KR101524181B1 - A system for exchanging clinical information based on lazy response model and the method thereof - Google Patents

Abstract

In the present invention, a server for inquiring medical information and a server for inquiring CDA document are separately constructed in constructing a medical information exchange system, so that the merits of the existing medical information exchange system based on the delayed response model are maintained, CDA documents can be viewed through a separate flow, thereby improving the response speed. In addition, it is possible to provide a health information exchange system based on a delayed response model And a method thereof.

Description

TECHNICAL FIELD [0001] The present invention relates to a system and method for exchanging medical information based on a delayed response model,

The present invention relates to a system and method for exchanging medical information based on a delayed response model, and more particularly, to a system and method for exchanging medical information and CDA (Clinical Document Architecture) documents while maintaining the advantages of a system based on a conventional delayed response model So that the response performance and convenience can be further improved.

The exchange of medical information related to the present invention is a mutual sharing of various medical information such as medical history, medication and examination result of the patient held in a hospital / clinic and a public medical institution. Through the exchange of the medical information, The main purpose is to improve the efficiency of the medical service, to improve the efficiency of the operation of medical institutions, and to increase the convenience of patients.

As an example, in the past, there was a case in which a medical information exchange system between the external first and second medical institutions was implemented centering on a large hospital. However, since only one-way inquiry service and unique information system and standard are used among each medical information system, The exchange was difficult. The Ministry of Health and Welfare has set up the EHR (Electronic Health Record) core common research and development project group in 2005 to build a system for sharing information on medical care across countries. However, unhealthy medical information exchange has virtually failed.

As described above, the domestic reality is not limited to a variety of levels of informatization by medical institutions, a standardized system is not provided, the system is constructed as a different information system for each institution, and a system is configured to perform medical information exchange in the domestic legal system Therefore, there is a difficult problem in exchanging practical medical information.
BACKGROUND OF THE INVENTION [0002] Korean Patent Registration No. 10-0805642 (Feb.

The present invention has been made to solve the above problems, and it is an object of the present invention to provide a system and method for exchanging medical information, which can further improve the performance while maintaining the merits of a medical information exchange system based on a conventional delay response model have.

It is another object of the present invention to provide a healthcare information exchange system and method which are highly secure and scalable and can be directly applied to the domestic legal system environment.

It is another object of the present invention to provide a system and method for exchanging medical information that can improve the response speed by constructing a server for inquiring medical information and a server for CDA document inquiry separately in exchanging medical information.

According to an aspect of the present invention, there is provided a medical information exchange system based on a delayed response model, including: a first terminal for searching for medical information and requesting a desired clinical document from the medical information; A second terminal storing the clinical information and the clinical document; A first server connected to a second terminal storing the medical care information and receiving the medical care information and providing the medical care information to the first terminal when the medical care information is retrieved from the first terminal; And a second server for receiving and registering at least one clinical document related to the requested medical care information from the second terminal and directly providing a clinical document requested by the first terminal, A terminal is a terminal connected to a hospital information system of a receiving organization for inquiring or requesting a clinical information or a clinical document, and the second terminal stores clinical information or a clinical document. A terminal connected to a hospital information system of a transmitting organization providing a clinical document, wherein the clinical document is a CDA (Clinical Document Architecture) document, and the medical care information is a list including metadata of the CDA document or CDA document information And the second terminal provides the requested care information to the first server through the first server, The second server transmits the clinical document corresponding to the information to the second server and registers the same in the second server, and the second server provides the function of inquiring the CDA document and the PACS image and is implemented in the form of an XML-based web server, When the registration of the clinical document is completed, the first server transmits the registration completion information to the first server. The first server manages the metadata of the CDA document and the PACS image, and supports searching and inquiry of the information using the metadata Searching for a hospital or hospital information system corresponding to the medical care information through its own database and requesting the medical care information from the terminal of the searched hospital or hospital information system when searching the medical care information at the first terminal, Receives the registration completion information of the clinical document from the second server, and provides the medical treatment information requested by the first terminal.

