WO2017126109A1

WO2017126109A1 - Information management system and information management method

Info

Publication number: WO2017126109A1
Application number: PCT/JP2016/051869
Authority: WO
Inventors: 啓之小林
Original assignee: 大塚製薬株式会社
Priority date: 2016-01-22
Filing date: 2016-01-22
Publication date: 2017-07-27
Also published as: JP6968704B2; JPWO2017126109A1

Abstract

An objective of the present invention is to provide an information management system and information management method with which efficiency in therapy on a patient, particularly a patient who has a mental illness, can be significantly increased. Provided is a psychiatric information management system 1, comprising: a medical record information storage unit 220 which stores medical record information relating to a patient who has a mental illness; an analysis unit 213 which extracts, from the medical record information, factor information which is associated with the patient's illness; a factor information storage unit 320 which stores the factor information which has been extracted by the analysis unit 213, in association with the patient's ID; and a factor information search unit 312 which, upon receiving a search request, outputs the factor information which corresponds to the patient who has been designated by the search request. The factor information includes factor information which relates to the patient's lifestyle and background.

Description

Information management system and information management method

The present invention relates to an information management system capable of improving the treatment efficiency of a patient, and more particularly to an information management system capable of improving the treatment efficiency of a patient having a psychiatric disorder symptom.

In recent years, an electronic medical record that manages a medical record in which a patient's medical condition, treatment, progress, and the like are recorded in a database as electronic information has been developed and spread (for example, Patent Document 1). With the introduction of electronic medical records, medical practice records that have been stored on a paper basis until now have been stored electronically.

The patient's personal information, symptoms, test results, etc. can be recorded in electronic medical records for internal medicine and surgery. In addition, electronic medical records for psychiatric use are basically simple applications of internal medical and surgical electronic medical records, but special items such as records of isolation and restraint, life episodes, etc. There is also an electronic medical record that includes a free input field in which can be recorded in text (for example, Patent Document 2).

JP 2000-235577 A Japanese Patent Laid-Open No. 2015-069348

In the treatment of patients with mental illness symptoms, not only information on test results and symptoms used in internal medicine and surgical fields, but also items recorded in the free entry column accurately determine the patient's treatment and nursing methods. It will be important information for. However, the amount described in the free entry field sometimes becomes enormous as it reaches several tens of pages. Therefore, doctors and the like have to read enormous text information in order to judge the treatment method and nursing method of the patient in charge from the electronic medical record, leading to a decrease in treatment efficiency. Here, diseases that exhibit psychiatric symptoms include depression, schizophrenia, anxiety disorder, drug / alcohol dependence, etc., as well as dementia such as Alzheimer's disease and central nervous disease such as Parkinson's disease. It is not limited to.

The present invention has been made to solve the above-described problems, and an object of the present invention is to provide an information management system and an information management method that can greatly improve the treatment efficiency for patients, particularly patients with psychiatric symptoms.

In order to solve the above problems, the present invention provides an information management system and an information management method described in the following section.
Item 1.
An analysis unit that extracts factor information related to the patient's disease from medical record information about the patient;
A factor information storage unit that stores the factor information extracted by the analysis unit in association with the patient;
A factor information search unit that outputs the factor information corresponding to the patient specified in the search request when receiving a search request;
The information management system according to claim 1, wherein the factor information includes at least one factor information related to a life background of the patient and / or at least one factor information related to a living environment after discharge from the patient.
Item 2.
Item 2. The psychiatric information management system according to Item 1, wherein the factor information related to the life background includes at least one of information on presence / absence of bullying, presence / absence of abuse, divorce experience, final educational background, and work experience.
Item 3.
A similar case search unit for searching for a case of a patient whose factor information is similar to the patient specified by external input;
The similar case search unit extracts the factor information associated with the designated patient from the factor information storage unit, and at least a part of the held factor information matches the extracted factor information. Item 3. The information management system according to

