WO2014157729A1 - Information provision system and method for controlling information provision system - Google Patents

Information provision system and method for controlling information provision system Download PDF

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Publication number
WO2014157729A1
WO2014157729A1 PCT/JP2014/059581 JP2014059581W WO2014157729A1 WO 2014157729 A1 WO2014157729 A1 WO 2014157729A1 JP 2014059581 W JP2014059581 W JP 2014059581W WO 2014157729 A1 WO2014157729 A1 WO 2014157729A1
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Prior art keywords
information
medical
consenter
facility
patient
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PCT/JP2014/059581
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French (fr)
Japanese (ja)
Inventor
至孝 川上
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三菱化学メディエンス株式会社
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Priority to JP2015508831A priority Critical patent/JPWO2014157729A1/en
Publication of WO2014157729A1 publication Critical patent/WO2014157729A1/en

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    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H10/00—ICT specially adapted for the handling or processing of patient-related medical or healthcare data
    • G16H10/60—ICT specially adapted for the handling or processing of patient-related medical or healthcare data for patient-specific data, e.g. for electronic patient records
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H10/00—ICT specially adapted for the handling or processing of patient-related medical or healthcare data
    • G16H10/40—ICT specially adapted for the handling or processing of patient-related medical or healthcare data for data related to laboratory analysis, e.g. patient specimen analysis

Definitions

  • the present invention relates to an information providing system for medical information and a control method for the information providing system.
  • the medical facilities belonging to a specific medical area will advance the function sharing and specialization according to the situation of the local medical care regarding the features such as their functions and scale, and patients will provide appropriate medical services with continuity. It is intended to be received.
  • Regional medical cooperation is expected to be effective not only in medical facilities but also in cooperation between medical facilities and other medical-related service providing facilities such as clinical laboratory facilities and dispensing pharmacies.
  • the medical-related service is a clinical laboratory as an example, most clinical laboratories are currently performed in core hospitals and large clinical laboratories in the region.
  • An embodiment in which a clinical test is performed at a core hospital upon receiving a request from a clinic where a patient has consulted, or a clinical test is performed at a clinical laboratory in response to a request from a clinic or core hospital are various.
  • Management of medical information is being considered as one of the tools to achieve regional medical cooperation, but this involves sharing medical information in each regional medical area using information integration technology of IT (Information Technology). A common information infrastructure is required.
  • IT Information Technology
  • a medical facility and a terminal are connected via a network, and information related to medical practice is transmitted from the management system in the medical facility to the terminal via the network (Patent Document 1).
  • a medical information management system (Patent Document 2) that centrally manages medical information in a medical information system of a plurality of medical facilities via a network, and a medical information management system (Patent Document 3) provided with personal information protection means. Proposed.
  • test system disclosed in Patent Document 1 is such that when a patient undergoes a clinical test at a contracted clinical laboratory other than the main clinical laboratory, the clinical test result is a contracted clinical test other than the main clinical laboratory. It is transferred from the clinical testing terminal of the facility to the clinical testing terminal of the main clinical laboratory. Furthermore, the clinical test result is notified to the doctor terminal in the medical facility and transferred to the electronic medical record system. That is, it does not consider the case where a patient's clinical examination is performed by a plurality of clinical examination facilities.
  • Patent Document 2 discloses a medical information management system that centrally manages medical information via a network and includes personal information protection means.
  • the access right to the database is limited to the medical facility in which the medical information is registered, and there is a possibility that even the medical information of the disagreement patient is included in the database.
  • facilities newly participating in regional medical cooperation have no access authority, and the purpose of sharing medical information among many medical facilities cannot be achieved.
  • Patent Document 3 describes a medical information management system that centrally manages medical information in medical information systems of a plurality of medical facilities via a network.
  • the medical information management system patient information that each of a plurality of medical facilities individually has is integrated and managed, access to a database is restricted, and medical information is provided based on personal authentication.
  • there is a risk of personal information leakage because personal information and medical information are not separated, and information on patients who disagree with disclosure of personal information is not discarded. I can't throw it away.
  • the medical facility directly registers information in the medical information management system, it is not assumed that the clinical test results performed in a plurality of clinical laboratory facilities are managed in an integrated manner. Therefore, even in such a medical information management system, it must be said that the amount of shared medical information is insufficient, and it is not possible to provide a highly convenient service.
  • the technology disclosed in the present disclosure has been made in view of the above circumstances, and the purpose thereof is to provide a variety of medical information created by a plurality of medical facilities providing medical-related services while protecting personal information. Is to realize a system that can be provided to a plurality of medical facilities in a simple format.
  • An information providing system includes a consenter information storage unit that stores consenter information in which medical facility information and patient identification information are associated and extracted from an information storage device accessible by a terminal of a medical facility
  • a medical information storage unit accessible by a terminal of a medical service providing facility requested by a medical facility, wherein medical facility information, patient identification information, and requested medical service information
  • Consent person information extraction which extracts medical person information which has medical facility information memorized in medical information storage part from medical information memory part which memorizes linked medical information, and consenter information memorized in consenter information memory part Part, the consenter information specifying part for specifying the medical information having the patient identification information of the extracted consenter information among the medical information, and the specified medical information are transmitted to the information storage device And a care information transmitting unit.
  • medical information such as clinical test results provided by the medical-related service providing facility among a plurality of medical facilities.
  • the consenter information stored in the consenter information storage unit is such that items that the patient does not agree are associated with the medical facility information and the patient identification information.
  • a non-consent item deletion unit that deletes items that the patient does not agree with included in the extracted consenter information.
  • the information provision system by one Embodiment is further provided with the medical information deletion part which deletes medical information other than the specified medical information among medical information.
  • the information providing system further includes a format conversion unit that converts the format of the specified medical information, and the medical information transmission unit transmits the medical information whose format has been converted.
  • the information provision system by one Embodiment is further provided with the master conversion part which converts the master of the specified said medical information, and a medical information transmission part transmits the medical information which converted the master.
  • medical information includes any of medical record information, receipt information, medical information, preventive health information, welfare information, and information related to biological samples of Biobank.
  • the medical information is medical chart information, and the medical chart information includes any of clinical test results, doctor's findings, progress and results of treatment, nursing records, prescriptions, and outpatient histories.
  • the control method of the information providing system includes the consenter information obtained by associating the medical facility information and the patient identification information extracted from the information storage device accessible by the medical facility terminal.
  • the medical information storage unit stores the medical facility information, the identification information of the patient, and the requested medical related service in the medical information storage unit that is stored in the information storage unit and accessible by the terminal of the medical related service providing facility requested by the medical facility.
  • the medical information associated with the information is stored, and from the consenter information stored in the consenter information storage unit, the consenter information having the medical facility information stored in the medical information storage unit is extracted, and among the medical information, Medical information having patient identification information corresponding to the extracted consenter information is specified, and the specified medical information is transmitted to the information storage device.
  • the consenter information stored in the consenter information storage unit is such that items that the patient does not agree are associated with the medical facility information and the patient identification information. Items that the patient does not consent to are included in the extracted consenter information is deleted from the medical information. Furthermore, the control method of the information provision system by one Embodiment deletes medical information other than the specified medical information among medical information.
  • control method of the information provision system by one Embodiment converts the format of the specified medical information, and transmits the medical information which converted the format.
  • the information providing system control method according to the embodiment converts the specified medical information master, and transmits the medical information converted from the master.
  • medical information includes any of medical record information, receipt information, medical information, preventive health information, welfare information, and information related to biological samples of Biobank.
  • the medical information is medical chart information, and the medical chart information includes any of clinical test results, doctor's findings, progress and results of treatment, nursing records, prescriptions, and outpatient histories.
  • the medical facility information extracted from the information storage device accessible by the terminal of the medical facility is associated with identification information of an individual including at least a patient or a medical information provider.
  • the consenter information storage unit for storing the consenter information and the medical information storage unit accessible by the terminal of the medical service providing facility for which the medical service is requested from the medical facility, and identifying the medical facility information and the individual Medical facility information stored in the medical information storage unit from the medical information storage unit that stores the medical information in which the information and the requested medical-related service information are associated, and the consenter information stored in the consenter information storage unit
  • the consenter information extraction unit for extracting the consenter information having the information, and the consenter information specification for identifying the medical information having the personal identification information of the extracted consenter information among the medical information When, and a medical information transmitting unit for transmitting the identified medical information in the information storage device.
  • a method for controlling an information providing system wherein medical facility information extracted from an information storage device accessible by a medical facility terminal is associated with identification information of an individual including at least a patient or a medical information provider.
  • the attached consenter information is stored in the consenter information storage unit, and the medical facility information and the individual identification are stored in the medical information storage unit accessible by the terminal of the medical service providing facility requested by the medical facility.
  • Information about the medical facility in which the information related to the requested medical-related service is stored, and the consenter information having the medical facility information stored in the medical information storage unit from the consenter information stored in the consenter information storage unit The medical information having personal identification information corresponding to the extracted consenter information is specified from the medical information, and the specified medical information is transmitted to the information storage device.
  • the information providing system and the control of the information providing system that can share medical information created by a plurality of medical facilities that provide medical related services while protecting personal information among the plurality of medical facilities.
  • a method is realized.
  • FIG. 1 is a diagram illustrating a schematic configuration of regional medical cooperation having an information providing system according to an embodiment.
  • FIG. 2 is a diagram illustrating a schematic hardware configuration of an information providing system according to an embodiment.
  • FIG. 3 is a diagram illustrating the contents of personal information and consenter information stored in the regional medical cooperation server in a tabular format according to an embodiment.
  • FIG. 4 is a diagram illustrating an example of items of the consenter information stored in the consenter information DB according to the embodiment.
  • FIG. 5 is a diagram illustrating an example of items of clinical test results stored in the clinical test result information DB for the clinical test center in one embodiment.
  • FIG. 6 is a diagram illustrating a flowchart of processing executed by the information providing system in one embodiment.
  • FIG. 1 is a diagram illustrating a schematic configuration of regional medical cooperation having an information providing system according to an embodiment.
  • FIG. 2 is a diagram illustrating a schematic hardware configuration of an information providing system according to an embodiment.
  • FIG. 3 is a diagram
  • FIG. 7 is a diagram illustrating a flowchart of processing executed by the information providing system in one embodiment.
  • FIG. 8 is a diagram illustrating a flowchart of processing executed by the information providing system in one embodiment.
  • FIG. 9 is a diagram illustrating a flowchart of processing executed by the information providing system in one embodiment.
  • FIG. 10 is a diagram illustrating a flowchart of processing executed by the information providing system in one embodiment.
  • FIG. 11 is a diagram illustrating a flowchart of processing executed by the information providing system and the regional medical cooperation server in the embodiment.
  • FIG. 12 is a diagram illustrating a flowchart of processing executed by the information providing system in another embodiment.
  • FIG. 13 is a diagram illustrating a flowchart of processing executed by the information providing system in another embodiment.
  • FIG. 14 is a diagram illustrating a schematic hardware configuration of an information providing system according to another embodiment.
  • medical service refers to the act of conducting diagnosis and treatment by a doctor.
  • Medical facilities mainly mean facilities that provide medical services, and include clinics and hospitals.
  • Medical-related services are services related to medical services other than medical services, and may be any services that are listed in the Enforcement Regulations of the Medical Law, such as contract clinical testing, dispensing pharmacy services, and sales / maintenance inspection of medical devices.
  • the medical-related service providing facility refers to a facility that provides a medical-related service, and includes, for example, a clinical laboratory and a clinical laboratory center. In some medical facilities such as hospitals, there are cases where clinical testing facilities, for example, medical related service providing facilities such as clinical testing centers and shared use facilities exist.
  • medical information includes medical record information, receipt information, and medical examination information.
  • the medical record information includes clinical test results, doctor's findings, progress and results of treatment, nursing records, and the like.
  • medical information includes medical facility information provided by medical facilities, medical information that describes the merits and demerits in addition to the methods of clinical examinations, diagnosis, and treatment, vaccinations, and prevalence of infectious diseases.
  • Welfare information about aftercare other than treatment such as prevention information and health information such as prevention of food poisoning, home care and care information after discharge, economic and psychological support, etc.
  • medical information such as the above-described clinical test results, prescriptions, medical chart contents, and hospital history can be easily shared between a plurality of medical facilities without risk of personal information leakage.
  • the personal information is information that can identify a specific individual and includes, for example, information defined by a law relating to the protection of personal information.
  • information that can identify the individual by combining a plurality of pieces of information is also included in the personal information.
  • Examples include biometric information, computer IP addresses, and information on remote hosts. Biometric information such as fingerprints, vein patterns, irises, and DNA base sequences may be handled as personal information, but in the present embodiment, these are information included in medical information.
  • regional medical cooperation refers to sharing medical information associated with medical services and medical-related services provided for patients using a plurality of different medical facilities, for example, designated by the Ministry of Health, Labor and Welfare. This includes providing medical services and medical-related services by linking medical facilities in the primary to tertiary medical areas and medical-related service providing facilities.
  • the consenter refers to a patient who has received a sufficient explanation about the policy of the service to receive when receiving a medical service or a medical-related service, and that correctly understands, agrees with, and agrees with.
  • the content of the consenter's consent varies depending on the type of consent to be obtained. For example, consent to participate in regional medical cooperation in the medical area to which the medical facility providing the service belongs, consent to share medical information in multiple medical facilities, secondary medical information in a form where personal information is separated Consent to use (such as cohort studies) is included.
  • the type of consent is appropriately selected according to the use form of the service by the patient. For example, individual patients can agree on all or some of the contents of the shared medical information. For example, the patient appropriately selects the content of consent according to the form of provision of medical service or medical related service, such as agreeing to share only specific items of medical record information, medication history, clinical test results among medical information can do.
  • the consenter information includes a number assigned to each medical facility, a number assigned to each patient by each medical facility, and the numbers of primary to tertiary medical areas to which the medical facility belongs as necessary. Can be added.
  • the contents of the agreed medical information can be added with a number. In particular, in the case of a patient who agrees only on some items, information on items of medical information that have been agreed can be added.
  • FIG. 1 is a diagram showing a schematic configuration of regional medical cooperation having an information providing system 10 in the present embodiment.
  • the information providing system 10 is connected to a server (not shown) of a hospital A100 or hospital B200 via a network N such as a LAN (Local Area Network) or the Internet.
  • the server manages and processes personal information and medical information related to patients who receive medical services at each hospital.
  • the information providing system 10 is also connected to the regional medical cooperation servers 300 and 400 via the network N. Further, the information providing system 10 is connected to a clinical laboratory center A 500, a clinical laboratory center B 600, and a clinical laboratory center C 700 through a network (not shown).
  • FIG. 1 is a diagram showing a schematic configuration of regional medical cooperation having an information providing system 10 in the present embodiment.
  • the information providing system 10 is connected to a server (not shown) of a hospital A100 or hospital B200 via a network N such as a LAN (Local Area Network) or the Internet.
  • the server manages and processes personal information
  • Hospital A100 and hospital B200 correspond to examples of medical facilities.
  • the clinical laboratory center A500, clinical laboratory center B600, and clinical laboratory center C700 correspond to an example of a medical-related service providing facility.
  • the regional medical cooperation servers 300 and 400 correspond to an example of an information storage device that can be accessed by a terminal of a medical facility.
  • Each terminal in the hospital A100, the hospital B200, the clinical laboratory center A500, the clinical laboratory center B600, and the clinical laboratory center C700 performs the following processing.
  • the hospital A100, the hospital B200, and the clinical laboratory center A500 The clinical laboratory center B600 and the clinical laboratory center C700 will be described and illustrated on behalf of them.
  • a relay server may be installed as a security measure against viruses.
  • FIG. 2 is a schematic configuration diagram showing a hardware configuration of the information providing system 10 in the present embodiment.
  • the information providing system 10 includes an agreeer information processing server 800 and a medical related service information processing server 900.
  • the consenter information processing server 800 includes a CPU 800a, a memory 800b, an HDD (Hard Disk Drive) 800c, and a NIC (Network Interface Card) 800d.
  • the consenter information processing server 800 includes an consenter information DB (Database) 800e, a master DB 800f, and a conversion DB 800g.
  • the consenter information DB corresponds to an example of the consenter information storage unit.
  • the consenter information processing server 800 corresponds to an example of the consenter information extraction unit, the format conversion unit, and the master conversion unit.
  • the medical related service information processing server 900 corresponds to an example of an agreeer information specifying unit, a non-consent item deleting unit, and a medical information deleting unit.
  • the information providing system 10 corresponds to an example of a medical information transmission unit.
  • the medical related service information processing server 900 includes a CPU 900a, a memory 900b, an HDD 900c, and a NIC 900d. Furthermore, the medical related service information processing server 900 includes a clinical test center A clinical test result information DB 900e, a clinical test center B clinical test result information DB 900f, and a clinical test center C clinical test result information DB 900g.
  • the clinical test result information DB 900e for the clinical test center A, the clinical test result information DB 900f for the clinical test center B, and the clinical test result information DB 900g for the clinical test center C correspond to an example of a medical information storage unit.
  • the CPU 800a develops various application software stored in the HDD 800c in the memory 800b, and uses the various information stored in the consenter information DB 800e, the master DB 800f, and the conversion DB 800g, Various processes such as updating and format conversion of consenter information are executed.
  • the consenter information processing server 800 communicates with the medical related service information processing server 900, the clinical laboratory centers A500, B600, and C700 and the network N by the NIC 800d.
  • the CPU 900a develops various application software stored in the HDD 900c in the memory 900b, the clinical laboratory result information DB 900e for the clinical laboratory center A, and the clinical laboratory result information DB 900f for the clinical laboratory center B.
  • various information stored in the clinical test result information DB 900g for the clinical test center C various processes such as extraction and transmission of a medical facility code such as a hospital, and deletion of non-consent information are executed. Details of the various processes will be described later.
  • a doctor obtains in advance an agreement from an individual patient about sharing personal information and medical information with other medical facilities for regional medical cooperation.
  • the doctor also obtains consent from each patient about the use of the information providing system 10.
  • the hospital A100 and the hospital B200 separate the consenter's personal information from the medical information so that the personal information and the medical information are not linked.
  • the hospital A100 and the hospital B200 participate in regional medical cooperation and have access authority to the regional medical cooperation server 300.
  • the hospital A100 and the hospital B200 send the separated personal information and the consenter information including the items agreed by the consenter from the respective servers in the hospital A100 and the hospital B200 via the network N. It transmits to the cooperation server 300.
  • the regional medical cooperation server 300 stores consenter information of patients who have agreed to regional medical cooperation in the regional medical area to which the hospital A100 and the hospital B200 belong.
  • FIG. 3 shows the contents of personal information and consenter information stored in the regional medical cooperation servers 300 and 400 in a table format. As shown in FIG. 3, these pieces of information are classified into basic patient information, documents, treatment / medicine history, disease names, sample test results, image test results, progress tables, and regional cooperation paths.
  • the patient basic information is information for specifying an individual patient.
  • the document is detailed information of medical services that the patient has received in the past.
  • the treatment / medication history is information on a prescription drug, a doctor in charge, etc. received by the patient in the medical service.
  • the disease name is information on the patient's disease.
  • the sample test result is information regarding the sample test received by the patient.
  • the image inspection result is information regarding an image created when the patient has undergone MRI (Magnetic Resonance Imaging), endoscopy, or the like, a doctor's findings, and the like.
  • the progress table is progress information such as surgery performed by the patient.
  • the regional alliance path is a so-called regional alliance critical path. From the "acute period" when the patient develops to the "recovery period” during which intensive rehabilitation is performed, until the "maintenance period” during which rehabilitation is performed to maintain living functions. It is information on a medical treatment plan table for receiving uninterrupted treatment. Further, primary information and secondary information as detailed information of each classification are stored below these classifications. Description of these detailed information is omitted.
  • the consenter information of the patient who has agreed to the disclosure and sharing is accumulated.
  • the consenter information processing server 800 of the information providing system 10 periodically connects to the regional medical cooperation servers 300 and 400, and is newly added from the consenter information stored in the regional medical cooperation servers 300 and 400.
  • the consenter information is acquired, and the consenter information stored in the consenter information DB 800e of the consenter information processing server 800 is updated.
  • the consenter information processing server 800 specifies the consenter information newly added to the regional medical cooperation servers 300 and 400 by using a known technique such as obtaining a difference of the consenter information data.
  • the regional medical cooperation servers 300 and 400 may transmit the consenter information to the consenter information processing server 800 periodically.
  • FIG. 4 shows an example of items of the consenter information stored in the consenter information DB 800e in addition to the consenter information shown in FIG. 3 in the present embodiment. Therefore, the consenter information DB 800e includes a wide area ID, a regional medical cooperation server code, a regional medical cooperation ID, a medical facility code, a medical facility patient ID, and consent clinical examination items. Each consenter information is associated with each other as a set of a wide area ID, a regional medical cooperation server code, a regional medical cooperation ID, a medical facility code, a medical facility patient ID, and consent clinical examination items.
  • the wide area ID is identification information that can identify individual patients within each prefecture or within the regional medical area.
  • An example of the wide area ID is an insurer number.
  • the regional medical cooperation server code is identification information assigned to the regional medical cooperation server.
  • the regional medical cooperation ID is unique identification information that the regional medical cooperation servers 300 and 400 allocate so that individual patients can be identified.
  • the medical facility code is unique identification information assigned to each medical facility, in this embodiment, the hospital A100 and the hospital B200.
  • the medical facility patient ID is identification information that the hospital A100 and the hospital B200 each independently allocate so as to be able to identify a patient who receives a medical service.
  • the consent clinical test item is information indicating details of the consenter information of the patient. In this embodiment, among the consenter information shown in FIG. 3, information that the patient has agreed to is registered as the consent clinical test item, and information that the patient does not agree is excluded from the consent clinical test item.
  • the hospitals A100 and B200 which are medical facilities participating in the regional medical cooperation, are connected to the clinical laboratory centers A500, B600, and C700 that are medical-related service providers in the regional medical area to which the hospitals A100 and B200 belong. Entrust clinical testing. Then, the hospital A100 and the hospital B200 receive reports on the results of clinical tests performed by the clinical laboratory centers A500, B600, and C700.
  • the hospital A100 and the hospital B200 each assign an identification number or the like that can identify an individual patient to a patient who receives medical services. Therefore, the hospital A100 and the hospital B200 also transmit the patient identification number and the like to the clinical laboratory centers A500, B600, and C700 to which clinical examinations are entrusted.
  • the clinical laboratory centers A500, B600, and C700 transmit clinical laboratory results to the medical related service information processing server 900 in the information providing system 10.
  • the clinical laboratory centers A500, B600, and C700 do not have consenter information regarding the patient to be clinically tested. Therefore, the clinical laboratory centers A500, B600, and C700 uniformly transmit all clinical laboratory results.
  • the medical related service information processing server 900 includes a clinical laboratory result information DB 900e for the clinical laboratory center A, a clinical laboratory result information DB 900f for the clinical laboratory center B, and a clinical laboratory result information DB 900g for the clinical laboratory center C.
  • the clinical laboratory result information DB 900e for the clinical laboratory center A, the clinical laboratory result information DB 900f for the clinical laboratory center B, and the clinical laboratory result information DB 900g for the clinical laboratory center C are the clinical laboratory results assigned to the clinical laboratory centers A500, B600, and C700, respectively. It is a database for storing.