According to another aspect of the present invention, there is provided a method for exchanging medical information based on a delayed response model, the method comprising: a first step of retrieving medical care information from a first terminal; The first server accessing the second terminal storing the medical care information when the first terminal searches for medical care information and requesting the corresponding medical care information; A third step of providing the clinical information requested by the first server to the first server and transferring the clinical document to the second server for registration; The second server transmits the registration completion information to the first server when the registration of the delivered clinical document is completed; The first server receives the registration completion information of the clinical document from the second server and then provides the first terminal with the medical information received from the second terminal. And the second server comprises a sixth step of directly providing a requested clinical document selected from the medical care information provided to the first terminal, wherein the first server of the second step comprises: And a seventh step of searching for a hospital or hospital information system corresponding to the medical care information and accessing a terminal of the searched hospital or hospital information system when retrieving the medical care information.

In the present invention, a server for inquiring medical information and a server for inquiring CDA document are separately constructed in constructing a medical information exchange system, so that the merits of the existing medical information exchange system based on the delayed response model are maintained, By enabling the CDA document to be viewed through a separate flow, it is possible to improve the response speed as well as to enhance security and scalability, as well as to enable the domestic legal system to be applied directly to the environment.

1 is an exemplary diagram for explaining a general medical care information exchange scenario;
FIG. 2 is an exemplary diagram for explaining the structure of a CDA document in FIG. 1; FIG.
FIG. 3 is an exemplary view showing a structure in which an actual medical information exchange service is bound in ebXML in FIG. 1; FIG.
FIG. 4 shows an example of a framework of a correspondence model among the clinical information exchange models; FIG.
FIG. 5 is a view showing a framework of a proactive model among the clinical information exchange models; FIG.
6 is a diagram showing a framework of a delayed response model among the clinical information exchange models;
FIG. 7 is an exemplary view showing a framework of a medical care information exchange model according to an embodiment of the present invention; FIG.
FIG. 8 is an exemplary view showing a configuration of a medical care information exchange system designed with reference to a delayed response model with improved performance according to an embodiment of the present invention; FIG.
9 is a flowchart illustrating an operation procedure of a medical care information exchange system according to an embodiment of the present invention.
FIG. 10 is an exemplary view showing a comparison between the performance information exchange system and the existing system according to the present invention.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Hereinafter, an embodiment of a medical care information exchange system and a method thereof according to the present invention will be described with reference to the accompanying drawings.

The medical information standard related to medical information exchange according to the present invention can be roughly divided into information exchange standard, information model standard, and terminology standard. Herein, the information exchange standard includes a Health Level 7 (HL7) message, an electronic business extensible markup language (ebXML), and a clinical document registry framework (DRF). The information model standard includes a CDA (Clinical Document Architecture) Model), and the term standard includes SNOMED-CT, ICD-10, and UMLS.

The medical information standard is required in the scenario situation shown in FIG.

1 is an exemplary diagram for explaining a general medical care information exchange scenario.

If it is assumed that an arbitrary patient visits the arbitrary private clinic 110 as shown in the figure, the private clinic 110 provides the medical care information previously performed in the other hospital / (Electronic Health Record System, 120). Then, the electronic health record system 120 requests medical information from the sick / clinic 130 where the patient was previously treated. At this time, an information exchange standard is required.

Accordingly, the sick / clinic 130 having requested the medical care information finds the medical care information (for example, a CDA document) of the patient and transmits the medical care information to the private clinic 110 through the electronic health record system 120. At this time, an information model standard and a terminology standard are required in the process of finding the medical care information (e.g., CDA document) in the sick / clinic 130, and the individual counselor 110 receiving the medical care information requests the patient's medical care Information can be stored.

Here, the CDA (Clinical Document Architecture) is a standard document specification defined by HL7 that specifies the structure and meaning of a document for the purpose of exchanging clinical documents related to medical care. The CDA document is written in XML, and the HL7 RIM Model) and is assumed to use the data type of HL7 version 3.0. However, the specification of the CDA document is not necessarily limited to the above standard, and may be changed as the standard is changed or upgraded.

For reference, the HL7 is a standards body approved by the American National Standards Institute (ANSI) in 1994, Version 2.x based on exchange message format and code definition, version 3.0 including RIM-based structure and CDA, And a CCCW (Clinical Context Object Workgroup) for synchronizing user interfaces between disparate applications. The above HL7 version 2.x is currently used in most hospitals, and there are subtle differences between the versions, but the overall structure is similar.

The basic principle of the HL7 message is that if one event is triggered by a trigger event, two or more systems whose data will be exchanged by the event are routed through the network, and one system The data is transmitted in the form of a message. In the target system receiving the message, a message confirming the reception is sent to the original system, thereby completing one cycle.

