JPH11242702A - Hospital ward information system - Google Patents

Abstract

PROBLEM TO BE SOLVED: To appropriately and quickly execute a medical instruction by using the ruled medial instruction for guiding the quick and exact counter measures of a nurse to a generated phenomenon for each patient. SOLUTION: This hospital ward information system is provided with a knowledge base 8 for storing knowledge for ruling a medial instruction constituted of a series of instruction group in a medical action based on medical knowledge, medical instruction inputting means 24 and 32 for preparing a ruled medical instruction related with each patient based on the knowledge base 8, an instruction rule base 41 for storing the ruled medical instruction related with each patient prepared based on the knowledge base 8 and the medical instruction inputting means 24 and 32, and instruction guiding means 26 and 35 for guiding the instruction based on the medical instruction stored in the instruction rule base 41.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a ward information system that supports the transmission of instructions from a doctor to a nurse at a medical practice, confirmation of execution, monitoring of the validity of the execution results, and collection of information for medical treatment.

[0002]

2. Description of the Related Art In a medical practice, a physician orders various measurements or observation instructions for an event whose occurrence is predicted based on the medical condition of an individual patient, and the physician immediately responds to the occurrence of the event. Order for detailed instructions in advance so that the intention of the customer can be accurately achieved (such as a sliding scale). The instruction content is composed of a combination of a measurement or observation instruction for sensing the occurrence of a predicted event, a set value that defines the occurrence of the event, and an instruction that is activated when the event occurs. If the instructions to be activated include a follow-up observation instruction or a progress measurement instruction and a further (secondary) instruction activation condition and further instructions, the instruction will undergo secondary development. If this combination is continued, theoretically, the instruction can be developed into a secondary or tertiary order (medical instruction). Specifically, according to the doctor's instructions, the nurse administers the drug, administers the injection, or changes the infusion rate, observes the change in the situation, and then implements a new procedure.

[0003]

Detailed instructions for an event after a change in situation are often ambiguous compared to injection and drug instructions in the initial operation, and nurses on the spot often have clear behaviors (treatments). They tend to lack guidelines. Nurses have considerable discretion and make their own decisions as appropriate, resulting in deviations from the intent of the attending physician and conversely, asking the physician for detailed instructions every time a situation is observed, which tends to reduce work efficiency. Met.

[0004] In addition, the instructions on the paper surface relying on the memory, as a result of coping with all the events that occur, as a result of progress observation and measurement, it is possible to accurately understand the coping with all of the events that occur secondarily and tertiarily. It is practically impossible to easily and easily place an order, and the activation conditions are often ambiguous or various parts are omitted and often incomplete.

SUMMARY OF THE INVENTION The present invention has been made in view of the above problems, and has been made in consideration of the creation of a complex of instructions (medical care instructions) for guiding nurses to promptly and accurately respond to the occurrence events of individual patients;
It is an object of the present invention to provide a ward information system that monitors the occurrence of a predictive event using the created ruled instructions, and then monitors and assists the execution of the instructions.

[0006]

A first ward information system according to the present invention is a knowledge storage which stores knowledge for making a medical treatment instruction consisting of a series of instructions in a medical practice into a rule based on medical knowledge. Means, medical care instruction input means for creating a ruled medical care instruction for each patient based on the knowledge storage means, and medical treatment instruction input means for each patient created based on the knowledge storage means and the medical care instruction input means. It is characterized by comprising a rule base for storing medical treatment instructions in a rule form, and instruction guiding means for guiding the instructions based on the medical treatment instructions stored in the rule base.

A second ward information system according to the present invention comprises:
Also, a knowledge storage means storing knowledge for making a medical treatment instruction composed of a series of instruction groups in a medical practice based on medical knowledge, and a ruled medical treatment for each patient based on the knowledge storage means. Medical treatment instruction input means for creating instructions, a rule base for storing medical treatment instructions for each patient created based on the knowledge storage means and the medical treatment instruction input means, and a rule base stored in the rule base. Instruction response means for inputting an execution result in response to an instruction activated based on the medical instruction, and verifying the execution result input by the instruction response means based on the ruled medical instruction, Instruction processing means for activating the next instruction based on the verification result, and instruction guiding means for guiding the next instruction activated by the instruction processing means are provided. And wherein the door.

[0008] Various instructions regarding treatment of a patient transmitted from a doctor to a nurse are arranged as follows, for example. Measurement instruction: An instruction for measuring a quantitative value at a specified time or at the occurrence of a specified event and recording the measured value includes a measurement instruction for blood pressure, pulse, body weight, urine volume, and the like. Observation instruction: An instruction to observe a specific qualitative value at a specified time or when a specified event occurs, and to record the result. There are observation instructions such as a consciousness level and an electrocardiogram waveform. Treatment instructions: Instructions for performing medical treatment at a specified time or at the occurrence of a specified event, and include treatment instructions such as inclusivity, postural change, injection and administration of drugs, and exchange of IVH routes. Basic instructions: These are stationary instructions and include instructions for resting degree, moving means, and the like.

[0009] Among the above instructions, the execution instruction time (day of the week for measuring the weight, etc.) or the triggering event (the temperature of the body requiring re-measurement of body temperature: 38 ° C., etc.) is clearly defined by the doctor's instruction, Also, the interval between execution times varies from several minutes to several weeks.

[0010] These instructions may also include measurements, observations, treatments,
It is divided into a simple instruction consisting of a single item such as a degree of rest and a composite instruction consisting of a group of a plurality of simple instructions. Further, the composite instruction is classified into an instruction composed of only a primary instruction regardless of the result of instruction execution, and an instruction composed of execution of further secondary instructions and tertiary instructions one after another. In the former, a set of multi-system instructions (reservation of angiography for angiography, order of pre-treatment medicine, order of injection medicine, instruction of rest degree to nurses, etc.) are combined to achieve a certain purpose. This is called a multi-system instruction. The latter is the instruction activation condition, the instruction items (measurement, observation, treatment), and the combination of the additional measurement and the observation instruction at the time of the treatment instruction (for example, if the blood glucose level of the measurement instruction is determined to be low blood sugar, the pet sugar is taken. An instruction for blood glucose measurement after 30 minutes is issued, and if the blood glucose level in the follow-up observation result is 30 mg / dl, hypoglycemia is determined based on the instruction activation conditions, and 20 cc of 20% glucose is injected intravenously and 30 minutes later. An instruction for blood glucose measurement is activated.), And such an instruction group is referred to as a medical treatment instruction here.

The medical treatment instruction defines, for example, an observation instruction or a measurement instruction for an occurrence prediction event and the occurrence of the event, and a set value for activating the medical treatment instruction, an instruction for the predicted event occurrence, a progress observation instruction or a progress measurement instruction. The activation condition of the next instruction is composed of n combinations as necessary. The trigger condition of the next instruction includes, for example, an end instruction indicating cancellation of a medical treatment instruction when the occurrence event is resolved, and a communication instruction to a doctor when the occurrence event becomes serious, and an instruction to end the medical treatment instruction. Included as These medical instructions can be easily and accurately input by the doctor using the medical instruction input / output means,
The input medical care instruction of each patient is stored in the rule base as a rule.

