RU116662U1 - ADVISORY-DIAGNOSTIC SYSTEM IN THE FIELD OF TELEMEDICINE - Google Patents

Abstract

1. Consultative and diagnostic system in the field of telemedicine, containing a user's workplace with an Internet access system, a server, a patient database, an intelligent system with an expert system, with a system for formalizing input text concepts, a concept dictionary processor with a library of functions and a complete set of relationships between concepts, a processor of a database directory, a database of an intelligent system based on the ontology of a subject area, a block of operational consultations, a workstation and a server are connected by a two-way communication channel to ensure the identification of a doctor and determine access rights, the server is connected to the database of patients, the intelligent system is connected with a server, characterized in that the server is made in the form of a web server as a single center with the system software, the access of the workplace to the software is implemented according to the SaaS model, the workplace is equipped with an Internet browser, a web camera, the system is equipped with a media server rum with audio / video content, a system for transferring content to the workplace and terminals of specialists in the subject area, with a system for informing the workplace and specialists about the upcoming conference call, the media server is made to work online, the media server is connected to the workplace and terminals of specialists, the web server, patient database, workplace and other system components, their network connection to the server is equipped with a security program. ! 2. The system according to claim 1, characterized in that the network connection of the workplace with the server is equipped with a firewall. ! 3. The system according to claim 1, characterized by t�

Description

The solution relates to medical equipment, namely to telemedicine and expert intelligent systems for virtual consultations and medical examinations.

There is a well-known information-analytical system in the field of telemedicine, which contains the workplace of a remote user - the attending staff, connected by a network communication channel to the control unit of a specialist consultant - a server via TCP / IP protocol and a multiplexer that provides communication with patient monitoring equipment and a centralized documentation unit diagnosis results. The system contains an adaptation unit for self-tuning and self-training, an operational consultation unit and an intelligent interface unit. The control unit of the specialist consultant contains an expert system. The workplace is connected to the smart interface unit. The specialist consultant unit is connected to the operational consultation unit, the adaptation unit and the smart interface unit. The system allows you to increase the effectiveness of treatment and preventive measures by automating the analysis procedures (see RU 2251965, IPC 7 A61 B5 / 0205, G06F 19/00, G06F 159: 00, published on 05/20/2005.).

The system assumes the functioning of the workplace of the attending physician (PM) on the basis of a personal computer connected to the intelligent interface unit.

The doctor enters data on each patient with the results of his examination, which are sent to the documenting unit through the server of the consultant's control unit. The documentation unit is designed for centralized storage of electronic patient records and journals with the formation of a patient database. The PM communicates directly with the server of the consultant's control unit via the TCP / IP network protocol, ensuring doctor identification and determining access rights to the medical history. This connection is two-way. The consultant’s control unit is an information and analytical center (the core of the complex) and contains an expert system and a multiplexer that provides communication with the patient condition monitoring equipment and the documentation unit.

In the process of work, if necessary, for the doctor to establish an accurate diagnosis with the PM, a request is made to the server to establish or clarify the diagnosis on the part of the consultant and develop recommendations on request using the previously entered patient data, placed in the patient database in the documentation unit. The consultant carries out the diagnosis and development of recommendations using his accumulated experience and / or after searching for information on databases with the transfer of the necessary information to the RM. In difficult situations, the specialist consultant himself goes to the operational consultation unit with specialists from leading medical institutions to obtain the latest data on the patient’s disease on-line or in delayed mode. Consultations are conducted on the basis of analysis methods and recognition of complex situations in automatic mode, including on the basis of the analysis of typical errors. The results of the consultations replenish the database of a particular patient with entering them into his electronic card and electronic journals.

The intelligent interface unit is connected with the RM and the consultant’s control unit, on the basis of which it operates, carrying out the function of combining knowledge (to maintain interactions with the RM using direct and feedback). The intelligent interface unit contains a database reference processor, a conceptual dictionary processor with a library of functions, and a complete set of relations between concepts, including associative "part-whole", "symptom-diagnosis".