  • the clinical laboratory centers A500, B600, and C700 transmit all clinical laboratory results to the medical related service information processing server 900 installed in the information providing system 10.
  • each clinical laboratory center transmits the medical related service information processing server.
  • clinical laboratory results are sent to the clinical laboratory result information DB 900e for clinical laboratory center A, clinical laboratory result information DB 900f for clinical laboratory center B, and clinical laboratory result information DB 900g for clinical laboratory center C assigned to each clinical laboratory center.
  • each clinical laboratory center cannot obtain and view the clinical laboratory results of other clinical laboratory centers, and security for each clinical laboratory center is guaranteed. Therefore, the information providing system 10 can avoid the risk of information leakage and contamination of clinical test results.
  • FIG. 5 shows an example of items of clinical test results stored in the clinical test result DB 900e for the clinical test center A in this embodiment.
  • the clinical test result includes a medical facility code, a medical facility patient ID, and a clinical test content.
  • Each clinical test result is associated with a medical facility code, a medical facility patient ID, and a clinical test content as a set.
  • the medical facility code and the medical facility patient ID are the same as the information shown in FIG.
  • the contents of the clinical test are information on detailed information such as clinical tests commissioned by the clinical test center A500 from the hospital A100 and the hospital B200, clinical test results, and the like. Since the items of the clinical test results stored in the clinical test result DB 900f for the clinical test center B and the clinical test result information DB 900g for the clinical test center C are the same, the description thereof is omitted.
  • FIG. 6 shows a flowchart of the process of consenter information in the information providing system 10.
  • each step of the flowchart is abbreviated as S.
  • the flowchart illustrated in FIG. 6 is started.
  • the hospital A100 entrusts a clinical test to the clinical laboratory center A500, and after the clinical laboratory center A500 completes the clinical test, the clinical laboratory center A500 performs login processing to the medical-related service information processing server 900. The case where it went is demonstrated. The same applies to the description of the flowchart below.
  • clinical test result data from the clinical test center A500 is uploaded to the clinical test center A clinical test result information DB 900e.
  • the clinical test result data also includes medical facility code data received from the hospital A100 by the clinical test center A500. That is, in this embodiment, the medical facility code is identification information indicating the hospital A100.
  • the process proceeds to S102.
  • the medical facility code is extracted from the clinical test result uploaded to the clinical test center A clinical test result information DB 900e.
  • the process proceeds to S103.
  • the medical facility code is transmitted to the consenter information processing server 800 for inquiry processing to the consenter information DB 800e based on the medical facility code extracted from the clinical laboratory result information DB 900e for the clinical laboratory center A.
  • the consenter information processing server 800 refers to the received medical facility code with the consenter information stored in the consenter information DB. Thereby, the consenter information processing server 800 confirms whether or not the medical facility patient ID linked to the medical facility code exists.
  • the consenter information processing server 800 in S105, the regional medical cooperation server code and the regional medical cooperation ID associated with the medical facility patient ID.
  • the medical facility code, the medical facility patient ID, and the consent clinical test items are extracted and transmitted to the clinical test result information DB for each clinical test center.
  • the consenter information processing server 800 indicates that there is no corresponding consenter in the consenter information DB 800e in S106. 900 is notified.
  • the process of S105 or S106 is completed, the process of the flowchart shown in FIG. 6 ends.
  • description is abbreviate
  • the clinical laboratory result information DB 900e for the clinical laboratory center A receives the consenter out of the clinical laboratory results received from the clinical laboratory center A500 based on the consenter information received from the consenter information processing server 800 by the above processing.
  • the clinical test results of the corresponding patient and the clinical test results of the patient corresponding to the non-consent are selected.
  • FIG. 7 shows a flowchart regarding the selection process of the consenter and the non-agreeant in the clinical laboratory result information DB 900e for the clinical laboratory center A.
  • the clinical laboratory result information DB 900e for the clinical laboratory center A has received the extraction result of the above consenter information from the consenter information processing server 800, that is, has acquired data in S105, This flowchart is started when a notification that it does not exist is received.
  • the clinical laboratory result information DB 900e for the clinical laboratory center A uses the medical facility code transmitted to the consenter information processing server 800 in S103 for the consenter information received from the consenter information processing server 800. It is determined whether or not the associated medical facility patient ID exists.
  • the clinical laboratory result information DB 900e for the clinical laboratory center A advances the process to S202.
  • the clinical laboratory result information DB 900e for the clinical laboratory center A is a clinical facility having the medical facility patient ID determined to exist in S201 among the clinical laboratory results stored in the clinical laboratory result information DB 900e for the clinical laboratory center A.
  • the test result is determined to be a clinical test result corresponding to the consenter, and the clinical test result is held.
  • the clinical laboratory result information DB 900e for the clinical laboratory center A holds information corresponding to the consent clinical laboratory items received from the consenter information processing server 800 in S105 among the clinical laboratory results corresponding to the consenter. Then, the clinical laboratory result information DB 900e for the clinical laboratory center A deletes information that does not correspond to the consent clinical laboratory items from the clinical laboratory results.
  • the clinical laboratory result information DB 900e for the clinical laboratory center A is a medical facility other than the medical facility patient ID determined to exist in S201 among the clinical laboratory results stored in the clinical laboratory result information DB 900e for the clinical laboratory center A.
  • the clinical test result having the patient ID is determined to be a clinical test result corresponding to the non-consent, and the clinical test result is deleted.
  • the clinical laboratory result information DB 900e for the clinical laboratory center A ends this flowchart.
  • the clinical laboratory result information DB 900e for the clinical laboratory center A also ends this flowchart when the process of S202 is completed.
  • the medical-related service information processing server 900 performs the process of FIG. 7, and the clinical test result of the clinical test performed by the clinical test center A500 based on the commission by the hospital A100, That is, the clinical test result of the non-consent can be selected. Then, the medical related service information processing server 900 transmits the clinical test result of the consenter selected by the above processing to the regional medical cooperation server 300. Thereby, the regional medical cooperation server 300 can share the clinical test result of the consenter between the hospital A100 and the hospital B200.
  • the stored clinical test results may be converted into a master or format as described below, as necessary. Only the master or the format may be converted, or the master and the format may be converted.
  • the clinical test result of the consenter stored in the regional medical cooperation server 300 by the above processing can be shared with another regional medical cooperation server 400.
  • medical facilities and medical-related service providing facilities manage various information according to so-called masters that systematize codes related to medical terms, medicines, disease names, and the like.
  • masters that systematize codes related to medical terms, medicines, disease names, and the like.
  • the regional medical cooperation servers 300 and 400 employ different masters.
  • the formats used when the regional medical cooperation servers 300 and 400 provide information data to medical facilities, medical related service providing facilities, and the like, that is, the formats of electronic medical records, are also different.
  • the information providing system 10 can share clinical test results even when the masters and formats adopted by the regional medical cooperation servers 300 and 400 are different.
  • the conversion DB 800g of the consenter information processing server 800 stores various formats employed by medical facilities, medical-related service providing facilities, and the like that the information providing system 10 provides various information.
  • the conversion DB 800g manages each medical facility, each medical-related service providing facility, and the like in association with the adopted format.
  • the master DB 800f of the consenter information processing server 800 stores various masters adopted by medical facilities, medical-related service providing facilities, and the like that the information providing system 10 provides various information.
  • the master DB 800f manages each medical facility, each medical-related service providing facility, and the like associated with the adopted master.
  • FIG. 8 shows a flowchart when the information providing system 10 performs settings related to conversion of data of clinical test results in the present embodiment.
  • the conversion of medical information including clinical test results is a master conversion of the format of the master code and the report format, and a plurality of formats are used for each medical facility and medical-related service providing facility. Conversion to a format in which data can be shared at a facility in the country is called format conversion.
  • the medical-related service information processing server 900 inquires of the conversion DB 800g about the clinical test result sending destination, here, the method of editing the clinical test result data including the format adopted by the regional medical cooperation server 400.
  • the conversion DB 800g receives an inquiry about a data editing method from the medical related service information processing server 900, the conversion DB 800g confirms the format adopted in the regional medical cooperation server 400.
  • the conversion DB 800g confirms that the format exists, that is, it can cope with the editing method for the data requested by the regional medical cooperation server 400 (S302: Yes), information such as the confirmed format Is transmitted to the medical-related service information processing server 900.
  • the medical-related service information processing server 900 sets a data editing method based on information such as the format received from the conversion DB 800g.
  • the medical-related service information processing server 900 has information on the association between the master to which the clinical test result is compliant and the delivery destination of the clinical test result, here, the master adopted by the regional medical cooperation server 400. Queries the master DB 800f. That is, by confirming the association information, the medical related service information processing server 900 can convert the master adopted by the clinical test result transmission source into the master adopted by the clinical test result transmission destination.
  • the master DB 800f when the master DB 800f receives an inquiry about the master linking information from the medical related service information processing server 900, the master DB 800f adopts the master adopted by the source of the clinical test result to be converted and the destination of the clinical test result. Check if there is any linking information with the master.
  • the master DB 800f When the master DB 800f confirms that the master's association information exists (S402: Yes), the master DB 800f transmits the confirmed master's association information to the medical-related service information processing server 900. In step S ⁇ b> 403, the medical related service information processing server 900 sets the master association information received from the master DB 800 f to be used for conversion of clinical test results.
  • FIGS. 8 and 9 may be executed first or in parallel.
  • the information providing system 10 starts the process of the flowchart shown in FIG.
  • master conversion and format conversion may be executed by the consenter information processing server 800 or may be executed by the server 900.
  • the master DB 800f or the conversion DB 800g in the consenter information processing server 800 is inquired about an editing method, and as a result, the medical information is processed according to the method notified to the medical related service information processing server 900. Conversion is executed in the related service information processing server 900.
  • FIG. 10 is a flowchart illustrating an example of a case in which the medical-related service information processing server 900 of the information providing system 10 performs the master conversion after the format conversion in the clinical test result conversion processing in the present embodiment.
  • the medical related service information processing server 900 validates the data editing method such as the format set by the processing of the flowchart shown in FIG. Next, the process proceeds to S502.
  • the medical related service information processing server 900 validates the master linking information set by the processing of the flowchart shown in FIG. Next, the process proceeds to S503.
  • the medical related service information processing server 900 converts the clinical test result in accordance with the validated format or the master information.
  • the medical related service information processing server 900 obtains the converted clinical test result.
  • the clinical test result after conversion becomes a clinical test result based on the format or the master adopted by the regional medical cooperation server 400 here. Therefore, the regional medical cooperation server 400 can provide the hospital A100 and the hospital B200 also with the clinical test results with different formats and masters by the information providing system 10.
  • FIG. 11 shows a flowchart when the information providing system 10 transmits the clinical test result converted to the regional medical cooperation servers 300 and 400 in the present embodiment.
  • the case where the clinical test result converted for the regional medical cooperation server 400 as described above is transmitted to the regional medical cooperation server 400 will be described.
  • the medical-related service information processing server 900 when the medical-related service information processing server 900 generates converted clinical test result data by the process of the flowchart shown in FIG. 10, the information providing system 10 starts the process of the flowchart shown in FIG. .
  • the medical related service information processing server 900 transmits the data of the clinical test result after conversion to the consenter information processing server 800.
  • the consenter information processing server 800 receives the converted data.
  • the consenter information processing server 800 advances the processing to S603.
  • the consenter information processing server 800 transmits the conversion data received in S602 to the regional medical cooperation server 400.
  • the regional medical cooperation server 400 receives the conversion data.
  • the provision of medical services and medical-related services is one facility-complete type that completes all medical services and medical-related services within a single medical facility, such as the current one. It is conceivable that the number of distributed types will increase as medical facilities and a plurality of medical-related service facilities will be shared. Therefore, the number of cases where a single patient uses multiple medical facilities will increase further in the future, and the importance of managing personal information will increase further.
  • each medical facility is primarily responsible for obtaining consent individually, but the type of consent acquired also depends on the medical care to which the medical facility belongs. Consent to participate in regional medical cooperation in the area, consent to data sharing at multiple medical facilities, consent to secondary use of data in a form that separates personal information (cohort studies, etc.).
  • the consent content is not uniform, such as the fact that each item of medical record information, medication history, and clinical test results included in medical information may be agreed to share only specific items. It is possible that not only will increase, but the contents will become more complex in the future.
  • Physician associations, medical facilities, and healthcare-related service providers that control the medical sphere have restrictions on the information they can own and manage.
  • the medical facility can only grasp information about the patient at its own facility, and the medical association overseeing the medical sphere has only information about who is the consenter.
  • medical-related service providers for example, clinical laboratories cannot grasp the results of clinical tests at other facilities, and for clinical tests that have been commissioned, patient identification information such as patient names and clinical Although we know the test results, we cannot know which patients are the patients who have agreed to share medical information.
  • the above embodiment makes it easy to share data transmitted by a plurality of medical-related service providing facilities with a plurality of medical facilities. If it becomes easy for medical facilities and medical related service providing facilities to participate in such an integrated system, it becomes easier to construct a system in which more medical facilities and medical related service providing facilities cooperate.
  • the patient information integrated across the medical facilities can be referred to by the patient individually, which leads to improvement of patient convenience.
  • medical facilities and medical service providers can share high-efficiency medical information to support a high level of expertise that can cope with the advancement and complexity of medical care due to advances in medical technology and equipment. . As a result, it becomes possible to enjoy high-quality medical services efficiently.
  • the regional medical cooperation server is configured to accumulate patient information transmitted from a medical facility such as a hospital.
  • the information processing system receives patient information and receives a DB or the like. It is good also as a structure accumulate
  • a server for cohort research can be provided, and by the above configuration and processing, consenter information can also be shared in cohort research.
  • the medical information to be shared is not limited to this.
  • the medical information may include any of medical record information, receipt information, medical information, medical information, prevention information, health information, and welfare information.
  • the medical information is medical chart information
  • the medical information may include a clinical test result, a doctor's findings, a progress or result of treatment, a nursing record, a prescription, or a visit history.
  • a medical-related service falls under any of those listed in the Medical Law Enforcement Regulations, such as contracted clinical testing, dispensing pharmacy services, medical device sales / maintenance inspection, etc., it is transmitted from the medical-related service providing facility Information may be shared.
  • the structure of said embodiment can be made to respond
  • a system that can predict future diseases by designing an algorithm that combines medical record information, medical information, medical information, prevention information, health information, clinical test results, doctor's findings, progress and results of treatment, etc. Can also be built.
  • a case is assumed in which medical information is shared across medical areas when the patient uses medical facilities in different medical areas.
  • medical information and a medical-related service can be efficiently provided by sharing medical information among a plurality of medical facilities in different medical areas.
  • different regional medical spheres that is, operated by a medical association, etc.
  • the regional medical cooperation servers in the respective regional medical areas can share medical information via the information providing system of the above embodiment.
  • a server may be provided for wide area connection that can be connected to these regional medical cooperation servers, and this wide area cooperation server may relay each regional medical cooperation server and the information providing system.
  • the information providing system may be configured to perform this relay.
  • the regional medical cooperation servers 300 and 400 transmit medical information to the wide area cooperation server via the medical information to the information providing system 10 and share the medical information between the regional medical cooperation servers 300 and 400.
  • the clinical test result transmitted from the clinical laboratory center A500 to the information providing system 10 is shared by the regional medical cooperation server and further shared by the wide area medical cooperation server.
  • clinical test results are transmitted from the regional medical cooperation server to the test result information DB for the test center A.
  • the clinical test result also includes a regional medical cooperation server code, a regional medical cooperation ID, and a wide area ID.
  • FIG. 14 is a schematic configuration diagram showing a hardware configuration of the information providing system 10 in the present embodiment.
  • the medical related service information processing server 900 is a regional medical cooperation server that can be accessed by the regional medical cooperation server 300 clinical test result information DB 900 h accessible by the regional medical cooperation server 300 and the regional medical cooperation server 400. 400 clinical test result information DB 900i is provided.
  • the regional medical cooperation server code is transmitted to the consenter information processing server 800 for inquiry processing to the consenter information DB 800e based on the regional medical cooperation server code extracted from the clinical test result information DB 900h for the regional medical cooperation server 300. Is done.
  • the consenter information processing server 800 inquires the received regional medical cooperation server code with the consenter information stored in the consenter information DB. Thereby, the consenter information processing server 800 confirms whether or not the wide area ID associated with the regional medical cooperation server code exists.
  • the consenter information processing server 800 in S705, the regional medical cooperation server code, the regional medical cooperation ID, and the medical facility code associated with the wide area ID.
  • the medical facility patient ID and consent clinical examination items are extracted and transmitted to the clinical examination result information DB for each regional medical cooperation server.
  • the consenter information processing server 800 indicates that the corresponding wide-area ID does not exist in the consenter information DB 800e in S706. Notify the result information DB 900h.
  • FIG. 13 shows a flowchart regarding the selection process of the consenter and the non-agreeant in the clinical test result information DB 900h for the regional medical cooperation server 300.
  • the clinical examination result information DB 900h for the regional medical cooperation server 300 has received the extraction result of the above-mentioned consenter information from the consenter information processing server 800, that is, acquired data in S705 or a wide area ID in S706. This flowchart is started when a notification to the effect that no exists is received.
  • the clinical examination result information DB 900h for the regional medical cooperation server 300 transmits the local medical cooperation transmitted from the consenter information processing server 800 to the consenter information processing server 800 in step S703. It is determined whether or not a wide area ID associated with the server code exists.
  • the clinical test result information DB 900h for the regional medical cooperation server 300 advances the process to S802.
  • the clinical test result information DB 900h for the regional medical cooperation server 300 is the clinical ID having the wide area ID determined to exist in S801 among the clinical test results stored in the clinical test result information DB 900h for the regional medical cooperation server 300.
  • the test result is determined to be a clinical test result corresponding to the consenter, and the clinical test result is held.
  • the clinical test result information DB 900h for the regional medical cooperation server 300 holds information corresponding to the consent clinical test item received from the consenter information processing server 800 in S705 among the clinical test results corresponding to the consenter. Then, the clinical test result information DB 900h for the regional medical cooperation server 300 deletes information that does not correspond to the agreed clinical test items from the clinical test results.
  • the clinical examination result information DB 900h for the regional medical cooperation server 300 is a wide area ID other than the wide area ID determined to exist in S801 among the clinical examination results stored in the clinical examination result information DB 900h for the regional medical cooperation server 300. Is determined to be a clinical test result corresponding to a non-consent, and the clinical test result is deleted.
  • the clinical test result information DB 900h for the regional medical cooperation server 300 ends this flowchart.
  • the clinical test result information DB 900h for the regional medical cooperation server 300 also ends this flowchart when the process of S802 is completed.
  • the configuration and processing of the present embodiment are the same as in FIG. 1 except that the above-mentioned regional medical cooperation server 300 belongs to a medical area and the regional medical cooperation server 400 belongs to another medical area. Since the specific configuration and processing of the embodiment shown in FIG. 11 are the same, detailed description thereof is omitted.
  • telemedicine refers to an act of performing medical care using a communication technology such as the Internet at a distance between a doctor and a patient.
  • a communication technology such as the Internet
  • the present invention can be used mainly in telediagnosis.
  • telemedicine can be effective not only for sparsely populated areas but also for patients who are difficult to visit hospitals, such as doctors can diagnose patients before they become serious. It is done.
  • it can be used for sharing medical information in the same medical facility, for example, in one hospital.
  • medical information can be shared using the configuration of the above embodiment.
  • the results output by different clinical laboratory instruments are integrated and shared, for example, in a medical facility such as a large hospital, an X-ray diagnostic apparatus, an X-ray CT apparatus, a magnetic resonance imaging apparatus, a nuclear medicine apparatus, an ultrasonic diagnostic apparatus, etc. It can be used when there are a plurality of clinical laboratory instruments that output clinical laboratory results in various formats.
  • the above regional medical cooperation servers 300 and 400 are considered as cooperation servers belonging to one hospital, and the hospital A100 and hospital B200 are considered as respective clinical departments in the hospital, and the information providing system 10
  • the network N is the same as the specific configuration and processing of the above-described embodiment except that the network N is arranged in the hospital, and detailed description thereof is omitted.
  • regional medical cooperation refers to sharing medical information associated with medical services and medical-related services provided for patients using a plurality of different medical facilities.
  • the Ministry of Health, Labor and Welfare Includes the provision of medical services and medical-related services by linking medical facilities in the primary to tertiary medical areas and medical-related service providing facilities.
  • they may be referred to as wide-area medical collaborations.
  • target consenter information not only specific regional medical cooperation such as wide area medical cooperation and regional medical cooperation in Japan but also medical information in a wide range using insurer database, national database and global database. Sharing is also possible.
  • the content of the consenter's consent varies depending on the type of consent to be obtained. For example, consent to participate in regional medical cooperation in the medical area to which the medical facility providing the service belongs, consent to share medical information in multiple medical facilities, secondary medical information in a form where personal information is separated Consent to use (such as cohort studies) is included.
  • the contents of the consent of the consenter can further include information on organ donation, living will refusal of life extension, dignity death, and the like.
  • the consenter information includes a number assigned to each medical facility, a number assigned to each patient by each medical facility, and from the primary to which the medical facility belongs as necessary.
  • a tertiary medical zone number can be added.
  • the medical facility information is associated with the number assigned to each medical facility
  • the patient identification information is associated with the number assigned to the patient by each medical facility.
  • the wide area ID is an insurer number as an example, but a number assigned to each area, for example, a prefectural number, a country code, a national number, an international number, or a combination thereof is used. There are also things.
  • the consenter information DB is installed and operated separately from the medical information DB.
  • the consenter information DB may be installed in the same server as the medical information DB or may be installed in another server.
  • the consenter information DB is preferably installed in another server of the medical information DB. This is particularly effective when medical information is shared across multiple regions as described above.
  • the medical service in the above description may include an act of performing diagnosis or treatment using a biological sample in the biobank or information related thereto.
  • medical-related services include biobanks and biobank information system operations.
  • the biobank refers to a biological sample derived from a provider belonging to a certain group or a part of the group or information related thereto
  • the biobank information system refers to the biological sample of the biobank or information related thereto. Refers to the accumulation of information stored in a systematized system.
  • a medical-related service providing facility a facility that manages and operates a biobank information system can be cited.
  • information related to biological samples which is handled in the biobank and the biobank information system, in medical information shared among a plurality of medical facilities.
  • Information related to biological samples includes, for example, genome and its mutation information, protein, sugar chain, information obtained by metabolomic analysis, bioimaging information, information on separated microorganisms, and a combination of these information.
  • the individuals in the personal information handled in the biobank and the biobank information system include medical information providers and patients who receive diagnosis and treatment by doctors.
  • the present invention is particularly effective when applied to a case where there are a plurality of medical-related service providing facilities that provide operation of the biobank and the biobank information system.
  • the biological samples and medical information are derived from the same medical information provider, the medical information held in the respective medical related service providing facilities may not be unified and may not completely match.
  • the above problems may occur.
  • the method of the present invention such a problem may occur. The problem can also be solved.
  • an area in regional medical cooperation refers to an area (for example, a medical area or the like) that forms a group or organization under a certain agreement and includes a plurality of medical facilities and medical related service providing facilities ).