According to the first ward information system of the present invention, when the condition for activating the medical treatment instruction is satisfied, the medical treatment instruction for the corresponding patient is activated according to the rule, and the nurse is instructed to instruct the nurse via the instruction guiding means. Since the flow is displayed in an easy-to-understand manner, clear guidelines for actions to be taken in response to event changes are given, enabling appropriate treatment in line with the intention of the attending physician and at the same time greatly contributing to improvement in work efficiency. .

According to the second ward information system of the present invention, in addition to the above points, the execution result of the response to the instruction is input via the instruction response means, the input execution result is verified, and the result is verified. Then, the next new instruction is activated, so that quick and accurate execution corresponding to the event can be supported.

The medical treatment instruction input means creates an input screen capable of inputting, for example, correspondence to all events that are expected to occur (including criteria for asking the attending physician), and then deals with the results of follow-up observation By repeating the development to a new input screen for the purpose, it is possible to create a medical treatment instruction in a ruled manner. When such a medical treatment instruction input means is used, complicated instructions can be easily and accurately input, and appropriate medical treatment instruction items are set as rules.

[0015] The current rule-forming instructions verified by the monitoring mechanism based on the ruled medical care instructions, the observation and measurement results via the instruction response means, and the execution results up to the present stored in the patient database. May be displayed on the instruction guide means. In addition, it is possible to sequentially display the possibility of future instructions. For example, the execution history display means sequentially displays the ruled instructions and the observation results and measurement results that determine the development of the ruled instructions, and the instruction response means displays the current treatment, observation, and measurement instructions. Then, the necessary items may be input at the required time.

An execution result input by the instruction response means,
By further providing a patient database that stores the execution time and the verification result of the monitoring means, all the abnormal observation results and measurement results can be left as history information, and more detailed analysis from medical detection and It is also very useful for elucidating problems in medical work, etc., and can also improve the accuracy of medical work.

[0017]

Preferred embodiments of the present invention will be described below with reference to the accompanying drawings. FIG. 1 is a block diagram showing a configuration of a ward information system according to one embodiment of the present invention.

A doctor terminal device 1 installed in a doctor's office;
The nurse's terminal device 2 and the terminal device 3 for the patient and the ward monitor 4 and the terminal device 5 for the manager and the terminal device 5 for the nurse and the clinic, respectively.
It is connected to a host system 6 composed of a host computer and various servers.

The host system 6 includes a patient database 7 for collecting patient information and a knowledge database 8 as knowledge storage means having medical knowledge and knowledge generalizing the instructions of a doctor. To realize the function of actively monitoring the information transmission based on the knowledge base 8 and to establish the function of providing medical care information with due consideration to the work contents, It supports information transmission from the ordering of items to auditing, deployment, guidance, post-execution response, recording, and retransmission, and information collection for medical treatment. Therefore, the host system 6 is provided with a ward information input / output mechanism 9 and a medical care information reporting mechanism 10. The ward information input / output mechanism 9 accesses the patient database 7 and the knowledge base 8 via the inference mechanism 11 and
The ward information is input / output based on the instructions and reports given by ~ 3. The medical information reporting mechanism 10 reports medical information 12 based on the patient database 8 and the knowledge base 8. The knowledge base management mechanism 13 manages the contents of the knowledge base 8 based on the maintenance data input from the administrator terminal 5. The patient information in this ward system is also linked via an in-hospital information output mechanism 14 to external systems such as pharmacies, examination departments, and medical accounting.

FIGS. 2 and 3 are functional block diagrams showing the ward information system in more detail. As shown in FIG. 2, the simple instruction input / output panel 23 and the medical treatment instruction input / output panel 24 are mainly displayed on the doctor terminal device 1, and the doctor gives simple instructions and medical treatment instructions necessary for nurses and the like. . The inspection panel 25, the instruction guide panel 26, and the instruction response panel 27 are mainly displayed on the nurse terminal device 2. A patient input panel 28 is displayed on the patient terminal device 3. The ward information input / output mechanism 9 includes a simple instruction input / output mechanism 31, a medical care instruction input / output mechanism 32, an audit mechanism 33, an instruction guide mechanism 35, and an instruction response mechanism for input / output control of necessary information corresponding to these panels. 36, a patient input mechanism 37, an instruction manual output mechanism 34 for outputting an instruction manual 29 addressed to a nurse, and a ward monitoring mechanism 38 for displaying information to be monitored on the ward monitor 4 and the like. It is configured.

The inference mechanism 11 is configured as follows. That is, the instruction rule base 41 pools medical treatment instructions that are ruled for each patient and transmitted to the nurse from the doctor. The instruction rule base 41 includes an audit pool 42 for pooling the contents of medical treatment orders ordered by doctors, and an audit pool 4
2 is provided with an instruction pool 43 in which the pooled instructions are audited by a nurse and registered and pooled. The instruction processing mechanism 44 uses the instruction rule base 41
The medical treatment instruction is supplied to the instruction guide panel 26 via the instruction guide mechanism 35 in conjunction with the instruction guidance mechanism 35, or is output as the instruction manual 29 via the instruction manual output mechanism 34, and a necessary warning is issued to the instruction guide mechanism 35 and The information is output to the instruction guide panel 26 and the ward monitor 4 via the ward monitoring mechanism 38. The instruction processing mechanism 44 also performs execution input (response status) via the instruction response panel 28 and the instruction response mechanism 36.
Monitoring means for monitoring the execution result and issuing the next instruction or generating a necessary warning based on the monitoring result. Time information serving as a reference for the instruction activation is provided by a clock 45.

The inference mechanism 11 further includes a medical verification mechanism 46 for performing periodic verification on the patient information in the patient database 7 based on the medical verification knowledge in the knowledge base 8 and returning the information to the medical care site. And a verification rule base 47 that pools the medical verification knowledge in a medical verification pool 48.

On the other hand, as shown in FIG. 3, the medical information reporting mechanism 10 outputs various information based on the patient database 7 and the knowledge base 8, and sends the information to the attending doctor every morning via the patient report panel 61 to the attending doctor. A daily medical report system 51 for outputting daily medical reports for each patient, and a patient information output system 52 for outputting weekly patient information 62 for rounds such as hospital directors
A progress chart creation mechanism 53 for displaying a progress chart to the attending physician via a progress chart display panel 63; and a discharge summary creation mechanism 5 for outputting a hospitalization record 64 for a patient at discharge.
4, a ward daily report mechanism 55 for displaying a ward daily report to nurses via the ward panel 65 of the present day, and a medical record 66 for recording ward records, medical care, instruction history, injection history, etc. It is configured to include a medical record output mechanism 56 and a medical verification request input / output mechanism 57 for requesting an object to be verified by the medical verification mechanism 46 via a medical verification request input / output panel 67. The in-hospital information output mechanism 14 displays in-hospital information via the in-hospital information input / output panel 71. Knowledge base editing panel 81 displayed on administrator terminal device 5
Is for editing the knowledge base 8 via the knowledge base management mechanism 13.