Item

1 or 2, which extracts factor information of patients.
Item 4.
Item 4. The information management system according to Item 3, wherein the similar case search unit extracts, from the stored factor information, other patients whose at least one factor information related to a patient's life background matches the extracted factor information. .
Item 5.
Item 4. The information according to Item 3, wherein the similar case search unit extracts other patients whose at least one factor information related to the post-discharge living environment matches the extracted factor information among the factor information held. Management system.
Item 6.
Item 6. The information management system according to any one of Items 1 to 5, wherein the factor information storage unit stores the factor information in association with a patient ID of the patient.
Item 7.
An analysis step of extracting factor information related to the patient's disease from the medical record information about the patient;
Factor information storage step for storing the factor information extracted by the analysis step in association with the patient;
A factor information search step for outputting the factor information corresponding to the patient specified in the search request when receiving the search request; and
The information management method according to claim 1, wherein the factor information includes at least one factor information relating to a patient's life background and / or at least one factor information relating to a patient's life environment after discharge.
Item 8.
A similar case search step of searching for a case of a patient whose factor information is similar to the patient specified by external input;
In the similar case search step, the factor information associated with the designated patient is extracted from the factor information stored in the factor information storage step, and at least a part of the held factor information is extracted. Item 8. The information management method according to Item 7, wherein factor information of another patient that matches the factor information is extracted.
Item 9.
Item 9. The information management method according to Item 7 or 8, wherein, in the factor information storage step, the factor information is stored in association with the patient ID of the patient.

According to the present invention, it is possible to provide an information management system and an information management method that can greatly improve the treatment efficiency for patients, particularly patients with psychiatric symptoms.

It is a schematic diagram which shows the structure of the psychiatric information management system of embodiment of this invention. It is a specific example of factor information. It is a figure explaining the extraction method of factor information. It is a specific example of extraction of factor information by text mining, (a) is text data regarding a certain patient, (b) is factor information extracted from this text data. It is an example of the factor information of a certain patient. It is a list of similar cases. It is a specific example of a screen of a patient's treatment difficulty level, nursing difficulty level, and discharge difficulty level.

Hereinafter, embodiments of the present invention will be described with reference to the drawings. In addition, this invention is not limited to the following embodiment.

(overall structure)
This embodiment shows an example when the information management system of the present invention is applied to a psychiatric hospital. FIG. 1 is a schematic diagram showing a configuration of a psychiatric information management system 1 according to the present embodiment. In FIG. 1, the psychiatric information management system 1 includes a client terminal 100, an electronic medical record server 200, and a psychiatric data processing server 300.

<Client terminal>
The client terminal 100 is a terminal operated by a user such as a doctor or a nurse, and one or a plurality of client terminals 100 are provided in a hospital to which the user belongs. The client terminal 100 is configured by, for example, a general-purpose personal computer or a portable terminal such as a tablet, and includes an input device 110, a display device 120, and an information processing device 130.

The input device 110 includes a keyboard, a mouse, a touch panel, and the like that accept operation input and data input from the user. The display device 120 is configured by a liquid crystal monitor or the like, and displays a screen for data input by the input device 110, a screen showing a search result of factor information described later, a result of difficulty, and the like. The information processing device 130 includes a CPU, a hard disk device, a memory, and the like (not shown), and performs various information processing and communication processing according to operations from the input device 110 and the like.

For example, a doctor who has examined a psychiatric patient activates a program for displaying an electronic medical record to display a screen of the electronic medical record on the display device 120, and displays the patient's symptom / disease name via the input device 110. Enter the medical practice given to the patient. The input information is transmitted from the client terminal 100 to the electronic medical record server 200 as medical chart information.

In this embodiment, medical record information is classified into medical record data, prescription information data, nursing record data, mental health worker (PSW) record data, and test result data.

The medical record data is data such as a patient's symptom / disease name and medical practice performed on the patient, which is input by a doctor at the time of a medical examination through the input device 110. In psychiatry, the details of what the patient talks about during examinations and counseling are recorded in detail, but the patient speaks in a variety of ways and does not fit into certain forms such as fever and rash. For this reason, psychiatric medical record data is usually recorded in an irregular text format, not in a fixed format.

Prescription record data is information on medicines prescribed to patients.

The nursing record data is data in which a nurse records the status of sleep disorder or suicide attempt about an inpatient via the input device 110. Like medical record data by a doctor, psychiatric nursing record data does not fit in a certain format, and is often recorded in the style of each recorder.