  • the set area is a municipality unit, a prefecture unit, a country unit, an organization formed for a specific purpose or a study group unit, etc.
  • size, the range, etc. are not limited, What is necessary is just to include several medical facilities and medical related service provision facilities.
  • An information storage device having a medical information storage unit can be installed for each unit for which provision of medical information is desired, and the medical information in this embodiment is controlled by installing the information storage device for each unit. It becomes possible to share.
  • the above-described embodiment can be realized for a medical information provider in place of or in addition to the patient. Therefore, individuals including at least a patient or a medical information provider can appropriately select the usage of the medical information to be shared according to the form of providing the medical service or the medical related service.

Abstract

In the present invention, an information processing system is configured to be provided with: an assenter information storage unit for storing assenter information extracted from an information storage device accessible by a terminal of a medical facility, in which information medical facility information and patient identification information are linked; a medical information storage unit accessible by a terminal of a medical-related-service-providing facility requested for a medical-related service from the medical facility, and used for storing medical information in which the medical facility information, the patient identification information, and information about the requested medical-related service are linked; an assenter information extraction unit for extracting, from the assenter information stored in the assenter information storage unit, assenter information having the medical facility information stored in the medical information storage unit; an assenter information specification unit for specifying, from among the medical information, medical information having the patient identification information of the extracted assenter information; and a medical information transmission unit for transmitting the specified medical information to the information storage device.

Description

情報提供システム及び情報提供システムの制御方法Information providing system and information providing system control method
　本発明は、医療情報の情報提供システム及び情報提供システムの制御方法に関する。 The present invention relates to an information providing system for medical information and a control method for the information providing system.
　日々技術的進化を遂げている質の良い医療サービスには、多くの人びとがそのサービスを享受できる仕組みが必要である。一方で医療費を含む社会保障費の増加を背景として、不必要な出費を抑える医療費抑制の動きが出てきており、品質だけでなく効率的に医療サービスを提供することの重要性が求められてきている。 A high-quality medical service that is undergoing technological evolution every day requires a mechanism that allows many people to enjoy the service. On the other hand, against the backdrop of an increase in social security costs including medical expenses, there has been a movement to curb medical expenses to reduce unnecessary expenses, and the importance of providing medical services efficiently as well as quality is required. It has been.
　そして、医療費抑制の施策としては、例えば、地域医療連携という考えに基づいて、特定の医療圏内における各種医療施設の連携による医療サービス及び医療関連サービスの提供が試みられている。 And, as a measure to control medical expenses, for example, based on the idea of regional medical cooperation, attempts have been made to provide medical services and medical-related services by cooperation of various medical facilities in a specific medical area.
　地域医療連携とは、特定の医療圏に属する医療施設がそれぞれの機能や規模といった特色について、地域医療の状況に応じて機能分担や専門化を進め、患者が継続性のある適切な医療サービスを受けられるようにするものである。 With regional medical cooperation, the medical facilities belonging to a specific medical area will advance the function sharing and specialization according to the situation of the local medical care regarding the features such as their functions and scale, and patients will provide appropriate medical services with continuity. It is intended to be received.
　地域医療連携では、医療施設どうしだけでなく、医療施設と他の医療関連サービス提供施設、例えば臨床検査施設や調剤薬局などとの連携においても効果が期待される。医療関連サービスが臨床検査である場合を例に取ると、現在、臨床検査は、そのほとんどが地域内の中核病院や大規模な臨床検査施設において実施されている。患者が受診した診療所から依頼を受けて中核病院で臨床検査が実施される場合、あるいは、診療所や中核病院から依頼を受けて臨床検査施設で臨床検査が実施される場合など、実施の形態は様々である。 Regional medical cooperation is expected to be effective not only in medical facilities but also in cooperation between medical facilities and other medical-related service providing facilities such as clinical laboratory facilities and dispensing pharmacies. Taking the case where the medical-related service is a clinical laboratory as an example, most clinical laboratories are currently performed in core hospitals and large clinical laboratories in the region. An embodiment in which a clinical test is performed at a core hospital upon receiving a request from a clinic where a patient has consulted, or a clinical test is performed at a clinical laboratory in response to a request from a clinic or core hospital Are various.
　異なる医療施設どうしが連携して医療情報を共有することで、複数の医療施設を利用する患者についての医療情報、例えば臨床検査結果や投薬履歴などをそれぞれの医療施設で共有することができるため、効率的に医療サービスを提供することが可能となる。 By sharing medical information between different medical facilities, medical information about patients who use multiple medical facilities, such as clinical test results and medication history, can be shared with each medical facility. It becomes possible to provide medical services efficiently.
　医療情報の管理は地域医療連携を達成するためのツールの１つとして検討されているが、これには、ＩＴ（Information Technology）の持つ情報統合力を利用した各地域医療圏における医療情報を共有する共通情報基盤が求められる。 Management of medical information is being considered as one of the tools to achieve regional medical cooperation, but this involves sharing medical information in each regional medical area using information integration technology of IT (Information Technology). A common information infrastructure is required.
　ネットワークを介した医療情報の送受信に関しては、医療施設と端末とをネットワークで接続し、医療行為に関連する情報を医療施設内の管理システムからネットワークを介して端末に送信すること（特許文献１）や、複数の医療施設の医療情報システムにおける医療情報を、ネットワークを介して一元管理する医療情報管理システム（特許文献２）や、個人情報保護手段を備えた医療情報管理システム（特許文献３）が提案されている。 Regarding transmission / reception of medical information via a network, a medical facility and a terminal are connected via a network, and information related to medical practice is transmitted from the management system in the medical facility to the terminal via the network (Patent Document 1). And a medical information management system (Patent Document 2) that centrally manages medical information in a medical information system of a plurality of medical facilities via a network, and a medical information management system (Patent Document 3) provided with personal information protection means. Proposed.
特開２００４－１１０８１８号公報JP 2004-110818 A 特開２００５－１６５４４２号公報JP 2005-165442 A 特開２００２－３４２４９２号公報JP 2002-342492 A
　しかし、特許文献１に掲載された検査システムなどは、患者が主とする臨床検査施設以外の委託臨床検査施設において臨床検査を受けた場合に、臨床検査結果が主臨床検査施設以外の委託臨床検査施設の臨床検査用端末から主臨床検査施設の臨床検査用端末に転送される。さらに、臨床検査結果は、医療施設の医師用端末に通知され、電子カルテシステムに転送される。すなわち、患者の臨床検査が複数の臨床検査施設によって行われる場合を考慮したものではない。 However, the test system disclosed in Patent Document 1 is such that when a patient undergoes a clinical test at a contracted clinical laboratory other than the main clinical laboratory, the clinical test result is a contracted clinical test other than the main clinical laboratory. It is transferred from the clinical testing terminal of the facility to the clinical testing terminal of the main clinical laboratory. Furthermore, the clinical test result is notified to the doctor terminal in the medical facility and transferred to the electronic medical record system. That is, it does not consider the case where a patient's clinical examination is performed by a plurality of clinical examination facilities.
　また、特許文献２では、ネットワークを介して医療情報を一元管理し、個人情報保護手段を備える医療情報管理システムについて開示されている。しかし、この方法では、データベースへのアクセス権限を医療情報を登録した医療施設に制限する形を取っており、データベースには不同意患者の医療情報までもが含まれる可能性がある。そして、新たに地域医療連携に参加した施設にはアクセス権限がないことになり、多数の医療施設間で医療情報を共有するという目的を達成しえない。 Patent Document 2 discloses a medical information management system that centrally manages medical information via a network and includes personal information protection means. However, in this method, the access right to the database is limited to the medical facility in which the medical information is registered, and there is a possibility that even the medical information of the disagreement patient is included in the database. In addition, facilities newly participating in regional medical cooperation have no access authority, and the purpose of sharing medical information among many medical facilities cannot be achieved.
　さらに、特許文献３には、複数の医療施設の医療情報システムにおける医療情報を、ネットワークを介して一元管理する医療情報管理システムについて記載されている。当該医療情報管理システムでは、複数の医療施設がそれぞれ独自に保有している患者情報が統合・管理され、データベースへのアクセス制限が行われ、個人認証に基づいて医療情報が提供される。しかし、このような医療情報管理システムでは、個人情報と医療情報とが切り分けられていない点、個人情報の開示に不同意の患者の情報を破棄していない点などから、個人情報漏洩のリスクが捨てきれない。また、医療施設が医療情報管理システムに対して情報を直接登録するため、複数の臨床検査施設において実施された臨床検査結果を一元管理することは想定されていない。したがって、このような医療情報管理システムでも、共有される医療情報量が不十分であると言わざるを得ず、利便性の高いサービスの提供は望めない。 Furthermore, Patent Document 3 describes a medical information management system that centrally manages medical information in medical information systems of a plurality of medical facilities via a network. In the medical information management system, patient information that each of a plurality of medical facilities individually has is integrated and managed, access to a database is restricted, and medical information is provided based on personal authentication. However, in such a medical information management system, there is a risk of personal information leakage because personal information and medical information are not separated, and information on patients who disagree with disclosure of personal information is not discarded. I can't throw it away. In addition, since the medical facility directly registers information in the medical information management system, it is not assumed that the clinical test results performed in a plurality of clinical laboratory facilities are managed in an integrated manner. Therefore, even in such a medical information management system, it must be said that the amount of shared medical information is insufficient, and it is not possible to provide a highly convenient service.
　本件開示の技術は、上記の事情に鑑みてなされたものであり、その目的とするところは、医療関連サービスを提供する複数の医療施設が作成した医療情報を、個人情報を保護しつつ、多様なフォーマットで複数の医療施設に提供することができるシステムを実現することである。 The technology disclosed in the present disclosure has been made in view of the above circumstances, and the purpose thereof is to provide a variety of medical information created by a plurality of medical facilities providing medical-related services while protecting personal information. Is to realize a system that can be provided to a plurality of medical facilities in a simple format.
　一実施形態による情報提供システムは、医療施設の端末がアクセス可能な情報記憶装置から抽出された、医療施設情報と患者の識別情報とが紐付けられた同意者情報を記憶する同意者情報記憶部と、医療施設から医療関連サービスを依頼された医療関連サービス提供施設の端末がアクセス可能な医療情報記憶部であって、医療施設情報と患者の識別情報と依頼された医療関連サービスの情報とが紐付けられた医療情報を記憶する医療情報記憶部と、同意者情報記憶部に記憶した同意者情報から、医療情報記憶部に記憶した医療施設情報を有する同意者情報を抽出する同意者情報抽出部と、医療情報のうち、抽出した同意者情報の患者の識別情報を有する医療情報を特定する同意者情報特定部と、特定した医療情報を情報記憶装置に送信する医療情報送信部とを備える。これにより、医療関連サービス提供施設が提供する臨床検査結果などの医療情報を複数の医療施設で共有させることが可能になる。 An information providing system according to an embodiment includes a consenter information storage unit that stores consenter information in which medical facility information and patient identification information are associated and extracted from an information storage device accessible by a terminal of a medical facility A medical information storage unit accessible by a terminal of a medical service providing facility requested by a medical facility, wherein medical facility information, patient identification information, and requested medical service information Consent person information extraction which extracts medical person information which has medical facility information memorized in medical information storage part from medical information memory part which memorizes linked medical information, and consenter information memorized in consenter information memory part Part, the consenter information specifying part for specifying the medical information having the patient identification information of the extracted consenter information among the medical information, and the specified medical information are transmitted to the information storage device And a care information transmitting unit. Thereby, it is possible to share medical information such as clinical test results provided by the medical-related service providing facility among a plurality of medical facilities.
　また、一実施形態による情報提供システムは、同意者情報記憶部に記憶される同意者情報は、患者が同意しない項目が医療施設情報及び患者の識別情報と紐付けられており、特定した医療情報から、抽出した同意者情報に含まれる患者が同意しない項目を削除する非同意項目削除部をさらに備える。さらに、一実施形態による情報提供システムは、医療情報のうち、特定した医療情報以外の医療情報を削除する医療情報削除部をさらに備える。これにより、患者が同意しない項目や非同意者情報を削除することで同意者情報の保守及び管理の信頼性を高めることができる。 Further, in the information providing system according to the embodiment, the consenter information stored in the consenter information storage unit is such that items that the patient does not agree are associated with the medical facility information and the patient identification information. To a non-consent item deletion unit that deletes items that the patient does not agree with included in the extracted consenter information. Furthermore, the information provision system by one Embodiment is further provided with the medical information deletion part which deletes medical information other than the specified medical information among medical information. Thereby, the reliability of maintenance and management of the consenter information can be enhanced by deleting the items that the patient does not agree and the non-agreement information.
　そして、一実施形態による情報提供システムは、特定した医療情報のフォーマットを変換するフォーマット変換部をさらに備え、医療情報送信部は、フォーマットを変換した医療情報を送信する。また、一実施形態による情報提供システムは、前記特定した医療情報のマスターを変換するマスター変換部をさらに備え、医療情報送信部は、マスターを変換した医療情報を送信する。これにより、当該情報提供システムを利用する複数の医療施設などがそれぞれ異なるフォーマットやマスターを採用していても、医療施設側がフォーマットやマスターを変更することなく、これら医療施設間で医療情報を共有させることができる。 The information providing system according to the embodiment further includes a format conversion unit that converts the format of the specified medical information, and the medical information transmission unit transmits the medical information whose format has been converted. Moreover, the information provision system by one Embodiment is further provided with the master conversion part which converts the master of the specified said medical information, and a medical information transmission part transmits the medical information which converted the master. As a result, even if a plurality of medical facilities using the information providing system adopt different formats and masters, the medical facility can share medical information between these medical facilities without changing the format or master. be able to.
　さらに、医療情報は、カルテ情報、レセプト情報、医学情報、予防健康情報、福祉情報、バイオバンクの生物試料に関連する情報のいずれかを含む。また、医療情報がカルテ情報であり、カルテ情報は、臨床検査結果、医師の所見、治療の経過や結果、看護記録、処方箋、通院履歴のいずれかを含む。これにより、上記情報提供システムにおいて、これらの医療情報を組み合わせるアルゴリズムを設計することで、将来の疾病について予測することが可能なシステムを構築することもできる。 Furthermore, medical information includes any of medical record information, receipt information, medical information, preventive health information, welfare information, and information related to biological samples of Biobank. The medical information is medical chart information, and the medical chart information includes any of clinical test results, doctor's findings, progress and results of treatment, nursing records, prescriptions, and outpatient histories. Thereby, in the information providing system, a system capable of predicting a future disease can be constructed by designing an algorithm that combines these medical information.
　次いで、一実施形態による情報提供システムの制御方法は、医療施設の端末がアクセス可能な情報記憶装置から抽出された、医療施設情報と患者の識別情報とが紐付けられた同意者情報を同意者情報記憶部に記憶し、医療施設から医療関連サービスを依頼された医療関連サービス提供施設の端末がアクセス可能な医療情報記憶部に、医療施設情報と患者の識別情報と依頼された医療関連サービスの情報とが紐付けられた医療情報を記憶し、同意者情報記憶部に記憶した同意者情報から、医療情報記憶部に記憶した医療施設情報を有する同意者情報を抽出し、医療情報のうち、抽出した同意者情報に対応する患者の識別情報を有する医療情報を特定し、特定した医療情報を情報記憶装置に送信する。 Next, the control method of the information providing system according to the embodiment includes the consenter information obtained by associating the medical facility information and the patient identification information extracted from the information storage device accessible by the medical facility terminal. The medical information storage unit stores the medical facility information, the identification information of the patient, and the requested medical related service in the medical information storage unit that is stored in the information storage unit and accessible by the terminal of the medical related service providing facility requested by the medical facility. The medical information associated with the information is stored, and from the consenter information stored in the consenter information storage unit, the consenter information having the medical facility information stored in the medical information storage unit is extracted, and among the medical information, Medical information having patient identification information corresponding to the extracted consenter information is specified, and the specified medical information is transmitted to the information storage device.
　また、一実施形態による情報提供システムの制御方法は、同意者情報記憶部に記憶される同意者情報は、患者が同意しない項目が医療施設情報及び患者の識別情報と紐付けられており、特定した医療情報から、抽出した同意者情報に含まれる患者が同意しない項目を削除する。さらに、一実施形態による情報提供システムの制御方法は、医療情報のうち、特定した医療情報以外の医療情報を削除する。 In addition, according to the control method of the information providing system according to the embodiment, the consenter information stored in the consenter information storage unit is such that items that the patient does not agree are associated with the medical facility information and the patient identification information. Items that the patient does not consent to are included in the extracted consenter information is deleted from the medical information. Furthermore, the control method of the information provision system by one Embodiment deletes medical information other than the specified medical information among medical information.
　そして、一実施形態による情報提供システムの制御方法は、特定した医療情報のフォーマットを変換し、フォーマットを変換した医療情報を送信する。また、一実施形態によるによる情報提供システムの制御方法は、特定した医療情報のマスターを変換し、マスターを変換した医療情報を送信する。 And the control method of the information provision system by one Embodiment converts the format of the specified medical information, and transmits the medical information which converted the format. The information providing system control method according to the embodiment converts the specified medical information master, and transmits the medical information converted from the master.
　さらに、医療情報は、カルテ情報、レセプト情報、医学情報、予防健康情報、福祉情報、バイオバンクの生物試料に関連する情報のいずれかを含む。また、医療情報がカルテ情報であり、カルテ情報は、臨床検査結果、医師の所見、治療の経過や結果、看護記録、処方箋、通院履歴のいずれかを含む。 Furthermore, medical information includes any of medical record information, receipt information, medical information, preventive health information, welfare information, and information related to biological samples of Biobank. The medical information is medical chart information, and the medical chart information includes any of clinical test results, doctor's findings, progress and results of treatment, nursing records, prescriptions, and outpatient histories.
　また、別の実施形態による情報提供システムは、医療施設の端末がアクセス可能な情報記憶装置から抽出された、医療施設情報と少なくとも患者又は医療情報提供者を含む個人の識別情報とが紐付けられた同意者情報を記憶する同意者情報記憶部と、医療施設から医療関連サービスを依頼された医療関連サービス提供施設の端末がアクセス可能な医療情報記憶部であって、医療施設情報と個人の識別情報と依頼された医療関連サービスの情報とが紐付けられた医療情報を記憶する医療情報記憶部と、同意者情報記憶部に記憶した同意者情報から、医療情報記憶部に記憶した医療施設情報を有する同意者情報を抽出する同意者情報抽出部と、医療情報のうち、抽出した同意者情報の個人の識別情報を有する医療情報を特定する同意者情報特定部と、特定した医療情報を情報記憶装置に送信する医療情報送信部とを備える。 Further, in the information providing system according to another embodiment, the medical facility information extracted from the information storage device accessible by the terminal of the medical facility is associated with identification information of an individual including at least a patient or a medical information provider. The consenter information storage unit for storing the consenter information and the medical information storage unit accessible by the terminal of the medical service providing facility for which the medical service is requested from the medical facility, and identifying the medical facility information and the individual Medical facility information stored in the medical information storage unit from the medical information storage unit that stores the medical information in which the information and the requested medical-related service information are associated, and the consenter information stored in the consenter information storage unit The consenter information extraction unit for extracting the consenter information having the information, and the consenter information specification for identifying the medical information having the personal identification information of the extracted consenter information among the medical information When, and a medical information transmitting unit for transmitting the identified medical information in the information storage device.
　さらに別の実施形態による情報提供システムの制御方法は、医療施設の端末がアクセス可能な情報記憶装置から抽出された、医療施設情報と少なくとも患者又は医療情報提供者を含む個人の識別情報とが紐付けられた同意者情報を同意者情報記憶部に記憶し、医療施設から医療関連サービスを依頼された医療関連サービス提供施設の端末がアクセス可能な医療情報記憶部に、医療施設情報と個人の識別情報と依頼された医療関連サービスの情報とが紐付けられた医療情報を記憶し、同意者情報記憶部に記憶した同意者情報から、医療情報記憶部に記憶した医療施設情報を有する同意者情報を抽出し、医療情報のうち、抽出した同意者情報に対応する個人の識別情報を有する医療情報を特定し、特定した医療情報を情報記憶装置に送信する。 According to still another embodiment of the present invention, there is provided a method for controlling an information providing system, wherein medical facility information extracted from an information storage device accessible by a medical facility terminal is associated with identification information of an individual including at least a patient or a medical information provider. The attached consenter information is stored in the consenter information storage unit, and the medical facility information and the individual identification are stored in the medical information storage unit accessible by the terminal of the medical service providing facility requested by the medical facility. Information about the medical facility in which the information related to the requested medical-related service is stored, and the consenter information having the medical facility information stored in the medical information storage unit from the consenter information stored in the consenter information storage unit The medical information having personal identification information corresponding to the extracted consenter information is specified from the medical information, and the specified medical information is transmitted to the information storage device.
　そして、医療サービスを提供する複数の医療施設が作成した医療情報を共有可能にする場合にも、上記の情報提供システムまたは情報提供システムの制御方法を適用することで、個人情報を保護しつつ複数の医療施設間で医療情報を共有することができる。 Even when medical information created by a plurality of medical facilities providing medical services can be shared, by applying the information providing system or the control method of the information providing system, a plurality of information can be protected while protecting personal information. Medical information can be shared between medical facilities.
　上記の実施形態によれば、医療関連サービスを提供する複数の医療施設が作成した医療情報を、個人情報を保護して複数の医療施設間で共有可能にする情報提供システム及び情報提供システムの制御方法が実現される。 According to the above-described embodiment, the information providing system and the control of the information providing system that can share medical information created by a plurality of medical facilities that provide medical related services while protecting personal information among the plurality of medical facilities. A method is realized.
図１は、一実施形態における情報提供システムを有する地域医療連携の概略の構成を示す図である。FIG. 1 is a diagram illustrating a schematic configuration of regional medical cooperation having an information providing system according to an embodiment. 図２は、一実施形態における情報提供システムの概略のハードウェア構成を示す図である。FIG. 2 is a diagram illustrating a schematic hardware configuration of an information providing system according to an embodiment. 図３は、一実施形態において、地域医療連携サーバーが蓄積する個人情報と同意者情報の内容を表形式で示す図である。FIG. 3 is a diagram illustrating the contents of personal information and consenter information stored in the regional medical cooperation server in a tabular format according to an embodiment. 図４は、一実施形態において、同意者情報ＤＢに格納される同意者情報の項目の一例を示す図である。FIG. 4 is a diagram illustrating an example of items of the consenter information stored in the consenter information DB according to the embodiment. 図５は、一実施形態において、臨床検査センター用の臨床検査結果情報ＤＢに格納される臨床検査結果の項目の一例を示す図である。FIG. 5 is a diagram illustrating an example of items of clinical test results stored in the clinical test result information DB for the clinical test center in one embodiment. 図６は、一実施形態において、情報提供システムが実行する処理のフローチャートを示す図である。FIG. 6 is a diagram illustrating a flowchart of processing executed by the information providing system in one embodiment. 図７は、一実施形態において、情報提供システムが実行する処理のフローチャートを示す図である。FIG. 7 is a diagram illustrating a flowchart of processing executed by the information providing system in one embodiment. 図８は、一実施形態において、情報提供システムが実行する処理のフローチャートを示す図である。FIG. 8 is a diagram illustrating a flowchart of processing executed by the information providing system in one embodiment. 図９は、一実施形態において、情報提供システムが実行する処理のフローチャートを示す図である。FIG. 9 is a diagram illustrating a flowchart of processing executed by the information providing system in one embodiment. 図１０は、一実施形態において、情報提供システムが実行する処理のフローチャートを示す図である。FIG. 10 is a diagram illustrating a flowchart of processing executed by the information providing system in one embodiment. 図１１は、一実施形態において、情報提供システム及び地域医療連携サーバーが実行する処理のフローチャートを示す図である。FIG. 11 is a diagram illustrating a flowchart of processing executed by the information providing system and the regional medical cooperation server in the embodiment. 図１２は、別の実施形態において、情報提供システムが実行する処理のフローチャートを示す図である。FIG. 12 is a diagram illustrating a flowchart of processing executed by the information providing system in another embodiment. 図１３は、別の実施形態において、情報提供システムが実行する処理のフローチャートを示す図である。FIG. 13 is a diagram illustrating a flowchart of processing executed by the information providing system in another embodiment. 図１４は、別の実施形態における情報提供システムの概略のハードウェア構成を示す図である。FIG. 14 is a diagram illustrating a schematic hardware configuration of an information providing system according to another embodiment.