Next, details of each part will be described. 1. Regarding the Knowledge Base 7 The knowledge base 7 stores knowledge for converting instruction contents into rules, instruction item control knowledge, and medical verification medical knowledge.

(1) Knowledge for forming instruction content into rules The simplest knowledge among rules for converting instruction content into rules is a simple instruction. That is, in FIG.
The simple instruction input / output panel 23 displayed on the screen selects a continuous and fixed form of the instruction normally described in the instruction book,
For example, the display form is as shown in the patient information input screen of FIG. The body temperature, pulse, blood pressure, urine volume, and blood sugar of the measurement instruction are measured in the ward, and the results are input to the present system via the instruction response panel 27. When the number of measurement of the body temperature is selected on the selection screen of FIG. 4, the measurement time is determined according to the setting in each ward. For example, if "2 test" is selected, 10:00 am and 2 pm
The time measurement is automatically selected. Or "2
If "times / week" is selected, the measurement date is determined by the nurse selecting a day of the week at the time of inspection. Such a simple instruction (measurement instruction) is input using the simple instruction input / output mechanism 31, and the instruction rule This is the rule for the patient in the base 41.

The knowledge to make the contents of instructions into a rule includes not only such primary instructions but also a medical treatment instruction consisting of a series of instruction groups including instructions to be activated secondary and tertiary from the state after follow-up observation. Includes the knowledge required to generate For example, medical treatment instructions for fever, chest pain, abdominal pain, hypoglycemia, hypertension, etc. are given as follows. As shown in FIG. 5, a series of medical treatments is made up of repetition of a doctor's instruction, its execution and report, observation and report after execution, re-instruction according to the observation result, and so on. Traditionally, doctors only give the first instruction, or if they do not provide enough instructions, nurses always ask the doctor for re-instruction after observation, which reduces the efficiency of medical treatment. I was In this system, from the first instruction to the re-instruction for each next observation value, a series of medical treatment instructions are created in advance for each patient as rules, and after the medical treatment instruction is activated, the rules for the registered medical treatment instructions are used. Medical treatment is carried out along with it.
FIG. 6 is a diagram showing medical treatment instructions in a rule. From the primary instruction to execution / observation, the instruction branches according to the IF THEN rule. This series of medical treatment instructions ends when the instruction ends or “contact the attending physician”.

A series of medical treatment instructions in such a rule are generated based on knowledge for rule formation in the knowledge base 8.
According to the development of the input screens shown in FIGS. 7 and 8 displayed on the medical care instruction input / output panel 24 formed by the medical care instruction input / output mechanism 32, the doctor can easily create the screen by inputting necessary values. can do. For example,
The illustrated example is an example of an instruction for continuous infusion of insulin, and an instruction of a preparation, an injection speed, and a timing of blood glucose measurement is a primary instruction. The following is an instruction to increase or decrease the amount of insulin infusion based on the blood sugar level at the time of blood sugar level measurement.
Is an instruction for low blood sugar, and is an instruction for high blood sugar.

For example, assuming that the blood sugar level is 40 mg / dl, when the blood sugar level is 40 mg / dl or less, an instruction for low blood sugar is activated. The instruction content is, for example, as follows. -a Slowly inject 20 ml of 50% glucose solution from the side tube. -b Humulin R injection rate 1U / hour, 2cc /
Please change the time to 0.5U / hour, 1cc / hour. -c Please check your consciousness level and subjective symptoms, and measure your blood pressure and pulse. -d Please measure blood sugar after 30 minutes.

Next, the blood glucose level after 30 minutes (additional measurement items)
, The medical care instruction is further stored as a rule. -a If blood sugar level is over 80mg / dl, please retest blood sugar after 1 hour. -b If the blood sugar level is 50-80mg / dl, retest the blood sugar after 30 minutes. -c-1 When the blood sugar level is 50 mg / dl or less, stop the infusion of Humulin R.
Infusion at 100 ml / hour. -c-2 Please measure blood sugar after 30 minutes.

Hereinafter, a combination of the retest value and an instruction based on the result is stored as a rule. As long as the instruction includes a reexamination, the combination of instructions continues, and the series of medical instructions stops at "contact the attending physician" or at the end of the instruction (no instruction).

(2) Knowledge for Controlling Instructions The input of ward measurement variables such as blood pressure, body temperature, pulse, urine volume, body weight, and number of stools is a ruled instruction and is monitored as if by a doctor. Variations in measurements can have significant clinical significance, but can also result in typographical errors and measurement errors. Further, there may be a mistake in input of the doctor's instruction value. There is no countermeasure to discriminate between the two, except for early reporting to the nurse and attending physician who input a large value of fluctuation outside the allowable range, and for consideration.

The instruction values and measured values input via the simple instruction input / output panel 23, the medical treatment instruction input / output panel 24, and the instruction response panel 27 are transmitted to the instruction processing mechanism 44 (monitoring means) of the inference mechanism 11 by the instruction processing mechanism 44 (monitoring means). Monitoring is based on individual patients stored in the instruction pool 43 or the knowledge base 8 or based on general medical knowledge. That is, an allowable range for the absolute value and the Δ value (difference from the previous value) is set in the knowledge base 8 for all indicated values and measured values, and the instruction processing mechanism 44
Monitors the indicated value and the measured value, and outputs a warning on the monitor screen of the currently input doctor terminal device 1 or nurse terminal device 2 when the value deviates from the allowable range. For example, if the previous weight is 55 kg and the current weight is 58 kg, the difference is 3 kg (assuming the allowable range of the Δ value is 1 kg), which exceeds the allowable range, and a warning is output. Although there is a possibility of an input error, a short weight gain indicates a clinically important meaning such as heart failure or nephrotic deterioration. Prompt warning output will result in a quick re-weighting, increase the accuracy of the measurements, and prompt the attending physician for early recognition of outliers.

(3) Medical Knowledge for Medical Verification In this ward information system, medical verification is added to the patient information in the patient database 7, and the verification result is returned to the site as medical treatment information. The medical verification is performed by the medical verification mechanism 46 by using the medical knowledge in the knowledge base 8 and the internal clock 45 by periodic observation for each target event. The verification target is the medical verification request input / output panel 67
The medical verification request input / output mechanism 57
The required medical verification knowledge is read out of the knowledge base 8 via the, and is pooled in a medical verification pool 48 constituting a verification rule base 47. Medical knowledge for medical verification is roughly divided into medical knowledge that verifies individual patient information and outputs medical information for each patient information, and estimates the existence of specific events from multiple patient information of individual patients Medical knowledge, specific objectives and medical knowledge to verify their achievement.