The PSW record data is data that records the contents heard when receiving a consultation from a patient, such as the patient's life history / environment, the presence / absence of a key person who supports the patient, and the like.

Test result data is data that records the results of various tests performed on patients. Specifically, the results of various blood tests and X-ray and CT scan images correspond to the test result data.

In the psychiatric field, it is necessary to record the results of interviews with patients at each stage of medical care, nursing, and PSW consultation, so the electronic medical record screen can be input in a free format. It has a column. In the psychiatric field, the amount of information entered in this input field sometimes becomes enormous as it reaches several tens of pages, and the items described here are important information for determining a treatment method and a nursing method.

<Electronic medical record server>
The electronic medical record server 200 is installed in the hospital and is connected to the client terminal 100 so as to be communicable via the LAN 2, for example. The connection between the electronic medical record server 200 and the client terminal 100 may be a wired connection or a wireless connection. The electronic medical record server 200 includes a medical record information processing unit 210 and a medical record information storage unit 220.

The medical record information processing unit 210 is a functional block realized by the CPU executing an electronic medical record program stored therein, and includes a medical record information search / reference unit 211, a medical record information update unit 212, and an analysis unit 213. Yes.

The medical record information storage unit 220 is constituted by, for example, a hard disk device, and stores medical record information related to a psychiatric patient. Specifically, the chart information storage unit 220 stores a medical record database 221, a prescription record database 222, a nursing record database 223, a mental health welfare person (PSW) record database 224, and a test result database 225 as chart information. Yes. Each of these databases 221 to 225 is obtained by converting the above-mentioned medical record data, prescription information data, nursing record data, PSW record data, and test result data relating to a patient who has undergone medical examination / treatment in a hospital into a beta base. .

The chart information search / reference unit 211 has a function of searching and referring to the chart information stored in the chart information storage unit 220 in response to a request from the client terminal 100. Specifically, when the user operates the input device 110 at the client terminal 100, the initial screen of the electronic medical record is displayed on the display device 120 in accordance with the format stored in the storage area of the information processing device 130. Subsequently, when the user designates a patient number or the like on the initial screen, the information processing apparatus 130 transmits a request for referring to the patient's medical record information corresponding to the designated patient number to the electronic medical record server 200. In response to this, the chart information search / reference unit 211 accesses each of the databases 221 to 225 stored in the chart information storage unit 220, searches the chart information of the requested patient, and sends the search result to the client terminal. To 100. As a result, the patient chart information corresponding to the designated patient number is displayed on the display device 120.

The display device 120 may display all the data of the medical record information collectively, or by switching the screen, each data of the medical record information (medical record data, prescription record data, nursing record data, PSW record data, Inspection result data) may be displayed one by one.

The chart information update unit 212 has a function of updating the chart information stored in the chart information storage unit 220. Specifically, when the chart information is transmitted from the client terminal 100, the chart information update unit 212 receives the chart information and stores it as text data in the chart information storage unit 220 according to the classification of the chart information data. Specifically, the medical record information update unit 212 stores the medical record information, prescription information data, nursing record data, PSW record data, and test result data of the received medical record information, respectively, as a medical record database 221, a prescription record database 222, and a nursing record. The information is added to the recording database 223, the PSW recording database 224, and the inspection result database 225.

The recorded contents in each of the databases 221 to 225 are given a predetermined electronic medical record tag or electronic medical record code for each recorded content. For example, in the case of reference / search by the medical record information search / reference unit 211, By using the electronic medical record tag / electronic medical record code, rapid processing can be performed. In addition, although a tag and a code are not usually attached to a portion input by the user in a free format, a search index may be attached.

The analysis unit 213 has a function of extracting factor information of symptoms of the psychiatric patient from the medical record information stored in the medical record information storage unit 220. Details of the function of the analysis unit 213 will be described later.

<Psychiatric data processing server>
The psychiatric data processing server 300 is installed in, for example, an external organization that manages information related to psychiatric medical care, and is accessible from one or more hospitals affiliated with the external organization. The electronic medical record server 200 and the client terminal 100 are communicably connected to the psychiatric data processing server 300 via the LAN 2 and the Internet 3.