The structure of the HL7 message is called a field, which is a minimum unit of a data type consisting of a combination of letters and numbers. These fields are grouped into similar information units and have a meaning, which is called a segment, and each segment is combined to become a message representing one event.

The HL7 message 2.x has a number of optional elements in the message, and the segments may be repeated, omitted or grouped. This flexibility has contributed to the dissemination of HL7, but in the end, the lack of a clear methodology with such autonomy is revealed to the limit of HL7. Therefore, the HL7 version 3.0 is a newly emerging standard to overcome the problems of the existing 2.x. The birth of the version 3.0 is closely related to the development of the development methodology such as process orientation, object orientation, and component-based (CBD) Which is expected to continue to expand in the future. In general, the clinical document (for example, a CDA document) is classified according to the characteristics of the document, such as the patient's name, the date of medical treatment, the doctor's office, the doctor's name, It contains information that is different (eg, doctor's findings, test results, prescriptions, etc.). Therefore, the CDA document also divides information according to this logic.

Hereinafter, the basic structure of the CDA document will be briefly described.

FIG. 2 is an exemplary diagram for explaining the structure of a CDA document in FIG. 1; FIG.

As shown in the figure, the CDA document starts with a <Clinical Document> element, which is a tag indicating that the document is a clinical document, and is largely composed of a header and a body. The header is located between the <ClinicalDocument> and the <structuredBody> tags and includes information on the provider, authentication, visitor, patient, etc. of the document.

In the body, a structured clinical document is created. The inside of the body divides sections by topic of each document using the <section> element. In this section, there is a section called 'Section Narrative Block' to describe the entire description, and a <text> element is mainly used. The <entry> element may be present in the section, and various information may be input using the attributes of the class inherited from the RIM (Reference Information Model) (eg, Acts, Participants, Relationships, etc.). In addition, the <Clinical Document> class at the top of the CDA document inherits the <InfrastructuredRoot> class of the RIM and includes various attributes. In addition, the contents of the CDA document are changed in the text, unlike the case where the specific attribute of the document is specified in the header The computer includes a context model for eliminating errors caused by failure to detect the change, and rewrites information such as an author name, a language, and a subject in headers, bodies, sections, and entries.

Although ebXML (electronic business eXtensible Markup Language) is originally an open standard for e-commerce based on XML, the ebXML is recognized as a standard for exchange of medical information documents in the field of medical information.

Hereinafter, a structure in which the medical information exchange service is connected in the ebXML will be described.

FIG. 3 is a diagram illustrating a structure in which an actual medical care information exchange service is bound in ebXML in FIG. 1, wherein the ebXML uses a registry and a repository concept to exchange documents, The registry stores information about a document, user information, institution information, and the like. The repository can use a file system, a database, or the like as a place for storing documents. As shown in the figure, a web protocol such as HTTP, SOAP, It is used. For reference, ebXML v3.0 is based on the RIM standard of HL7. It uses the XML schema suggested by ebXML RIM and ebXML RS (Registry Service) standard.

Hereinafter, a clinical document (or clinical information) exchange system having the above basic structure will be described.

In general, the system of medical information exchange is based on the point of contact and storage location of data (for example, CDA document and metadata) to be exchanged, and the security model, the proactive model and the delayed response model It is divided into three types. Features of the respective care information exchange models will be described below with reference to FIGS. 4 to 6. FIG.

FIG. 4 is a diagram illustrating an example of a framework of a correspondence model among the clinical information exchange models. As shown in FIG. 4, the Conservative model includes a broker (for example, broker 1 ).

4, the hospital 1 (210) transmits the created CDA document to the broker 1 (220) using a specific application for exchanging medical information, and the broker 1 (220) analyzes the header information of the CDA document And only the meta information including the information of the transmitting organization and the receiving organization is transmitted to the broker-2 230. Subsequently, according to the request and consent of the patient visiting the hospital 2 (240), the person in charge of the hospital 2 (for example, a doctor) searches the CDA document from the broker 2 (230) Once analyzed, the broker 1 (220) requests the CDA document via the web service. The retrieved CDA document is automatically transferred to brokers 2 (230) and 2 (240) clients in sequence.