Medical knowledge for control of output of medical information. Extensive patient information from prescription contents to examination results and ward observation items is verified and returned to the medical practice site. In the ward observation results, for example, patients whose bowel movements were not more than 4 days, weight
A reference range is set according to individual observation items such as a patient who has increased or decreased by 1 kg or more and a patient whose urine volume has become less than or equal to 前 of the previous day, and outputs medical treatment information “no defecation for 4 days or more”. In the case of medicines, the medicines (albumin, various blood coagulation factor preparations, etc.), the administration method, and the amount of administration, which are restricted for the number of days for each medicine, are verified in each ordering unit and cumulative amount, and the medical treatment information is output.

Medical knowledge for estimating the existence of a clinically important event from a plurality of patient information. The most important medical knowledge group. The plurality of patient information includes prescription and prescription, prescription and examination result, prescription and ward information, Prescription and school lunch,
It means a combination of a test result and ward information, a test result and a disease name, a radiation reservation and a disease name, and the like. In the prescription and prescription, for example, when the concomitant caution medicine ferromia (iron medicine) and cefzone (antibiotic) are administered, the combination period is different even if the administration day, prescription department, and prescription form (in-hospital, out-of-hospital) are different. Calculate, "Feromia (prescription) and cefzone (prescription) may be prescribed at the same time, and cefzone titer may decrease."
Is output. In the prescription and laboratory values, low serum K, high serum uric acid, serum N
When a appears, "there is a possibility of hypokalemia caused by a diuretic" or "there is a possibility of hyperuricemia caused by a diuretic". With regard to prescription, feeding, and injections, if a patient receiving a high potassium infusion or taking a non-potassium restricted diet receives calimate or oxalate (K excretion agent), "Does a K restriction diet be necessary?" A significant amount of K is included in the infusion, is it OK? In relation to the prescription and the disease name, if a patient with bronchial asthma in the disease name is prescribed tenormin, Inderal, etc., "it seems to have a history of asthma.
In the ward and radiation-related patients, patients who gained more than 2 kg compared to the previous (previous week) and who had not undergone chest radiation in the past (2 weeks) have been reported. Weight is suddenly increasing. Do you need to check the breasts? "

Medical knowledge for verifying specific purpose Specific medical knowledge registers medical arithmetic expressions, preoperative inspections, necessary items for detailed inspections, operable test values, and the like, and the medical verification mechanism 46 performs periodic verification. . For patients who need daily balance of water and electrolytes, the balance of water and electrolytes is automatically calculated from the composition and amount of injections ordered, the amount of drinking water, the content and amount of meals, the amount of urine, and the amount of urinary electrolyte excretion. Gastric fluoroscopy, gastroscopy, gastroscopy, intestinal fluoroscopy, abdominal ultrasound, chest photo, abdomen, HCV, Hb
Register s, ATLA, blood chemistry, blood test, urine test, stool test, blood type, creatinine clearance, electrocardiogram, respiratory function, and verify performance.

2. About the transmission of medical information Mutually linked functional blocks (double-lined information transmission network) effectively support the process of transmitting medical treatment policies (instructions),
Improve transmission accuracy and efficiency. This system uses a variety of inference mechanisms using ruled instruction contents and medical knowledge.
To generate and provide warnings and guidance in the information transmission process from ordering to auditing, deployment, guidance, post-execution response, recording, and retransmission, and to actively and smoothly achieve instructions (commands). To help.

(1) Ordering of orders Orders of medical treatment policies (instructions) of doctors are made by filling in an instruction book. In addition to the burden of writing, handwritten instructions have different expression forms, and the interpretation itself is often difficult and the burden on the interpreter is large. The screen is input using a screen indicating items necessary for smoothly transmitting a medical treatment policy, that is, a simple instruction input / output panel 23 and a medical treatment input / output panel 24.

A) Ordering function for routine instructions Basic instructions on the in-patient's rest, bathing availability, number of times, means of transportation, etc., and measurement instructions on body temperature, pulse, blood pressure, urine volume, weight, etc. measured in the ward are simple. Instruction input panel 2
3 using the patient information (1) screen (FIG. 4) and the patient information (1-2) screen (FIG. 9) for inputting more detailed instructions.

B) Ordering function for medical treatment instructions In addition to instructions for injection and drug administration, instructions for re-measurement to nurses include instructions for administration of injections and drugs during fever, abdominal pain, chest pain, low blood sugar, blood pressure management, and blood sugar management. , And the measurement results will generate a new indication. Using the medical treatment instruction input / output panel 24, the user can easily and accurately input an aggregate including a reexamination instruction and a new instruction based on the reexamination result.

Examples of the input of the medical treatment instruction include the following cases. The target instruction is selected on the patient information (2) screen (FIG. 10). For example, when "when fever is generated" is clicked, an input screen for a medical treatment instruction when fever is generated is developed. 38.5 ° C
For the above fever, insert Inteban suppository 25mg,
In the case where the device can be used up to three times a day at intervals of 6 hours or more, all the settings are the same as the initial settings, and therefore, it is only necessary to place the cursor on the relevant part and input. Then, when "invalid" is entered, the initial screen of the medical treatment instruction at the time of fever is displayed again, and the instruction when invalid is input in the same manner.

When "end" is input, the input items are ordered and the screen returns to the patient information (2) screen. When "maintain blood pressure" is clicked, an instruction screen for maintaining blood pressure (FIG. 11) is developed. Decisions (inputs) for blood pressure drop and blood pressure rise are made according to the guidelines on the screen. Finally, it is determined whether to repeat the instruction or separately. It is also possible to give a double instruction to the measurement result. For example, each of the low blood pressure instructions of 100 mmHg or less and 80 mmHg or less may be issued. A similar example is subcutaneous insulin injection (FIG. 12).

Next, an example of ordering a medical care instruction will be described. First, a medical care instruction at the time of heat generation of a predicted event is created in the patient Ohno. Starting with the set value of 38.5 ° C to activate the medical treatment instruction, 1
The next, second,... N-order instructions (drugs, instructions on injection contents and medication time limits, follow-up observation instructions and time limits, activation conditions for the next instructions, and allowable values for execution time limits may be initial values) Enter all. FIG. 13 is an example of a medical care instruction rule. Actually, an individual medical care instruction is created by substituting the patient identifier for P, the instruction execution time for Ts, and the allowable range of the execution time for Td. In the temperature measurement instruction of (1), when it is detected that the time (Ts-Td) has come, the temperature measurement is prompted and a response is waited.
In the temperature measurement confirmation instruction of (2), the process is performed when the temperature measurement data has been normally input at the confirmation time Tw. In this case, the temperature measurement confirmation ends. The temperature measurement confirmation instruction of (3) is a process in a case where temperature measurement data has not been input at the confirmation time Tw, warns, and further waits. In addition, since the body temperature is measured on a regular basis every day, it is not necessary to order a measurement instruction. With the above ordering of the medical treatment instructions, the medical treatment instruction items ordered are stored in the instruction rule base 41 as ruled instructions for the patient Ohno.

