JPWO2011083607A1 - Medical information processing apparatus and program - Google Patents

Abstract

Patient profile information is available at the time of examination. The gateway device 30 acquires a modality work list including basic patient information and imaging condition information from the RIS 20, and acquires patient profile information such as infectious disease information, disability information, and allergy information from the electronic medical record system 10. The gateway device 30 adds the acquired patient profile information to any DICOM tag of the patient comment, examination comment, and examination description in the modality work list, and the modality work list to which the patient profile information is added. Is transmitted to the console 40. The console 40 displays infectious disease information, physical disability information, allergy information, etc. in addition to patient basic information and imaging condition information.

Description

  The present invention relates to a medical information processing apparatus and a program.

  In a modality (imaging device) installed in a hospital, a patient is imaged based on examination request information instructed by a doctor. Examination request information includes patient-specific basic patient information (patient ID, name, gender, date of birth, etc.) and imaging condition information (examination date, part, direction, left and right, tube voltage, tube current, equipment, etc.) It is.

  The medical radiographer operates the modality by referring to the basic patient information and the imaging condition information on a computer screen called a console connected to the modality. Part of the basic patient information and imaging condition information is transferred from the console to the modality, and imaging is performed based on these information.

  In hospitals, various medical information about patients is often required. Therefore, a medical information browsing system has been proposed in which medical information is stored in folders for each browsing item, for each patient, and for each photographing date and time, and medical information can be browsed from a computer terminal connected to a network ( Patent Document 1).

JP 2001-76078 A

  By the way, when the patient to be photographed suffers from an infectious disease or has a physical disability or allergy, the medical radiographer has to perform photographing according to each case. For example, if a patient suffers from an infection, it is necessary to prevent infection to others, and if the patient has allergies, it is necessary to pay attention to the drugs used. .

  However, profile information such as infectious disease information, disability information, and allergy information about the patient is not included in the basic patient information and is managed only by the electronic medical record system. It was difficult to obtain this information when shooting.

  The present invention has been made in view of the above problems in the prior art, and an object of the present invention is to make it possible to use patient profile information at the time of examination.

  In order to solve the above-mentioned problem, the invention according to claim 1 is an electronic medical record system in which basic patient information including patient identification information and profile information of the patient are stored in association with each other. A medical information processing apparatus connected so as to be capable of data communication, including examination request information for requesting examination by modality, including the basic patient information and imaging condition information, and from the obtained examination request information Control means for extracting the patient identification information, acquiring profile information corresponding to the extracted patient identification information from the electronic medical record system, and adding the acquired profile information to the acquired examination request information; Prepare.

  According to a second aspect of the present invention, in the medical information processing apparatus according to the first aspect, the examination request information is a modality work list conforming to a DICOM standard, and the control means includes the modality work list in the modality work list. The acquired profile information is added to any DICOM tag of patient comments, examination comments, and examination descriptions.

  According to a third aspect of the present invention, in the medical information processing apparatus according to the first or second aspect, the profile information includes infection information, physical disability information, or allergy information about the patient.

  According to a fourth aspect of the present invention, there is provided a computer that is communicably connected to an electronic medical record system in which basic patient information including patient identification information and profile information of the patient are stored in association with each other. Means for obtaining examination request information for requesting examination by modality, including the patient basic information and imaging condition information, means for extracting the patient identification information from the obtained examination request information, This is a program for functioning as means for acquiring profile information corresponding to the patient identification information from the electronic medical record system, and means for adding the acquired profile information to the acquired examination request information.

  According to the first and fourth aspects of the present invention, the profile information is added to the examination request information, so that the patient profile information can be used during the examination.

  According to the invention described in claim 2, profile information can be added to the DICOM tag of the patient comment, examination comment or examination description in the modality work list.

  According to the invention described in claim 3, infectious disease information, physical disability information or allergy information about a patient can be used at the time of examination.