　以下、実施形態に係る情報提供システムについて、図面を参照しながら説明する。ただし、本実施形態は情報提供システムの一例を示すものであって、以下に説明する構成に限定されるものではない。また、以下の説明において、サーバー、ネットワーク、システムなどの用語の定義に関しては、現在のコンピュータサイエンスなどの分野で広く一般的に使用されている用語と同じ意味である。 Hereinafter, the information providing system according to the embodiment will be described with reference to the drawings. However, this embodiment shows an example of an information providing system, and is not limited to the configuration described below. In the following description, terms such as server, network, and system have the same meaning as terms that are widely used in the field of computer science or the like.
　また、医療サービスとは、医師による診断や治療などを実施する行為をいう。医療施設とは、主に医療サービスを提供する施設をいい、診療所や病院などが含まれる。医療関連サービスとは、医療サービス以外の医療に関連するサービスであって、例えば、臨床検査受託、調剤薬局業務、医療機器の販売・保守点検など、医療法施行規則に挙げられるものであればよい。医療関連サービス提供施設とは、医療関連サービスを提供する施設をいい、例えば、臨床検査施設や臨床検査センターなどが含まれる。病院などの医療施設内に、臨床検査施設、例えば、臨床検査センターや共同利用施設などの医療関連サービス提供施設が存在する場合もある。 Also, medical service refers to the act of conducting diagnosis and treatment by a doctor. Medical facilities mainly mean facilities that provide medical services, and include clinics and hospitals. Medical-related services are services related to medical services other than medical services, and may be any services that are listed in the Enforcement Regulations of the Medical Law, such as contract clinical testing, dispensing pharmacy services, and sales / maintenance inspection of medical devices. . The medical-related service providing facility refers to a facility that provides a medical-related service, and includes, for example, a clinical laboratory and a clinical laboratory center. In some medical facilities such as hospitals, there are cases where clinical testing facilities, for example, medical related service providing facilities such as clinical testing centers and shared use facilities exist.
　次に、医療情報とは、カルテ情報やレセプト情報、健診情報などが挙げられる。カルテ情報とは、臨床検査結果、医師の所見、治療の経過や結果、看護記録などが含まれる。さらに、医療情報には、医療施設から提供される、医療施設情報、臨床検査や診断、治療の方法そのものに加えてそのメリットやデメリットが記載された医学情報や、予防接種、感染症の流行状況、食中毒の予防法、といった予防情報や健康情報、退院後の在宅看護や介護情報、経済的あるいは心理的サポートなど、治療以外のアフターケアについての福祉情報が含まれ、医療関連サービス施設から提供される各種情報も含まれる。本実施形態により、複数の医療施設間で、例えば、上記の臨床検査結果、処方箋、カルテ内容や通院歴などの医療情報を簡便にかつ個人情報漏洩のリスク無く共有することが可能となる。 Next, medical information includes medical record information, receipt information, and medical examination information. The medical record information includes clinical test results, doctor's findings, progress and results of treatment, nursing records, and the like. In addition, medical information includes medical facility information provided by medical facilities, medical information that describes the merits and demerits in addition to the methods of clinical examinations, diagnosis, and treatment, vaccinations, and prevalence of infectious diseases. Welfare information about aftercare other than treatment, such as prevention information and health information such as prevention of food poisoning, home care and care information after discharge, economic and psychological support, etc. Various information is also included. According to the present embodiment, for example, medical information such as the above-described clinical test results, prescriptions, medical chart contents, and hospital history can be easily shared between a plurality of medical facilities without risk of personal information leakage.
　そして、個人情報とは、特定の個人を識別することができる情報であって、例えば、個人情報の保護に関する法律により定義される情報が含まれる。また、複数の情報の組み合わせにより、その個人を特定し得る情報も個人情報に含まれる。例えば、氏名、性別、生年月日、住所、住民票コード、保険証番号、携帯電話の番号、勤務場所、職業、年収、家族構成、写真、指紋、静脈パターン、虹彩、ＤＮＡの塩基配列などの生体情報、コンピュータのＩＰアドレスやリモートホストに関する情報などが挙げられる。指紋、静脈パターン、虹彩、ＤＮＡの塩基配列などの生体情報については、個人情報として扱われる場合があるが、本実施形態においては、これらは医療情報にも含まれる情報とする。 The personal information is information that can identify a specific individual and includes, for example, information defined by a law relating to the protection of personal information. In addition, information that can identify the individual by combining a plurality of pieces of information is also included in the personal information. For example, name, gender, date of birth, address, resident card code, insurance card number, mobile phone number, working place, occupation, annual income, family structure, photograph, fingerprint, vein pattern, iris, DNA base sequence, etc. Examples include biometric information, computer IP addresses, and information on remote hosts. Biometric information such as fingerprints, vein patterns, irises, and DNA base sequences may be handled as personal information, but in the present embodiment, these are information included in medical information.
　本実施形態において、地域医療連携とは、異なる複数の医療施設を利用する患者について提供される医療サービスや医療関連サービスに伴う医療情報を共有することをさし、例えば、厚生労働省が指定する、一次から三次の各医療圏内の医療施設どうしと医療関連サービス提供施設どうしとが連携し合い、医療サービスや医療関連サービスを提供することなどが含まれる。 In this embodiment, regional medical cooperation refers to sharing medical information associated with medical services and medical-related services provided for patients using a plurality of different medical facilities, for example, designated by the Ministry of Health, Labor and Welfare. This includes providing medical services and medical-related services by linking medical facilities in the primary to tertiary medical areas and medical-related service providing facilities.
　また、同意者とは、医療サービスあるいは医療関連サービスを受ける際に、受けるサービスの方針について十分な説明を受けた上で、正しく理解し、納得し、賛成した患者をいう。同意者の同意の内容は、取得する同意の種類によって異なる。例えば、当該サービスを提供する医療施設が属する医療圏における地域医療連携への参加への同意、複数の医療施設における医療情報共有への同意、個人情報が切り離された形での医療情報の二次活用（コホート研究など）への同意が含まれる。同意の種類は、患者によるサービスの利用形態に応じて適宜選択される。例えば、個々の患者は、共有される医療情報の内容について、全てについて同意することもできるし、一部についてのみ同意することもできる。例えば、患者は、医療情報のうちカルテ情報、投薬履歴、臨床検査結果の特定の項目についてのみ共有に同意するなど、医療サービスあるいは医療関連サービスの提供の形態に応じて、同意の内容を適宜選択することができる。 Also, the consenter refers to a patient who has received a sufficient explanation about the policy of the service to receive when receiving a medical service or a medical-related service, and that correctly understands, agrees with, and agrees with. The content of the consenter's consent varies depending on the type of consent to be obtained. For example, consent to participate in regional medical cooperation in the medical area to which the medical facility providing the service belongs, consent to share medical information in multiple medical facilities, secondary medical information in a form where personal information is separated Consent to use (such as cohort studies) is included. The type of consent is appropriately selected according to the use form of the service by the patient. For example, individual patients can agree on all or some of the contents of the shared medical information. For example, the patient appropriately selects the content of consent according to the form of provision of medical service or medical related service, such as agreeing to share only specific items of medical record information, medication history, clinical test results among medical information can do.
　本実施形態では、同意者情報は、医療施設ごとに割り振られた番号、各医療施設が患者に対して割り振った番号を含み、必要に応じて医療施設が属する一次から三次の医療圏の番号を付加することができる。また、同意した医療情報の内容について番号をつけて付加することもできる。特に、一部の項目についてのみ同意する患者の場合には同意した医療情報の項目についての情報を付加することができる。 In the present embodiment, the consenter information includes a number assigned to each medical facility, a number assigned to each patient by each medical facility, and the numbers of primary to tertiary medical areas to which the medical facility belongs as necessary. Can be added. In addition, the contents of the agreed medical information can be added with a number. In particular, in the case of a patient who agrees only on some items, information on items of medical information that have been agreed can be added.
　以下の説明では、医療情報が臨床検査結果である場合の臨床検査結果の共有について説明する。ただし、これは一例であって、本実施形態の範囲はこれに限定されるものではない。 In the following explanation, sharing of clinical test results when medical information is clinical test results will be described. However, this is an example, and the scope of the present embodiment is not limited to this.
　図１は、本実施形態において、情報提供システム１０を有する地域医療連携の概略の構成を示す図である。図１に示すように、情報提供システム１０は、ＬＡＮ（Local Area Network）やインターネットなどのネットワークＮを経由して病院Ａ１００や病院Ｂ２００のサーバー（図示せず）と接続する。当該サーバーは、各病院で医療サービスを受ける患者に関する個人情報や医療情報などを管理及び処理する。また、情報提供システム１０は、ネットワークＮを経由して地域医療連携サーバー３００、４００とも接続する。さらに、情報提供システム１０は、ネットワーク（図示せず）を経由して臨床検査センターＡ５００、臨床検査センターＢ６００、臨床検査センターＣ７００とそれぞれ接続されている。なお、図１は本実施形態の一例を示すものであり、病院、臨床検査センター、地域医療連携サーバーの数はこれに限れられない。なお、病院Ａ１００、病院Ｂ２００が、医療施設の一例に相当する。また、臨床検査センターＡ５００、臨床検査センターＢ６００、臨床検査センターＣ７００が、医療関連サービス提供施設の一例に相当する。そして、地域医療連携サーバー３００、４００が、医療施設の端末がアクセス可能な情報記憶装置の一例に相当する。なお、病院Ａ１００、病院Ｂ２００、臨床検査センターＡ５００、臨床検査センターＢ６００、臨床検査センターＣ７００内の各端末が以下の処理を行うが、以下の説明においては、病院Ａ１００、病院Ｂ２００、臨床検査センターＡ５００、臨床検査センターＢ６００、臨床検査センターＣ７００に代表させて説明及び図示する。　更に、ウイルスなどに対するセキュリティ対策として中継サーバーを設置してもよい。 FIG. 1 is a diagram showing a schematic configuration of regional medical cooperation having an information providing system 10 in the present embodiment. As shown in FIG. 1, the information providing system 10 is connected to a server (not shown) of a hospital A100 or hospital B200 via a network N such as a LAN (Local Area Network) or the Internet. The server manages and processes personal information and medical information related to patients who receive medical services at each hospital. The information providing system 10 is also connected to the regional medical cooperation servers 300 and 400 via the network N. Further, the information providing system 10 is connected to a clinical laboratory center A 500, a clinical laboratory center B 600, and a clinical laboratory center C 700 through a network (not shown). FIG. 1 shows an example of this embodiment, and the number of hospitals, clinical examination centers, and regional medical cooperation servers is not limited to this. Hospital A100 and hospital B200 correspond to examples of medical facilities. The clinical laboratory center A500, clinical laboratory center B600, and clinical laboratory center C700 correspond to an example of a medical-related service providing facility. The regional medical cooperation servers 300 and 400 correspond to an example of an information storage device that can be accessed by a terminal of a medical facility. Each terminal in the hospital A100, the hospital B200, the clinical laboratory center A500, the clinical laboratory center B600, and the clinical laboratory center C700 performs the following processing. In the following description, the hospital A100, the hospital B200, and the clinical laboratory center A500 The clinical laboratory center B600 and the clinical laboratory center C700 will be described and illustrated on behalf of them. Furthermore, a relay server may be installed as a security measure against viruses.
　図２は、本実施形態における情報提供システム１０のハードウェア構成を示す概略構成図である。図２に示すように、情報提供システム１０は、同意者情報処理サーバー８００及び医療関連サービス情報処理サーバー９００を備える。同意者情報処理サーバー８００は、ＣＰＵ８００ａ、メモリ８００ｂ、ＨＤＤ（Hard Disk Drive）８００ｃ、ＮＩＣ（Network Interface Card）８００ｄを有する。さらに、同意者情報処理サーバー８００は、同意者情報ＤＢ（Database）８００ｅ、マスターＤＢ８００ｆ、変換ＤＢ８００ｇを備える。なお、同意者情報ＤＢが、同意者情報記憶部の一例に相当する。また、同意者情報処理サーバー８００が、同意者情報抽出部、フォーマット変換部、マスター変換部の一例に相当する。また、医療関連サービス情報処理サーバー９００が、同意者情報特定部、非同意項目削除部、医療情報削除部の一例に相当する。また、情報提供システム１０が、医療情報送信部の一例に相当する。 FIG. 2 is a schematic configuration diagram showing a hardware configuration of the information providing system 10 in the present embodiment. As shown in FIG. 2, the information providing system 10 includes an agreeer information processing server 800 and a medical related service information processing server 900. The consenter information processing server 800 includes a CPU 800a, a memory 800b, an HDD (Hard Disk Drive) 800c, and a NIC (Network Interface Card) 800d. Further, the consenter information processing server 800 includes an consenter information DB (Database) 800e, a master DB 800f, and a conversion DB 800g. The consenter information DB corresponds to an example of the consenter information storage unit. Further, the consenter information processing server 800 corresponds to an example of the consenter information extraction unit, the format conversion unit, and the master conversion unit. Further, the medical related service information processing server 900 corresponds to an example of an agreeer information specifying unit, a non-consent item deleting unit, and a medical information deleting unit. The information providing system 10 corresponds to an example of a medical information transmission unit.
　また、医療関連サービス情報処理サーバー９００は、ＣＰＵ９００ａ、メモリ９００ｂ、ＨＤＤ９００ｃ、ＮＩＣ９００ｄを有する。さらに、医療関連サービス情報処理サーバー９００は、臨床検査センターＡ用臨床検査結果情報ＤＢ９００ｅ、臨床検査センターＢ用臨床検査結果情報ＤＢ９００ｆ、臨床検査センターＣ用臨床検査結果情報ＤＢ９００ｇを備える。なお臨床検査センターＡ用臨床検査結果情報ＤＢ９００ｅ、臨床検査センターＢ用臨床検査結果情報ＤＢ９００ｆ、臨床検査センターＣ用臨床検査結果情報ＤＢ９００ｇが、医療情報記憶部の一例に相当する。 The medical related service information processing server 900 includes a CPU 900a, a memory 900b, an HDD 900c, and a NIC 900d. Furthermore, the medical related service information processing server 900 includes a clinical test center A clinical test result information DB 900e, a clinical test center B clinical test result information DB 900f, and a clinical test center C clinical test result information DB 900g. The clinical test result information DB 900e for the clinical test center A, the clinical test result information DB 900f for the clinical test center B, and the clinical test result information DB 900g for the clinical test center C correspond to an example of a medical information storage unit.
　同意者情報処理サーバー８００では、ＣＰＵ８００ａが、ＨＤＤ８００ｃに格納された各種アプリケーションソフトウェアをメモリ８００ｂに展開し、同意者情報ＤＢ８００ｅ、マスターＤＢ８００ｆ、変換ＤＢ８００ｇに格納された各種情報を用いて、同意者情報の更新や同意者情報のフォーマット変換などの種々の処理を実行する。また、同意者情報処理サーバー８００は、ＮＩＣ８００ｄによって医療関連サービス情報処理サーバー９００や臨床検査センターＡ５００、Ｂ６００、Ｃ７００やネットワークＮに対する通信を行う。 In the consenter information processing server 800, the CPU 800a develops various application software stored in the HDD 800c in the memory 800b, and uses the various information stored in the consenter information DB 800e, the master DB 800f, and the conversion DB 800g, Various processes such as updating and format conversion of consenter information are executed. The consenter information processing server 800 communicates with the medical related service information processing server 900, the clinical laboratory centers A500, B600, and C700 and the network N by the NIC 800d.
　また、医療関連サービス情報処理サーバー９００では、ＣＰＵ９００ａが、ＨＤＤ９００ｃに格納された各種アプリケーションソフトウェアをメモリ９００ｂに展開し、臨床検査センターＡ用臨床検査結果情報ＤＢ９００ｅ、臨床検査センターＢ用臨床検査結果情報ＤＢ９００ｆ、臨床検査センターＣ用臨床検査結果情報ＤＢ９００ｇに格納された各種情報を用いて、病院などの医療施設コードの抽出や送信、非同意者情報の削除など、種々の処理を実行する。上記の各種処理の詳細については後述する。 In the medical related service information processing server 900, the CPU 900a develops various application software stored in the HDD 900c in the memory 900b, the clinical laboratory result information DB 900e for the clinical laboratory center A, and the clinical laboratory result information DB 900f for the clinical laboratory center B. Using various information stored in the clinical test result information DB 900g for the clinical test center C, various processes such as extraction and transmission of a medical facility code such as a hospital, and deletion of non-consent information are executed. Details of the various processes will be described later.
　本実施形態においては、あらかじめ、病院Ａ１００、病院Ｂ２００において、医師が個々の患者から、地域医療連携のために個人情報や医療情報を他の医療施設と共有することについての同意を得る。また、医師は各患者から情報提供システム１０の利用についての同意も得る。そして、病院Ａ１００、病院Ｂ２００は、同意者の個人情報と医療情報との切り離しを行い、個人情報と医療情報とが紐付けされない状態にする。本実施形態では、病院Ａ１００、病院Ｂ２００は、地域医療連携に参加し、地域医療連携サーバー３００へのアクセス権限を有する。次に、病院Ａ１００、病院Ｂ２００は、切り離された個人情報と、同意者の同意した項目を含む同意者情報とを、病院Ａ１００、病院Ｂ２００内のそれぞれのサーバーからネットワークＮを経由して地域医療連携サーバー３００に送信する。地域医療連携サーバー３００には、病院Ａ１００と病院Ｂ２００が所属する地域医療圏における地域医療連携に同意した患者の同意者情報が蓄積される。 In this embodiment, in hospital A100 and hospital B200, a doctor obtains in advance an agreement from an individual patient about sharing personal information and medical information with other medical facilities for regional medical cooperation. The doctor also obtains consent from each patient about the use of the information providing system 10. Then, the hospital A100 and the hospital B200 separate the consenter's personal information from the medical information so that the personal information and the medical information are not linked. In this embodiment, the hospital A100 and the hospital B200 participate in regional medical cooperation and have access authority to the regional medical cooperation server 300. Next, the hospital A100 and the hospital B200 send the separated personal information and the consenter information including the items agreed by the consenter from the respective servers in the hospital A100 and the hospital B200 via the network N. It transmits to the cooperation server 300. The regional medical cooperation server 300 stores consenter information of patients who have agreed to regional medical cooperation in the regional medical area to which the hospital A100 and the hospital B200 belong.
　図３に、地域医療連携サーバー３００、４００が蓄積する個人情報と同意者情報の内容を表形式で示す。図３に示すように、これらの情報は、患者基本情報、文書、処置・投薬履歴、病名、検体検査結果、画像検査結果、経過表、地域連携パスに分類されている。患者基本情報は、患者個人を特定するための情報である。文書は、患者が過去に受けた医療サービスの詳細情報である。処置・投薬履歴は、患者が医療サービスにおいて受けた処方薬や担当医などに関する情報である。病名は、患者の疾患に関する情報である。検体検査結果は、患者が受けた検体検査に関する情報である。画像検査結果は、患者がＭＲＩ（Magnetic Resonance Imaging）や内視鏡検査などを受けた際に作成された画像や医師の所見などに関する情報である。経過表は、患者が受けた手術などの経過情報である。地域連携パスは、いわゆる地域連携クリティカルパスであり、患者が、発症した「急性期」から集中的なリハビリなどを行う「回復期」、生活機能維持のためのリハビリをする「維持期」まで、切れ目のない治療を受けるための診療計画表に関する情報である。そして、これらの各分類の下位に、各分類の詳細情報としての１次情報や２次情報が格納されている。これらの詳細情報については、説明を省略する。これらの開示及び共有について同意した患者の同意者情報が蓄積される。 FIG. 3 shows the contents of personal information and consenter information stored in the regional medical cooperation servers 300 and 400 in a table format. As shown in FIG. 3, these pieces of information are classified into basic patient information, documents, treatment / medicine history, disease names, sample test results, image test results, progress tables, and regional cooperation paths. The patient basic information is information for specifying an individual patient. The document is detailed information of medical services that the patient has received in the past. The treatment / medication history is information on a prescription drug, a doctor in charge, etc. received by the patient in the medical service. The disease name is information on the patient's disease. The sample test result is information regarding the sample test received by the patient. The image inspection result is information regarding an image created when the patient has undergone MRI (Magnetic Resonance Imaging), endoscopy, or the like, a doctor's findings, and the like. The progress table is progress information such as surgery performed by the patient. The regional alliance path is a so-called regional alliance critical path. From the "acute period" when the patient develops to the "recovery period" during which intensive rehabilitation is performed, until the "maintenance period" during which rehabilitation is performed to maintain living functions. It is information on a medical treatment plan table for receiving uninterrupted treatment. Further, primary information and secondary information as detailed information of each classification are stored below these classifications. Description of these detailed information is omitted. The consenter information of the patient who has agreed to the disclosure and sharing is accumulated.
　情報提供システム１０の同意者情報処理サーバー８００は、定期的に地域医療連携サーバー３００、４００に接続し、地域医療連携サーバー３００、４００に蓄積された同意者情報の中から、新たに追加された同意者情報を取得して、同意者情報処理サーバー８００の同意者情報ＤＢ８００ｅに格納されている同意者情報を更新する。なお、同意者情報処理サーバー８００は、同意者情報データの差分を取るなど、周知の技術を用いて、地域医療連携サーバー３００、４００に新たに追加された同意者情報を特定する。あるいは、地域医療連携サーバー３００、４００が、定期的に同意者情報処理サーバー８００に同意者情報を送信する構成としてもよい。 The consenter information processing server 800 of the information providing system 10 periodically connects to the regional medical cooperation servers 300 and 400, and is newly added from the consenter information stored in the regional medical cooperation servers 300 and 400. The consenter information is acquired, and the consenter information stored in the consenter information DB 800e of the consenter information processing server 800 is updated. The consenter information processing server 800 specifies the consenter information newly added to the regional medical cooperation servers 300 and 400 by using a known technique such as obtaining a difference of the consenter information data. Alternatively, the regional medical cooperation servers 300 and 400 may transmit the consenter information to the consenter information processing server 800 periodically.