Thus, the known system has a specialized knowledge base with information storage in a single information center, the ability to obtain new theoretical and experimental data regarding the diagnosis of the disease and its treatment method for a particular patient by ensuring the operative connection of the attending physician with a specialist consultant, with leading scientific - research, medical and preventive, diagnostic institutions that ensure the establishment, clarification of the diagnosis, doctor changes in treatment in conditions of incompleteness and uncertainty of the initial medical information.

The disadvantages of the system are its complexity (adaptation unit, unit for setting up, verification of expert rules, unit for monitoring the actions of doctors, etc.), as well as insufficient functionality to obtain timely necessary information for the attending physician, especially if the doctor is inexperienced, does not have a full set of medical knowledge (paramedic in rural areas), and the picture of the non-standard course of the disease is blurred (pathomorphosis). Another disadvantage is the high workload of the attending physicians in the field. In this regard, there is no possibility of automated SMS alerts of patients about upcoming events for them: passing tests, a new appointment, the need to come to the doctor, a new examination in the diagnostic center. In addition, for the functioning of the system, it is supposed to provide it with expensive programs at the workplace of the treating staff, in particular, the medical assistant of a rural medical institution, which is often the reason for refusing to use such a system.

The task is to simplify the system, expand its functionality by quickly organizing automated SMS alerts of patients about upcoming events, operational organization of the conference call of the treating medical staff with leading experts in the subject area. Another task is to reduce the cost of using the system for a medical institution and its staff by consulting via an Internet browser using the SaaS model.

Tasks are solved by building a consultative diagnostic system in the field of telemedicine, containing:

- workplace of a remote user - attending personnel (hereinafter referred to as RM) - a terminal with a processor, memory, disk space, with an Internet access system,

- specialist consultant control unit - a server with a processor, memory, disk space,

- a centralized unit for documenting patient data - a database of patients,

- an intelligent interface unit - an intelligent system with an expert system, with a system for formalizing the concepts of input text, a conceptual dictionary processor with a library of functions, and a complete set of relations between concepts, including associative “part-whole”, “symptom-diagnosis”, database reference processor data, its database of information on the subject area (hereinafter IP database),

- a database of an intellectual system (IS database), based on the ontology of the subject area;

- a block of operational consultations with a processor, memory, disk space with the following functions: conducting teleconsultations, managing access rights;

- The RM and the server are connected by a two-way communication channel to ensure the identification of the doctor and determination of access rights to the medical history;

- the server is connected to the patient database,

- RM is connected to the patient database through the server,

- an intelligent system is connected to the server;

- the server is connected to the operational consultation unit.

The difference from the prototype is the following.

- the server is designed as a web server that accepts HTTP orders from a web browser and issues HTTP responses along with an HTML page using the HTTP protocol;

- the system software is deployed in a single center - on a web server in the form of a single software core,

- RM users' access to the system software is implemented according to the SaaS model;

- The RM is equipped with a webcam, electronic digital signature system (EDS), an Internet browser for access to other nodes of the system, provided after identifying the attending physician, if necessary, with a printer;

- a block of operational consultations with the processor, memory, disk space is installed directly on the web server,

- the system is equipped with a media server with audio / video content, a system for transferring content to RM and terminals of leading medical institutions and / or specialists in the subject area (hereinafter specialists), a mobile operator’s server, a system for informing RM and specialists about the upcoming conference call,

- the media server is equipped with an automatic system for transmitting and receiving SMS messages of remote patients,

- the media server is designed to work online;

- the media server is connected to the RM and specialist terminals, a web server, a patient database and a mobile operator;

- the RM computer and other system components, their network connection to the server is equipped with a protection program, for example, CryptoPro;

- the network connection of the RM with the server is equipped with a firewall.

It is widely known to use systems with software organized by the SaaS model. At the same time, users are given access to the software via the Internet without installing it on user terminals, in rental mode, which reduces the costs of the software user.