FIG. 14 is a diagram showing an example of the activated state of the medical care instruction. First, the patient Ohno is placed under the monitoring of the medical treatment instruction activation by the monitoring function of the instruction processing mechanism 44, that is, in a medical treatment instruction activation standby state (0.1). As a result of the scheduled temperature measurement at 2:00 pm, the body temperature of the patient Ohno was 40 ° C. When this measurement result is input using the instruction response panel 27 (0.4), the instruction processing mechanism 44 sets the medical treatment instruction activation set value 3 at the time of heat generation.
It is detected that 8.5 ° C. has been satisfied (0.3), a warning (0.2.1) is output to the instruction guide panel 26, and a medical treatment instruction (primary instruction) set in advance for the patient Ohno. Antipyretic treatment) is triggered (ignited). If the body temperature is not input even after the scheduled time limit is exceeded, the monitoring function of the instruction processing mechanism 44 detects this, outputs a warning (0.2.2.2), and waits for a response. When the body temperature input value is lower than the set value of 38.5 ° C., a standby state (0.1) is set.

When the primary instruction is activated, the rule of the medical instruction [Please administer indasin suppository (1.
1.1)] and [Take the temperature again after 1 hour (1.
1.2)] is activated, and the corresponding items are indicated by the instruction guide panel 2.
6 (1.2.1, 1.2.2) and instruction response panel 27
(1.4.1, 1.4.2). [Please administer Indasin suppository] is monitored from the response input time of body temperature at the internal allowable time of 0.5 hours (changeable, 0.5 hours for convenience) (1.3.1). Even if 0.5 hour has passed, if the response to the administration of medication is not input, the monitoring function of the instruction processing mechanism 44 senses and a warning (1.2.3) is displayed on the instruction guide panel 26. The measurement instruction of "Please measure again after 1 hour" is also drafted from the above-mentioned response input time of the body temperature, and 1.5 hours, which is 1 hour of the designated time of measurement and 0.5 hour of the allowable time, is measured. It is monitored as a value input time limit (1.3.2). When the measurement result of the progress measurement instruction is not input within the time limit, the instruction processing means 4 is similarly operated.
4 is monitored, and a warning (1.2.4) is displayed on the instruction guide panel 26. On the other hand, when an input is made within the time limit, monitoring of the time limit is released and verification (1.3.2) of the measurement result and the activation condition of the secondary instruction is started. The activation condition is, in principle, to release the activation of the medical treatment instruction, to shift to the normal medical treatment instruction standby state, to stop the treatment of the medical treatment instruction, and to request the direct instruction of the doctor (1.
2.5) and the activation condition for the secondary instruction are satisfied. In addition,
The contents of the secondary instruction can be subdivided, in which case the set level is defined ((A), (B), (C),...).
(N)).

It is also possible to set the activation time instead of the predicted event of the activation of the medical treatment instruction. In the time limit activation, the monitoring function of the instruction processing mechanism 44 monitors only the time, and when the scheduled time comes, a medical treatment instruction (for example, a medication instruction of 1.1.1, a 1.1.
2) is invoked without verifying the value. The following is the same as the previous section.

When the measurement result of the preceding paragraph matches the condition for activating the secondary instruction (2.1), the secondary instruction (medication instruction, progress measurement instruction) is activated. The secondary instruction is actually subdivided as shown in FIG. For example, if the difference from the previous value is 0 ° C or more,
In addition, when the body temperature is 39 ° C. or higher and 40 ° C. or lower, it is determined that the administration of the above-mentioned indacin suppository is insufficient, and an administration instruction (2.1.1-A) of a new drug (injection of methylon) (1 hour) Is issued (2.1.2-A). On the other hand, the difference from the previous value is less than 0 ° C (at least falling) or 39 ° C
If less than 1 hour, follow-up observation after 1 hour (2.1.
2-B) is activated. Therefore, the essential conditions for the multi-order development are the follow-up observation instruction or the progress measurement instruction and the measurement time, and a treatment such as medication is appropriately input (instructed). Thereafter, verification of the progress observation items based on the input time limit, and verification of the input value of the observation result (instruction response panel) and the next instruction activation condition (monitoring function of the instruction processing mechanism 44) are repeated. A current instruction is displayed on the instruction guide panel 26, and an input screen for the result of the current instruction is prepared on the instruction response panel 27.

C) Request and Request Function to Doctor The "change request" is used when a nurse proposes a change in instruction to the attending physician. (2) Instruction auditing and registration system Instructions ordered and ordered by a doctor are ordered by a nurse after being confirmed and registered, and operate only as instructions at a clinic once registered. This sequence corresponds to the usual work of a nurse checking an instruction book. Specifically, the instructions input from the doctor terminal device 1 via the simple instruction input / output panel 21 and the medical treatment instruction input / output panel 24 are transmitted to the rule base 41.
Are pooled on the audit pool 42, and the pooled instructions are displayed as a request for instructions on the audit panel 25 via the audit mechanism 33. The pooled units are set to, for example, the entire ward or nursing units (usually about two systems).

FIG. 16 is a diagram showing a flow of a normal instruction. A doctor or a nurse inputs instructions from different terminal devices, and this is normally used as an instruction pool by the audit pool 42.
Will be pooled. The nurse in charge of the audit audits the pooled instructions via the audit panel 25 at the time of the regular audit, for example, at 3:00 pm. If the periodic audit is performed once a day, the instructions pooled at this time will be
It means that the order was ordered from 3:00 pm to 3 pm on the day. If you have any questions about the instructions, check with the ordering party,
Register instructions. The registration is performed by, for example, moving the cursor to the ID of each patient and inputting the execution. When the registration is made, the instruction moves from the audit pool 41 to the instruction pool 43, and the instruction content is sent to the instruction manual output mechanism 34 and the instruction guide mechanism 35 via the instruction processing mechanism 44, and the patient-specific instruction manual 29 is transmitted. Is printed out or an instruction guide screen is developed.

FIG. 17 shows the flow of an emergency instruction. For urgent instructions, the ordering physician inputs "instruction contents" and "urgent instructions", then directly requests the ward nurse, the contractor, and sends the relevant instructions from the emergency instruction pool in the audit pool 42. Have them audited. The contents of the audit panel 25 are immediately switched to new instruction contents after the inspection, and the instruction contents are registered. Transmission via paper, such as an instruction manual, requires change processing on the order receiving side. Instructions and audits are
From the viewpoint of ensuring safety, it is desirable to be able to operate with the ID of a doctor or nurse.