　図４に、本実施形態において、図３に示した同意者情報の他に同意者情報ＤＢ８００ｅに格納される同意者情報の項目の一例を示す。したがって、同意者情報ＤＢ８００ｅには、広域ＩＤ、地域医療連携サーバーコード、地域医療連携ＩＤ、医療施設コード、医療施設患者ＩＤ、同意臨床検査項目も含まれる。各同意者情報は、広域ＩＤ、地域医療連携サーバーコード、地域医療連携ＩＤ、医療施設コード、医療施設患者ＩＤ、同意臨床検査項目が一組として互いに紐付けられている。広域ＩＤは、各都道府県内や地域医療圏内において個々の患者を識別可能な識別情報である。広域ＩＤの一例としては、保険者番号などが挙げられる。地域医療連携サーバーコードは、地域医療連携サーバーに割り振られた識別情報である。地域医療連携ＩＤは、地域医療連携サーバー３００、４００が、個々の患者を識別可能に割り振る独自の識別情報である。医療施設コードは、各医療施設、本実施形態においては病院Ａ１００と病院Ｂ２００に割り振られた一意の識別情報である。医療施設患者ＩＤは、本実施形態においては病院Ａ１００や病院Ｂ２００がそれぞれ独自に、医療サービスを受ける患者を識別可能に割り振る識別情報である。同意臨床検査項目は、患者の同意者情報の詳細を示す情報である。本実施形態においては、図３に示す同意者情報のうち、患者が同意した情報が同意臨床検査項目として登録され、患者が同意しない情報は同意臨床検査項目から除外される。 FIG. 4 shows an example of items of the consenter information stored in the consenter information DB 800e in addition to the consenter information shown in FIG. 3 in the present embodiment. Therefore, the consenter information DB 800e includes a wide area ID, a regional medical cooperation server code, a regional medical cooperation ID, a medical facility code, a medical facility patient ID, and consent clinical examination items. Each consenter information is associated with each other as a set of a wide area ID, a regional medical cooperation server code, a regional medical cooperation ID, a medical facility code, a medical facility patient ID, and consent clinical examination items. The wide area ID is identification information that can identify individual patients within each prefecture or within the regional medical area. An example of the wide area ID is an insurer number. The regional medical cooperation server code is identification information assigned to the regional medical cooperation server. The regional medical cooperation ID is unique identification information that the regional medical cooperation servers 300 and 400 allocate so that individual patients can be identified. The medical facility code is unique identification information assigned to each medical facility, in this embodiment, the hospital A100 and the hospital B200. In the present embodiment, the medical facility patient ID is identification information that the hospital A100 and the hospital B200 each independently allocate so as to be able to identify a patient who receives a medical service. The consent clinical test item is information indicating details of the consenter information of the patient. In this embodiment, among the consenter information shown in FIG. 3, information that the patient has agreed to is registered as the consent clinical test item, and information that the patient does not agree is excluded from the consent clinical test item.
　ここで、地域医療連携に参加している医療施設である病院Ａ１００や病院Ｂ２００は、病院Ａ１００や病院Ｂ２００が所属する地域医療圏内の医療関連サービス提供者である臨床検査センターＡ５００、Ｂ６００、Ｃ７００に臨床検査を委託する。そして、当該病院Ａ１００や病院Ｂ２００は、臨床検査センターＡ５００、Ｂ６００、Ｃ７００が実施した臨床検査の結果の報告を受ける。本実施形態では、病院Ａ１００、病院Ｂ２００は、医療サービスを受ける患者に対して、個々の患者を識別可能な識別番号などをそれぞれ割り振る。そこで、病院Ａ１００、病院Ｂ２００は、臨床検査の委託先の臨床検査センターＡ５００、Ｂ６００、Ｃ７００に、患者の識別番号なども送信する。 Here, the hospitals A100 and B200, which are medical facilities participating in the regional medical cooperation, are connected to the clinical laboratory centers A500, B600, and C700 that are medical-related service providers in the regional medical area to which the hospitals A100 and B200 belong. Entrust clinical testing. Then, the hospital A100 and the hospital B200 receive reports on the results of clinical tests performed by the clinical laboratory centers A500, B600, and C700. In the present embodiment, the hospital A100 and the hospital B200 each assign an identification number or the like that can identify an individual patient to a patient who receives medical services. Therefore, the hospital A100 and the hospital B200 also transmit the patient identification number and the like to the clinical laboratory centers A500, B600, and C700 to which clinical examinations are entrusted.
　一方、臨床検査センターＡ５００、Ｂ６００、Ｃ７００は、臨床検査結果を情報提供システム１０内の医療関連サービス情報処理サーバー９００に送信する。このとき、臨床検査センターＡ５００、Ｂ６００、Ｃ７００は、臨床検査対象の患者に関する同意者情報を持ち合わせていない。そこで、臨床検査センターＡ５００、Ｂ６００、Ｃ７００は、一律にすべての臨床検査結果を送信する。本実施形態においては、医療関連サービス情報処理サーバー９００が臨床検査センターＡ用臨床検査結果情報ＤＢ９００ｅ、臨床検査センターＢ用臨床検査結果情報ＤＢ９００ｆ、臨床検査センターＣ用臨床検査結果情報ＤＢ９００ｇを備える。臨床検査センターＡ用臨床検査結果情報ＤＢ９００ｅ、臨床検査センターＢ用臨床検査結果情報ＤＢ９００ｆ、臨床検査センターＣ用臨床検査結果情報ＤＢ９００ｇは、臨床検査センターＡ５００、Ｂ６００、Ｃ７００にそれぞれ割り当てられた臨床検査結果の格納用のデータベースである。 Meanwhile, the clinical laboratory centers A500, B600, and C700 transmit clinical laboratory results to the medical related service information processing server 900 in the information providing system 10. At this time, the clinical laboratory centers A500, B600, and C700 do not have consenter information regarding the patient to be clinically tested. Therefore, the clinical laboratory centers A500, B600, and C700 uniformly transmit all clinical laboratory results. In the present embodiment, the medical related service information processing server 900 includes a clinical laboratory result information DB 900e for the clinical laboratory center A, a clinical laboratory result information DB 900f for the clinical laboratory center B, and a clinical laboratory result information DB 900g for the clinical laboratory center C. The clinical laboratory result information DB 900e for the clinical laboratory center A, the clinical laboratory result information DB 900f for the clinical laboratory center B, and the clinical laboratory result information DB 900g for the clinical laboratory center C are the clinical laboratory results assigned to the clinical laboratory centers A500, B600, and C700, respectively. It is a database for storing.
　臨床検査センターＡ５００、Ｂ６００、Ｃ７００は、は全ての臨床検査結果を情報提供システム１０に設置された医療関連サービス情報処理サーバー９００に送信するが、このとき各臨床検査センターは医療関連サービス情報処理サーバー９００内で、臨床検査センターごとに割り当てられた臨床検査センターＡ用臨床検査結果情報ＤＢ９００ｅ、臨床検査センターＢ用臨床検査結果情報ＤＢ９００ｆ、臨床検査センターＣ用臨床検査結果情報ＤＢ９００ｇに臨床検査結果を送信する。これにより、各臨床検査センターは他の臨床検査センターの臨床検査結果を取得し閲覧することができない、臨床検査センターごとのセキュリティが保証された状態となる。したがって、情報提供システム１０により、臨床検査結果の情報漏洩リスク、コンタミリスクを回避することができる。 The clinical laboratory centers A500, B600, and C700 transmit all clinical laboratory results to the medical related service information processing server 900 installed in the information providing system 10. At this time, each clinical laboratory center transmits the medical related service information processing server. In 900, clinical laboratory results are sent to the clinical laboratory result information DB 900e for clinical laboratory center A, clinical laboratory result information DB 900f for clinical laboratory center B, and clinical laboratory result information DB 900g for clinical laboratory center C assigned to each clinical laboratory center. To do. As a result, each clinical laboratory center cannot obtain and view the clinical laboratory results of other clinical laboratory centers, and security for each clinical laboratory center is guaranteed. Therefore, the information providing system 10 can avoid the risk of information leakage and contamination of clinical test results.
　図５に、本実施形態において、臨床検査センターＡ用臨床検査結果ＤＢ９００ｅに格納される臨床検査結果の項目の一例を示す。図５に示すように、臨床検査結果には、医療施設コード、医療施設患者ＩＤ、臨床検査内容が含まれる。各臨床検査結果は、医療施設コード、医療施設患者ＩＤ、臨床検査内容が一組として互いに紐付けられている。医療施設コード及び医療施設患者ＩＤは、それぞれ図４に示す情報と同じであるため説明を省略する。また、臨床検査内容は、臨床検査センターＡ５００が病院Ａ１００や病院Ｂ２００から委託された臨床検査などの詳細情報や臨床検査結果などに関する情報である。なお、臨床検査センターＢ用臨床検査結果ＤＢ９００ｆ及び臨床検査センターＣ用臨床検査結果情報ＤＢ９００ｇに格納される臨床検査結果の項目も同じであるため、説明は省略する。 FIG. 5 shows an example of items of clinical test results stored in the clinical test result DB 900e for the clinical test center A in this embodiment. As illustrated in FIG. 5, the clinical test result includes a medical facility code, a medical facility patient ID, and a clinical test content. Each clinical test result is associated with a medical facility code, a medical facility patient ID, and a clinical test content as a set. The medical facility code and the medical facility patient ID are the same as the information shown in FIG. Further, the contents of the clinical test are information on detailed information such as clinical tests commissioned by the clinical test center A500 from the hospital A100 and the hospital B200, clinical test results, and the like. Since the items of the clinical test results stored in the clinical test result DB 900f for the clinical test center B and the clinical test result information DB 900g for the clinical test center C are the same, the description thereof is omitted.
　次に、地域医療連携サーバー３００、４００に蓄積された同意者情報と、情報提供システム１０の医療関連サービス情報処理サーバー９００の各臨床検査センター用に設けられた臨床検査結果情報ＤＢ、すなわち臨床検査センターＡ用臨床検査結果情報ＤＢ９００ｅ、臨床検査センターＢ用臨床検査結果情報ＤＢ９００ｆ、臨床検査センターＣ用臨床検査結果情報ＤＢ９００ｇに蓄積された臨床検査結果とを照合して、患者が同意者であるか否かを判定する処理について説明する。 Next, the consenter information accumulated in the regional medical cooperation servers 300 and 400, and the clinical test result information DB provided for each clinical test center of the medical-related service information processing server 900 of the information providing system 10, that is, clinical test Whether the patient is the consenter by comparing the clinical test results accumulated in the clinical test result information DB 900e for the center A, the clinical test result information DB 900f for the clinical test center B, and the clinical test result information DB 900g for the clinical test center C Processing for determining whether or not will be described.
　図６に、情報提供システム１０における同意者情報の処理のフローチャートを示す。なお、以下の説明では、フローチャートの各ステップをＳと略記する。本実施形態では、臨床検査センターＡ５００、Ｂ６００、Ｃ７００のいずれかが医療関連サービス情報処理サーバー９００にアクセスしてログイン処理が完了すると、図６に示すフローチャートが開始される。ここでは、一例として、病院Ａ１００が臨床検査センターＡ５００に臨床検査を委託し、臨床検査センターＡ５００が当該臨床検査を完了した後、臨床検査センターＡ５００が医療関連サービス情報処理サーバー９００へのログイン処理を行った場合について説明する。以下のフローチャートの説明でも同様とする。 FIG. 6 shows a flowchart of the process of consenter information in the information providing system 10. In the following description, each step of the flowchart is abbreviated as S. In the present embodiment, when any of the clinical laboratory centers A500, B600, and C700 accesses the medical related service information processing server 900 and the login process is completed, the flowchart illustrated in FIG. 6 is started. Here, as an example, the hospital A100 entrusts a clinical test to the clinical laboratory center A500, and after the clinical laboratory center A500 completes the clinical test, the clinical laboratory center A500 performs login processing to the medical-related service information processing server 900. The case where it went is demonstrated. The same applies to the description of the flowchart below.
　まず、Ｓ１０１では、臨床検査センターＡ５００からの臨床検査結果データが臨床検査センターＡ用臨床検査結果情報ＤＢ９００ｅにアップロードされる。当該臨床検査結果データには、臨床検査センターＡ５００が病院Ａ１００から受信した、医療施設コードのデータも含まれる。すなわち、本実施形態では、医療施設コードは病院Ａ１００を示す識別情報である。臨床検査センターＡ５００が、当該臨床検査結果データのアップロードが完了すると、処理はＳ１０２に進む。Ｓ１０２では、臨床検査センターＡ用臨床検査結果情報ＤＢ９００ｅにアップロードされた臨床検査結果から医療施設コードが抽出される。次いで、処理はＳ１０３に進む。 First, in S101, clinical test result data from the clinical test center A500 is uploaded to the clinical test center A clinical test result information DB 900e. The clinical test result data also includes medical facility code data received from the hospital A100 by the clinical test center A500. That is, in this embodiment, the medical facility code is identification information indicating the hospital A100. When the clinical laboratory center A500 completes uploading of the clinical laboratory result data, the process proceeds to S102. In S102, the medical facility code is extracted from the clinical test result uploaded to the clinical test center A clinical test result information DB 900e. Next, the process proceeds to S103.
　Ｓ１０３では、臨床検査センターＡ用臨床検査結果情報ＤＢ９００ｅから抽出された医療施設コードに基づく同意者情報ＤＢ８００ｅへの問合せ処理のため、医療施設コードが同意者情報処理サーバー８００に送信される。Ｓ１０４では、同意者情報処理サーバー８００が、受信した医療施設コードを同意者情報ＤＢに格納されている同意者情報と照会する。これにより、同意者情報処理サーバー８００は、医療施設コードに紐付けられている医療施設患者ＩＤが存在するか否かを確認する。 In S103, the medical facility code is transmitted to the consenter information processing server 800 for inquiry processing to the consenter information DB 800e based on the medical facility code extracted from the clinical laboratory result information DB 900e for the clinical laboratory center A. In S104, the consenter information processing server 800 refers to the received medical facility code with the consenter information stored in the consenter information DB. Thereby, the consenter information processing server 800 confirms whether or not the medical facility patient ID linked to the medical facility code exists.
　そして、同意者情報処理サーバー８００は、該当する医療施設患者ＩＤが存在する場合（Ｓ１０４：Ｙｅｓ）、Ｓ１０５において、その医療施設患者ＩＤに紐付けられている地域医療連携サーバーコード、地域医療連携ＩＤ、医療施設コード、医療施設患者ＩＤ、同意臨床検査項目を抽出して各臨床検査センター用臨床検査結果情報ＤＢに送信する。一方、同意者情報処理サーバー８００は、該当する医療施設患者ＩＤが存在しない場合（Ｓ１０４：Ｎｏ）、Ｓ１０６において、同意者情報ＤＢ８００ｅには該当する同意者が存在しない旨を医療関連サービス情報処理サーバー９００に通知する。Ｓ１０５又はＳ１０６の処理が完了すると、図６に示すフローチャートの処理は終了する。なお、臨床検査センターＢ用臨床検査結果ＤＢ９００ｆ及び臨床検査センターＣ用臨床検査結果情報ＤＢ９００ｇに格納される臨床検査結果が使用される場合についても同じであるため、説明は省略する。 When the corresponding medical facility patient ID exists (S104: Yes), the consenter information processing server 800, in S105, the regional medical cooperation server code and the regional medical cooperation ID associated with the medical facility patient ID. The medical facility code, the medical facility patient ID, and the consent clinical test items are extracted and transmitted to the clinical test result information DB for each clinical test center. On the other hand, if the corresponding medical facility patient ID does not exist (S104: No), the consenter information processing server 800 indicates that there is no corresponding consenter in the consenter information DB 800e in S106. 900 is notified. When the process of S105 or S106 is completed, the process of the flowchart shown in FIG. 6 ends. In addition, since it is the same also when the clinical test result stored in clinical test result DB900f for clinical test center B and clinical test result information DB900g for clinical test center C is used, description is abbreviate | omitted.
　次に、臨床検査センターＡ用臨床検査結果情報ＤＢ９００ｅは、上記の処理によって同意者情報処理サーバー８００から受信した同意者情報に基づいて、臨床検査センターＡ５００から受信した臨床検査結果のうち同意者に該当する患者の臨床検査結果と非同意者に該当する患者の臨床検査結果とを選別する。図７に、臨床検査センターＡ用臨床検査結果情報ＤＢ９００ｅにおける、同意者及び非同意者の選別処理に関するフローチャートを示す。本実施形態では、臨床検査センターＡ用臨床検査結果情報ＤＢ９００ｅが、同意者情報処理サーバー８００から上記の同意者情報の抽出結果を受信した、すなわちＳ１０５においてデータを取得したかあるいはＳ１０６において同意者が存在しない旨の通知を受信したときに、本フローチャートが開始される。 Next, the clinical laboratory result information DB 900e for the clinical laboratory center A receives the consenter out of the clinical laboratory results received from the clinical laboratory center A500 based on the consenter information received from the consenter information processing server 800 by the above processing. The clinical test results of the corresponding patient and the clinical test results of the patient corresponding to the non-consent are selected. FIG. 7 shows a flowchart regarding the selection process of the consenter and the non-agreeant in the clinical laboratory result information DB 900e for the clinical laboratory center A. In this embodiment, the clinical laboratory result information DB 900e for the clinical laboratory center A has received the extraction result of the above consenter information from the consenter information processing server 800, that is, has acquired data in S105, This flowchart is started when a notification that it does not exist is received.
　本フローチャートの開始後、Ｓ２０１では、臨床検査センターＡ用臨床検査結果情報ＤＢ９００ｅは、同意者情報処理サーバー８００から受信した同意者情報について、Ｓ１０３において同意者情報処理サーバー８００に送信した医療施設コードに紐付けられている医療施設患者ＩＤが存在するか否かを判定する。当該医療施設患者ＩＤが存在する場合（Ｓ２０１：Ｙｅｓ）は、臨床検査センターＡ用臨床検査結果情報ＤＢ９００ｅは、処理をＳ２０２に進める。Ｓ２０２では、臨床検査センターＡ用臨床検査結果情報ＤＢ９００ｅは、臨床検査センターＡ用臨床検査結果情報ＤＢ９００ｅに格納されている臨床検査結果のうち、Ｓ２０１において存在すると判定された医療施設患者ＩＤを有する臨床検査結果を、同意者に該当する臨床検査結果であると決定し、当該臨床検査結果を保持する。ここで、臨床検査センターＡ用臨床検査結果情報ＤＢ９００ｅは、同意者に該当する臨床検査結果のうち、Ｓ１０５において同意者情報処理サーバー８００から受信した同意臨床検査項目に該当する情報を保持する。そして、臨床検査センターＡ用臨床検査結果情報ＤＢ９００ｅは、臨床検査結果のうち同意臨床検査項目に該当しない情報を削除する。 After starting this flowchart, in S201, the clinical laboratory result information DB 900e for the clinical laboratory center A uses the medical facility code transmitted to the consenter information processing server 800 in S103 for the consenter information received from the consenter information processing server 800. It is determined whether or not the associated medical facility patient ID exists. When the medical facility patient ID exists (S201: Yes), the clinical laboratory result information DB 900e for the clinical laboratory center A advances the process to S202. In S202, the clinical laboratory result information DB 900e for the clinical laboratory center A is a clinical facility having the medical facility patient ID determined to exist in S201 among the clinical laboratory results stored in the clinical laboratory result information DB 900e for the clinical laboratory center A. The test result is determined to be a clinical test result corresponding to the consenter, and the clinical test result is held. Here, the clinical laboratory result information DB 900e for the clinical laboratory center A holds information corresponding to the consent clinical laboratory items received from the consenter information processing server 800 in S105 among the clinical laboratory results corresponding to the consenter. Then, the clinical laboratory result information DB 900e for the clinical laboratory center A deletes information that does not correspond to the consent clinical laboratory items from the clinical laboratory results.
　さらに、臨床検査センターＡ用臨床検査結果情報ＤＢ９００ｅは、臨床検査センターＡ用臨床検査結果情報ＤＢ９００ｅに格納されている臨床検査結果のうち、Ｓ２０１において存在すると判定された医療施設患者ＩＤ以外の医療施設患者ＩＤを有する臨床検査結果を、非同意者に該当する臨床検査結果であると決定し、当該臨床検査結果を削除する。 Furthermore, the clinical laboratory result information DB 900e for the clinical laboratory center A is a medical facility other than the medical facility patient ID determined to exist in S201 among the clinical laboratory results stored in the clinical laboratory result information DB 900e for the clinical laboratory center A. The clinical test result having the patient ID is determined to be a clinical test result corresponding to the non-consent, and the clinical test result is deleted.
　一方、Ｓ２０１において、医療施設コードに紐付けられている医療施設患者ＩＤが存在しない場合（Ｓ２０１：Ｎｏ）は、臨床検査センターＡ用臨床検査結果情報ＤＢ９００ｅは本フローチャートを終了する。また、臨床検査センターＡ用臨床検査結果情報ＤＢ９００ｅは、Ｓ２０２の処理が完了した場合も本フローチャートを終了する。 On the other hand, in S201, when there is no medical facility patient ID linked to the medical facility code (S201: No), the clinical laboratory result information DB 900e for the clinical laboratory center A ends this flowchart. The clinical laboratory result information DB 900e for the clinical laboratory center A also ends this flowchart when the process of S202 is completed.
　医療関連サービス情報処理サーバー９００は、図７の処理を行うことにより、病院Ａ１００による委託に基づいて臨床検査センターＡ５００が実施した臨床検査の臨床検査結果について、同意者についての臨床検査結果とそれ以外、すなわち非同意者の臨床検査結果を選別することができる。そして、医療関連サービス情報処理サーバー９００は、上記の処理により選別された同意者の臨床検査結果を地域医療連携サーバー３００に送信する。これにより、地域医療連携サーバー３００は、同意者の臨床検査結果を病院Ａ１００と病院Ｂ２００とで共有させることができる。格納された臨床検査結果は、必要に応じて、以下に記すようなマスターやフォーマットの変換を行ってもよい。マスターのみ、フォーマットのみの変換であってもよいし、マスターとフォーマットそれぞれの変換を行ってもよい。 The medical-related service information processing server 900 performs the process of FIG. 7, and the clinical test result of the clinical test performed by the clinical test center A500 based on the commission by the hospital A100, That is, the clinical test result of the non-consent can be selected. Then, the medical related service information processing server 900 transmits the clinical test result of the consenter selected by the above processing to the regional medical cooperation server 300. Thereby, the regional medical cooperation server 300 can share the clinical test result of the consenter between the hospital A100 and the hospital B200. The stored clinical test results may be converted into a master or format as described below, as necessary. Only the master or the format may be converted, or the master and the format may be converted.