The psychiatric data processing server 300 includes a factor information processing unit 310 and a factor information storage unit 320. The factor information processing unit 310 is a functional block realized by the CPU executing a factor information processing program stored therein. The factor information acquisition unit 311, the factor information search unit 312, the specific case search unit 313, and the like A case search unit 314, a difficulty level setting unit 315, a best practice (PB) extraction unit 316, a hospitalization period prediction unit 317, and a readmission rate prediction unit 318 are provided. The functions of these units will be described later.

The factor information storage unit 320 is configured by, for example, a hard disk device, and stores factor information extracted by the analysis unit 213 of the electronic medical record server 200 as a factor information database 321.

(Definition of factor information)
The factor information is a summary of information related to the illness of the psychiatric patient, and is an element that determines a treatment / nursing method for the patient. A specific example of the factor information is shown in FIG. The factor information is information including factors that are items related to the disease such as disease names and symptoms, and the responses and diagnosis results of the patients for each factor.

In the present embodiment, the factor information includes information on disease name information, patient information, hospitalization information, drug information, a patient's life background, and a post-discharge living environment. Among these information, in the field of internal medicine and surgery, information on disease name information, patient information, hospitalization information, and drug information is included as factor information. The disease name information is information indicating the patient's disease name and symptoms, the patient information is information indicating the patient ID, date of birth, sex, age at first onset, tendency to refuse drugs, etc., and the hospitalization information is the number of days of hospitalization. , Age at admission, number of admissions, admission form at admission, presence / absence of isolation, presence / absence of restraint, sleep disorder, stress tolerance, willingness to discharge, drug dependence, suicide attempt, etc. This is information indicating the medicine that was being taken and the medicine that was being taken at the time of discharge. Here, the patient ID may be the same as the patient number in the electronic medical record server, or may be different from the patient number for personal information protection and security. When the patient ID is different from the patient number, it is necessary to store a table showing the correlation between the patient number and the patient ID for each hospital / facility, for example.

In the present embodiment, the factor information further includes information on the life background of the patient and the living environment after discharge. Factor information on the patient's life background is, for example, whether or not bullying or mistreatment of the patient, the patient's divorce experience, the patient's final education and working experience, etc.Factor information on the post-discharge life environment includes, for example, the patient's occupation, The existence of key persons (guardians, etc.) and residences.

Note that the factor information shown in FIG. 2 is an example, and is not particularly limited as long as it is information related to a disease. For example, the factor information on the patient's life background includes the presence or absence of parents' divorce or bereavement, interpersonal problems, the presence or absence of reports / crimes.

(Function of psychiatric information management system)
Hereinafter, functions available to the user in the psychiatric information management system 1 of the present embodiment will be described.

<Extraction and acquisition of factor information>
In the present embodiment, the above-described factor information can be extracted from each of the databases 221 to 225 stored in the chart information storage unit 220 by the analysis unit 213 in FIG. Specifically, the analysis unit 213 extracts factor information such as a disease name, symptom, suicide attempt, and presence / absence of bullying from the medical record database 221, and extracts factor information such as an administered drug from the prescription record database 222. Then, factor information such as sleep disorder, restraint and suicidal intention is extracted from the nursing record database 223, and factor information such as bullying and working experience is extracted from the PSW record database 224.

In the present embodiment, the analysis unit 213 extracts factor information from the text data of each of the databases 221 to 225 by using a text mining technique. FIG. 3 is a diagram for explaining a method for extracting factor information by the analysis unit 213.

The analysis unit 213 first reads the text data of the chart information recorded in each of the databases 221 to 225, analyzes the contents of the text data, and extracts the factor information. This text analysis is also performed for interview records, etc. that are written in free format. Specifically, the text information is divided into words, syntactic analysis is performed, and synonyms are further arranged to extract information related to each factor stored in the dictionary in the system. Furthermore, by extracting the tense from the text information, the occurrence time of the event related to each factor is also extracted. This factor extraction can be executed by a conventionally known text mining technique.

A specific example of extracting factor information by text mining is shown in FIG. FIG. 4A shows text data relating to a patient recorded in the medical record database 221, and FIG. 4B shows factor information extracted from the text data. By executing text mining on other chart information, factor information as shown in FIG. 2 is extracted.

