence, an executable format program, etc.) on an IC card. This IC card is stored in the IC card drive 39 of the operation terminal 31.
When set to, the stored work procedure is read out and executed, and a bathing instruction of the care support center is displayed on the operation terminal 31. Further, a sensor (connected to a patient (not shown in FIG. 3)) for measuring vital signs (body temperature, blood pressure, pulse) is connected to the operation terminal 31. When the program module for measuring the signature and the measurement of the vital sign of the patient (Taro Yamada) are recorded in the service item table, when the service provider inserts the IC card into the operation terminal, the sensor becomes the patient (Yamada). The vital sign of Taro) is automatically measured, and the measurement result is recorded as a care record on an IC card. As described above, according to the present invention, the service provider supports the execution of the service work authorized by the service provider, the patient in charge of the service provider, and the service item table indicating the contents of the service work performed on the patient. Is recorded on a portable recording medium that prohibits reading and writing by a third party, and after confirming that the service provider using the portable recording medium is the service provider, the patient is provided from the portable recording medium to the patient. Reads out a program module (agent working as an agent of a service provider) that supports a service task to be performed and performs a desired service task. Therefore, a program module (agent) and a service item that support the service task to a portable storage medium Tables and records provide not only access to patient information but also services performed by the service provider. The contents of the business in more detail can be managed independently for each service provider. Further, the present invention has a service erasing step and a service resuming step, and during execution of the agent recorded on the portable storage medium, the currently-executing agent cannot be newly used. An agent managed by the service provider by preventing the same service provider from executing a new agent, such as taking out the IC card and reading and executing the same agent with another IC card drive.
Can be limited, and agent management becomes easy. Furthermore, since a security circuit is incorporated in the IC card used in the present invention, falsification of data or provision of erroneous information by a third party can be prevented, and a catastrophic failure in the entire system can be prevented. It goes without saying that various modifications and combinations are possible without departing from the gist of the present invention.

[0036]

As described above, according to the present invention, not only the right to access the patient information but also the service work performed by the service provider is described in detail for each service provider such as a doctor, a nurse, and a social worker. In addition, it is possible to quickly manage the system, prevent intrusion of the system by a third party, easily prevent falsification of patient information data in the information storage device and transmission of erroneous information. Information can be automatically referred to in an organized manner without omission, and home medical treatment can be performed quickly and accurately.

[Brief description of the drawings]

FIG. 1 is a diagram showing an example of a flow showing a processing procedure in a system of the present invention.

FIG. 2 is a diagram showing an example of a configuration of a portable storage medium used in the present invention.

FIG. 3 is a diagram showing a configuration of an example of a community health care information system of the present invention.

FIG. 4 is a diagram showing a flow of an example of an agent for displaying a patient care record on an operation terminal according to the present invention.

FIG. 5 is a diagram showing a flow of an example of an agent for displaying a patient bathing instruction according to the present invention on an operation terminal.

FIG. 6 is a diagram showing a flow of an example of an agent for creating a patient visit schedule according to the present invention.

FIG. 7 is a diagram showing an example of a patient medical record according to the present invention.

FIG. 8 is a diagram showing an example of a patient bathing instruction according to the present invention.

FIG. 9 is a diagram showing an example of care consultation service information by the welfare section of the city hall in the present invention.

FIG. 10 is a diagram showing an example of a patient care record according to the present invention.

FIG. 11 is a diagram showing an example of a service item table recorded on a portable storage medium of a doctor according to the present invention.

FIG. 12 is a diagram showing an example of a service item table recorded on a portable storage medium of a nurse according to the present invention.

FIG. 13 is a diagram showing an example of a service item table recorded on a portable storage medium of a social worker in the present invention.

FIG. 14 is a diagram showing another example of the configuration of the portable storage medium used in the present invention.

FIG. 15 is a diagram showing another example of a service item table recorded on a portable storage medium of a nurse according to the present invention.

[Explanation of symbols]

11: business record step, 12: business execution step, 1
3 ... portable storage medium, 14 ... module creation step,
15: Module recording step, 16: Medium reading step, 17: Service erasing step, 18: Service execution step, 19: Service restoration step, 21: I
C card, 22: IC card drive, 23: IC card slot, 24: contacts for input / output, 25: security circuit, 26: memory, 27: storage area for storing agents, 28: storage for storing nursing records Region, 29 ...
Storage area for recording flags to disable agents,
30: storage area for recording service item table, 31, 32
... operation terminal, 33 ... information storage terminal (hospital), 34 ... information storage terminal (care support center), 35 ... information storage terminal (city hall welfare section), 36 ... management terminal, 37 ... network,
38, 39, 41-43 ... IC card drive, 40 ...
IC card slot, 44-46 ... Database, 51 ...
Care record display agent, 52: Care record inquiry agent, 53, 54 ... Care record collection agent, 71
... bathing instruction display agent, 72, 73 ... bathing instruction collection agent, 91 ... schedule display agent, 92
-94: schedule collection agent, 171: service item table creation step, 172: service item table recording step

 ──────────────────────────────────────────────────続 き Continuing from the front page (72) Inventor: Satoru Mitsuyama 1-280 Higashi Koigakubo, Kokubunji-shi, Tokyo Inside the Central Research Laboratory, Hitachi, Ltd.

Claims (10)

[Claims] Claims: 1. A portable healthcare information system in which a service provider dispatched from a predetermined medical or nursing care organization performs medical or nursing service at a visiting location, and is distributed to the service provider. A recording medium, a management terminal that records the contents of the service work authorized by the service provider on the portable recording medium by the administrator of the predetermined organization, and information recorded on the portable recording medium. An operation terminal installed at the visited site for identifying the service provider and the service giver / receiver receiving the service operation, and reading out the contents of the service operation recorded on the portable recording medium, A connection is made between an information storage device that records community health care information for performing medical or nursing service operations and the operation terminal, and a predetermined value is determined from the community health care information. District Health Information system, comprising a network device for transmitting information. 2. The local health care information system according to claim 1, wherein the operation terminal collects, from the information storage device, information necessary for executing the service task read from the portable recording medium. A community health and medical information system. 3. The local health care information system according to claim 2, wherein the information collected from the information storage device is:
A community health care information system, comprising: a program module for supporting execution of the service work and information on the service recipient. 4. A portable recording medium used in the community health care information system according to claim 1, wherein the storage contents of the portable recording medium can be changed by the manager. A management recording area that allows the service provider to only read the storage content of the portable recording medium, and prohibits reading and writing by a third party other than the administrator and the service provider. Portable recording medium. 5. The portable recording medium according to claim 4, further comprising an area for storing a flag indicating whether information recorded in said management recording area is valid or invalid. 6. The portable recording medium according to claim 4, wherein said portable recording medium is an IC card. 7. The portable recording medium according to claim 4, further comprising an area for storing a service agent, which is a program module that supports the service operation. 8. The portable recording medium according to claim 7, wherein the service agent collects information necessary for executing the service task while moving through the network to which the information storage device is connected. A portable recording medium comprising an information collection agent. 9. The portable recording medium according to claim 4, wherein the contents of the service business authorized by the service provider are recorded in the management recording area. Portable recording media. 10. The portable recording medium according to claim 5, wherein, after the information necessary for the service operation is read by the service provider, the flag of the management recording area relating to the service operation is invalidated. The portable recording medium, wherein the flag of the management recording area related to the service business is effectively changed after the execution of the changed and read service business is completed.