　また、本実施形態では、上記の処理によって地域医療連携サーバー３００に格納された同意者の臨床検査結果を、別の地域医療連携サーバー４００と共有させることもできる。ところで、医療施設や医療関連サービス提供施設などは、医療情報の標準化の一環として、医療関連の用語や医薬品や病名などのコードを分野別に体系化したいわゆるマスターに従って種々の情報を管理している。ただし、マスターは複数存在し、本実施形態では、地域医療連携サーバー３００、４００は、それぞれ異なるマスターを採用しているとする。また、地域医療連携サーバー３００、４００が情報データを医療施設や医療関連サービス提供施設などに提供する際に使用する書式、すなわち電子カルテのフォーマットもそれぞれ異なる。 Further, in the present embodiment, the clinical test result of the consenter stored in the regional medical cooperation server 300 by the above processing can be shared with another regional medical cooperation server 400. By the way, as a part of the standardization of medical information, medical facilities and medical-related service providing facilities manage various information according to so-called masters that systematize codes related to medical terms, medicines, disease names, and the like. However, there are a plurality of masters, and in the present embodiment, it is assumed that the regional medical cooperation servers 300 and 400 employ different masters. In addition, the formats used when the regional medical cooperation servers 300 and 400 provide information data to medical facilities, medical related service providing facilities, and the like, that is, the formats of electronic medical records, are also different.
　そこで、本実施形態では、情報提供システム１０によって、地域医療連携サーバー３００、４００が採用するマスターやフォーマットが異なる場合でも臨床検査結果を共有できるようになる。図８～１０を参照しながら、情報提供システム１０における、臨床検査結果の情報の変換処理について説明する。本実施形態において、同意者情報処理サーバー８００の変換ＤＢ８００ｇに、情報提供システム１０が種々の情報を提供する医療施設や医療関連サービス提供施設などが採用する種々のフォーマットが格納されている。変換ＤＢ８００ｇは、各医療施設や各医療関連サービス提供施設などと採用されているフォーマットとを紐付けて管理する。また、同意者情報処理サーバー８００のマスターＤＢ８００ｆに、情報提供システム１０が種々の情報を提供する医療施設や医療関連サービス提供施設などが採用する種々のマスターが格納されている。マスターＤＢ８００ｆは、各医療施設や各医療関連サービス提供施設などと採用されているマスターとを紐付けて管理する。 Therefore, in the present embodiment, the information providing system 10 can share clinical test results even when the masters and formats adopted by the regional medical cooperation servers 300 and 400 are different. With reference to FIGS. 8 to 10, a process of converting information on clinical test results in the information providing system 10 will be described. In the present embodiment, the conversion DB 800g of the consenter information processing server 800 stores various formats employed by medical facilities, medical-related service providing facilities, and the like that the information providing system 10 provides various information. The conversion DB 800g manages each medical facility, each medical-related service providing facility, and the like in association with the adopted format. The master DB 800f of the consenter information processing server 800 stores various masters adopted by medical facilities, medical-related service providing facilities, and the like that the information providing system 10 provides various information. The master DB 800f manages each medical facility, each medical-related service providing facility, and the like associated with the adopted master.
　図８に、本実施形態において、情報提供システム１０が臨床検査結果のデータの変換に関する設定を行う際のフローチャートを示す。なお、本実施形態において、臨床検査結果を含む医療情報の変換とは、マスターコードや報告形式についての書式の統一をマスター変換、医療施設や医療関連サービス提供施設ごとに使用されているフォーマットから複数の施設においてデータを共有することのできるフォーマットへの変換をフォーマット変換という。 FIG. 8 shows a flowchart when the information providing system 10 performs settings related to conversion of data of clinical test results in the present embodiment. In this embodiment, the conversion of medical information including clinical test results is a master conversion of the format of the master code and the report format, and a plurality of formats are used for each medical facility and medical-related service providing facility. Conversion to a format in which data can be shared at a facility in the country is called format conversion.
　Ｓ３０１では、医療関連サービス情報処理サーバー９００が、臨床検査結果の送付先、ここでは地域医療連携サーバー４００が採用するフォーマットを含む臨床検査結果のデータの編集方法について、変換ＤＢ８００ｇに問い合わせる。Ｓ３０２では、変換ＤＢ８００ｇは、医療関連サービス情報処理サーバー９００からデータ編集方法の問合せを受けると、地域医療連携サーバー４００において採用されているフォーマットなどを確認する。 In S301, the medical-related service information processing server 900 inquires of the conversion DB 800g about the clinical test result sending destination, here, the method of editing the clinical test result data including the format adopted by the regional medical cooperation server 400. In S302, when the conversion DB 800g receives an inquiry about a data editing method from the medical related service information processing server 900, the conversion DB 800g confirms the format adopted in the regional medical cooperation server 400.
　変換ＤＢ８００ｇは、当該フォーマットなどが存在する、すなわち地域医療連携サーバー４００が要求するデータへの編集方法に対応することが可能であることを確認した場合（Ｓ３０２：Ｙｅｓ）、確認したフォーマットなどの情報を医療関連サービス情報処理サーバー９００に送信する。そして、Ｓ３０３において、医療関連サービス情報処理サーバー９００は、変換ＤＢ８００ｇから受信したフォーマットなどの情報に基づいてデータの編集方法を設定する。 When the conversion DB 800g confirms that the format exists, that is, it can cope with the editing method for the data requested by the regional medical cooperation server 400 (S302: Yes), information such as the confirmed format Is transmitted to the medical-related service information processing server 900. In step S303, the medical-related service information processing server 900 sets a data editing method based on information such as the format received from the conversion DB 800g.
　一方、変換ＤＢ８００ｇは、上記フォーマットなどが存在しない、すなわち地域医療連携サーバー４００が要求するデータへの編集方法に対応することができないことを確認した場合（Ｓ３０２：Ｎｏ）、Ｓ３０４において、変換ＤＢ８００ｇは、該当するデータの編集方法が存在しないことを医療関連サービス情報処理サーバー９００に通知する。Ｓ３０３又はＳ３０４の処理が完了すると、本フローチャートは終了する。 On the other hand, when the conversion DB 800g confirms that the above-described format or the like does not exist, that is, it cannot cope with the data editing method requested by the regional medical cooperation server 400 (S302: No), in S304, the conversion DB 800g Then, the medical-related service information processing server 900 is notified that there is no corresponding data editing method. When the processing of S303 or S304 is completed, this flowchart ends.
　次に、図９を参照しながら、情報提供システム１０が、臨床検査結果のデータのマスター変換に関する設定を行う際のフローチャートを示す。本実施形態Ｓ４０１では、医療関連サービス情報処理サーバー９００が、臨床検査結果が準拠するマスターと、臨床検査結果の送付先、ここでは地域医療連携サーバー４００が採用するマスターとの紐付けに関する情報について、マスターＤＢ８００ｆに問い合わせる。すなわち、この紐付け情報を確認することにより、医療関連サービス情報処理サーバー９００は、臨床検査結果の送信元が採用するマスターを臨床検査結果の送信先が採用するマスターに変換することができる。 Next, referring to FIG. 9, a flowchart when the information providing system 10 performs setting related to master conversion of data of clinical test results is shown. In the present embodiment S401, the medical-related service information processing server 900 has information on the association between the master to which the clinical test result is compliant and the delivery destination of the clinical test result, here, the master adopted by the regional medical cooperation server 400. Queries the master DB 800f. That is, by confirming the association information, the medical related service information processing server 900 can convert the master adopted by the clinical test result transmission source into the master adopted by the clinical test result transmission destination.
　Ｓ４０２では、マスターＤＢ８００ｆは、医療関連サービス情報処理サーバー９００からマスターの紐付け情報の問合せを受けると、変換対象の臨床検査結果の送信元が採用するマスターと、臨床検査結果の送信先が採用するマスターとの紐付け情報が存在するか否かを確認する。 In S402, when the master DB 800f receives an inquiry about the master linking information from the medical related service information processing server 900, the master DB 800f adopts the master adopted by the source of the clinical test result to be converted and the destination of the clinical test result. Check if there is any linking information with the master.
　マスターＤＢ８００ｆは、当該マスターの紐付け情報が存在することを確認した場合（Ｓ４０２：Ｙｅｓ）、確認したマスターの紐付け情報を医療関連サービス情報処理サーバー９００に送信する。そして、Ｓ４０３において、医療関連サービス情報処理サーバー９００は、マスターＤＢ８００ｆから受信したマスターの紐付け情報を臨床検査結果の変換に使用するよう設定する。 When the master DB 800f confirms that the master's association information exists (S402: Yes), the master DB 800f transmits the confirmed master's association information to the medical-related service information processing server 900. In step S <b> 403, the medical related service information processing server 900 sets the master association information received from the master DB 800 f to be used for conversion of clinical test results.
　一方、マスターＤＢ８００ｆは、上記マスターの紐付け情報が存在しないことを確認した場合（Ｓ４０２：Ｎｏ）、Ｓ４０４において、マスターＤＢ８００ｆは、該当するマスターの紐付け情報が存在しないことを医療関連サービス情報処理サーバー９００に通知する。Ｓ４０３又はＳ４０４の処理が完了すると、本フローチャートは終了する。 On the other hand, when the master DB 800f confirms that the above-described master linking information does not exist (S402: No), the master DB 800f determines that the corresponding master linking information does not exist in S404. The server 900 is notified. When the process of S403 or S404 is completed, this flowchart ends.
　なお、上記の図８、９に示す処理は、いずれが先に実行されてもよく、あるいは並列に実行されてもよい。図８、９に示す処理が完了した後、情報提供システム１０は図１０に示すフローチャートの処理を開始する。また、マスター変換、フォーマット変換は同意者情報処理サーバー８００で実行されてもよいし、サーバー９００で実行されてもよい。医療関連サービス情報処理サーバー９００で実行される場合には、同意者情報処理サーバー８００内のマスターＤＢ８００ｆや変換ＤＢ８００ｇに編集方法を問合せ、その結果医療関連サービス情報処理サーバー９００に通知された方法に従って医療関連サービス情報処理サーバー９００において変換が実行される。図１０は、本実施形態において、情報提供システム１０の医療関連サービス情報処理サーバー９００において、臨床検査結果の変換処理をフォーマット変換の後にマスター変換を行う場合を例にフローチャートに示す。 Note that any of the processes shown in FIGS. 8 and 9 may be executed first or in parallel. After the processes shown in FIGS. 8 and 9 are completed, the information providing system 10 starts the process of the flowchart shown in FIG. Further, master conversion and format conversion may be executed by the consenter information processing server 800 or may be executed by the server 900. When executed by the medical related service information processing server 900, the master DB 800f or the conversion DB 800g in the consenter information processing server 800 is inquired about an editing method, and as a result, the medical information is processed according to the method notified to the medical related service information processing server 900. Conversion is executed in the related service information processing server 900. FIG. 10 is a flowchart illustrating an example of a case in which the medical-related service information processing server 900 of the information providing system 10 performs the master conversion after the format conversion in the clinical test result conversion processing in the present embodiment.
　Ｓ５０１では、医療関連サービス情報処理サーバー９００は、図８に示すフローチャートの処理によって設定されたフォーマットなどのデータの編集方法を有効にする。次いで、処理はＳ５０２に進む。Ｓ５０２では、医療関連サービス情報処理サーバー９００は、図９に示すフローチャートの処理によって設定されたマスターの紐付け情報を有効にする。次いで、処理はＳ５０３に進む。Ｓ５０３では、医療関連サービス情報処理サーバー９００は、有効にされたフォーマットなどやマスターの情報に従って、臨床検査結果を変換する。その結果、Ｓ５０４において、医療関連サービス情報処理サーバー９００は変換後の臨床検査結果を得る。これにより、変換後の臨床検査結果は、ここでは地域医療連携サーバー４００が採用するフォーマットなどやマスターに準拠した臨床検査結果となる。したがって、情報提供システム１０により、地域医療連携サーバー４００は、フォーマットやマスターなどが異なる臨床検査結果も病院Ａ１００や病院Ｂ２００に提供することができる。 In S501, the medical related service information processing server 900 validates the data editing method such as the format set by the processing of the flowchart shown in FIG. Next, the process proceeds to S502. In S502, the medical related service information processing server 900 validates the master linking information set by the processing of the flowchart shown in FIG. Next, the process proceeds to S503. In step S503, the medical related service information processing server 900 converts the clinical test result in accordance with the validated format or the master information. As a result, in S504, the medical related service information processing server 900 obtains the converted clinical test result. Thereby, the clinical test result after conversion becomes a clinical test result based on the format or the master adopted by the regional medical cooperation server 400 here. Therefore, the regional medical cooperation server 400 can provide the hospital A100 and the hospital B200 also with the clinical test results with different formats and masters by the information providing system 10.
　図１１に、本実施形態において、情報提供システム１０が、地域医療連携サーバー３００、４００に変換した臨床検査結果を送信する際のフローチャートを示す。ここでは、上記の通り地域医療連携サーバー４００用に変換した臨床検査結果を地域医療連携サーバー４００に送信する場合について説明する。本実施形態では、医療関連サービス情報処理サーバー９００が図１０に示すフローチャートの処理によって変換後の臨床検査結果のデータを生成したときに、情報提供システム１０は図１１に示すフローチャートの処理を開始する。 FIG. 11 shows a flowchart when the information providing system 10 transmits the clinical test result converted to the regional medical cooperation servers 300 and 400 in the present embodiment. Here, the case where the clinical test result converted for the regional medical cooperation server 400 as described above is transmitted to the regional medical cooperation server 400 will be described. In the present embodiment, when the medical-related service information processing server 900 generates converted clinical test result data by the process of the flowchart shown in FIG. 10, the information providing system 10 starts the process of the flowchart shown in FIG. .
　Ｓ６０１では、医療関連サービス情報処理サーバー９００は、同意者情報処理サーバー８００に変換後の臨床検査結果のデータを送信する。これにより、Ｓ６０２において、同意者情報処理サーバー８００は当該変換データを受信する。次いで、同意者情報処理サーバー８００は処理をＳ６０３に進める。Ｓ６０３では、同意者情報処理サーバー８００は、地域医療連携サーバー４００にＳ６０２において受信した変換データを送信する。これにより、Ｓ６０４において、地域医療連携サーバー４００は当該変換データを受信する。 In S601, the medical related service information processing server 900 transmits the data of the clinical test result after conversion to the consenter information processing server 800. Thereby, in S602, the consenter information processing server 800 receives the converted data. Next, the consenter information processing server 800 advances the processing to S603. In S603, the consenter information processing server 800 transmits the conversion data received in S602 to the regional medical cooperation server 400. Thereby, in S604, the regional medical cooperation server 400 receives the conversion data.
　以下、上記の実施形態によって得られる利点について説明する。上記の通り、異なる複数の医療施設において医療情報を共有できるシステムを構築して運営していく際にはいくつかの大きな課題が存在する。 Hereinafter, advantages obtained by the above embodiment will be described. As described above, there are some major problems when building and operating a system capable of sharing medical information in a plurality of different medical facilities.
　まず、個人情報管理の問題すなわち漏洩リスクが挙げられる。個人情報は、法に基づいた管理が求められており、臨床検査施設をはじめとした医療関連サービス提供施設でも委託を受けて実施した医療情報に含まれる個人情報の厳重な管理が求められる。 First, there is a problem of personal information management, that is, leakage risk. Personal information is required to be managed in accordance with the law, and strict management of personal information included in medical information that has been commissioned at medical-related service providing facilities such as clinical laboratories is required.
　地域医療連携に象徴されるように、医療サービス及び医療関連サービスの提供は、現在のような一医療施設内において全ての医療サービス、医療関連サービスを完結させる一施設完結型から、今後は複数の医療施設、複数の医療関連サービス施設を利用して補う形で分担しあう、分散型が増加することが考えられる。したがって、一人の患者が複数の医療施設を利用するケースは今後さらに増加し、個人情報の管理についてもその重要性はさらに増していくと考えられる。 As symbolized by the regional medical cooperation, the provision of medical services and medical-related services is one facility-complete type that completes all medical services and medical-related services within a single medical facility, such as the current one. It is conceivable that the number of distributed types will increase as medical facilities and a plurality of medical-related service facilities will be shared. Therefore, the number of cases where a single patient uses multiple medical facilities will increase further in the future, and the importance of managing personal information will increase further.
　医療サービスの提供、医療関連サービスの提供及び医療情報の共有に際しては、主に個々の医療施設がそれぞれ個別に同意を取得する作業を行うが、取得する同意の種類も、当該医療施設が属する医療圏における地域医療連携への参加への同意、複数の医療施設におけるデータ共有への同意、個人情報が切り離された形のデータの二次活用（コホート研究など）への同意、と様々である。さらに、同意内容は、医療情報に含まれるカルテ情報、投薬履歴、臨床検査結果の各項目についても、特定の項目のみ共有することに同意する場合もあるなど一律の内容ではないため、同意者情報は増加するだけでなくその内容は今後さらに複雑化していくことが考えられる。 When providing medical services, providing medical-related services, and sharing medical information, each medical facility is primarily responsible for obtaining consent individually, but the type of consent acquired also depends on the medical care to which the medical facility belongs. Consent to participate in regional medical cooperation in the area, consent to data sharing at multiple medical facilities, consent to secondary use of data in a form that separates personal information (cohort studies, etc.). In addition, the consent content is not uniform, such as the fact that each item of medical record information, medication history, and clinical test results included in medical information may be agreed to share only specific items. It is possible that not only will increase, but the contents will become more complex in the future.
　医療圏を統括する医師会、医療施設、医療関連サービス提供者は、それぞれが所有及び管理できる情報に制約がある。医療施設では自施設の患者に関する情報しか把握することができず、医療圏を統括する医師会では誰が同意者であるかという情報しか保有していいない。医療関連サービス提供事業者においても、例えば臨床検査会社では、他施設の臨床検査結果については把握することができないし、委託を受けて行った臨床検査については患者の氏名などの患者識別情報と臨床検査結果については把握しているものの、どの患者が医療情報の共有に同意をした患者であるのかを知ることができない。 Physician associations, medical facilities, and healthcare-related service providers that control the medical sphere have restrictions on the information they can own and manage. The medical facility can only grasp information about the patient at its own facility, and the medical association overseeing the medical sphere has only information about who is the consenter. Even in medical-related service providers, for example, clinical laboratories cannot grasp the results of clinical tests at other facilities, and for clinical tests that have been commissioned, patient identification information such as patient names and clinical Although we know the test results, we cannot know which patients are the patients who have agreed to share medical information.
　次に、電子化された医療情報のフォーマットの違いが存在する。医療施設側では、マスターと呼ばれる基礎情報となるデータについて、診療報酬請求用や電子カルテ用といったようにそれぞれ独自にコードを設定している。一方で、医療関連サービス提供施設側でも施設ごとに、名称やコードを振り分けており、例えば臨床検査施設では臨床検査項目名称やコード、報告形式がそれぞれ施設ごとに異なる。 Next, there is a difference in the format of electronic medical information. On the medical facility side, codes for basic data called masters are individually set for medical fee billing and electronic medical records. On the other hand, names and codes are assigned to each facility on the medical service providing facility side. For example, in clinical laboratory facilities, the names of clinical laboratory items, codes, and report formats differ from facility to facility.
　これに加えて、各医療施設で採用されているシステムの違いや個々の要望に応じて電子カルテが仕様変更されて設計されているなど、対応可能な形式が制限される場合がある。医療関連サービス提供施設と医療施設とが一対一の関係である場合にデータをフォーマット変換することは対応可能でも、複数の医療施設と複数の医療関連サービス施設とが医療情報を共有して利用する場合には、フォーマットを統一することは容易ではない。 In addition to this, there are cases where compatible formats are limited, such as the design of electronic medical records being changed according to the differences in systems adopted by each medical facility and individual requests. Although it is possible to convert the format of data when there is a one-to-one relationship between the medical service providing facility and the medical facility, multiple medical facilities and multiple medical service facilities share and use medical information In some cases, it is not easy to unify the format.
　このようなフォーマットの違いについては、厚生労働省の主導による医療用語やコード標準化の動きはあるものの、全国には１０万を超える数の医療施設が存在し、膨大な種類のフォーマットに対応するように一対一の関係で関連付けをしていく作業は困難である。また、１つのコードを変更した場合には、当該コードのみならずシステム全体を見直す必要が生じることが多くあるなど、システムの管理・運営の観点から見ると、その実現には膨大な労力と費用を必要とするために容易には進まず、現在でも完全に統一されるには至っていない。 Regarding the difference in format, although there are movements in medical terminology and code standardization led by the Ministry of Health, Labor and Welfare, there are more than 100,000 medical facilities nationwide, so that it supports a huge variety of formats. The work of associating in a one-to-one relationship is difficult. In addition, when one code is changed, it is often necessary to review not only the code but also the entire system. From the viewpoint of system management and operation, enormous effort and cost are required for its realization. It does not progress easily because it requires it, and it has not yet been completely unified.
　したがって、中長期的な視点で安定的でかつ効率のよい医療供給体制を確立するためには、マスター管理についての標準化作業を進めるとともに、既存の医療施設において利用されているシステムをそのまま使用できるシステムを迅速に構築することが、患者にとってはもちろん医療施設、医療関連サービス提供施設にとっても有用である。それにより患者にとっては利便性が向上するのでより多くの良質な医療サービスを享受できるようになり、医療施設、医療関連サービス提供施設にとっては医療技術や機器の進歩による医療の高度化・複雑化に対応できる高い専門性に対応することができる、というメリットがある。 Therefore, in order to establish a stable and efficient medical supply system from a medium- to long-term perspective, a system that can proceed with standardization work for master management and can directly use the systems used in existing medical facilities It is useful not only for patients but also for medical facilities and medical related service providing facilities. As a result, convenience is improved for patients so that more high-quality medical services can be enjoyed. For medical facilities and medical-related service providing facilities, the advancement of medical technology and equipment will lead to the advancement and complexity of medical care. There is a merit that it is possible to correspond to a high level of expertise.
　上記の実施形態により、複数の医療関連サービス提供施設が送信したデータを複数の医療施設などで共有することが容易になる。このような統合システムに医療施設や医療関連サービス提供施設が参加することが容易となれば、さらに多くの医療施設や医療関連サービス提供施設が連携したシステムを構築しやすくなる。 The above embodiment makes it easy to share data transmitted by a plurality of medical-related service providing facilities with a plurality of medical facilities. If it becomes easy for medical facilities and medical related service providing facilities to participate in such an integrated system, it becomes easier to construct a system in which more medical facilities and medical related service providing facilities cooperate.
　また、上記の実施形態によって、医療施設を跨いで統合された患者情報を、該当患者個人が一括して参照するといった利用も可能となるため、患者の利便性向上につながる。つまり、複数の医療施設がそれぞれ独自に保有している患者情報を統合・管理し、個人認証に基づく医療情報の提供が可能となる。 In addition, according to the above-described embodiment, the patient information integrated across the medical facilities can be referred to by the patient individually, which leads to improvement of patient convenience. In other words, it is possible to integrate and manage patient information that each of a plurality of medical facilities has independently and provide medical information based on personal authentication.
　さらに、患者にとってはもちろん、医療施設や医療関連サービス提供施設にとっても有用である。すなわち、医療施設や医療関連サービス提供施設にとっては、より効率よく医療情報を共有することで、医療技術や機器の進歩による医療の高度化・複雑化に対応できる高い専門性に対応することができる。結果として、効率よく良質な医療サービスを享受することができるようになる。 Furthermore, it is useful not only for patients but also for medical facilities and medical-related service provision facilities. In other words, medical facilities and medical service providers can share high-efficiency medical information to support a high level of expertise that can cope with the advancement and complexity of medical care due to advances in medical technology and equipment. . As a result, it becomes possible to enjoy high-quality medical services efficiently.