1 is a system configuration diagram of a medical image system. It is a figure which shows the outline | summary of the process performed in a gateway apparatus. It is a block diagram which shows the functional structure of a gateway apparatus. It is a figure which shows the structure of a work item. It is a figure which shows the detailed data structure of a work item. It is a block diagram which shows the functional structure of a console. It is a ladder chart which shows the process performed in a medical image system. It is an example of the console screen displayed on a console.

[System configuration of medical imaging system]
Embodiments of the present invention will be described below with reference to the drawings.
FIG. 1 shows a system configuration of the medical image system 100. As shown in FIG. 1, a medical image system 100 includes an electronic medical record system 10, a RIS (Radiological Information System) 20, a gateway device 30 as a medical information processing device, a console 40, and a modality 50. The image management server 60 and other devices (not shown) are connected to each other, except for the modality 50, via a communication network N so that data communication is possible.

  The electronic medical record system 10 is an information processing apparatus that stores and manages medical record data (information such as a patient's medical condition and diagnosis result), prescription data, and the like. The electronic medical record system 10 includes a control unit including a CPU (Central Processing Unit) and a RAM (Random Access Memory), a storage unit such as a hard disk, a communication unit that performs data communication with an external device, and the like. The storage unit of the electronic medical record system 10 stores at least patient basic information and patient profile information (hereinafter referred to as patient profile information) in association with each other. The patient basic information is patient-specific information and includes patient ID, name, sex, date of birth, etc. as patient identification information. The patient profile information is information indicating characteristics of the patient's body and illness, and includes infectious disease information, physical disability information, allergy information, and the like.

  The infectious disease information is information relating to an infectious disease affecting the patient, and includes a disease name (tuberculosis, measles, influenza, hepatitis B, Staphylococcus aureus, etc.), symptoms, and the like. The physical disability information is information related to the physical disability of the patient, and includes symptoms of physical disability (such as hearing impairment and consciousness impairment). The allergy information is information related to the allergy of the patient, and includes substances (drugs, latex, food (buckwheat, eggs, wheat, shellfish), etc.), symptoms, etc. that induce allergies. When receiving an acquisition request for patient profile information from the gateway apparatus 30, the electronic medical chart system 10 transmits patient profile information corresponding to the acquisition request to the gateway apparatus 30.

  The RIS 20 performs information management such as medical appointment reservation, diagnosis result report, results management, and material inventory management in the radiology department. The RIS 20 includes a control unit including a CPU and a RAM, a storage unit such as a hard disk, a communication unit that performs data communication with an external device, and the like. The RIS 20 creates inspection request information for requesting an inspection by the modality 50 based on the image inspection request received from the electronic medical chart system 10. In the present embodiment, a case will be described in which a modality work list (Modality WorkList: MWL) compliant with DICOM (Digital Imaging and Communications in Medicine) standards is created as inspection request information. The modality work list includes basic patient information, imaging condition information, and the like. The imaging condition information includes the date and time of examination, part, direction, left and right, tube voltage, tube current, equipment, and the like. When receiving a modality work list acquisition request from the gateway device 30, the RIS 20 transmits a modality work list corresponding to the acquisition request to the gateway device 30.

  The gateway device 30 is a medical information processing device that relays data among the electronic medical record system 10, the RIS 20, and the console 40.

  FIG. 2 shows an outline of processing executed in the gateway device 30. The gateway device 30 acquires a modality work list including basic patient information and imaging condition information from the RIS 20, and patient profile information (infectious disease information, disability information, allergy information, etc.) acquired from the electronic medical record system 10 in the modality work list. The modality work list to which the patient profile information is added is transmitted to the console 40.

  FIG. 3 shows a functional configuration of the gateway device 30. As shown in FIG. 3, the gateway device 30 includes a control unit 31, an operation unit 32, a display unit 33, a communication unit 34, a ROM (Read Only Memory) 35, and a storage unit 36. It is connected.