FIG. 5 is a diagram illustrating a framework of a proactive model among the clinical information exchange models. As shown in FIG. 5, the proactive model includes a CDA document and metadata to a broker (for example, broker 2) .

Referring to FIG. 5, in the hospital 1 (310), the created CDA document is transmitted to the broker 1 (320) using a specific medical care information exchange application. The broker 1 (320) analyzes the header information of the CDA document, And directly transmits the CDA document to the broker 2 (330) which is the gateway of the hospital 2 (340).

Thereafter, in accordance with the request and consent of the patient who visited the hospital 2 340, the person in charge of the hospital 2 340 requests the broker 2 330 to search for the CDA document, and the retrieved CDA document is sent to the hospital 2 340 It is possible to retrieve the existing CDA document of the patient transmitted to the client. However, in this transmission method, since the CDA document is directly transmitted to the partner institution in advance as well as the patient's request for consultation and transmission of the CDA document in the hospital 1 (310), the patient does not visit the hospital 2 (340) If the patient does not want his or her medical information to be stored elsewhere, that responsibility and legal problems may arise.

FIG. 6 is a diagram illustrating a framework of a delayed response model among the clinical information exchange models. As shown in FIG. 6, the Lazy response model is stored in the hospital information system of the agency in which the CDA document is created, Are stored in a broker (for example, broker 1 or broker 2) of a transmitting organization and a receiving organization.

Referring to FIG. 6, in the first hospital 410, the meta information including the transmitting organization and the receiving organization information of the CDA document to be shared is registered in the broker 1 420 using the specific medical care information exchange application, 1 420 transmits the registered meta information to the broker 2 430 which is the gateway of the receiving organization. Then, in response to the request and consent of the patient who visited the hospital 2 (440), the person in charge of the hospital 2 (440) searches the CDA document from the broker 2 430. When the location of the CDA document is identified by the meta information, The broker 1 420 and the hospital 1 410 access the document storage server (not shown) of its own hospital information system through the web service to sequentially request the CDA document.

The CDA document retrieved subsequently is automatically transmitted to the clients of the broker 1 420, the broker 2 430 and the hospital 2 440 in sequence, and the person in charge of the hospital 2 (440) The patient's CDA document can be viewed.

However, the delayed response model has a problem in that it is difficult to share the CDA document when the document storage server of the first hospital 410 storing the CDA document is not operating properly, and the transmission step of the CDA document is complicated . However, it may be the most realistic model for patients and service providers in the current situation where it is not legally permissible to store medical records outside the current medical institution.

The three types of medical information exchange models described above have advantages and disadvantages in terms of performance, security, system scalability, and the like, depending on the point of view and storage location of the shared objects. Table 1 below compares the strengths and weaknesses of the three types of clinical information exchange models described above by selecting key evaluation indicators.

Table 1 shows that the proactive model has the best performance but the security problem and the domestic legal system are not applicable to the environment. The delayed response model has the best security and system scalability, It is a model that can be applied immediately. However, in the case of the delayed response model, there is a disadvantage in that the data of the subject of the medical care information exchange is stored only in the hospital's own hospital information system, which is a problem in performance.

In other words, the conventional delayed response model stores the actual medical care information exchange document (CDA document) in the hospital information system built in the hospital itself, and stores only the metadata of the CDA document in the outside (for example, transmission / reception broker) In order to access the medical information of the hospital from outside, it is necessary to use the transmission / reception broker to transmit the hospital information established in the hospital itself (CDA document) must be fetched after accessing the system, there is a problem that the performance (for example, the response speed) is lowered for retrieving the medical care information compared to other comparative models.

Therefore, it is an object of the present invention to provide a new medical care information exchange system based on a delayed response model that can improve the performance of the medical care information exchange system while maintaining the advantages of the conventional delayed response model.

Hereinafter, a medical information exchange system according to the present invention will be described.

FIG. 7 is a diagram illustrating a framework of a medical care information exchange model according to an embodiment of the present invention. As shown in FIG. 7, the medical care information exchange system according to the present invention includes, apart from a conventional broker system for inquiring medical information, And a CDA view server 530 for transmission and inquiry of the CDA document.

That is, the medical care information exchange system according to the present invention maintains the advantages of the existing delayed response model, while the actual medical care information (CDA document) is transmitted to the corresponding hospital (not shown) through the CDA view server 530 (Eg, the medical information system of the receiving organization), thereby improving the performance (eg, the response speed) by simplifying the procedure and structure for transmitting the actual medical information.