　そして、上記の実施形態により、遠隔地や離島などの地域においては、複数の医療施設が連携して医療情報を共有することが可能となり、遠隔地医療サービスの提供を促進することも期待できる。 In addition, according to the above embodiment, it is possible to share medical information among a plurality of medical facilities in an area such as a remote place or a remote island, and it can be expected to promote provision of a remote place medical service.
　以上が本実施形態に関する説明であるが、上記の情報提供システムなどの構成や処理は、上記の実施形態に限定されるものではなく、本発明の技術的思想と同一性を失わない範囲内において種々の変更が可能である。例えば、上記の説明では、病院などの医療施設から送信された患者情報を地域医療連携サーバーが蓄積する構成としているが、地域医療連携サーバーの代わりに情報処理システムが患者情報を受信してＤＢなどに蓄積する構成としてもよい。これにより、情報処理システムが上記の同意者情報の選別処理や変換処理などのみならず患者の個人情報や医療情報の保守や管理も一括して担うことができる。さらに、地域医療連携サーバーの代わりあるいはこれに加えてコホート研究用のサーバーを設け、上記の構成及び処理によって、コホート研究においても同意者情報を共有することもできる。 The above is the description of the present embodiment. However, the configuration and processing of the information providing system and the like are not limited to the above embodiment, and are within the scope that does not lose the same technical idea as the present invention. Various changes are possible. For example, in the above description, the regional medical cooperation server is configured to accumulate patient information transmitted from a medical facility such as a hospital. However, instead of the regional medical cooperation server, the information processing system receives patient information and receives a DB or the like. It is good also as a structure accumulate | stored in. Accordingly, the information processing system can collectively perform maintenance and management of patient personal information and medical information as well as the above-described consenter information selection process and conversion process. Furthermore, instead of or in addition to the regional medical cooperation server, a server for cohort research can be provided, and by the above configuration and processing, consenter information can also be shared in cohort research.
　また、上記の説明では、臨床検査センターからの臨床検査結果を共有対象として説明したが、共有対象とする医療情報はこれに限られない。例えば、医療情報は、カルテ情報、レセプト情報、診療情報、医学情報、予防情報、健康情報、福祉情報のいずれかを含む構成としてもよい。さらに、医療情報がカルテ情報である場合、医療情報は、臨床検査結果、医師の所見、治療の経過や結果、看護記録、処方箋、通院履歴のいずれかを含む構成としてもよい。そして、医療関連サービスが、臨床検査受託、調剤薬局業務、医療機器の販売・保守点検など、医療法施行規則に挙げられているものに該当する場合に、当該医療関連サービス提供施設から送信される情報を共有対象としてもよい。これにより、上記の実施形態の構成を、種々の医療サービスや医療関連サービスにおける医療情報の共有に対応させることができる。例えばカルテ情報、診療情報、医学情報、予防情報、健康情報、臨床検査結果、医師の所見、治療の経過や結果などを組み合わせるアルゴリズムを設計することで、将来の疾病について予測することが可能なシステムを構築することもできる。 In the above description, the clinical test result from the clinical laboratory center is described as a shared object, but the medical information to be shared is not limited to this. For example, the medical information may include any of medical record information, receipt information, medical information, medical information, prevention information, health information, and welfare information. Furthermore, when the medical information is medical chart information, the medical information may include a clinical test result, a doctor's findings, a progress or result of treatment, a nursing record, a prescription, or a visit history. When a medical-related service falls under any of those listed in the Medical Law Enforcement Regulations, such as contracted clinical testing, dispensing pharmacy services, medical device sales / maintenance inspection, etc., it is transmitted from the medical-related service providing facility Information may be shared. Thereby, the structure of said embodiment can be made to respond | correspond to the sharing of medical information in various medical services and medical related services. For example, a system that can predict future diseases by designing an algorithm that combines medical record information, medical information, medical information, prevention information, health information, clinical test results, doctor's findings, progress and results of treatment, etc. Can also be built.
　また、上記の説明では、臨床検査結果を複数の医療施設で共有する場合を例として、地域医療圏における地域医療連携を効果的に運営するためのシステムを取り上げたが、さらに以下のような実施形態における利用が可能である。なお、以下の説明において、上記の実施形態と同じ構成については同じ符号を用いて説明する。 In the above description, taking the case of sharing clinical test results among multiple medical facilities as an example, the system for effectively managing regional medical cooperation in the regional medical sphere was taken up. Use in form is possible. In the following description, the same components as those in the above embodiment will be described using the same reference numerals.
　例えば、別の実施形態としては、患者が異なる医療圏内の医療施設を利用した場合に、医療圏を跨いで医療情報を共有するケースを想定する。移動手段の発達した現代社会においては、居住地のある医療圏のみならず、他の医療圏内の医療施設を利用する可能性が十分に考えられる。この場合、それぞれ異なる医療圏にある複数の医療施設間で医療情報を共有することで効率的に医療サービス及び医療関連サービスが提供できることは、患者の医療施設へのフリーアクセスの観点からも好ましい。例えば、自宅付近の医療圏と勤務地の医療圏とが異なる医療圏である場合など、上記の実施形態の構成を利用することで、異なる地域医療圏どうし、つまり、医師会などが運営している各地域医療圏内の地域医療連携サーバーどうしが上記の実施形態の情報提供システムを介して医療情報を共有することができる。 For example, as another embodiment, a case is assumed in which medical information is shared across medical areas when the patient uses medical facilities in different medical areas. In modern societies where transportation has developed, there is a good possibility of using medical facilities in other medical areas as well as in medical areas where residential areas are located. In this case, it is preferable from the viewpoint of free access to a patient's medical facility that medical information and a medical-related service can be efficiently provided by sharing medical information among a plurality of medical facilities in different medical areas. For example, when the medical sphere near the home and the medical sphere of the work place are different medical spheres, by using the configuration of the above embodiment, different regional medical spheres, that is, operated by a medical association, etc. The regional medical cooperation servers in the respective regional medical areas can share medical information via the information providing system of the above embodiment.
　その場合には、例えば、これら地域医療連携サーバーに接続可能な広域連携用としてサーバーを設け、この広域連携用サーバーが各地域医療連携サーバーと情報提供システムとの中継を行う構成としてもよい。もちろん、情報提供システムがこの中継を担う構成としてもよい。例えば、地域医療連携サーバー３００、４００が情報提供システム１０に医療情報を介して広域連携用サーバーに医療情報を送信し、地域医療連携サーバー３００、４００間で医療情報を共有する場合などが想定される。 In that case, for example, a server may be provided for wide area connection that can be connected to these regional medical cooperation servers, and this wide area cooperation server may relay each regional medical cooperation server and the information providing system. Of course, the information providing system may be configured to perform this relay. For example, it is assumed that the regional medical cooperation servers 300 and 400 transmit medical information to the wide area cooperation server via the medical information to the information providing system 10 and share the medical information between the regional medical cooperation servers 300 and 400. The
　図１２、１３に、本実施形態における情報処理システム１０が実行する処理のフローチャートを示す。本実施形態では、臨床検査センターＡ５００が情報提供システム１０に送信した臨床検査結果が地域医療連携サーバーで共有され、更に広域医療連携サーバーで共有される場合を想定する。ここで、検査センターＡ用検査結果情報ＤＢには、地域医療連携サーバーからも臨床検査結果が送信されるものとする。また、臨床検査結果には、地域医療連携サーバーコード、地域医療連携ＩＤ及び広域ＩＤも含まれる。 12 and 13 show flowcharts of processing executed by the information processing system 10 according to this embodiment. In the present embodiment, it is assumed that the clinical test result transmitted from the clinical laboratory center A500 to the information providing system 10 is shared by the regional medical cooperation server and further shared by the wide area medical cooperation server. Here, it is assumed that clinical test results are transmitted from the regional medical cooperation server to the test result information DB for the test center A. The clinical test result also includes a regional medical cooperation server code, a regional medical cooperation ID, and a wide area ID.
　図１４は、本実施形態における情報提供システム１０のハードウェア構成を示す概略構成図である。図２に示す構成要素と同じものについては同じ符号を付し、説明を省略する。図１４に示すように、医療関連サービス情報処理サーバー９００は、地域医療連携サーバー３００がアクセス可能な地域医療連携サーバー３００用臨床検査結果情報ＤＢ９００ｈと地域医療連携サーバー４００がアクセス可能な地域医療連携サーバー４００用臨床検査結果情報ＤＢ９００ｉを備える。 FIG. 14 is a schematic configuration diagram showing a hardware configuration of the information providing system 10 in the present embodiment. The same components as those shown in FIG. 2 are denoted by the same reference numerals, and description thereof is omitted. As shown in FIG. 14, the medical related service information processing server 900 is a regional medical cooperation server that can be accessed by the regional medical cooperation server 300 clinical test result information DB 900 h accessible by the regional medical cooperation server 300 and the regional medical cooperation server 400. 400 clinical test result information DB 900i is provided.
　まず、図１２に示すＳ７０１では、地域医療連携サーバー３００からの臨床検査結果データが地域医療連携サーバー３００用臨床検査結果情報ＤＢ９００ｈにアップロードされる。地域医療連携サーバー３００が、当該臨床検査結果データのアップロードが完了すると、処理はＳ７０２に進む。Ｓ７０２では、地域医療連携サーバー３００用臨床検査結果情報ＤＢ９００ｈにアップロードされた臨床検査結果から地域医療連携サーバーコードが抽出される。次いで、処理はＳ７０３に進む。 First, in S701 shown in FIG. 12, clinical test result data from the regional medical cooperation server 300 is uploaded to the clinical test result information DB 900h for the regional medical cooperation server 300. When the regional medical cooperation server 300 completes uploading of the clinical test result data, the process proceeds to S702. In S702, the regional medical cooperation server code is extracted from the clinical test result uploaded to the clinical test result information DB 900h for the regional medical cooperation server 300. Next, the process proceeds to S703.
　Ｓ７０３では、地域医療連携サーバー３００用臨床検査結果情報ＤＢ９００ｈから抽出された地域医療連携サーバーコードに基づく同意者情報ＤＢ８００ｅへの問合せ処理のため、地域医療連携サーバーコードが同意者情報処理サーバー８００に送信される。Ｓ７０４では、同意者情報処理サーバー８００が、受信した地域医療連携サーバーコードを同意者情報ＤＢに格納されている同意者情報と照会する。これにより、同意者情報処理サーバー８００は、地域医療連携サーバーコードに紐付けられている広域ＩＤが存在するか否かを確認する。 In S703, the regional medical cooperation server code is transmitted to the consenter information processing server 800 for inquiry processing to the consenter information DB 800e based on the regional medical cooperation server code extracted from the clinical test result information DB 900h for the regional medical cooperation server 300. Is done. In S704, the consenter information processing server 800 inquires the received regional medical cooperation server code with the consenter information stored in the consenter information DB. Thereby, the consenter information processing server 800 confirms whether or not the wide area ID associated with the regional medical cooperation server code exists.
　そして、同意者情報処理サーバー８００は、該当する広域ＩＤが存在する場合（Ｓ７０４：Ｙｅｓ）、Ｓ７０５において、その広域ＩＤに紐付けられている地域医療連携サーバーコード、地域医療連携ＩＤ、医療施設コード、医療施設患者ＩＤ、同意臨床検査項目を抽出して各地域医療連携サーバー用臨床検査結果情報ＤＢに送信する。一方、同意者情報処理サーバー８００は、該当する広域ＩＤが存在しない場合（Ｓ７０４：Ｎｏ）、Ｓ７０６において、同意者情報ＤＢ８００ｅには該当する広域ＩＤが存在しない旨を地域医療連携サーバー３００用臨床検査結果情報ＤＢ９００ｈに通知する。Ｓ７０５又はＳ７０６の処理が完了すると、図１２に示すフローチャートの処理は終了する。 When the corresponding wide area ID exists (S704: Yes), the consenter information processing server 800, in S705, the regional medical cooperation server code, the regional medical cooperation ID, and the medical facility code associated with the wide area ID. The medical facility patient ID and consent clinical examination items are extracted and transmitted to the clinical examination result information DB for each regional medical cooperation server. On the other hand, if the corresponding wide-area ID does not exist (S704: No), the consenter information processing server 800 indicates that the corresponding wide-area ID does not exist in the consenter information DB 800e in S706. Notify the result information DB 900h. When the process of S705 or S706 is completed, the process of the flowchart shown in FIG. 12 ends.
　次に、図１３に、地域医療連携サーバー３００用臨床検査結果情報ＤＢ９００ｈにおける、同意者及び非同意者の選別処理に関するフローチャートを示す。本実施形態では、地域医療連携サーバー３００用臨床検査結果情報ＤＢ９００ｈが、同意者情報処理サーバー８００から上記の同意者情報の抽出結果を受信した、すなわちＳ７０５においてデータを取得したかあるいはＳ７０６において広域ＩＤが存在しない旨の通知を受信したときに、本フローチャートが開始される。 Next, FIG. 13 shows a flowchart regarding the selection process of the consenter and the non-agreeant in the clinical test result information DB 900h for the regional medical cooperation server 300. In the present embodiment, the clinical examination result information DB 900h for the regional medical cooperation server 300 has received the extraction result of the above-mentioned consenter information from the consenter information processing server 800, that is, acquired data in S705 or a wide area ID in S706. This flowchart is started when a notification to the effect that no exists is received.
　本フローチャートの開始後、Ｓ８０１では、地域医療連携サーバー３００用臨床検査結果情報ＤＢ９００ｈは、同意者情報処理サーバー８００から受信した同意者情報について、Ｓ７０３において同意者情報処理サーバー８００に送信した地域医療連携サーバーコードに紐付けられている広域ＩＤが存在するか否かを判定する。当該広域ＩＤが存在する場合（Ｓ８０１：Ｙｅｓ）は、地域医療連携サーバー３００用臨床検査結果情報ＤＢ９００ｈは、処理をＳ８０２に進める。Ｓ８０２では、地域医療連携サーバー３００用臨床検査結果情報ＤＢ９００ｈは、地域医療連携サーバー３００用臨床検査結果情報ＤＢ９００ｈに格納されている臨床検査結果のうち、Ｓ８０１において存在すると判定された広域ＩＤを有する臨床検査結果を、同意者に該当する臨床検査結果であると決定し、当該臨床検査結果を保持する。ここで、地域医療連携サーバー３００用臨床検査結果情報ＤＢ９００ｈは、同意者に該当する臨床検査結果のうち、Ｓ７０５において同意者情報処理サーバー８００から受信した同意臨床検査項目に該当する情報を保持する。そして、地域医療連携サーバー３００用臨床検査結果情報ＤＢ９００ｈは、臨床検査結果のうち同意臨床検査項目に該当しない情報を削除する。 After the start of this flowchart, in S801, the clinical examination result information DB 900h for the regional medical cooperation server 300 transmits the local medical cooperation transmitted from the consenter information processing server 800 to the consenter information processing server 800 in step S703. It is determined whether or not a wide area ID associated with the server code exists. When the wide area ID exists (S801: Yes), the clinical test result information DB 900h for the regional medical cooperation server 300 advances the process to S802. In S802, the clinical test result information DB 900h for the regional medical cooperation server 300 is the clinical ID having the wide area ID determined to exist in S801 among the clinical test results stored in the clinical test result information DB 900h for the regional medical cooperation server 300. The test result is determined to be a clinical test result corresponding to the consenter, and the clinical test result is held. Here, the clinical test result information DB 900h for the regional medical cooperation server 300 holds information corresponding to the consent clinical test item received from the consenter information processing server 800 in S705 among the clinical test results corresponding to the consenter. Then, the clinical test result information DB 900h for the regional medical cooperation server 300 deletes information that does not correspond to the agreed clinical test items from the clinical test results.
　さらに、地域医療連携サーバー３００用臨床検査結果情報ＤＢ９００ｈは、地域医療連携サーバー３００用臨床検査結果情報ＤＢ９００ｈに格納されている臨床検査結果のうち、Ｓ８０１において存在すると判定された広域ＩＤ以外の広域ＩＤを有する臨床検査結果を、非同意者に該当する臨床検査結果であると決定し、当該臨床検査結果を削除する。 Further, the clinical examination result information DB 900h for the regional medical cooperation server 300 is a wide area ID other than the wide area ID determined to exist in S801 among the clinical examination results stored in the clinical examination result information DB 900h for the regional medical cooperation server 300. Is determined to be a clinical test result corresponding to a non-consent, and the clinical test result is deleted.
　一方、Ｓ８０１において、医療施設コードに紐付けられている広域ＩＤが存在しない場合（Ｓ８０１：Ｎｏ）は、地域医療連携サーバー３００用臨床検査結果情報ＤＢ９００ｈは本フローチャートを終了する。また、地域医療連携サーバー３００用臨床検査結果情報ＤＢ９００ｈは、Ｓ８０２の処理が完了した場合も本フローチャートを終了する。 On the other hand, when there is no wide area ID linked to the medical facility code in S801 (S801: No), the clinical test result information DB 900h for the regional medical cooperation server 300 ends this flowchart. The clinical test result information DB 900h for the regional medical cooperation server 300 also ends this flowchart when the process of S802 is completed.
　なお、上記のほか、本実施形態の構成や処理については、上記の地域医療連携サーバー３００がある医療圏内に所属し、地域医療連携サーバー４００が別の医療圏に所属する点以外は図１～図１１に示す実施形態の具体的な構成や処理と同じであるため、詳細な説明は省略する。 In addition to the above, the configuration and processing of the present embodiment are the same as in FIG. 1 except that the above-mentioned regional medical cooperation server 300 belongs to a medical area and the regional medical cooperation server 400 belongs to another medical area. Since the specific configuration and processing of the embodiment shown in FIG. 11 are the same, detailed description thereof is omitted.
　このような実施形態においては、遠隔医療における利用も可能となる。ここでの遠隔医療とは医師と患者が距離を隔てたところでインターネットなどの通信技術を用いて診療を行う行為をいう。遠隔医療は、さらに遠隔診断と遠隔治療とに分けられるが、本発明は主に遠隔診断において利用することができる。そして、遠隔医療によって、人口が希薄な地域のみならず、病院への来院が困難な患者に対して、重症化する前に医師などが患者を診断することができるようになるなどの効果が考えられる。 In such an embodiment, use in telemedicine is also possible. Here, telemedicine refers to an act of performing medical care using a communication technology such as the Internet at a distance between a doctor and a patient. Although telemedicine is further divided into telediagnosis and telemedicine, the present invention can be used mainly in telediagnosis. And telemedicine can be effective not only for sparsely populated areas but also for patients who are difficult to visit hospitals, such as doctors can diagnose patients before they become serious. It is done.
　さらに、別の実施形態としては、同一の医療施設内、例えば１病院内において医療情報を共有するために使用することができる。例えば、患者が、同一施設内であってもすべての医療情報を共有することには同意せず、特定項目の共有のみに同意する場合も想定される。このような場合に、上記の実施形態の構成を利用して医療情報を共有することができる。あるいは、異なる臨床検査機器が出力する結果を統合して共有する、例えば、大病院など医療施設内においてＸ線診断装置、Ｘ線ＣＴ装置、磁気共鳴イメージング装置、核医学装置、超音波診断装置など、様々なフォーマットで臨床検査結果を出力する臨床検査機器が複数台存在する場合に利用することができる。 Furthermore, as another embodiment, it can be used for sharing medical information in the same medical facility, for example, in one hospital. For example, it is assumed that the patient does not agree to share all medical information even in the same facility, but only agrees to share specific items. In such a case, medical information can be shared using the configuration of the above embodiment. Alternatively, the results output by different clinical laboratory instruments are integrated and shared, for example, in a medical facility such as a large hospital, an X-ray diagnostic apparatus, an X-ray CT apparatus, a magnetic resonance imaging apparatus, a nuclear medicine apparatus, an ultrasonic diagnostic apparatus, etc. It can be used when there are a plurality of clinical laboratory instruments that output clinical laboratory results in various formats.
　複数の臨床検査機器が医療施設内に構築されたネットワークに接続されている場合、臨床検査機器が異なれば採用されているシステムの形式が異なるため、臨床検査結果を同じ端末で取得することが困難な場合がある。上記の実施形態の構成を利用することで、異なる臨床検査機器から出力された医療情報である個々の臨床検査結果を、出力先であるレポートサーバーに対して、共通の出力形式で定義された臨床検査結果を提供し、医療施設内で結果を共有することが容易になる。また、複数の異なった形式で得られた医用画像どうしを比較しながら診断することによって、患者の状態を正確に把握でき、医療サービス提供による治療効率を格段に向上させることが可能となる。 When multiple clinical laboratory devices are connected to a network built in a medical facility, it is difficult to obtain clinical laboratory results on the same terminal because different systems are used for different clinical laboratory devices. There are cases. By using the configuration of the above-described embodiment, individual clinical test results, which are medical information output from different clinical testing devices, are defined in a common output format with respect to the report server that is the output destination. It is easier to provide test results and share the results within the medical facility. Further, by making a diagnosis while comparing medical images obtained in a plurality of different formats, it is possible to accurately grasp the patient's condition, and to significantly improve the treatment efficiency by providing the medical service.
　この実施形態の構成や処理は、上記の地域医療連携サーバー３００、４００を１病院内に所属する連携サーバーと考え、病院Ａ１００、病院Ｂ２００が当該病院内の各診療科と考え、情報提供システム１０及びネットワークＮが当該病院内に配置されている点以外は上記の実施形態の具体的な構成や処理と同じであるため、詳細な説明は省略する。 In the configuration and processing of this embodiment, the above regional medical cooperation servers 300 and 400 are considered as cooperation servers belonging to one hospital, and the hospital A100 and hospital B200 are considered as respective clinical departments in the hospital, and the information providing system 10 The network N is the same as the specific configuration and processing of the above-described embodiment except that the network N is arranged in the hospital, and detailed description thereof is omitted.
　上述したように、本実施形態において、地域医療連携とは、異なる複数の医療施設を利用する患者について提供される医療サービスや医療関連サービスに伴う医療情報を共有することを指し、例えば、厚生労働省が指定する、一次から三次の各医療圏内の医療施設どうしと医療関連サービス提供施設どうしとが連携し合い、医療サービスや医療関連サービスを提供することなどが含まれる。複数の地域医療連携どうしで実施される場合、それらを広域医療連携と呼ぶ場合もある。対象同意者情報を取得することで、広域医療連携のような特定の地域医療連携どうしや日本国内の地域医療連携だけでなく保険者データベース、ナショナルデータベース、グローバルデータベースを利用した広範囲での医療情報の共有も可能となる。 As described above, in the present embodiment, regional medical cooperation refers to sharing medical information associated with medical services and medical-related services provided for patients using a plurality of different medical facilities. For example, the Ministry of Health, Labor and Welfare Includes the provision of medical services and medical-related services by linking medical facilities in the primary to tertiary medical areas and medical-related service providing facilities. When implemented by multiple regional medical collaborations, they may be referred to as wide-area medical collaborations. By acquiring target consenter information, not only specific regional medical cooperation such as wide area medical cooperation and regional medical cooperation in Japan but also medical information in a wide range using insurer database, national database and global database. Sharing is also possible.