The widespread use of a media server for organizing various shows and conferences on-line is widely known. However, its use and integration into the proposed consultative diagnostic system allows remote medical personnel to quickly and without expensive online to consult with leading medical experts and thereby promptly clarify the patient’s diagnosis, prescribe treatment in time and even save his life.

Despite the prominence of restrictive features and part of the distinguishing features of the claimed combination of features from the prior art is unknown.

The figure shows the consultative diagnostic system, made in accordance with the proposed solution.

The consultative diagnostic system contains terminal 1 of the treating staff: a doctor, a feldsher of a rural hospital (system user). The user terminal 1 is equipped with an electronic digital signature (EDS) 2 system for identifying the treating medical personnel in the system and checking their access to prevent unauthorized access. EDS can be a usb keychain, e-token or rutoken (http://www.rutoken.ru/).

CryptoPro information protection software is installed on terminal 1. At the terminal 1 of the user access to the Internet browser for using the unified software of the system. User terminal 1 in the context of the present solution is understood to mean many terminals of such users. Terminal 1 is connected to an encrypted communication channel 3 with web server 4 via the Internet. Additionally, a firewall / firewall 5 - filter is introduced into the encrypted communication channel 3. It is a complex of hardware and / or software that monitors and filters network packets passing through it in accordance with predefined rules for filtering packets that do not fit the criteria defined in the configuration to protect computer networks or individual nodes from unauthorized access. Web server 4 is a single center in the system and includes a processor, memory, disk space. The web server 4 has deployed software in the form of a single software core, which is necessary for the functioning of the entire system with its components, access to which for user terminals and for specialists participating in a video conference is carried out according to the SaaS model via an Internet browser. The system contains an intelligent system 6, equipped with its database - IS 7 database, connected to the web server 4. Intelligent system 6 is organized as the system logic with the functions of analyzing a specific user request and issuing a recommendatory answer as a synthesis of the patient’s medical history and medical knowledge with treatment recommendations, while the web server 4 is organized as the business logic of this system. Intelligent system 6 contains an expert system, a subsystem for receiving requests from a web server 4, a subsystem for primary processing of requests and incoming information, a subsystem for analyzing requests and incoming information in accordance with the algorithms laid down in it, a subsystem for analyzing the patient’s condition, a subsystem for analyzing the course of the disease, and a subsystem for generating recommendations. Intelligent system 6 is made with a subsystem for formalizing the concepts of input text, a conceptual dictionary processor with a library of functions and a complete set of relationships between concepts, including associative "part-whole", "symptom-diagnosis", database reference processor. The database 7 of the intellectual system 6 is formed on the basis of the ontology of the subject area, each relationship in which represents a certain entity, phenomenon, process of the subject area. Relations between entities are considered as relations in which they are in the subject area (the entity “diagnosis” has symptoms represented in the entity “symptoms”). Database 7 of the intellectual system 6 is a specialized database of medical knowledge collected over the entire existence of the subject area, with a description of diseases, methods for diagnosing them, methods for examining the patient’s condition, treatment methods and means, contains electronic versions of directories and other information of the subject area, an electronic library of medical information, systematically updated, in particular, when perceiving new theoretical and experimental data and / or after accessing it ELSE on the current issue. The system also contains a database of 8 patients associated with the web server 4. The database of 8 patients contains information about electronic journals and patient cards with their identification data (name, passport, policy, etc.), with their medical history, analysis results and other results of the examination, diagnoses of diseases, established treatment methods, their implementation, with the means and treatment regimens, etc. The database schema 8 is designed in such a way as to increase the speed of query execution through the use of the procedure to shirovaniya, ensure the integrity and consistency of data stored in tables.