When the extraction of the factor information is completed, the analysis unit 213 encodes the factor information data and transmits it to the psychiatric data processing server 300 together with the patient ID. In the psychiatric data processing server 300, the factor information acquisition unit 311 receives the factor information and stores it in the factor information database 321 in the factor information storage unit 320 in association with the patient ID. Thereby, the factor information database 321 is updated. Here, as described above, the patient ID may be different from the patient number in the electronic medical record server.

Of the medical record information stored in each of the databases 221 to 225, for the information attached with the electronic medical record tag and the electronic medical record code, the actual medical record tag and the electronic medical record code are directly read instead of reading the actual text data. May be converted into a factor information code.

The extraction of factor information by the analysis unit 213 is first performed by accessing the databases 221 to 225 at the initial setting of the psychiatric information management system 1. After the initial setting, the analysis unit 213 may fetch updated contents of the databases 221 to 225 at regular intervals, or in cooperation with each client terminal 100, new medical record information is stored in the electronic medical record server 200. The factor information may be extracted by activating the analysis unit 213 each time the data is transmitted.

<Factor information search / display>
The factor information database 321 stored in the factor information storage unit 320 can be searched from the outside. In the present embodiment, when the factor information search unit 312 receives a search request from the outside, the factor information search unit 312 has a function of outputting factor information corresponding to the patient specified by the search request. For example, when searching for factor information of a patient, the user operates the input device 110 on the client terminal 100 accessible to the psychiatric data processing server 300 to specify a patient ID (for example, ABCDE-12345). And make a search request. In response to this, the factor information search unit 312 searches the factor information database 321 for factor information corresponding to the patient ID specified in the search request, and outputs the factor information to the client terminal 100. Thereby, the factor information shown in FIG. 5 is displayed on the display device 120 of the client terminal 100. When the patient ID is different from the patient number in the electronic medical record server, when the user designates the patient number, the client terminal 100 converts the patient number into the patient ID, and the psychiatric data processing server 300 Will make an inquiry.

(Main features of psychiatric information management system)
As described above, in the psychiatric information management system 1 according to the present embodiment, information described in a free format such as interview information with a patient can be extracted as factor information and converted into a database. In particular, in the present embodiment, the factor information includes factor information related to a patient's life background that has not been databased until now. For this reason, for example, a doctor or a nurse can search for the factor information for each patient ID and display it on the display device 120, so that the patient's condition can be grasped based on the factor information. Therefore, time and labor can be greatly reduced and the efficiency of psychiatric treatment can be greatly improved compared to the conventional system that had to read a large amount of text information in order to grasp the factor information related to life background. be able to. Furthermore, since information separately registered in the databases 221 to 225 can be integrated and displayed, information sharing among the entire treatment team is facilitated.

(Other functions)
In the psychiatric information management system 1, the user can use the following functions in addition to the functions described above.

<Search for specific cases>
In the present embodiment, the specific case search unit 313 can search for a specific case from the factor information database 321. Specifically, in the client terminal 100, when the user operates the input device 110, the initial screen of the electronic medical record is displayed on the display device 120, the search button on the initial screen is selected, and factor information is displayed in the search box. input. For example, each factor is arranged in the search box, and the user can input factor information by clicking a factor corresponding to a specific case.

Here, the factor information that can be entered includes the life background of the patient and the living environment after discharge. For example, if you enter "20s" in the age factor information column, "Yes" in the factor information column for work experience, and "Unemployed" in the factor information column for occupation, you have working experience in your 20s but are currently unemployed. A search for patient information can be performed.

When the search is executed, a search request for a specific case corresponding to the input factor information is transmitted from the client terminal 100 to the psychiatric data processing server 300. The specific case search unit 313 refers to the factor information database 321 in response to the search request, extracts a case having the input factor information, and transmits the extracted case information to the client terminal 100. Thereby, the information of the patient's case corresponding to the factor information input in the search box can be displayed on the display device 120. FIG. 5 is a specific example of information on a specific case displayed on the display device 120.

Note that a specific processing procedure by the specific case search unit 313 is as follows. When factor information to be searched is input by the input device 110 and the search button is clicked, the specific case search unit 313 performs code conversion on all factor information that has been input, and stores the factor information database 321. The patient IDs linked to all factor information codes that have been input are searched for and extracted. Then, the specific case search unit 313 converts the factor information code related to the extracted patient ID into factor information and transmits the factor information code to the client terminal 100.