  The control unit 31 includes a CPU, a RAM, and the like, and comprehensively controls processing operations of the respective units of the gateway device 30. Specifically, the CPU reads various processing programs stored in the ROM 35 in accordance with an operation signal input from the operation unit 32 or an instruction signal received by the communication unit 34, and a work piece formed in the RAM. Expand to the area and perform various processes in cooperation with the program.

  The operation unit 32 includes a keyboard having cursor keys, character input keys, various function keys, and the like, and a pointing device such as a mouse. The control unit 32 controls operation signals input by key operations or mouse operations on the keyboard. To 31.

  The display unit 33 is configured by an LCD (Liquid Crystal Display), and displays various screens based on display data input from the control unit 31.

  The communication unit 34 includes a LAN (Local Area Network) adapter, a router, a TA (Terminal Adapter), and the like, and is connected to an external device such as the electronic medical record system 10, the RIS 20, and the console 40 connected via the communication network N. Send and receive data.

  The ROM 35 is configured by a nonvolatile semiconductor memory or the like, and stores various processing programs, parameters and files necessary for executing the programs.

  The storage unit 36 is a storage device including a semiconductor memory, a hard disk, and the like. The storage unit 36 stores a modality work list acquired from the RIS 20, patient profile information acquired from the electronic medical chart system 10, and the like.

  Upon receiving a modality work list acquisition request (C-FIND request conforming to the DICOM standard) from the console 40 via the communication unit 34, the control unit 31 transmits a modality work list acquisition request to the RIS 20. Specifically, based on the AE (Application Entity) title of the modality 50, the control unit 31 transmits to the RIS 20 an acquisition request for the modality work list regarding the inspection performed in the modality 50. Then, the control unit 31 acquires a modality work list from the RIS 20 via the communication unit 34.

  The modality work list is composed of one or a plurality of work items. FIG. 4 shows the structure of the work item. The work item is composed of SCHEDULED PROCEDURE STEP (reserved procedure step), REQUESTED PROCEDURE (requested procedure), IMAGING SERVICE REQUEST (image service request), and PATIENT (patient). One work item corresponds to inspection request information for one inspection.

FIG. 5 shows a detailed data structure of the work item.
SCHEDULED PROCEDURE STEP includes AE TITLE (AE title), SCHEDULED PROCEDURE STEP START DATE (scheduled inspection start date), SCHEDULED PROCEDURE STEP START TIME (scheduled inspection start time), MODALITY (shooting device type), SCHEDULED PROTOCOL CODE SEQUENCE (shooting conditions) )including.
REQUESTED PROCEDURE includes STUDY INSTANCE UID (inspection instance UID), STUDY DESCRIPTION (inspection description), and STUDY COMMENT (inspection comment).
IMAGING SERVICE REQUEST includes ACCESSION NUMBER.
PATIENT includes PATIENT ID (patient ID), PATIENT NAME (patient name), PATIENT BIRTH DATE (birth date), PATIENT SEX (gender), and PATIENT COMMENT (patient comment).

  In the example shown in FIG. 5, PATIENT ID, PATIENT NAME, PATIENT BIRTH DATE, and PATIENT SEX in the work item correspond to basic patient information, and SCHEDULED PROTOCOL CODE SEQUENCE in the work item corresponds to imaging condition information.

  The control unit 31 extracts the patient ID from the modality work list acquired from the RIS 20. Based on the extracted patient ID, the control unit 31 transmits an acquisition request for patient profile information corresponding to the patient ID to the electronic medical chart system 10 via the communication unit 34. Then, the control unit 31 acquires patient profile information corresponding to the patient ID from the electronic medical record system 10 via the communication unit 34. Specifically, the control unit 31 transmits the patient ID to the electronic medical record system 10 using a QRY / ADR message conforming to the HL7 (Health Level Seven) standard, and acquires the patient profile information from the OBX Segment of the ADR message.