FIG. 8 is a diagram illustrating a structure of a medical care information exchange system designed with reference to a delayed response model with improved performance according to an embodiment of the present invention.

As shown, the hospital terminal 1 520 of the hospital 1 receives metadata of the corresponding CDA document from the receiving institution (e.g., hospital 2) 550 requesting the CDA document through the CDA registry server 540 , And the actual CDA document is transmitted to the CDA view server 530 to the hospital information system 560 of the receiving institution (e.g., hospital 2). By separating the metadata flow from the actual CDA document flow, it is possible to effectively respond to requests for external hospital information.

At this time, the communication protocol of the CDA view server 530 utilizes a web server without developing a separate protocol. The reason is that the CDA document itself has a standard XML structure, so there is no need for a separate viewer, and in particular, the Web service method is most suitable in terms of development efficiency and scalability in realizing network-based medical information inquiry function.

Referring to Table 2 below, the CDA view server 530 provides an inquiry function of a CDA document and a PACS image, and is implemented in the form of an XML-based web server. The registry server 540 records a CDA document and a PACS image Management of meta data, support of inquiry of information, log management of transactions between systems, user registration, management, access management of system, and other system management services.

9 is a flowchart illustrating an operation procedure of the medical care information exchange system according to an embodiment of the present invention.

As shown, the hospital terminal 2 550 is a terminal for requesting a CDA document in the hospital information system of the hospital 2. The hospital terminal 1 520 is a terminal for transmitting the requested CDA document, 520 is assumed to be a terminal of the hospital information system built in the hospital 1 having the CDA document requested by the hospital terminal 2.

9, when the person in charge of the hospital terminal 2 (550) requests a CDA document list (or metadata) related to a specific patient, the hospital terminal 2 (550) To the registry server 540 (S101). Accordingly, the registry server 540 searches the hospital (or hospital information system) having the requested CDA document list (S102) through its own database (S102) And requests the CDA document list (S103).

The hospital terminal 1 520 having received the CDA document list transmits the corresponding CDA document list to the registry server 540 in step S104 and loads the actual CDA document into the CDA view server 530 (S105). The CDA view server 530 loaded with the CDA document from the hospital terminal 1 520 transmits the load information (e.g., CDA document information, hospital information, etc.) to the registry server 540 (S106). When the loading of the actual CDA document is completed in the CDA view server 530 as described above, the registry server 540 transfers the CDA document list received from the hospital terminal 1 520 to the hospital terminal 2 550 S107).

The hospital terminal 2 550 requests the CDA document request information from the CDA view server 530 to the hospital terminal 2 550, (S108). The CDA view server 530 receiving the CDA document request information directly transmits the requested CDA document to the hospital terminal 2 550 in step S109. That is, when the CDA document list is requested, the hospital terminal 1 (520) transfers the CDA document list through the registry server 540 and simultaneously registers the CDA document corresponding thereto in the CDA view server 530 : Response speed).

As described above, in the clinical information exchange system according to the present invention, the hospital terminal 2 550 requests and receives a list (CDA List) including CDA document information through the registry server 540, and receives the CDA document list After that, a process of requesting and receiving the actual CDA document selected from the CDA document list through the CDA view server 530 is performed. As described above, the medical care information exchange system of the present invention distinguishes between a meta data receiving flow (a flow for requesting and receiving a CDA document list) and an actual CDA document receiving flow (a flow for receiving a CDA document selected from a CDA document list) Hospital information (for example, hospital terminal 2).

In the medical information exchange system according to the present invention, brokers for storing meta data are not arranged in each hospital information system, but may be arranged in each hospital information system according to the implementation environment of medical information exchange in the future .

Hereinafter, an experiment for comparing the performance of the clinical information exchange system based on the new delayed response model according to the present invention and the clinical information exchange system based on the conventional delayed response model will be described.

The performance comparison test is an experiment to compare the response time according to the CDA document request. The CDA document was measured based on the test results, the prescription details and the read results that are frequently referred to in the exchange of the medical information, and the experiment Data were collected from three days of data from a specific university hospital.

Table 3 below summarizes the detailed specifications of the system and experimental data for the simulation according to the present invention.