As described above, in the psychiatric information management system 1, conventionally, cases can be extracted and referred to based on the life background of the patient and the life environment after discharge as described only in the interview record in the free entry field. it can.

<Search for similar cases>
Further, in the present embodiment, the similar case search unit 314 can search the factor information database 321 for cases of patients whose factor information is similar to the patient specified by external input. Specifically, when the user selects a display portion of “similar case” with the input device 110 in a state where information about a patient is displayed on the display device 120 in the client terminal 100, the patient terminal 100 displays the patient. A search request for cases similar to is sent to the psychiatric data processing server 300. When the similar case search unit 314 receives the search request, the similar case search unit 314 first refers to the factor information database 321 of the factor information storage unit 320 and extracts all factor information associated with the corresponding patient ID. And the similar case search part 314 searches ID of the other patient in which at least one part of the held factor information corresponds with the extracted factor information.

Specifically, when there is another patient whose all factor information that is held matches the extracted factor information, the similar case search unit 314 extracts the ID of the patient. On the other hand, if there is no patient whose all factor information that matches the extracted factor information, the similar case search unit 314 selects the ID of a patient with a large number of factor information that matches the extracted factor information. You may make it extract. When the similar case search unit 314 extracts the ID of the corresponding patient, the similar case search unit 314 extracts the factor information of the patient and transmits it to the client terminal 100. As a result, a case of a patient whose factor information is similar to the designated patient is displayed on the display device 120.

FIG. 6 is a specific example of a list of similar cases displayed on the display device 120. The “best practice” in the rightmost column of the list will be described later.

In the present embodiment, it is preferable that the similar case search unit 314 extracts other patients in which at least one factor information related to the life background of the patient matches the extracted factor information among the factor information held. . Or it is preferable that the similar case search part 314 extracts the other patient in which the at least 1 factor information regarding the living environment after discharge of a patient corresponds with the extracted factor information among the held factor information. That is, the factor information on the patient's life background and living environment after discharge is used as a target for detecting similar cases.

Although the patient's life background and post-discharge life environment are important factor information in psychiatric treatment / nursing, the information is conventionally input in a free format. It was difficult to search for cases of patients with similar environments. On the other hand, in the present embodiment, it is possible to easily detect a case of a patient whose life background and living environment after discharge are similar, so that it can greatly contribute to the treatment and nursing of the patient.

<Setting the difficulty level>
In the present embodiment, the difficulty level setting unit 315 sets various difficulty levels such as treatment difficulty level, nursing difficulty level, discharge difficulty level, and the like for each patient ID. It can be stored in the storage unit 320. The difficulty level can be calculated by combining a plurality of predetermined factor information related to the difficulty level. Hereinafter, a calculation method of the difficulty level by the difficulty level setting unit 315 will be described.

For example, when the factors A, B, C, and D are used from the factor information stored in the factor information database 321,
Difficulty points = Ka x A + Kb x B + Kc x C + Kd x D (Ka to Kd: weighting factors)
By calculating the difficulty level point and comparing it with a plurality of threshold values, the difficulty level can be determined in three stages, for example. The factors A to D can be set to 0 or 1 depending on the presence or absence of each factor, or can be scored depending on the degree. Specifically, if it is a nursing difficulty level, it can be determined as follows, for example. First, the nursing difficulty point is calculated by the following formula.

Nursing difficulty level = 4 x presence / absence of restraint + 2 x presence / absence of sleep disorder + 1 x stress tolerance level Difficulty level 3 if 1 is greater than 4, difficulty level 2 if greater than 1 and less than 4 If it is less than that, it can be set to a difficulty level of 1.

The difficulty level setting unit 315 stores the set difficulty level in the factor information storage unit 320 in association with the patient ID. Thereby, when the user of the client terminal 100 operates the input device 110 and requests information on the difficulty level of a patient, the difficulty level information is transmitted together with the factor information from the psychiatric data processing server 300. Various difficulty levels of the patient are displayed on the display device 120. FIG. 7 is a specific example of a screen of the difficulty level of treatment / nursing difficulty / discharge difficulty displayed on the display device 120.