(3) Development of instruction contents It is difficult to bring the instruction book to the execution site, change the transmission medium to memos and instruction manuals according to the business form, and change the handwritten instruction contents to the business instruction form of the nursing department. It involves a lot of posting work to convert to. Since the notes and instruction manuals are used in the nursing department, it was difficult for the doctor to confirm the actual contents. In this ward system, instructions are routinely rewritten and the transmission medium is converted, and the information is widely disclosed using various transmission media. Specifically, the contents of the instructions are added to the same space as before, and are developed on the terminal screen so that the latest instructions are efficiently transmitted to doctors and nurses.

A) Printing of Instruction Contents on Instruction Instructions Instruction instructions 29 printed out from the instruction instruction output mechanism 34 include individual ward instruction instructions and work instruction instructions. The ward instruction manual for each individual is medical information output for each individual patient, and is used as a nursing diary or medical record.
It is easily accessible to doctors' eyes. This individual ward instruction manual, for example, as shown in FIG. 18, is composed of items such as patient basic information, measurement information, hospitalization order, outpatient order, yesterday's state, examination result, medical history, and the like. The individual ward instruction manual is output at the time of order placement, change, or every Monday. On the other hand, the work instruction manual is automatically printed in an easily understandable expression form for each work unit, as shown in FIG. 19, for example. In the instruction manual, the latest instruction contents are easily recognized as compared with the conventional instruction book, but the immediacy is slightly inferior to the transmission using the terminal screen described in the next section.

B) Display of a patient-specific instruction confirmation (instruction response panel) screen When a relevant patient is selected on the basic transmission screen of the instruction content of the instruction guide panel 26 and "instruction" is input, the instruction items of the patient are displayed. Is done. FIG. 20 is a diagram showing an example of the screen for the instruction. The instruction confirmation screen displays the latest instructions such as a basic instruction, a measurement instruction, and a medical treatment instruction, and can be confirmed by a doctor and a nurse. The latest instructions are displayed reliably, and the contents of past instructions are also displayed accurately. In this screen, the “execute” and “prescription required” buttons have a function of responding to instruction execution, which will be described later.

C) Display of an instruction response screen for each target treatment The instruction guide panel 26 can also guide the contents of an instruction for each target treatment. FIG. 21 is a diagram in which only instructions for the procedure of injection are extracted.
The execution and response are collectively performed, and in the case of injection, body weight measurement, urine volume measurement, and the like, the instruction content is displayed for each target treatment.

(4) Explanation or Display Guidance Function of Instruction Contents and Execution Conditions In the conventional incomplete handwritten instruction, it is easy to judge the execution conditions of the instruction contents or inconsistency in transmission occurs.
According to this system, the instruction guidance mechanism 35 guides the explanation of the instruction content or the instruction to be executed via the instruction guidance panel 26 based on the ruled instruction.

A) Instruction and guidance function for instruction contents Based on the input items on the medical treatment instruction input / output panel 24, instruction contents and execution conditions for each patient are explained and guided to medical staff in a detailed and easy-to-understand manner. Predetermined items (blood pressure, pulse, body temperature,
When blood glucose, urine volume, etc.) are measured and the user wants to receive the medical guidance, the user inputs the “instruction guidance” button.
The instruction guide selection screen shown in FIG. When a measurement value desired for guidance is input, the instruction selection screen (the built-in rule is the same as the ward monitor system) follows the medical treatment instruction (built-in rule), and the instruction guide panel 26 is developed.

For example, when a blood sugar level of 30 mg is input, the blood sugar level of 30 mg / dl satisfies the criteria for activating a medical instruction at the time of low blood sugar.
As shown in-3, slowly inject 20 ml of 50% glucose solution intravenously through the side tube. -B Infusion rate of Humarin R 1U / hour, 2cc
/ Hour to 0.5U / hour, 1cc / hour. -C Please check your consciousness level and subjective symptoms, and measure your blood pressure and pulse. -D Measure blood glucose after 30 minutes. Is displayed. By further inputting the blood glucose level, the next screen as shown in FIG. 24 is developed. When viewing the instruction content itself, a rule content screen as shown in FIG. 25 is developed on the “next page”.

B) Display guidance function of instruction items Instructions to be executed in order to smoothly execute instructions started due to occurrence of an unexpected event are displayed and guided on the screen of the ward monitor 4. The measurement result in the ward is input via the instruction response panel 27, and the instruction processing mechanism 44 sets the setting area (a setting area for each individual patient defined in the medical care instruction or a setting area universally defined for each measurement variable). ), A medical treatment instruction or a universal re-measurement instruction is issued. For example, when heat is generated at 39 ° C. or more, re-measurement is performed after one hour. An alert is sent to the ward monitoring mechanism 38,
The re-examination of the body temperature and the time (12:00) are displayed on the screen of the ward monitor 4. At this time, the presence / absence of ★ at the head of the abnormal value indicates the presence / absence of medical treatment instruction activation.

(5) Execution of instruction and post-processing When the instruction is executed, a signature of execution confirmation, recording in a medical record,
It is necessary to fill out the prescriptions, examinations, and other items to be communicated to the physician that occurred during the execution. The system automates the response to this execution and subsequent processing.

A) Response of Execution When executing a medical treatment instruction, for example, as shown in FIG. 20, a corresponding button, “execution”, and “prescription required” of an instruction response screen (instruction response panel 27) for each patient or each target action are displayed. When input, the execution status is stored in the computer, and the recording and transmission to the doctor are automatically activated. The contents of the medical treatment instruction, the input date and time, and the name of the terminal operator are input as the implementation status, and post-processing is performed using this implementation status. Instructions are displayed for each target procedure in procedures for confirming, executing, and responding to instructions in the ward, injection, body weight measurement, urine volume measurement, etc., but when an injection order is ordered, the figure is automatically displayed. An injection instruction screen such as 21 is displayed. For example, if today is June 26, corresponding to the injection scheduled to be performed on June 26, the buttons of “Drip injection A”, “Drip injection B”, “Intravenous injection C”, and “Drip injection D” are prepared. Is done. When each button is clicked, the contents of the injection and the comment are displayed, and an “execute” button, “stop”, and “comment” buttons are prepared based on the number of injections per day. "Implementation" at the time of each injection
When the button is pressed, the name of the implementer is recorded with the date and time. Press the "Cancel" button when stopping, or press "Comment" to keep a record (memo), and input word processing. When the predetermined number of times has been performed, the color tone of the “Drip Injection A” and the “Perform” button of each patient will change or be highlighted. In “All printing”, all of the day is “Unexecuted” and the unexecuted injection of the day is performed.
It is printed out with the name of the implementer and the date and time. FIG. 26 shows an example of print output. The details of the injection, the name of the practitioner, and the date and time can also be printed on the instruction manual for each individual. The contents of the injection can also be developed on the instruction response screen shown in FIG.