The system contains a media server 9, which contains audio / video content and organizes the transfer of content data between users and leading specialists of medical institutions. This is an analogue of Skype with video calling capabilities with a doctor and his colleagues. The media server 9 is equipped with a mobile operator terminal 10 connected to the media server 9 with a secure Internet communication channel, with means for transmitting / receiving SMS messages from patients, providing a service for patients from the database of 8 patients, with the possibility of disconnecting the operator terminal from the media server 9. Terminal 10 the cellular operator is connected by cellular communication with the phones of 11 patients. In the context of the media server of this solution, user terminal 1 is also understood to mean many terminals of specialists / leading medical institutions involved in operational consultations and audio-video conferences.

The web server 4 is connected via the Internet to the patient database 8, to the media server 9, which is also connected to the Internet using the terminal 1 of the user and the database of his patients 8.

The consultative diagnostic system for solving the tasks also involves centralized management and servicing of the patient bank 8 and works as follows.

The attending physician or paramedic of the countryside (the user of the proposed system) carries out their activities, being away from other medical institutions, leading medical training, research, diagnostic, rehabilitation centers, institutes for the improvement of doctors and other institutions. Every day he has to deal with filling out reporting forms, maintaining records and patient logs, and so on. Being connected to the above diagram of the consultative diagnostic system, he inserts his EDS ID 2 card into the corresponding socket of his terminal 1, which has access to the software via the SaaS model through an Internet browser, enters this system by connecting to a web server 4, and sends the electronic versions of all reporting forms and maps of patient logs to server 4. The connection of user 1 with the database of 8 patients occurs through the web server 4. The server, before verifying the doctor’s identity and identifying him, checks Having verified the legitimacy of access rights, it accepts the specified information and automatically sends it to the database of patients 8. Thus, the formation and replenishment of this database with all the patient data, which is necessary for the functioning of the system, occurs. Further, faced with the non-standard course of a patient’s disease, its latent forms, its complications, the attending physician cannot always adequately recognize the disease, analyze the patient’s condition, make a diagnosis and prescribe appropriate timely adequate treatment. In such cases, he can take advantage of the described consultative-diagnostic system to which he is connected according to the scheme described above to support decision-making on the diagnosis and treatment of the disease. To do this, he inserts his EDS 2 identification card into the corresponding slot of his terminal 1, which has access through the SaaS model via an Internet browser, enters this system, connects to the web server 4 and makes a request to select the necessary data about his patient . The request is transmitted through the encrypted channel 3. Web server 4 receives an HTTP request from a web browser / doctor, processes the request with an application that implements business logic with its programs and data analysis algorithms, makes a request to data bank 8 and receives some data sample. In this case, it is possible to use the caching block of previously issued results to speed up the receipt of the necessary data. Web server 4 generates a response in the format of marked-up web pages, which contain the results of the application, algorithms and queries in the database. Web server 4 sends the data in the form of HTTP responses to terminal 1 of the doctor.

Then the doctor goes to the intelligent system 6, namely to its expert part. A medical expert system is an intelligent system that implements a process of logical reasoning carried out using software, and based on medical knowledge bases and knowledge of highly qualified medical specialists; the system is also a consultative system, which provides a mechanism for explaining and justifying proposed solutions, including alternative ones.

An expert (intellectual - knowledge-based) system, in contrast to state recognition systems based on computational procedures (i.e., statistical processing of data on specific cases of diseases), imitates the logic of medical thinking, based on a knowledge base (KB) in a specific subject area medicine. The knowledge base contains formalized information about the relationships, severity, diagnostic (prognostic) significance of the observed signs. This may be information about the etiology, pathogenesis of diseases, about the associative relationship of symptoms. The knowledge acquired by the user of other specialists to a large extent is a synthesis of their extensive experience (clinical observations) and information in their problem area, obtained during the training (advanced training), work experience and from literature, contain ideas about the frequency of occurrence of individual symptoms and syndromes and are of great value to him in each case. It can be argued that the doctor in a specific situation combines basic ideas with personal experience, using analogies to confirm his assumptions (hypotheses). At the same time, depending on qualifications, it is easier or harder to recognize atypical forms of diseases, predicts the dynamics of the process.