Here, the CDA document has the largest capacity among the CDA documents as the data combined with the PACS (Picture Archiving and Communication System) image, while the inspection result and the prescription details are composed of numbers and text data, . Experiments were conducted on 4,696 experimental data corresponding to three sets of data generated in the specific university hospital in order to increase the accuracy of the experimental results and to reduce errors. We implemented CDA view server and registry server using health record system. Also, performance comparison between the conventional delayed response model based system and the delayed response model based system according to the present invention with improved performance was measured based on the response time as shown in FIG.

As a result of the test results based on the test results, the prescription details, and the read results as a whole, the performance information exchange system based on the delay response model according to the present invention has improved the performance by about 24% I could.

Referring to FIG. 10, the average response time of the readout result was 0.71 sec, which was about 31% improved, and the test result was decreased by 0.2 sec. The breakdown was reduced by 0.08 seconds, and the performance improvement was about 13%.

As a result of analyzing the above experimental results, it was found that the performance is improved as the amount of response data is large and the frequency of requests is low. Referring to the above experimental results, it can be seen that the new medical information exchange system based on the delayed response model according to the present invention has a considerable performance improvement effect for requests with low request frequency for medical information and high data amount.

While the present invention has been particularly shown and described with reference to exemplary embodiments thereof, it is to be understood that the invention is not limited to the disclosed embodiments, but, on the contrary, I will understand the point. Accordingly, the technical scope of the present invention should be defined by the following claims.

510, 560: Hospital information system built in each hospital
520, 550: terminal connected to each hospital information system
530: CDA view server
540: Registry server

Claims (8)

A first terminal that is a hospital terminal for requesting a clinical document as a CDA (Clinical Document Architecture) document related to a specific patient;
Medical information related to the specific patient, which is a list including metadata of the CDA document or information of the CDA document, and a second terminal which is a hospital terminal storing the clinical document;
When the first terminal requests the clinical document related to the specific patient, searches the hospital having the clinical information corresponding to the requested clinical document through its own database, and transmits the clinical information to the second terminal, A first server for requesting treatment information other than a document and providing the treatment information to the first terminal when the treatment information is transmitted from the second terminal; And
And a second server for receiving and registering at least one clinical document related to the requested medical care information from the second terminal and directly providing the clinical document requested by the first terminal without going through the first server,
The clinical information is directly provided to the first terminal through the first server and the clinical document is transmitted to the first terminal through the separate second server so that the transmission and reception paths of the clinical information and the clinical document are distinguished, ,
Wherein the first server transmits the medical care information to the first terminal when information indicating completion of registration of a clinical document transmitted from the second terminal is received from the second server, Response Model Based Medical Information Exchange System. The method according to claim 1,
Wherein the first terminal is a terminal connected to a hospital information system of a receiving organization for inquiring or requesting medical information or a clinical document,
Wherein the second terminal stores the clinical information or the clinical document and is a terminal connected to the hospital information system of the transmitting institution providing the medical information or the clinical document corresponding to the inquiry or request of the receiving institution. Medical Information Exchange System.
delete delete The server according to claim 1,
The first server receives the registration completion information from the second terminal when the registration of the clinical document received from the second terminal is completed, A clinical information exchange system based on delayed response model.
delete A first step of requesting a first server for a clinical document as a CDA (Clinical Document Architecture) document related to a specific patient in a first terminal;
The first server may include a second step of searching for a hospital having the information of the clinical document including the requested clinical document list or the metadata of the clinical document through the database of the clinical document at the first terminal upon its request;
The first server accessing a second terminal storing information of the clinical document through a search and requesting information of the clinical document;
A fourth step of providing information on a clinical document requested by the first server to the first server and transferring the actual clinical document to a second server for registration;
A fifth step of delivering the registration completion information to the first server when registration of the clinical document received from the second terminal is completed;
A sixth step of receiving information on completion of registration of the clinical document in the second server and providing the information of the clinical document received from the second terminal to the first terminal;
The first terminal selecting a desired clinical document from the information of the clinical document and requesting the selected server to the second server; And
And the second server provides the registered clinical document directly to the first terminal according to the request of the seventh step,
The information of the clinical document is directly provided to the first terminal through the first server and the clinical document itself is transmitted to the first terminal through a separate second server so that the information of the clinical document and the clinical document A method of exchanging medical information based on a delayed response model that performs transmission and reception by distinguishing a transmission / reception path to itself. delete

Images