B) Post-processing record The input items to the ward system, that is, ordering and response of instructions,
Record and save all. As a record in the medical record, the state of execution of the instruction, the content of the instruction, the time, and the name of the executor are printed on a patient-specific instruction manual as shown in FIG. Also, instead of the execution signature on the slip, the contents of the injection and the executor (with the response time) are printed out as the injection execution history as shown in FIG.
The history of injections should be bound and stored in the medical record. The instruction history of the instruction items as shown in FIG. 27 is also printed out. In addition, medical records,
The medical record 66 such as the instruction history is output via the medical record output mechanism 56.

Re-transmission (transmission from nurse to doctor) The event that occurred in the process of executing the ordered instruction / instruction is transmitted from the nurse to the doctor on the screen of the patient report panel 61 addressed to the attending physician and the instruction manual for each patient. Is re-transmitted via For example, the instruction confirmation screen as shown in FIG. 20 is opened via the instruction response panel 27, and the content of the instruction of bradycardia "When the pulse is 40 or less," Atropine 1A, intramuscularly. In accordance with the instructions of "nurse, when a nurse executes at 10 pm using atropine in the ward stock and inputs" execute "and" prescription required "to use the stock medicine, as shown in FIG. 28," bradycardia ( Atropine 1A IM (Nurse
B. "Please prescribe the stock for 7:00 pm on June 10)" is displayed as the patient report screen for the attending physician on the patient report panel for attending physician 61 on the next day.

(6) Monitor System a) Instruction Processing Mechanism The inference mechanism 11 periodically executes inference for monitoring the execution status of the ruled instructions using the built-in clock 45, and outputs the inference result. It is sent to the ward monitoring mechanism 38. The inference in the instruction processing mechanism 44 is performed based on the time set for each purpose job because the ruled instruction is performed using the knowledge for controlling the instruction. In other words, the monitoring items such as body temperature, pulse, blood pressure, etc., which are the items to be measured in the ward, are monitored every hour for the presence or absence of input. Further, in the medical treatment instruction in which the reexamination time is set by the individual rule, monitoring is performed according to the set rule. For example, if a blood glucose level of 30 mg / dl is input in a situation in which a blood glucose management instruction is stored as a rule, a blood glucose level of 40 mg / dl or less satisfies the triggering condition of the low blood glucose instruction, and a warning to the system is given. "Measure blood glucose after 30 minutes." Is adopted as a rule by the monitoring mechanism 38. The existence or nonexistence of the blood sugar level after 30 minutes and the blood sugar level itself are inferred. The rules adopted by the monitoring mechanism 38 are limited to re-measurement that can be verified, and changes in the injection speed are displayed on the screen, but are not monitored. As long as the re-measurement instruction continues, the presence / absence of the input and the issuance of a new instruction (warning) based on the input value are repeated.

As an inference example of a simple measurement instruction, “body temperature,
The pulse is measured at 10 am and 2 pm. When the body temperature and the pulse are input at a regular time in the presence of the instruction "", an alarm to the system is blocked, and an alarm is output if the input is not input within a predetermined time (up to one hour after the set time). .
The alarm of the above rule is output to the ward monitor 4, the instruction guide panel, etc., and various medical information sheets.

B) Ward Monitoring Mechanism The alarm generated by the instruction processing mechanism 44 is output on the screen of the ward monitor 4, for example, as shown in FIG. Here, “★ Heat 39.6 ° C (11:00)” is 3
9.6 ° C is input, and the value is set in the setting range (3
(8.5 ° C. or higher), which means that an instruction at the time of heat generation is activated (★ mark). Reexamination of body temperature (12:00)
Is a guidance display for re-examination of the body temperature one hour later, and is an information display from the instruction guidance mechanism 35. The “missing values of body temperature, pulse, and urine volume” are alarms generated from the measurement instruction rule in the instruction processing mechanism 44, but the screen display is erased when an additional value is input. “Decrease in blood pressure and urine volume” is an alarm display generated from the instruction item control knowledge. If an input error or the like is found out, the change is deleted from the monitor screen. The alarm sent to the ward monitoring mechanism 38 is then sent to the patient report panel 61 to the attending physician.
It is transferred and output to today's ward panel 65 and the patient's individual instruction manual page 29.

3. Provision of medical information (1) Function of collecting medical information All patient instructions, response actions, and audit items input to the system are entered into the patient database 7 along with the input person name and input time.
Is stored in The instruction processing mechanism 4 and the ward monitoring mechanism 3
The medical information generated in step 8 is also stored in the patient database 7. The medical worker or the inpatient himself / herself uses the screen of the patient panel 28 of the patient terminal device 3 to make various requests, subjective symptoms, hospital treatment history, life history, food intake, QOL.
Can be input to the patient information database 7. FIG. 30 shows a screen configuration example of the patient input panel. In this example, it is possible to easily input a partner to be met, contents to be conveyed, and the like. Thus, the patient database 7
Information is collected in all ways.

(2) Medical Verification Mechanism All patient information stored in the patient database 7 is verified using medical knowledge on the knowledge base 8. This enables the use of general medical knowledge to monitor prescription contents, test results, and ward information (body temperature, pulse), and to verify and calculate order contents, test results, injection orders, etc. using specific medical knowledge registered in advance. (Monitoring).

(3) Medical Information Output Function Using the patient database 7 and the knowledge base 8 of the present system, it is possible to output information that supports various tasks in the ward. a) Daily medical report mechanism 51 Various information generated by the system, for example, information relating to a body temperature table such as fever and blood pressure rise, reporting abnormal test values, running out of medicine, side effect information, and then the nurse's treatment based on the instructions And a request for prescription, an unsubmitted radiation slip, patient's request, etc. are output as a patient report screen to the attending physician as shown in FIG. The screen display is switched at a certain time, for example, 5:00 pm, but it is convenient to make it possible to confirm the matter that could not be confirmed later if the previous minutes can be displayed.

B) Patient information output mechanism 52 The ward round performed by the director or the like usually depends on one-sided reports from the attending physician and the attending physician, and bedside examination tends to be insufficient. In this system, the state of a patient for one week is output as weekly patient information 62, and bedside discussion is realized based on this output information. FIG. 31 is a diagram illustrating an output example of weekly patient information. Inpatient name, purpose,
Weekly examination schedules, body temperature table information, abnormal test values, patient access items, etc. are output on a weekly basis for each patient at the time of rounds.
From the viewpoint of usage, print output is more appropriate than screen display. In the example shown in the figure, it can be seen that no treatment or examination has been performed on the patient indicated by * for one week. Thus, this weekly patient information report can also be used for a physician check. It is also possible to output a list of drug prescriptions and injection prescriptions. In addition, the output of each patient can be considered by matching the temperature table.