  The control unit 31 adds the patient profile information acquired from the electronic medical chart system 10 to the modality work list acquired from the RIS 20. At this time, the control unit 31 adds the acquired patient profile information to any DICOM tag among the patient comment, examination comment, and examination description in the modality work list.

  For example, patient comment (PATIENT COMMENT) of DICOM tag (0010, 4000), examination comment (STUDY COMMENT) of DICOM tag (0032, 4000), and examination description (STUDY DESCRIPTION) of DICOM tag (0008, 1030) 10240 characters of text can be stored. If each DICOM tag has already been used in the facility, the description destination tag of the patient profile information may be changed to one that is not used.

  The console 40 is a photographing control device that controls the modality 50. The console 40 and the modality 50 are connected via a dedicated cable so that data communication is possible.

  FIG. 6 shows a functional configuration of the console 40. As shown in FIG. 6, the console 40 includes a control unit 41, an operation unit 42, a display unit 43, a communication unit 44, a ROM 45, a storage unit 46, and a communication I / F (InterFace) 47. 48 is connected.

  The control unit 41 includes a CPU, a RAM, and the like, and comprehensively controls processing operations of each unit of the console 40. Specifically, the CPU reads various processing programs stored in the ROM 45 in response to an operation signal input from the operation unit 42 or an instruction signal received by the communication unit 44, and a work piece formed in the RAM. Expand to the area and perform various processes in cooperation with the program.

  The operation unit 42 includes a keyboard having cursor keys, character input keys, various function keys, and the like, and a pointing device such as a mouse. The control unit 42 controls operation signals input by keyboard operations or mouse operations. 41 is output.

  The display unit 43 is configured by an LCD, and displays various screens based on display data input from the control unit 41.

  The communication unit 44 includes a LAN adapter, a router, a TA, and the like, and exchanges data with external devices such as the gateway device 30 and the image management server 60 connected via the communication network N.

  The ROM 45 is composed of a nonvolatile semiconductor memory or the like, and stores various processing programs, parameters and files necessary for executing the programs.

  The storage unit 46 is a storage device including a semiconductor memory, a hard disk, and the like. The storage unit 46 stores the modality work list acquired from the gateway device 30 and the image data of the medical image generated by the modality 50 (hereinafter referred to as medical image data).

  The communication I / F 47 is an interface for performing data communication with the modality 50.

  The control unit 41 transmits a modality work list acquisition request (C-FIND request conforming to the DICOM standard) to the gateway device 30. Specifically, based on the AE title of the modality 50, the control unit 41 transmits to the gateway device 30 an acquisition request for a modality work list regarding the examination performed in the modality 50. And the control part 41 acquires the modality work list to which patient profile information was added from the gateway apparatus 30. FIG. The control unit 41 causes the display unit 43 to display patient basic information, imaging condition information, infectious disease information, physical disability information, allergy information, and the like based on the acquired modality work list.

  The control unit 41 controls the modality 50 via the communication I / F 47 to perform imaging of the patient, and acquires medical image data generated in the modality 50. Then, the control unit 41 attaches supplementary information to the medical image data in accordance with the DICOM standard, and transmits it to the image management server 60 via the communication unit 44.

  The incidental information includes patient information, examination information, series information, and image information. Patient information is information about a patient, such as patient ID, name, sex, date of birth, age, height, and weight. The examination information is information relating to the examination such as the examination instance UID that identifies the examination, the examination date, the examination time, the reception number, and the doctor in charge. The series information is information about a series of medical images (series) for each modality generated in one examination, such as a series instance UID that identifies the series, a modality name (examination type), an examination part, and a series number. It is. The image information is information related to a medical image such as an SOP instance UID that identifies an image and an image number. The control unit 41 may add patient profile information such as infectious disease information, physical disability information, and allergy information as additional information to the medical image data.