In the present embodiment, since factor information is also obtained from the input field described in a free format such as interview record as described above, factor information obtained only from the input field, for example, whether the patient is restrained or discharged The degree of difficulty can be determined using factor information such as the presence or absence of motivation and the presence or absence of a key person. For this reason, the difficulty level can be accurately determined by finer setting.

In addition, it is preferable that the difficulty level setting unit 315 separately sets at least two difficulty levels among the patient's treatment difficulty level, nursing difficulty level, and discharge difficulty level.

<Extraction of best practices>
Moreover, in this Embodiment, the PB extraction part 316 can mark (extract) the case where optimal treatment and nursing were implemented as a best practice. Specifically, the PB extraction unit 316 extracts, as a best practice, a case of a patient whose difficulty is higher than a predetermined value and whose hospitalization period is shorter than the predetermined period. The number of best practices extracted is not particularly limited.

In the present embodiment, the analysis unit 213 of the electronic medical record server 200 extracts factor information from each of the databases 221 to 225 of the medical record information storage unit 220, and the extracted factor information is transmitted to the psychiatric data processing server 300. In this case, the PB extraction unit 316 refers to the factor information about the hospitalization period, and codes the best practice in the case where the hospitalization period is, for example, less than 90 days and the difficulty level is higher than a predetermined value (difficulty level 3). Give.

Thereby, when a similar case is searched in the client terminal 100, an item “best practice” is displayed as shown in the rightmost column of the list of FIG. In this item, “○” is displayed in cases corresponding to the best practice in terms of treatment, nursing, and discharge. Specifically, in the case where the patient ID is ABCDE-089, the degree of difficulty is high in all treatment, nursing, and discharge, but the hospitalization period was 66 days, so the best in all treatment, nursing, and discharge. Code is given as a practice. On the other hand, in the case where the patient ID is ABCDE-198, the degree of difficulty in treatment and nursing is not high, but the degree of difficulty in discharge is high, and the hospitalization period is 81 days. Has been granted. Physicians, etc. can more appropriately set the treatment / nursing policy for the patient in charge by referring to the patient's factor information and medical record information in the case corresponding to the best practice from the cases listed as similar cases of the patient in charge. It becomes possible to decide.

In addition, when the difficulty level setting unit 315 separately sets at least two difficulty levels among the patient's treatment difficulty level, nursing difficulty level, and discharge difficulty level, both of the at least two difficulty levels are higher than a predetermined value. It is desirable to extract information on patients whose hospitalization period is shorter and shorter than a predetermined period as a best practice. Thereby, doctors and the like can refer to a more ideal case.

<Prediction of hospital stay>
Moreover, in this Embodiment, the hospitalization period estimation part 317 can estimate the hospitalization period of the said patient based on the 1 or several factor information regarding the specific patient extracted from the factor information database 321. FIG. This hospitalization period can be calculated by referring to the difficulty level set by the above-described difficulty level setting unit 315 and converting the difficulty level into a hospitalization period using a conversion table. For example, when the set difficulty level is low (difficulty level 1), the hospitalization period prediction unit 317 records the hospitalization period within 30 days in association with the patient ID in the factor information database 321. In the client terminal 100, the predicted hospitalization period associated with the patient ID can be displayed on the display device 120 by a predetermined operation using the input device 110. The hospitalization period predicted in this way can be used for predicting the availability of beds in the hospital.

In this embodiment, in addition to the factor information used in internal medicine surgery for predicting the length of hospital stay, factor information related to the patient's life background, such as the presence of bullying and working experience, which is important for treatment / nursing in psychiatry Can be used. Therefore, it has become possible to accurately predict the hospitalization period of patients with mental illness, which has been difficult in the past.

<Prediction of readmission rate>
In the present embodiment, the readmission rate predicting unit 318 can predict the readmission rate of the patient by referring to one or more factor information regarding the discharged patient or the patient scheduled to be discharged. The factor information referred to by the readmission rate predicting unit 318 includes at least one factor information related to the living environment after discharge. The prognosis of patients with mental illness after discharge is greatly influenced by the living environment after discharge, but the readmission rate predicting unit 318 refers to factor information related to the living environment after discharge, and has been difficult in the past. It is possible to predict the readmission rate of patients with diseases more accurately.