Intelligent system 6 analyzes the received data, processes it, receives information from its data bank 7, generates recommendations for establishing a diagnosis, conducting additional, clarifying examinations, treatment methods and means, and sends them through the web server 4 to terminal 1 of the doctor. In this case, the web server 4 also transmits these recommendations to the corresponding part of the database 8 of the corresponding patient, replenishing it.

Media server 9, by a signal from the web server 4, making a selection from the patient database 8 for all new appointments, sends information about this to the phones of 11 patients in the form of SMS messages through operator 10. If necessary, for the user to discuss complex medical In the event, the user formulates a request for organizing a conference for web server 4 in the appropriate format with the participation of leading specialists from leading medical institutions in the region / country / medical community. The web server 4, having the data of these specialists / institutions, makes a request to the media server 9 to organize this conference or just any meeting in the central district hospital, indicating the circle of specialists, time, duration of the conference, order of speeches, formulates the subject with the statement problems, disclosing the symptoms of the disease, etc. The media server 9 contacts the relevant respondents, specifies the time of the conference, the possibility of participation in it of relevant specialists s and all organizational data is automatically reported to the web server 4. The participation of the attending physician and specialists in the conference provides an opportunity to discuss the problems arising as a user, and specialists, adding to their knowledge and experience, can quickly solve the task. Here, the issue of urgent delivery of a complex patient to a leading clinic in a region / country can be resolved to provide qualified care.

The system also allows you to quickly contact a specific patient and through the telecom operator inform / remind him of the need for any procedures, vaccinations or to accept his assessment of the quality of service by a doctor / paramedic after his visit, answer questionnaire questions, etc.

Thus, the proposed system allows remote medical staff on the basis of the existing knowledge base of medicine and patient information to solve problems arising at the workplace by a preliminary history, to receive relevant high-level consultations online, a preliminary diagnosis of the disease and alternative methods of treatment with a description of the basis of what and how this diagnosis was made, with the justification of decisions of specialists of leading medical institutions, the issuance of written documentation and to resolve other medical problems. The system allows you to automate the activities of medical personnel with electronic medical records by an electronic reporting system, organizing an electronic queue, a system for scheduling the work of medical personnel, organizing alerts for patients about upcoming actions at low costs for using the consulting and diagnostic system due to the simplicity of equipment, low costs for its use that is not implemented in known systems.

Claims (5)

1. Consultative and diagnostic system in the field of telemedicine, containing a user's workstation with an Internet access system, a server, a patient database, an intelligent system with an expert system, with a formalization system of input text concepts, a conceptual dictionary processor with a library of functions, and a complete set of relations between concepts, a database reference processor, an intelligent system database based on the ontology of the subject area, a block of operational consultations, a workplace and serv The servers are connected by a two-way communication channel to ensure the identification of the doctor and determination of access rights, the server is connected to the patient database, the intelligent system is connected to the server, characterized in that the server is designed as a web server as a single center with system software, access to the workstation the software is implemented according to the SaaS model, the workplace is equipped with an Internet browser, a web camera, the system is equipped with a media server with audio / video content, a system for transferring content to the workplace and terms There are specialists in the subject field, with a system for informing the workplace and specialists about the upcoming conference call, the media server is designed to work online, the media server is connected to the workplace and terminal of specialists, a web server, a patient database, a workstation and other system components, their network connection to the server is equipped with a security program. 2. The system according to claim 1, characterized in that the network connection of the workstation with the server is equipped with a firewall. 3. The system according to claim 1, characterized in that the operational consultation unit is installed directly on the web server. 4. The system according to claim 1, characterized in that the media server is equipped with an automatic system for transmitting and receiving SMS messages from patients and is associated with a cellular communication operator. 5. The system according to claim 1, characterized in that the workplace is equipped with an electronic digital signature system.