C) Progress Chart Creation Mechanism 53 Examination of the patient's condition begins with the creation of a progress chart. The doctor in charge of the ward and the doctor in charge collect patient information that is divided for each measurement system,
The progress chart is created manually, but the time load is extremely heavy, and the creation of the progress chart is limited to a minimum. It supports drawing and tabulation of all information in the patient database 7 composed of a plurality of information sources. When a variable and expression format (vertical axis; unit and its range, horizontal axis; date and time range) are specified, it is automatically and freely drawn and tabulated. If necessary, it is easily output to a free progress chart (the official ward progress chart is a temperature chart). It also outputs correlation charts, correlation coefficients, and regression equations to see the relationship between measurement variables.

D) Discharge summary creation mechanism 54 The post-discharge postscript prepared by the attending physician is taken into the progress chart creation mechanism 53 in the form of a floppy disk or text format to support creation of a discharge summary (report to a medical institution). The contents of the discharge summary include a summary output of hospitalization (instruction history, radiological examination history, physiological examination history, etc.), an output of discharge confirmation, an order display after the discharge date, and the like.

E) Ward daily report reporting mechanism 55 The knowledge base 7 created based on the medical care standards of the ward extracts relevant information from the patient information at regular time intervals, and outputs and reports it. Although the setting of the corresponding information is free, an example is shown in FIG.
It is shown in FIG. In this example, abnormalities such as heat generation, main treatments such as IVH replacement, and main inspections are output. Output rules,
In consideration of the output time and the situation of the user, it is also useful to output a drug exhaustion list, a current day inspection list, a next day inspection list, and the like.

F) Individual patient instruction manual All patient information stored in the patient database 7 can be printed out in the instruction manual 29 as needed.

[0074]

As described above, according to the present invention,
When the condition for activating the medical treatment instruction is satisfied, the medical treatment instruction for the corresponding patient is activated in accordance with the rule, and the flow of the instruction is displayed to the nurse through the instruction guiding means in an easy-to-understand manner. Guidance will be given, allowing appropriate treatment according to the intention of the attending physician,
It can greatly contribute to improvement of work efficiency.

[Brief description of the drawings]

FIG. 1 is a block diagram illustrating a schematic configuration of a ward information system according to an embodiment of the present invention.

FIG. 2 is a block diagram showing a part of the system in detail.

FIG. 3 is a block diagram showing another part of the system in detail.

FIG. 4 is a diagram showing a basic information input screen of a patient in the same system.

FIG. 5 is a diagram illustrating a feedback loop of a series of medical treatment instructions in the system.

FIG. 6 is a diagram showing a tree structure of a series of medical care instructions in the system.

FIG. 7 is a diagram showing a medical care instruction input screen in the system.

FIG. 8 is a diagram showing a medical care instruction input screen in the system.

FIG. 9 is a diagram showing a basic information input screen in the system.

FIG. 10 is a diagram showing a medical care instruction input screen in the system.

FIG. 11 is a diagram showing a medical care instruction input screen in the system.

FIG. 12 is a diagram showing a medical care instruction input screen in the system.

FIG. 13 is a diagram showing an example of a medical care instruction rule in the system.

FIG. 14 is a diagram illustrating an example of an instruction activation state in the system.

FIG. 15 is a view showing a state continued from FIG. 14;

FIG. 16 is a diagram for explaining a normal instruction and an audit in the system.

FIG. 17 is a diagram for explaining an emergency instruction and an audit in the same system.

FIG. 18 is a diagram showing an individual ward instruction manual created by the system.

FIG. 19 is a diagram showing a work instruction manual created by the system.

FIG. 20 is a diagram showing an instruction guide screen in the system.

FIG. 21 is a diagram showing an instruction guide screen in the same system.

FIG. 22 is a diagram showing an instruction guide screen in the system.

FIG. 23 is a diagram showing an instruction guide screen in the same system.

FIG. 24 is a diagram showing an instruction guide screen in the same system.

FIG. 25 is a diagram showing an instruction guide screen in the same system.

FIG. 26 is a diagram showing an injection execution history created by the same system.

FIG. 27 is a diagram showing an instruction history created by the system.

FIG. 28 is a diagram showing a patient report screen to the attending physician in the same system.

FIG. 29 is a diagram showing a display example of a ward monitor in the same system.

FIG. 30 is a diagram showing a patient input screen in the system.

FIG. 31 is a diagram showing weekly patient information created by the system.

FIG. 32 is a diagram showing a ward screen of the present day in the same system.

[Explanation of symbols]

DESCRIPTION OF SYMBOLS 1 ... Doctor terminal device, 2 ... Nurse terminal device, 3 ... Patient terminal device, 4 ... Ward monitor, 5 ... Administrator terminal device, 6 ... Host system, 7 ... Patient database, 8 ...
Knowledge base, 9: ward information input / output mechanism, 10: medical information reporting mechanism, 11: inference mechanism, 12: medical information, 13: knowledge base management mechanism, 14: in-hospital information input / output mechanism.

Claims (5)

[Claims] 1. A knowledge storage means for storing knowledge for making a medical treatment instruction consisting of a series of instructions in a medical practice based on medical knowledge, and a rule for each patient based on the knowledge storage means. Medical instruction input means for creating a medical instruction, a rule base storing ruled medical instructions for individual patients created based on the knowledge storage means and the medical instruction input means, A ward information system comprising: instruction guide means for guiding an instruction based on a medical instruction stored in the ward. 2. A knowledge storage means storing knowledge for making a medical treatment instruction consisting of a series of instruction groups in a medical practice based on medical knowledge, and a rule making for each patient based on the knowledge storage means. Medical instruction input means for creating a medical instruction, a rule base storing ruled medical instructions for individual patients created based on the knowledge storage means and the medical instruction input means, Instruction response means for inputting an execution result in response to an instruction activated based on the medical instruction stored in the medical instruction, and verifying the execution result input by the instruction response means based on the ruled medical instruction Instruction processing means for activating the next instruction based on the verification result; and instruction guiding means for guiding the next instruction activated by the instruction processing means Ward information system comprising the. 3. The medical treatment instruction includes a measurement instruction, an observation instruction,
3. The method according to claim 1, wherein the instruction includes at least one of a treatment instruction and a basic instruction, is sequentially activated when the activation condition is satisfied, and ends when the medical treatment instruction is completed or the doctor is contacted. Ward information system. 4. The medical care instruction input means creates an input screen capable of inputting correspondence to all events expected to occur, and then develops a new input screen for dealing with the results of follow-up observation The ward information system according to any one of claims 1 to 3, wherein a medical treatment instruction in a ruled form can be created by repeating the above procedure. 5. The patient database according to claim 2, further comprising a patient database for storing an execution result input by the instruction responding unit, an execution time thereof, and a verification result of the monitoring unit. Ward information system as described.