(Other forms)
Although the embodiments of the present invention have been described above, the present invention is not limited to the above-described embodiments, and various modifications can be made without departing from the spirit of the present invention.

For example, the psychiatric data processing server 300 shown in FIG. 1 may be provided in a medical institution including the electronic medical record server 200 and the client terminal 100. Alternatively, the electronic medical record server 200 may include the factor information processing unit 310 and the factor information storage unit 320 included in the psychiatric data processing server 300. In this case, one medical institution performs both management of medical chart information and management of factor information.

Further, a part or all of the functions of the factor information processing unit 310 of the psychiatric data processing server 300 may be provided in the medical record information processing unit 210 of the electronic medical record server 200. In a small private medical clinic, the client terminal 100 and the electronic medical record server 200 may be integrated into one information processing apparatus.

In the embodiment described above, an example in which the information management system of the present invention is applied to a psychiatric hospital has been shown. However, the information management system of the present invention improves the treatment efficiency of various patients, particularly patients having mental illness symptoms. For example, it can be used in general hospitals, geriatrics and neurology hospitals, care houses, and the like.

1 Psychiatric information management system 2 LAN
3 Internet 100 Client terminal 110 Input device 120 Display device 130 Information processing device 200 Electronic medical record server 210 Medical record information processing unit 211 Medical record information search / reference unit 212 Medical record information update unit 213 Analysis unit 220 Medical record information storage unit 221 Medical record database 222 Prescription Record database 223 Nursing record database 224 Mental health worker record database 225 Test result database 300 Psychiatric data processing server 310 Factor information processing unit 311 Factor information acquisition unit 312 Factor information search unit 313 Specific case search unit 314 Similar case search unit 315 Difficulty level setting unit 316 Best practice extraction unit 317 Hospitalization period prediction unit 318 Readmission rate prediction unit 320 Factor information storage unit 321 Factor information database

Claims

An analysis unit that extracts factor information related to the patient's disease from medical record information about the patient;
A factor information storage unit that stores the factor information extracted by the analysis unit in association with the patient;
A factor information search unit that outputs the factor information corresponding to the patient specified in the search request when receiving a search request;
The information management system according to claim 1, wherein the factor information includes at least one factor information related to a life background of the patient and / or at least one factor information related to a living environment after discharge from the patient.
The psychiatric information management system according to claim 1, wherein the factor information related to the life background includes at least one of information on presence / absence of bullying, presence / absence of abuse, divorce experience, final educational background, and working experience.
A similar case search unit for searching for a case of a patient whose factor information is similar to the patient specified by external input;
The similar case search unit extracts the factor information associated with the designated patient from the factor information storage unit, and at least a part of the held factor information matches the extracted factor information. The information management system according to claim 1, wherein factor information of the patient is extracted.
The information management according to claim 3, wherein the similar case search unit extracts other patients in which at least one factor information related to a patient's life background matches the extracted factor information from the factor information held. system.
The said similar case search part extracts the other patient in which at least 1 factor information regarding a patient's discharge living environment matches the extracted factor information among the held factor information. Information management system.
6. The information management system according to claim 1, wherein the factor information storage unit stores the factor information in association with a patient ID of the patient.
An analysis step of extracting factor information related to the patient's disease from the medical record information about the patient;
Factor information storage step for storing the factor information extracted by the analysis step in association with the patient;
A factor information search step for outputting the factor information corresponding to the patient specified in the search request when receiving the search request; and
The information management method according to claim 1, wherein the factor information includes at least one factor information relating to a patient's life background and / or at least one factor information relating to a patient's life environment after discharge.
A similar case search step of searching for a case of a patient whose factor information is similar to the patient specified by external input;
In the similar case search step, the factor information associated with the designated patient is extracted from the factor information stored in the factor information storage step, and at least a part of the held factor information is extracted. The information management method according to claim 7, wherein factor information of another patient that matches the factor information is extracted.
The information management method according to claim 7 or 8, wherein in the factor information storage step, the factor information is stored in association with a patient ID of the patient.