　また、上述したように、同意者の同意の内容は、取得する同意の種類によって異なる。例えば、当該サービスを提供する医療施設が属する医療圏における地域医療連携への参加への同意、複数の医療施設における医療情報共有への同意、個人情報が切り離された形での医療情報の二次活用（コホート研究など）への同意が含まれる。そして、同意者の同意の内容には、更に臓器提供、延命措置の拒否リビングウィル、尊厳死に関する情報等を含めることができる。 Also, as described above, the content of the consenter's consent varies depending on the type of consent to be obtained. For example, consent to participate in regional medical cooperation in the medical area to which the medical facility providing the service belongs, consent to share medical information in multiple medical facilities, secondary medical information in a form where personal information is separated Consent to use (such as cohort studies) is included. The contents of the consent of the consenter can further include information on organ donation, living will refusal of life extension, dignity death, and the like.
　また、上述したように、本実施形態では、同意者情報は、医療施設ごとに割り振られた番号、各医療施設が患者に対して割り振った番号を含み、必要に応じて医療施設が属する一次から三次の医療圏の番号を付加することができる。ここで、医療施設ごとに割り振られた番号には医療施設情報が、各医療施設が患者に対して割り振った番号には患者識別情報がそれぞれ紐付く。これらの番号を使用することで、医療情報に容易に紐付けることが可能となる。 Further, as described above, in the present embodiment, the consenter information includes a number assigned to each medical facility, a number assigned to each patient by each medical facility, and from the primary to which the medical facility belongs as necessary. A tertiary medical zone number can be added. Here, the medical facility information is associated with the number assigned to each medical facility, and the patient identification information is associated with the number assigned to the patient by each medical facility. By using these numbers, it is possible to easily associate with medical information.
　また、広域ＩＤは、一例として、保険者番号を挙げたが、地域ごとに割り振られた番号、例えば、都道府県単位の番号や国番号、国民番号、国際番号等、またはそれらを組み合わせた使用することなども挙げられる。 In addition, the wide area ID is an insurer number as an example, but a number assigned to each area, for example, a prefectural number, a country code, a national number, an international number, or a combination thereof is used. There are also things.
　また、上述したように、医療関連サービス提供事業者においても、例えば臨床検査会社では、他施設の臨床検査結果については把握することができないし、委託を受けて行った臨床検査については患者の氏名などの患者識別情報と臨床検査結果については把握しているものの、どの患者が医療情報の共有に同意をした患者であるのかを知ることができない。医療サービス及び医療関連サービスの利用形態は、複数の地域にまたがった場合など様々なケースが想定されるが、今後多様化していくにつれて、増え続ける医療情報や個人情報を適切に保護しつつ活用できるしくみが今後益々重要となる。本願発明は、同意者情報ＤＢを、医療情報ＤＢとは別に設置して運用するため、上記に対する解決法として期待される。ここで、同意者情報ＤＢは医療情報ＤＢと同じサーバー内に設置されていても、別のサーバーに設置されていてもよいが、複数の地域医療圏どうしの情報共有を目的として実施する場合には、同意者情報ＤＢは医療情報ＤＢの別のサーバーに設置されていることが好ましい。特に、上記のような複数地域に跨って医療情報を共有する場合において効果が大きい。 In addition, as described above, even in medical service providers, for example, a clinical laboratory company cannot grasp the results of clinical tests at other facilities, and the name of the patient for clinical tests performed on commission. However, it is impossible to know which patient is the patient who has agreed to share medical information. Various cases of use of medical services and medical-related services are assumed, such as cases that span multiple regions, but as diversification in the future, medical information and personal information that continue to increase can be used while being appropriately protected The mechanism will become more important in the future. The present invention is expected as a solution to the above because the consenter information DB is installed and operated separately from the medical information DB. Here, the consenter information DB may be installed in the same server as the medical information DB or may be installed in another server. However, in the case of carrying out for the purpose of sharing information between a plurality of regional medical areas. The consenter information DB is preferably installed in another server of the medical information DB. This is particularly effective when medical information is shared across multiple regions as described above.
　また、別の実施形態としては、同一人物が国境を跨いで移動して複数の国において医療サービス及び医療関連サービスの提供を受ける場合に、それぞれの施設間で医療情報を共有するために使用することができる。特に、近年医療ツーリズムと称して費用を抑制するために、自国以外、すなわち海外で医療サービス及び医療関連サービスの提供を受ける人の数が増加している。このような場合に、自国のサービス提供を受ける施設と海外のサービス提供を受ける施設との間で医療情報を共有するために使用することができる。また、欧州など隣国への移動が日常的となりつつある国では、本願発明の方法を使用することで医療情報を共有し医療サービス提供における効率を向上させることが可能となる。 Moreover, as another embodiment, when the same person moves across borders and is provided with medical services and medical-related services in a plurality of countries, it is used to share medical information between facilities. be able to. In particular, in recent years, the number of people who receive medical services and medical-related services outside of their own countries, that is, overseas, has been increasing in order to control costs, referred to as medical tourism. In such a case, it can be used to share medical information between a facility that receives service provision in the home country and a facility that receives service provision overseas. Further, in countries such as Europe where movement to neighboring countries is becoming routine, it is possible to share medical information and improve the efficiency in providing medical services by using the method of the present invention.
　また、更に別の実施形態としては、上記の説明における医療サービスに、バイオバンクにおける生物試料又はそれに関連する情報を使用して診断や治療を行う行為を含めてもよい。そして、医療関連サービスとして、バイオバンク及びバイオバンク情報システムの運用などを挙げることができる。ここでバイオバンクとは、一定の集団又は集団内の一部分に属する提供者に由来する生物試料又はそれに関連する情報をいい、バイオバンク情報システムとは、該バイオバンクの生物試料又はそれに関連する情報が、体系化されたシステムによって保管された、情報の集積をいう。また、医療関連サービス提供施設として、バイオバンク情報システムの管理や運用をする施設を挙げることができる。 As still another embodiment, the medical service in the above description may include an act of performing diagnosis or treatment using a biological sample in the biobank or information related thereto. Examples of medical-related services include biobanks and biobank information system operations. Here, the biobank refers to a biological sample derived from a provider belonging to a certain group or a part of the group or information related thereto, and the biobank information system refers to the biological sample of the biobank or information related thereto. Refers to the accumulation of information stored in a systematized system. In addition, as a medical-related service providing facility, a facility that manages and operates a biobank information system can be cited.
　そして、複数の医療施設間で共有する医療情報に、上記のバイオバンク及びバイオバンク情報システムにおいて扱われる、生物試料に関連する情報を含めることも可能となる。生物試料に関連する情報としては、例えば、ゲノムやその変異情報、蛋白質、糖鎖、メタボローム解析により得られる情報、バイオイメージング情報、分離された微生物についての情報及びこれら複数の情報を統合して得られた情報などが挙げられる。また、バイオバンク及びバイオバンク情報システムにおいて扱われる個人情報における個人とは、医療情報提供者と、医師による診断、治療を受ける患者とを含む。 And, it is possible to include information related to biological samples, which is handled in the biobank and the biobank information system, in medical information shared among a plurality of medical facilities. Information related to biological samples includes, for example, genome and its mutation information, protein, sugar chain, information obtained by metabolomic analysis, bioimaging information, information on separated microorganisms, and a combination of these information. Information. Moreover, the individuals in the personal information handled in the biobank and the biobank information system include medical information providers and patients who receive diagnosis and treatment by doctors.
　これにより、例えば、特に該バイオバンク及び該バイオバンク情報システムの運用を提供する医療関連サービス提供施設が複数存在する場合に適用して実施すると効果が高い。同一医療情報提供者に由来する生物試料及び医療情報であるにも関わらず、それぞれの医療関連サービス提供施設で保有する医療情報が統一されず完全に一致しない場合があるためである。具体的には、異なる施設で同一の医療情報提供者から複数回生物試料として採取された場合には、上記のような問題が生じる可能性があるが、本願発明の方法によればそのような問題も解決することができる。 Thus, for example, the present invention is particularly effective when applied to a case where there are a plurality of medical-related service providing facilities that provide operation of the biobank and the biobank information system. This is because, even though the biological samples and medical information are derived from the same medical information provider, the medical information held in the respective medical related service providing facilities may not be unified and may not completely match. Specifically, when collected as a biological sample multiple times from the same medical information provider at different facilities, the above problems may occur. However, according to the method of the present invention, such a problem may occur. The problem can also be solved.
　医療情報提供者に対して医療サービス及び医療関連サービスを提供する場合には、他施設の医療情報を参照することで正確な医療サービス及び医療関連サービスの提供が可能になる。医療情報利用者がバイオバンク及びバイオバンク情報システムの運用サービスを利用し、正確な情報を入手できることでコホート研究や診断、治療関連の研究などの二次利用が促進される。なお、このような実施形態であっても、上述した実施形態と具体的構成や処理などは同様であり、当業者であればその具体的構成や処理などを更に適宜変更して実施することができるため、その詳細な説明は省略する。 When providing medical services and medical-related services to medical information providers, it is possible to provide accurate medical services and medical-related services by referring to medical information of other facilities. Medical information users can use biobanks and biobank information system operation services to obtain accurate information, thereby promoting secondary use such as cohort research, diagnosis, and treatment-related research. Even in such an embodiment, the specific configuration and processing are the same as those of the above-described embodiment, and those skilled in the art can implement the specific configuration and processing with further appropriate modifications. Therefore, detailed description thereof is omitted.
　さらに、上記の各実施形態において、地域医療連携における地域とは、一定の合意のもとに集合体や組織を形成して複数の医療施設や医療関連サービス提供施設を含む区域（例えば医療圏など）を意味する。例えば、その設定された区域が市町村単位である場合、都道府県単位である場合、国単位である場合、特定の目的のために形成された団体や研究会単位である場合など様々であるが、特にその大きさや範囲などは限定されず、複数の医療施設や医療関連サービス提供施設を含んでいればよい。それぞれ医療情報の提供を所望する単位ごとに医療情報記憶部を有する情報記憶装置を設置することができ、その単位ごとに当該情報記憶装置を設置することで、本実施形態における医療情報を制御し共有することが可能となる。 Furthermore, in each of the embodiments described above, an area in regional medical cooperation refers to an area (for example, a medical area or the like) that forms a group or organization under a certain agreement and includes a plurality of medical facilities and medical related service providing facilities ). For example, when the set area is a municipality unit, a prefecture unit, a country unit, an organization formed for a specific purpose or a study group unit, etc. Especially the magnitude | size, the range, etc. are not limited, What is necessary is just to include several medical facilities and medical related service provision facilities. An information storage device having a medical information storage unit can be installed for each unit for which provision of medical information is desired, and the medical information in this embodiment is controlled by installing the information storage device for each unit. It becomes possible to share.
　また、上記の説明において、患者に代えてあるいは患者に加えて医療情報提供者を対象として、上記の実施形態を実現することが可能である。したがって、少なくとも患者又は医療情報提供者を含む個人が、医療サービスあるいは医療関連サービスの提供の形態に応じて、共有される医療情報の利用用途を適宜選択することができる。 Further, in the above description, the above-described embodiment can be realized for a medical information provider in place of or in addition to the patient. Therefore, individuals including at least a patient or a medical information provider can appropriately select the usage of the medical information to be shared according to the form of providing the medical service or the medical related service.
１０　　情報提供システム
１００、２００　　病院
３００、４００　　地域医療連携サーバー
５００、６００、７００　　臨床検査センター
８００　　同意者情報処理サーバー
８００ｅ　　同意者情報ＤＢ
８００ｆ　　マスターＤＢ
８００ｇ　　変換ＤＢ
９００　　医療関連サービス情報処理サーバー
９００ｅ、９００ｆ、９００ｇ　　臨床検査センター用臨床検査結果情報ＤＢ
Ｎ　　ネットワーク 10 Information providing system 100, 200 Hospital 300, 400 Regional medical cooperation server 500, 600, 700 Clinical laboratory center 800 Consensus information processing server 800e Consensus information DB
800f Master DB
800g conversion DB
900 Medical-related service information processing server 900e, 900f, 900g Clinical laboratory result information DB for clinical laboratory center
N network

Claims (16)

  1. 　医療施設の端末がアクセス可能な情報記憶装置から抽出された、医療施設情報と患者の識別情報とが紐付けられた同意者情報を記憶する同意者情報記憶部と、
    　前記医療施設から医療関連サービスを依頼された医療関連サービス提供施設の端末がアクセス可能な医療情報記憶部であって、医療施設情報と患者の識別情報と前記依頼された医療関連サービスの情報とが紐付けられた医療情報を記憶する医療情報記憶部と、
    　前記同意者情報記憶部に記憶した同意者情報から、前記医療情報記憶部に記憶した医療施設情報を有する同意者情報を抽出する同意者情報抽出部と、
    　前記医療情報のうち、前記抽出した同意者情報の患者の識別情報を有する医療情報を特定する同意者情報特定部と、
    　前記特定した医療情報を前記情報記憶装置に送信する医療情報送信部と、
    を備えることを特徴とする情報提供システム。     A consenter information storage unit that stores consenter information associated with medical facility information and patient identification information extracted from an information storage device accessible by a medical facility terminal;
    A medical information storage unit accessible by a terminal of a medical related service providing facility for which a medical related service is requested from the medical facility, wherein the medical facility information, patient identification information, and the requested medical related service information A medical information storage unit for storing the associated medical information;
    From the consenter information stored in the consenter information storage part, the consenter information extraction part for extracting the consenter information having the medical facility information stored in the medical information storage part,
    Among the medical information, the consenter information specifying unit for specifying the medical information having patient identification information of the extracted consenter information,
    A medical information transmitter that transmits the specified medical information to the information storage device;
    An information providing system comprising:
  2. 　前記同意者情報記憶部に記憶される同意者情報は、患者が同意しない項目が前記医療施設情報及び前記患者の識別情報と紐付けられており、
    　前記特定した医療情報から、前記抽出した同意者情報に含まれる前記患者が同意しない項目を削除する非同意項目削除部をさらに備えることを特徴とする請求項１に記載の情報提供システム。     The consenter information stored in the consenter information storage unit is associated with items that the patient does not agree with the medical facility information and the patient identification information,
    The information providing system according to claim 1, further comprising: a non-consent item deletion unit that deletes an item that the patient does not agree with included in the extracted consenter information from the specified medical information.
  3. 　前記医療情報のうち、前記特定した医療情報以外の医療情報を削除する医療情報削除部をさらに備えることを特徴とする請求項１又は請求項２に記載の情報提供システム。 The information providing system according to claim 1 or 2, further comprising a medical information deleting unit that deletes medical information other than the specified medical information in the medical information.
  4. 　前記情報提供システムは、前記特定した医療情報のフォーマットを変換するフォーマット変換部をさらに備え、
    　前記医療情報送信部は、前記フォーマットを変換した医療情報を送信する
    ことを特徴とする請求項１から請求項３のいずれか１項に記載の情報提供システム。     The information providing system further includes a format conversion unit that converts the format of the specified medical information,
    The information providing system according to any one of claims 1 to 3, wherein the medical information transmitting unit transmits medical information obtained by converting the format.
  5. 　前記情報提供システムは、前記特定した医療情報のマスターを変換するマスター変換部をさらに備え、
    　前記医療情報送信部は、前記マスターを変換した医療情報を送信する
    ことを特徴とする請求項１から請求項４のいずれか１項に記載の情報提供システム。     The information providing system further includes a master conversion unit that converts the identified medical information master,
    The information providing system according to any one of claims 1 to 4, wherein the medical information transmitting unit transmits medical information obtained by converting the master.
  6. 　前記医療情報は、カルテ情報、レセプト情報、医学情報、予防健康情報、福祉情報、バイオバンクの生物試料に関連する情報のいずれかを含むことを特徴とする請求項１から請求項５のいずれか１項に記載の情報提供システム。 6. The medical information according to claim 1, wherein the medical information includes any of medical record information, receipt information, medical information, preventive health information, welfare information, and information related to a biological sample of a biobank. The information providing system according to item 1.
  7. 　前記医療情報がカルテ情報であり、前記カルテ情報は、臨床検査結果、医師の所見、治療の経過や結果、看護記録、処方箋、通院履歴のいずれかを含むことを特徴とする請求項６に記載の情報提供システム。 The medical information is medical chart information, and the medical chart information includes any of clinical test results, doctor findings, progress and results of treatment, nursing records, prescriptions, and outpatient histories. Information provision system.
  8. 　医療施設の端末がアクセス可能な情報記憶装置から抽出された、医療施設情報と患者の識別情報とが紐付けられた同意者情報を同意者情報記憶部に記憶し、
    　前記医療施設から医療関連サービスを依頼された医療関連サービス提供施設の端末がアクセス可能な医療情報記憶部に、医療施設情報と患者の識別情報と前記依頼された医療関連サービスの情報とが紐付けられた医療情報を記憶し、
    　前記同意者情報記憶部に記憶した同意者情報から、前記医療情報記憶部に記憶した医療施設情報を有する同意者情報を抽出し、
    　前記医療情報のうち、前記抽出した同意者情報に対応する患者の識別情報を有する医療情報を特定し、
    　前記特定した医療情報を前記情報記憶装置に送信する
    ことを特徴とする情報提供システムの制御方法。     Stored in the consenter information storage unit is the consenter information extracted from the information storage device accessible by the terminal of the medical facility, and the medical facility information and the patient identification information associated with each other.
    The medical facility information, the patient identification information, and the requested medical-related service information are linked to the medical information storage unit accessible by the terminal of the medical-related service providing facility that is requested by the medical facility. Memorized medical information,
    Extracting consenter information having medical facility information stored in the medical information storage unit from the consenter information stored in the consenter information storage unit,
    Among the medical information, specify medical information having patient identification information corresponding to the extracted consenter information,
    A control method for an information providing system, wherein the specified medical information is transmitted to the information storage device.
  9. 　前記同意者情報記憶部に記憶される同意者情報は、患者が同意しない項目が前記医療施設情報及び前記患者の識別情報と紐付けられており、
    　前記特定した医療情報から、前記抽出した同意者情報に含まれる患者が同意しない項目を削除することを特徴とする請求項８に記載の情報提供システムの制御方法。     The consenter information stored in the consenter information storage unit is associated with items that the patient does not agree with the medical facility information and the patient identification information,
    9. The information providing system control method according to claim 8, wherein an item that the patient does not consent to is included in the extracted consenter information is deleted from the specified medical information.
  10. 　前記医療情報のうち、前記特定した医療情報以外の医療情報を削除することを特徴とする請求項８又は請求項９に記載の情報提供システムの制御方法。 10. The information providing system control method according to claim 8, wherein medical information other than the specified medical information is deleted from the medical information.
  11. 　前記特定した医療情報のフォーマットを変換し、
    　前記フォーマットを変換した医療情報を送信する
    ことを特徴とする請求項８から請求項１０のいずれか１項に記載の情報提供システムの制御方法。     Converting the format of the specified medical information,
    11. The information providing system control method according to claim 8, wherein medical information obtained by converting the format is transmitted.
  12. 　前記特定した医療情報のマスターを変換し、
    　前記マスターを変換した医療情報を送信する
    ことを特徴とする請求項８から請求項１１のいずれか１項に記載の情報提供システムの制御方法。     Transforming the identified medical information master,
    The method for controlling an information providing system according to any one of claims 8 to 11, wherein medical information obtained by converting the master is transmitted.
  13. 　前記医療情報は、カルテ情報、レセプト情報、医学情報、予防健康情報、福祉情報、バイオバンクの生物試料に関連する情報のいずれかを含むことを特徴とする請求項８から請求項１２のいずれか１項に記載の情報提供システムの制御方法。 The medical information includes any of medical record information, receipt information, medical information, preventive health information, welfare information, and information related to biological samples of a biobank. The control method of the information provision system of Claim 1.
  14. 　前記医療情報がカルテ情報であり、前記カルテ情報は、臨床検査結果、医師の所見、治療の経過や結果、看護記録、処方箋、通院履歴のいずれかを含むことを特徴とする請求項１３に記載の情報提供システムの制御方法。 The medical information is medical record information, and the medical record information includes any of clinical test results, doctor findings, progress and results of treatment, nursing records, prescriptions, and outpatient histories. Control method for information providing system.
  15. 　医療施設の端末がアクセス可能な情報記憶装置から抽出された、医療施設情報と少なくとも患者又は医療情報提供者を含む個人の識別情報とが紐付けられた同意者情報を記憶する同意者情報記憶部と、
    　前記医療施設から医療関連サービスを依頼された医療関連サービス提供施設の端末がアクセス可能な医療情報記憶部であって、医療施設情報と前記個人の識別情報と前記依頼された医療関連サービスの情報とが紐付けられた医療情報を記憶する医療情報記憶部と、
    　前記同意者情報記憶部に記憶した同意者情報から、前記医療情報記憶部に記憶した医療施設情報を有する同意者情報を抽出する同意者情報抽出部と、
    　前記医療情報のうち、前記抽出した同意者情報の前記個人の識別情報を有する医療情報を特定する同意者情報特定部と、
    　前記特定した医療情報を前記情報記憶装置に送信する医療情報送信部と、
    を備えることを特徴とする情報提供システム。     A consenter information storage unit that stores consenter information in which medical facility information and personal identification information including at least a patient or a medical information provider are associated and extracted from an information storage device accessible by a terminal of the medical facility When,
    A medical information storage unit accessible by a terminal of a medical related service providing facility requested for medical related services from the medical facility, the medical facility information, the individual identification information, and the requested medical related service information; A medical information storage unit for storing medical information associated with
    From the consenter information stored in the consenter information storage part, the consenter information extraction part for extracting the consenter information having the medical facility information stored in the medical information storage part,
    Among the medical information, the consenter information specifying unit for specifying the medical information having the individual identification information of the extracted consenter information,
    A medical information transmitter that transmits the specified medical information to the information storage device;
    An information providing system comprising:
  16. 　医療施設の端末がアクセス可能な情報記憶装置から抽出された、医療施設情報と少なくとも患者又は医療情報提供者を含む個人の識別情報とが紐付けられた同意者情報を同意者情報記憶部に記憶し、
    　前記医療施設から医療関連サービスを依頼された医療関連サービス提供施設の端末がアクセス可能な医療情報記憶部に、医療施設情報と前記個人の識別情報と前記依頼された医療関連サービスの情報とが紐付けられた医療情報を記憶し、
    　前記同意者情報記憶部に記憶した同意者情報から、前記医療情報記憶部に記憶した医療施設情報を有する同意者情報を抽出し、
    　前記医療情報のうち、前記抽出した同意者情報に対応する前記個人の識別情報を有する医療情報を特定し、
    　前記特定した医療情報を前記情報記憶装置に送信する
    ことを特徴とする情報提供システムの制御方法。     Stored in the consenter information storage unit is the consenter information extracted from the information storage device accessible by the terminal of the medical facility and associated with the medical facility information and at least the identification information of the individual including the patient or the medical information provider. And
    The medical facility information, the personal identification information, and the requested medical-related service information are linked to the medical information storage unit accessible by the terminal of the medical-related service providing facility that is requested by the medical facility. Memorize attached medical information,
    Extracting consenter information having medical facility information stored in the medical information storage unit from the consenter information stored in the consenter information storage unit,
    Among the medical information, specify the medical information having the individual identification information corresponding to the extracted consenter information,
    A control method for an information providing system, wherein the specified medical information is transmitted to the information storage device.
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