  The modality 50 is an image generation device that captures an image of a region to be diagnosed by a patient and generates medical image data. As the modality 50, a CR (Computed Radiography) apparatus, a CT (Computed Tomography) apparatus, an MRI (Magnetic Resonance Imaging) apparatus, or the like is used.

  The image management server 60 is configured by PACS (Picture Archiving and Communication System), and stores and manages medical image data and the like transmitted from the console 40. When receiving an acquisition request for medical image data from an external device, the image management server 60 transmits medical image data corresponding to the acquisition request to the external device.

[Operation of medical imaging system]
Next, the operation of each device of the medical image system 100 will be described.
FIG. 7 is a ladder chart showing processing executed in the electronic medical chart system 10, the RIS 20, the gateway device 30, and the console 40. Note that the processing in the gateway device 30 is realized by software processing in cooperation with the control unit 31 and a program stored in the ROM 35. Further, the processing in the console 40 is realized by software processing in cooperation with the control unit 41 and a program stored in the ROM 45.

  First, in the electronic medical chart system 10, a patient to be examined is selected from the patient list by the operation of the doctor (step S1), imaging conditions are designated, and an image examination is requested to the RIS 20 (step S2). . In the RIS 20, a modality work list including basic patient information, imaging condition information, and the like is created based on a request for an image examination from the electronic medical chart system 10 (step S3). The created modality work list is stored in the storage unit of the RIS 20.

  After that, the control unit 41 of the console 40 transmits a modality work list acquisition request to the gateway device 30 via the communication unit 44 (step S4). Specifically, based on the AE title of the modality 50, the control unit 41 transmits a request for acquiring a modality work list for the examination performed in the modality 50 to the gateway device 30.

  In the gateway device 30, when a modality work list acquisition request is received from the console 40 via the communication unit 34, the control unit 31 transmits a modality work list acquisition request to the RIS 20 via the communication unit 34 ( Step S5). In the RIS 20, the modality work list corresponding to the AE title included in the acquisition request is read from the storage unit and transmitted to the gateway device 30 (step S6). Then, the modality work list is acquired from the RIS 20 by the control unit 31 of the gateway device 30 via the communication unit 34 (step S7). The acquired modality work list is stored in the storage unit 36 by the control unit 31.

  Next, the patient ID is extracted from the modality work list by the control unit 31 (step S8). Next, based on the extracted patient ID, the control unit 31 transmits a patient profile information acquisition request to the electronic medical record system 10 via the communication unit 34 (step S9). In the electronic medical chart system 10, patient profile information corresponding to this patient ID is read from the storage unit and transmitted to the gateway device 30 (step S10). And the patient profile information is acquired from the electronic medical chart system 10 by the control part 31 of the gateway apparatus 30 via the communication part 34 (step S11). The acquired patient profile information is stored in the storage unit 36 by the control unit 31.

  Next, the patient profile information is added to the modality work list by the control unit 31 (step S12). Specifically, the control unit 31 stores the patient profile information in any predetermined DICOM tag among patient comments, examination comments, and examination descriptions in the modality work list.

  Next, the modality work list to which the patient profile information is added is transmitted to the console 40 via the communication unit 34 by the control unit 31 of the gateway device 30 (step S13). In the console 40, the modality work list is acquired from the gateway device 30 by the control unit 41 via the communication unit 44 (step S14). Then, based on the modality work list, the control unit 41 displays patient basic information, imaging condition information, patient profile information, and the like on the display unit 43 (step S15). In this way, the medical radiographer who operates the console 40 can refer to the patient profile information.

  FIG. 8 shows an example of the console screen 431 displayed on the display unit 43 of the console 40. As shown in FIG. 8, the console screen 431 includes a patient basic information display area 432, an image information display area 433, an imaging condition information display area 434, and a patient profile information display area 435. The patient basic information display area 432 is an area in which a patient ID, name, sex, date of birth, and the like are displayed based on the patient basic information. The image information display area 433 is an area in which a medical image captured by the modality 50 under the control of the console 40 is displayed. The imaging condition information display area 434 is an area in which an imaging part, an imaging direction, and the like are displayed based on the imaging condition information. The patient profile information display area 435 is an area where infectious disease information, physical disability information, allergy information, and the like are displayed based on the patient profile information. In the example of FIG. 8, infectious disease information “suspected of influenza”, allergy information “contrast allergy”, and disability information “wheelchair” and “severe language disorder” are displayed in the patient profile information display area 435. ing.

  As described above, according to the gateway device 30, the modality work list (examination request information) is acquired from the RIS 20, the patient ID is extracted from the acquired modality work list, and the extracted patient ID is supported. Patient profile information can be obtained from the electronic medical record system 10 and the patient profile information can be added to the modality work list. Specifically, the gateway device 30 can add patient profile information to the DICOM tag of the patient comment, examination comment, or examination description in the modality work list.

  Since the gateway device 30 adds patient profile information to the modality work list (examination request information), the console 40 can use patient profile information such as infectious disease information, disability information, or allergy information during the examination. .

  Further, even if the result of the infectious disease examination of the patient is not known at the time of the imaging examination request, the console 40 can inquire the patient profile information to the electronic medical record system 10 so that the console 40 can perform the examination. The latest patient profile information can be referred to.

  The description in the above embodiment is an example of the medical information processing apparatus according to the present invention, and the present invention is not limited to this. The detailed configuration and detailed operation of each part constituting the apparatus can be changed as appropriate without departing from the spirit of the present invention.

  For example, in the above embodiment, the gateway apparatus 30 exists as an independent apparatus in the medical image system 100, but the function of the gateway apparatus 30 may be included in the console 40 or the RIS 20.

  In the above description, an example in which a ROM is used as a computer-readable medium storing a program for executing each process is disclosed, but the present invention is not limited to this example. As other computer-readable media, a non-volatile memory such as a flash memory and a portable recording medium such as a CD-ROM can be applied. A carrier wave may be applied as a medium for providing program data via a communication line.

  The medical information processing apparatus and program according to the present invention may be used in the medical field in which examination is performed by modality.

10 Electronic medical record system 20 RIS
30 Gateway device 31 Control unit 32 Operation unit 33 Display unit 34 Communication unit 35 ROM
36 storage unit 37 bus 40 console 41 control unit 42 operation unit 43 display unit 44 communication unit 45 ROM
46 Storage 47 Communication I / F
48 Bus 50 Modality 60 Image management server 100 Medical image system 431 Console screen 432 Patient basic information display area 433 Image information display area 434 Imaging condition information display area 435 Patient profile information display area N Communication network

Claims (4)

A medical information processing apparatus that is connected to an electronic medical record system in which patient basic information unique to a patient including patient identification information and profile information of the patient are stored in association with each other and capable of data communication,
Including examination request information for requesting examination by modality, including the patient basic information and imaging condition information;
Extracting the patient identification information from the acquired examination request information,
Obtaining profile information corresponding to the extracted patient identification information from the electronic medical record system;
A medical information processing apparatus comprising control means for adding the acquired profile information to the acquired examination request information. The inspection request information is a modality work list conforming to the DICOM standard,
The control means adds the acquired profile information to a DICOM tag among patient comments, examination comments, and examination descriptions in the modality work list.
The medical information processing apparatus according to claim 1. The profile information includes infectious disease information, disability information or allergy information about the patient.
The medical information processing apparatus according to claim 1 or 2. A computer connected to the electronic medical record system in which data is communicated with an electronic medical record system in which patient-specific patient information including patient identification information and profile information of the patient are stored in association with each other.
Means for acquiring examination request information for requesting examination by modality, including the patient basic information and imaging condition information;
Means for extracting the patient identification information from the acquired examination request information;
Means for obtaining profile information corresponding to the extracted patient identification information from the electronic medical record system;
Means for adding the acquired profile information to the acquired inspection request information;
Program to function as.

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